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Sample records for ablative maze procedure

  1. Design and evaluation of a transesophageal HIFU probe for ultrasound-guided cardiac ablation: simulation of a HIFU mini-maze procedure and preliminary ex vivo trials.

    Constanciel, Elodie; N'Djin, W Apoutou; Bessière, Francis; Chavrier, Françoise; Grinberg, Daniel; Vignot, Alexandre; Chevalier, Philippe; Chapelon, Jean Yves; Lafon, Cyril

    2013-09-01

    Atrial fibrillation (AF) is the most frequent cardiac arrhythmia. Left atrial catheter ablation is currently performed to treat this disease. Several energy sources are used, such as radio-frequency or cryotherapy. The main target of this procedure is to isolate the pulmonary veins. However, significant complications caused by the invasive procedure are described, such as stroke, tamponade, and atrioesophageal fistula, and a second intervention is often needed to avoid atrial fibrillation recurrence. For these reasons, a minimally-invasive device allowing performance of more complex treatments is still needed. High-intensity focused ultrasound (HIFU) can cause deep tissue lesions without damaging intervening tissues. Left atrial ultrasound-guided transesophageal HIFU ablation could have the potential to become a new ablation technique. The goal of this study was to design and test a minimally-invasive ultrasound-guided transesophageal HIFU probe under realistic treatment conditions. First, numerical simulations were conducted to determine the probe geometry, and to validate the feasibility of performing an AF treatment using a HIFU mini-maze (HIFUMM) procedure. Then, a prototype was manufactured and characterized. The 18-mm-diameter probe head housing contained a 3-MHz spherical truncated HIFU transducer divided into 8 rings, with a 5-MHz commercial transesophageal echocardiography (TEE) transducer integrated in the center. Finally, ex vivo experiments were performed to test the impact of the esophagus layer between the probe and the tissue to treat, and also the influence of the lungs and the vascularization on lesion formation. First results show that this prototype successfully created ex vivo transmural myocardial lesions under ultrasound guidance, while preserving intervening tissues (such as the esophagus). Ultrasound-guided transesophageal HIFU can be a good candidate for treatment of AF in the future. PMID:24658718

  2. Freedom from atrial fibrillation after cox maze III ablation during follow-up

    Fariborz Akbarzadeh; Rezayat Parvizi; Naser Safaie; Mohammad-Mahdi Karbalaei; Bita Hazhir-Karzar; Babak Bagheri

    2015-01-01

    Background: Nearly 60% of patients undergoing mitral valve (MV) operations are affected by atrial fibrillation (AF). Cox Maze III ablation is one of the effective ways for restoring sinus rhythm for patients undergoing open heart surgery. The aim of present study was to evaluate efficacy of Maze III ablation procedure for restoring sinus rhythm among patients who had underwent open heart surgery. Materials and Methods: During present descriptive-analytic prospective study 114 patients with ch...

  3. Postoperative metabolic acidosis following the minimally invasive radiofrequency maze procedure

    Raymond Patrick Hom; Anna Dubovoy; Elizabeth Jewell; Milo Engoren

    2016-01-01

    Purpose: Atrial fibrillation (AF) is the most common arrhythmia treated in the world. While medical treatment with antiarrhythmic drugs remains the primary treatment modality, symptomatic refractory AF often requires treatment with a catheter or surgical ablation. One minimally invasive therapy is the Mini-Maze procedure, which utilizes epicardial radiofrequency ablation via a subxiphoid approach to rid the heart of arrhythmogenic atrial foci without a median sternotomy or cardiopulmonary byp...

  4. Surgical Radiofrequency MAZE III Ablation for Treatment of Atrial Fibrillation During Open Heart Surgery

    Fariborz Akbarzadeh

    2006-05-01

    Full Text Available Background: Atrial fibrillation is a common arrhythmia in patients with rheumatic mitral and other valve diseases who are candidates for valve repair surgeries. Conversion of rhythm to sinus has positive effects on quality of life and lower use of medications. The aim of this clinical study was to evaluate the effectiveness of the radiofrequency ablation Maze III procedure in the treatment of atrial fibrillation associated with rheumatic heart valve disease. Methods: We applied a modified Cox III Maze procedure using radiofrequency ablation in the treatment of atrial fibrillation associated with rheumatic heart valve disease and evaluated the outcome of 20 patients of atrial fibrillation associated rheumatic valve disease who underwent radiofrequency ablation Maze III procedure plus heart valve surgery. Demographic, echocardiographic, Electrocardiographic and Doppler study data were calculated before surgery, six month and one year after surgery.. Results: No perioperative deaths occurred in the study group. Duration of additional time for doing radiofrequency ablation was about 22 minutes. Freedom from atrial fibrillation was 85% and 75% at six months and one year follow-up respectively... Conclusions: The addition of the radiofrequency ablation Maze procedure to heart valve surgery is safe and effective in the treatment of atrial fibrillation associated with rheumatic heart valve disease.

  5. Postoperative metabolic acidosis following the minimally invasive radiofrequency maze procedure

    Raymond Patrick Hom

    2016-01-01

    Full Text Available Purpose: Atrial fibrillation (AF is the most common arrhythmia treated in the world. While medical treatment with antiarrhythmic drugs remains the primary treatment modality, symptomatic refractory AF often requires treatment with a catheter or surgical ablation. One minimally invasive therapy is the Mini-Maze procedure, which utilizes epicardial radiofrequency ablation via a subxiphoid approach to rid the heart of arrhythmogenic atrial foci without a median sternotomy or cardiopulmonary bypass. The goal of this retrospective cohort study was to identify clinical factors associated with metabolic acidosis following the Mini-Maze procedure. Materials and Methods: After Institutional Review Board approval, we studied patients undergoing the Mini-Maze procedure, off-pump coronary artery bypass grafting or patients conventional Cox-Maze on cardiopulmonary bypass. The first base deficit value obtained in the Intensive Care Unit was used as a measure of metabolic acidosis. Using logistic regression with Akaike information criteria, we analyzed preoperative, intraoperative, and postoperative data to determine the factors associated with changes in base deficit. Results: A multivariable model using stepwise selection demonstrated that diabetes mellitus and weight were associated with a decrease in the base deficit by 2.87 mEq/L (95% CI: −5.55-−0.19 and 0.04 mEq/L (95%CI: −0.08, 0.004, respectively. Furthermore, creatinine was associated with a 1.57 mEq/L (95% CI: 0.14, 2.99 increase in the base deficit. Conclusion: The Mini-Maze procedure was not associated with postoperative metabolic acidosis. Instead, nondiabetic patients and patients with higher creatinine were associated with greater base deficits after undergoing cardiac surgery.

  6. Performing the Left Atrial Maze Ablation Pattern Without Atriotomy.

    Weimar, Timo; Gaynor, Sydney L; Seubert, Daniela Y; Damiano, Ralph J; Doll, Nicolas

    2016-02-01

    The need to perform an additional atriotomy is a major concern that keeps many surgeons from performing an extended left atrial lesion set in patients with atrial fibrillation during procedures such as aortic valve replacement. This does result either in a suboptimal lesion set or even in ignoring the rhythm disorder, leaving the patient exposed to an increased risk of stroke and possible hemodynamic compromises. This report describes a technique how pulmonary vein isolation, an isolation of the posterior left atrial wall and an anterior mitral annular line, which substitutes for the mitral isthmus line in order to prevent perimitral atrial flutter, can be performed during aortic valve replacement without the need for an atriotomy. This technique allows for an optimal time management by minimizing additional cardiopulmonary bypass-time and cross-clamp-time; however, its equivalent efficacy in successfully treating atrial fibrillation compared to the left atrial Maze IV ablation pattern needs to be revealed in future trials. PMID:26777943

  7. Freedom from atrial fibrillation after cox maze III ablation during follow-up

    Fariborz Akbarzadeh

    2015-01-01

    Full Text Available Background: Nearly 60% of patients undergoing mitral valve (MV operations are affected by atrial fibrillation (AF. Cox Maze III ablation is one of the effective ways for restoring sinus rhythm for patients undergoing open heart surgery. The aim of present study was to evaluate efficacy of Maze III ablation procedure for restoring sinus rhythm among patients who had underwent open heart surgery. Materials and Methods: During present descriptive-analytic prospective study 114 patients with chronic AF had undergone open heart surgery for their valvular or coronary artery diseases in Educational-Medical centres of Tabriz University of Medical Sciences (Tabriz, Iran 2006-2012, were included in the study. For all patients Maze III ablation was done. Patients were evaluated by 12 lead electrocardiography (ECG and 24 hours ambulatory ECG monitoring after 3-6 years (mean 4.8 of follow-up. Result : Patients′ rhythm before Cox Maze III surgery was chronic AF in all patients. All patients were discharged from operating room with sinus rhythm. During intensive care unit (ICU hospitalization, rhythm of 34 patients changed to AF and 80 patients had sinus rhythm. Sixteen patients had undergone electrical cardioversion for restoring sinus rhythm which was successful in 12 patients. Ninety-two patients had sinus rhythm when discharged from the hospital. After termination of follow-up, freedom from atrial fibrillation was 51%. Patients with AF during follow-up on surface ECG didn′t have episodes of sinus rhythm in their ambulatory monitoring. One patient implanted cardiac pacemaker due to persistent sinus bradycardia. Conclusion: Based on the results of this study, Cox Maze III ablation procedure is an effective and safe way for restoring sinus rhythm among patients who are candidate for open heart surgery, while no significant complication was seen among patients.

  8. Surgical Radiofrequency MAZE III Ablation for Treatment of Atrial Fibrillation During Open Heart Surgery

    Fariborz Akbarzadeh; Rezayat Parvizi

    2006-01-01

    Background: Atrial fibrillation is a common arrhythmia in patients with rheumatic mitral and other valve diseases who are candidates for valve repair surgeries. Conversion of rhythm to sinus has positive effects on quality of life and lower use of medications. The aim of this clinical study was to evaluate the effectiveness of the radiofrequency ablation Maze III procedure in the treatment of atrial fibrillation associated with rheumatic heart valve disease. Methods: We applied a modified Cox...

  9. The Effects of Using Different Procedures to Score Maze Measures

    Pierce, Rebecca L.; McMaster, Kristen L.; Deno, Stanley L.

    2010-01-01

    The purpose of this study was to examine how different scoring procedures affect interpretation of maze curriculum-based measurements. Fall and spring data were collected from 199 students receiving supplemental reading instruction. Maze probes were scored first by counting all correct maze choices, followed by four scoring variations designed to…

  10. Paracardioscopic Ex-Maze

    Full Text Available ... The Ex-Maze procedure, which we have been working on for quite some time, is a procedure ... slide, that demonstrates how the VisiTrax ablation device works. It's a suction device. It actually sucks up ...

  11. Robotic excision of aortic valve papillary fibroelastoma and concomitant Maze procedure

    Murphy, Edward T

    2012-01-01

    Abstract: Cardiothoracic surgeons have utilized the surgical robot to provide a minimally invasive approach to a number of intracardiac operations, including tumor resection, valve repair, and ablation of atrial arrhythmia. We report the case of a 58 year-old woman who was found to have a mobile mass on her aortic valve during evaluation of atrial fibrillation. Both of these conditions were addressed when she underwent a combined robotic biatrial Maze procedure and excision of the mass, which...

  12. Robotic excision of aortic valve papillary fibroelastoma and concomitant Maze procedure

    Edward T Murphy

    2012-12-01

    Full Text Available Cardiothoracic surgeons have utilized the surgical robot to provide a minimally invasive approach to a number of intracardiac operations, including tumor resection, valve repair, and ablation of atrial arrhythmia. We report the case of a 58 year-old woman who was found to have a mobile mass on her aortic valve during evaluation of atrial fibrillation. Both of these conditions were addressed when she underwent a combined robotic biatrial Maze procedure and excision of the mass, which proved to be a papillary fibroelastoma of the aortic valve.

  13. The totally thoracoscopic left atrial maze procedure for the treatment of atrial fibrillation.

    van Laar, Charlotte; Geuzebroek, Guillaume S C; Hofman, Frederik N; Van Putte, Bart P

    2016-01-01

    The totally thoracoscopic left atrial maze (TT-maze) is a recent, minimally invasive surgical procedure for the treatment of atrial fibrillation, with promising results in terms of freedom from atrial fibrillation. The TT-maze consists of a bilateral, epicardial pulmonary vein isolation with the creation of a box using radiofrequency and exclusion of the left atrial appendage (LAA). In addition, the box is connected with the base of the LAA and furthermore with the mitral annulus with the so-called trigonum line. In this report, we describe our surgical approach and short-term results. PMID:26993056

  14. Outcome of Cox Maze procedure concomitant with mitral valve operation in treatment of atrial fibrillation

    ZHANG Sai; CHEN Ru-kun; DONG Ai-qiang; WANG Yong-qin; CHEN Suo-cheng; LI Zhi-jun

    2006-01-01

    @@ Atrial fibrillation (AF) is fairly common in patients with chronic mitral valve disease and a markedly dilated left atrium. These patients rarely return to sinus rhythm spontaneously, even after a successful mitral valve operation. The Maze procedure,developed by Cox and associates,1-5 has been used in patients undergoing a mitral valve operation.Restoration of normal sinus rhythm and atrial contraction in such patients have been reported by some groups. This study will summarize retrospectively a group of patients who underwent the Cox Maze procedure for the treatment of AF associated with rheumatic mitral valve disease in China.

  15. Modified Maze lines plus pulmonary vein isolation created by radiofrequency catheter ablation on the atrial wall to treat atrial fibrillation in elderly

    Caiyi LU; Shiwen WANG; Xinping DU; Yinglong HOU; Qiao XUE; Xinli WU; Rui CHEN; Peng LIU

    2005-01-01

    Objective To evaluate the effect of modified Maze lines plus pulmonary vein (PV) isolation created by radiofrequency catheter ablation (RFCA) on atrial wall guided by a novel geometry mapping system in the treatment of elderly patients with paroxysmal atrial fibrillation (PAF). Methods After regular electrophysiological study, transseptal punctures were achieved twice with Swartz L1 and R1 sheaths. PV angiographies were conducted to evaluate their orifices and branches. A balloon electrode array catheter with 64 electrodes was put in the middle of the left atrium. Atrium geometry was constructed using Ensite 3000 Navx system. Two RFCA lesion loops and three lines (modified Maze) were created on left and right atrial walls. Each lesion point was ablated for 30 seconds with preset temperature 50 (ae) and energy 30W. The disappearance or 80% decrease of the amplitude of target atrial potential and 10 to 20(|), decrease of ablation impedance were used as an index of effective ablation. Results A total of 11 patients (7 male and 4 female, mean age, 68.7±5.1 years) were enrolled. PAF history was 7.9±4.5 years. PAF could not be prevented by mean 3.1±1.6 antiarrhythmic agents in 6.3±3.4 years. None of the patients had complications with structural heart disease or stroke. Left atrial diameter was 41.3±3.6 mm and LVEF was 59.2±3.7% on echocardiography. Two loops and three lines were completed with 67.8±13.1 (73-167) lesion points. Altogether 76-168 (89.4±15.3) lesion points were created in each patient. PAF could not be provoked by rapid burst pacing up to 600 beat per minute delivered from paroxysmal coronary sinus electrode pair.Complete PV electrical isolation was confirmed by three-dimensional activation mapping. Mean procedure time was 2.7±0.6 hours and fluoroscopy time was 17.8±9.4 minutes. Patients were discharged with oral aspirin and without antiarrhythmic agents. During follow up of 6.5±1.8 months, seven patients were PAF symptom free (63.6%). PAF

  16. Electrocardiographic nature of restored sinus rhythm after Cox maze procedure in patients with chronic atrial fibrillation who also had other cardiac surgery.

    Kamata, J.; Nakai, K.; Chiba, N; Hosokawa, S.; Sato, Y.; Nasu, M.; Sasaki, T.; Kitahara, H; Izumoto, H.; Yagi, Y; Itoh, C.; Hiramori, K; Kawazoe, K

    1997-01-01

    OBJECTIVE: To characterise heart rate variability and high frequency components of restored sinus rhythm after the maze procedure. The maze procedure for chronic atrial fibrillation may prevent thrombotic events and improve the quality of life. However, the electrocardiographic nature of restored sinus rhythm after the maze procedure has not been fully elucidated. PATIENTS AND METHODS: Between March 1993 and August 1995, 104 consecutive patients undergoing the maze procedure in combination wi...

  17. Delayed improvement of autonomic nervous abnormality after the Maze procedure: time and frequency domain analysis of heart rate variability using 24 hour Holter monitoring

    K. Fukushima; Emori, T; Shimizu, W; Kurita, T; Aihara, N; Kosakai, Y; Isobe, F.; Shimomura, K.; Kawashima, Y.; Ohe, T

    1997-01-01

    Objective—To analyse heart rate variability in patients with atrial fibrillation after the Maze procedure, to investigate whether the procedure damages the cardiac autonomic fibres supplying the sinus node.
Design and patients—Time and frequency domain analyses of RR variability were performed using 24 hour Holter monitoring one month after surgery in 12 patients with atrial fibrillation who underwent the Maze procedure (Maze group) and in seven patients who underwent cardiac surgery without ...

  18. Learning-related coordination of striatal and hippocampal theta rhythms during acquisition of a procedural maze task

    DeCoteau, William E.; Thorn, Catherine; Gibson, Daniel J.; Courtemanche, Richard; Mitra, Partha; Kubota, Yasuo; Graybiel, Ann M.

    2007-01-01

    The striatum and hippocampus are conventionally viewed as complementary learning and memory systems, with the hippocampus specialized for fact-based episodic memory and the striatum for procedural learning and memory. Here we directly tested whether these two systems exhibit independent or coordinated activity patterns during procedural learning. We trained rats on a conditional T-maze task requiring navigational and cue-based associative learning. We recorded local field potential (LFP) acti...

  19. Pre-Procedural Imaging to Direct Catheter Ablation of Atrial Fibrillation: Anatomy and Ablation Strategy.

    Moussa Mansour; Ruskin, Jeremy N; Suhny Abbara; Godtfred Holmvang; E. Kevin Heist

    2008-01-01

    Successful catheter ablation of atrial fibrillation (AF) requires a detailed understanding of left atrial anatomy in order to maximize the safety and efficacy of the procedure. Common and rare variants of left atrial and pulmonary venous anatomy have been described which can affect the optimal ablation strategy for each individual patient. These variants include the presence of a right or left middle pulmonary vein, a left or right common pulmonary vein, a common inferior pulmonary vein, a ri...

  20. Pre-Procedural Imaging to Direct Catheter Ablation of Atrial Fibrillation: Anatomy and Ablation Strategy

    E. Kevin Heist MD PhD; Godtfred Holmvang MD; Suhny Abbara MD; Jeremy N. Ruskin MD; Moussa Mansour MD

    2008-01-01

    Successful catheter ablation of atrial fibrillation (AF) requires a detailed understanding of left atrial anatomy in order to maximize the safety and efficacy of the procedure. Common and rare variants of left atrial and pulmonary venous anatomy have been described which can affect the optimal ablation strategy for each individual patient. These variants include the presence of a right or left middle pulmonary vein, a left or right common pulmonary vein, a common inferior pulmonary vein, a ri...

  1. Wolf Mini-Maze procedure for atrial fibrillation%Wolf Mini-Maze手术治疗单纯性心房颤动

    刘胜中; 曾富春; 丛伟

    2013-01-01

    目的 总结Wolf Mini-Maze手术治疗单纯性心房颤动的临床经验,并评价其安全性和疗效.方法 自2010年11月起,我科采用AtriCureTM干式双极微创射频消融系统经胸腔镜对2例单纯性心房颤动患者施行了双侧肺静脉隔离及左心耳切除术.结果 2例手术过程顺利,消融术后即刻恢复窦性心律.术后随访3 ~17个月,维持窦性心律,无卒中及其它并发症发生.结论 Wolf Mini-Maze手术治疗单纯性心房颤动具有微创、简单、安全、高效的特点,值得推广.%Objective To summarize the experience of Wolf Mini-Maze procedure for atrial fibrillation, and to evaluate its safety and effect. Methods From November 2010, 2 patients with atrial fibrillation accepted thoracoscopic off-pump bilateral epicardial pulmonary vein isolation by using an AtriCure bipolar radiofrequency ablation device and endoscopic excision of the left atrial appendage by using a EZ-45G stapler. Results The operation was performed successfully. The patients were in sinus rhythm immediately after procedure, and still in sinus rhythm during following-up period (from 3 to 17 months). No stroke and other complications were found during following-up period. Conclusion Wolf Mini-Maze procedure is minimally invasive, simple, safe and effective. It is a promising procedure in atrial fibrillation treatment.

  2. Cox-Maze III procedure with valvular surgery in an autopneumonectomized patient

    Wi Jin

    2012-11-01

    Full Text Available Abstract Destructive pulmonary inflammation can leave patients with only a single functional lung, resulting in anatomical and physiological changes that may interfere with subsequent cardiac surgeries. Such patients are vulnerable to perioperative cardiopulmonary complications. Herein, we report the first case, to our knowledge, of an autopneumonectomized patient who successfully underwent a modified Cox-Maze III procedure combined with valvular repairs. The three major findings in this case can be summarized as follows: (1 a median sternotomy with peripheral cannulations, such as femoral cannulations, can provide an optimal exposure and prevent the obstruction of vision that may occur as a result of multiple cannulations through a median sternotomy; (2 a modified septal incision combined with biatrial incisions facilitate adequate exposure of the mitral valve; and (3 the aggressive use of intraoperative ultrafiltration may be helpful for the perioperative managements as decreasing pulmonary water contents, thereby avoiding the pulmonary edema associated with secretion of inflammatory cytokines during a cardiopulmonary bypass. We also provide several suggestions for achieving similar satisfactory surgical outcomes in patients with a comparable condition.

  3. Induction of habits in rats by a forced-choice procedure in T-maze and the effect of pre-test free exploration

    Moustgaard, Anette; Hau, Jann

    2009-01-01

    A forced-choice procedure in T-maze designed for the induction of habits was used to induce strong habits in rats. The response choices of rats in 20 free-choice trials were compared after the rats had been subjected to 1 or 200 forced-choice trials to one side of the T-maze. After 200 forced...

  4. Paracardioscopic Ex-Maze

    Full Text Available ... slide, I think we'll show you an animation of the procedure so that you can understand ... doing this procedure. This is actually a video animation of an Ex-Maze procedure done totally endoscopically. ...

  5. Factors influencing the efficacy of radiofrequency ablation Maze procedure combined with open-heart operation for treatment of atrial fibrillation%影响心内直视手术加射频消融迷宫术治疗心房颤动疗效的因素

    王邵华; 王春生

    2008-01-01

    目的 分析影响心内直视手术加射频(RF)消融迷宫(Maze)术治疗心房颤动(AF)疗效的因素.方法 连续收集58例接受心内直视手术加RF消融MazeⅢ术患者的临床资料并随访患者的心电图,运用COX回归分析确定影响手术疗效的独立因素.结果 本组失访3例,随访率为94.8%(55/58),随访6~28个月,平均随访时间为(14.2±6.5)个月,最后1次随访中窦性心律恢复率为76.4%(42/55).术前AF病程>4年是影响心内直视手术加RF消融Maze术治疗AF疗效的独立危险因素(P=0.025).结论 AF病程影响心内直视手术加RF消融Maze术治疗AF的疗效,AF病程越长,手术效果越差.

  6. Optimizing safety and efficacy of catheter ablation procedures

    F. Akca (Ferdi)

    2015-01-01

    markdownabstractAbstract In this thesis new developments in the field of invasive electrophysiology are studied and discussed. The aim of this work is to find strategies to optimize safety and efficacy of catheter ablation procedures. The most important developments that are studied in this thesis

  7. Learning-related coordination of striatal and hippocampal theta rhythms during acquisition of a procedural maze task.

    DeCoteau, William E; Thorn, Catherine; Gibson, Daniel J; Courtemanche, Richard; Mitra, Partha; Kubota, Yasuo; Graybiel, Ann M

    2007-03-27

    The striatum and hippocampus are conventionally viewed as complementary learning and memory systems, with the hippocampus specialized for fact-based episodic memory and the striatum for procedural learning and memory. Here we directly tested whether these two systems exhibit independent or coordinated activity patterns during procedural learning. We trained rats on a conditional T-maze task requiring navigational and cue-based associative learning. We recorded local field potential (LFP) activity with tetrodes chronically implanted in the caudoputamen and the CA1 field of the dorsal hippocampus during 6-25 days of training. We show that simultaneously recorded striatal and hippocampal theta rhythms are modulated differently as the rats learned to perform the T-maze task but nevertheless become highly coherent during the choice period of the maze runs in rats that successfully learned the task. Moreover, in the rats that acquired the task, the phase of the striatal-hippocampal theta coherence was modified toward a consistent antiphase relationship, and these changes occurred in proportion to the levels of learning achieved. We suggest that rhythmic oscillations, including theta-band activity, could influence not only neural processing in cortico-basal ganglia circuits but also dynamic interactions between basal ganglia-based and hippocampus-based forebrain circuits during the acquisition and performance of learned behaviors. Experience-dependent changes in coordination of oscillatory activity across brain structures thus may parallel the well known plasticity of spike activity that occurs as a function of experience. PMID:17372196

  8. Paracardioscopic Ex-Maze

    Full Text Available ... The Ex-Maze procedure, which we have been working on for quite some time, is a procedure ... off their coumadin now. Clearly we have to work with cardiologists to make sure that we don' ...

  9. Paracardioscopic Ex-Maze

    Full Text Available ... about doing this procedure. This is actually a video animation of an Ex-Maze procedure done totally ... fibrillation treatment. If we can go to the video, we'll go to the operating room and ...

  10. Effect of a water-maze procedure on the redox mechanisms in brain parts of aged rats

    Natalia Andreevna Krivova

    2015-03-01

    Full Text Available The Morris water maze (MWM is a tool for assessment of age-related cognitive deficits. In our work, MWM was used for appraisal of cognitive deficits in 11-month-old rats and investigation of the effect exerted by training in the Morris water maze on the redox mechanisms in rat brain parts. Young adult (3-month-old and aged (11-month-old male rats were trained in the water maze. Intact animals of the corresponding age were used as the reference groups. The level of pro- and antioxidant capacity in brain tissue homogenates was assessed using the chemiluminescence method.Cognitive deficits were found in 11-month-old rats: at the first day of training they showed only 30% of successful MWM trials. However, at the last training day the percentage of successful trials was equal for young adult and aged animals. This indicates that cognitive deficits in aged rats can be reversed by MWM training. Therewith, the MWM spatial learning procedure itself produces changes in different processes of redox homeostasis in 11-month-old and 3-month-old rats as compared to intact animals. Young adult rats showed a decrease in prooxidant capacity in all brain parts, while 11-month-old rats demonstrated an increase in antioxidant capacity in the olfactory bulb, pons + medulla oblongata and frontal lobe cortex. Hence, the MWM procedure activates the mechanisms that restrict the oxidative stress in brain parts. The obtained results may be an argument for further development of the animal training procedures aimed to activate the mechanisms responsible for age-related cognitive deficits. This may be useful not only for the development of training procedures applicable to human patients with age-related cognitive impairments, but also for their rehabilitation.

  11. Paracardioscopic Ex-Maze

    Full Text Available ... because as in every procedure there is a learning curve as we all know. The question is, “ ... procedure done. He told us exactly where the problem was, we did that ablation, that one ablation, ...

  12. The Surgical Treatment for Atrial Fibrillation: Ablation Technology and Surgical Approaches

    Linda Henry

    2013-07-01

    Full Text Available The Cox maze procedure developed originally in 1987 by Dr James Cox has evolved from a “cut and sew” surgical procedure, where the maze was applied using multiple surgical cuts, to an extensive use of surgical ablation technology where ablation lesions are placed with alternative energy sources (radiofrequency, cryothermy, microwave, and high-frequency ultrasound. Furthermore, the procedure has changed from a median sternotomy approach only to one that can be performed minimally invasively and robotically. The purpose of this paper is to review the current available technology for the ablation of atrial fibrillation as well as the different procedural approaches for the surgical ablation of atrial fibrillation.

  13. Case of successful surgical treatment for atrial fibrillation using «Maze III» procedure: 18 years on

    Bockeria L. A.

    2012-03-01

    Full Text Available Atrial fibrillation is one of the most common types of heart rhythm disturbances in humans. «Maze III» procedure is considered to be the most radical methods of surgical treatment for atrial fibrillation. It is performed according to the «incision-suture» technique using median sternotomy and cardiopulmonary bypass. This procedure is less frequently used in clinical practice because of its technical complexity, but the evaluation of longterm results is necessary to answer the question of expediency for using the new methods of surgical treatment for atrial fibrillation which were developed in view of essential principles of classical surgery. The clinical case of successful surgical treatment for atrial fibrillation with 18-years of follow-up is presented in the article.

  14. Paracardioscopic Ex-Maze

    Full Text Available ... pattern actually since the initiation of the entire development of the procedure. Perhaps you can give us ... comments about how we've progressed along the development of the Ex-Maze. 00:07:10 GERHARD ...

  15. Paracardioscopic Ex-Maze

    Full Text Available ... indication for heart surgery, and those people would benefit from a minimally invasive paracardioscopic Maze procedure, and ... was in A Fib, I went on the internet trying to find everything I could find out ...

  16. Paracardioscopic Ex-Maze

    Full Text Available ... to the video, we'll go to the operating room and actually see an Ex-Maze procedure ... totally endoscopically. We can see here in the operating room, there are three people at the table, ...

  17. Paracardioscopic Ex-Maze

    Full Text Available ... pattern that he described has been the gold standard to treat all types of atrial fibrillation, but ... A Fib and anti-rhythmic medications. The gold standard at six months, the surgical Maze 3 procedure, ...

  18. Paracardioscopic Ex-Maze

    Full Text Available ... see a live paracardioscopic Ex-Maze procedure for treatment of atrial fibrillation. You'll also learn how ... and often times don't have a good treatment opportunity because of their prolonged disease and because ...

  19. Results of Surgical Treatment of Isolated Atrial Fibrillations with the Use of Modified Maze Procedure

    Revishvili A. Sh.

    2012-09-01

    The total efficiency was estimated to be 96.9% (64/66. Conclusion. Bipolar epicardial radiofrequency modification of the Labyrinth operation is safe and efficient in the treatment of persistent and long-standing persistent atrial fibrillation. The major indications for the operation in normothermic artificial blood circulation are a poor performance of antiarrhythmic therapy in symptomatic patients, no chance and no efficiency of a catheter radiofrequency ablation (for over 1 or 2 times, long-standing persistent atrial fibrillations and the size of the left atrium of over 5 cm.

  20. What have we learned of ablation procedures for atrial fibrillation?

    Maurer, T; Lundqvist, C B; Tilz, R; Mont, L; Chierchia, G-B; Malmborg, H; Metzner, A; Kuck, K-H

    2016-05-01

    Atrial fibrillation is a widespread disease of growing clinical, economic and social importance. Interventional therapy for atrial fibrillation offers encouraging results, with pulmonary vein isolation (PVI) as the established cornerstone. Yet, the challenge to create durable transmural lesions remains, leading to recurrence of atrial fibrillation in long-term follow-up even after multiple ablation procedures in 20% of patients with paroxysmal atrial fibrillation and approximately 50% with persistent atrial fibrillation. To overcome these limitations, innovative tools such as the cryoballoon and contact force catheters have been introduced and have demonstrated their potential for safe and effective PVI. Furthermore, advanced pharmacological and pacing manoeuvres enhance evaluation of conduction block in PVI. PMID:26940476

  1. Surgical Ablation of Atrial Fibrillation.

    Ramlawi, Basel; Abu Saleh, Walid K

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality. The Cox-Maze IV is the most currently accepted iteration. It achieves the same lesion set of the Cox- maze III but uses alternative energy sources to create the transmural lesions, potentially in a minimally invasive approach on the beating heart. High-frequency ultrasound, microwave, and laser energy have all been used with varying success in the past. Today, bipolar radiofrequency heat or cryotherapy cooling are the most accepted sources for creating linear lesions with consistent safety and transmurality. The robust and reliable nature of these energy delivery methods has yielded a success rate reaching 90% freedom from atrial fibrillation at 12 months. Such approaches offer a significant long-term advantage over catheter-based ablation, especially in patients having longstanding, persistent atrial fibrillation with characteristics such as dilated left atrial dimensions, poor ejection fraction, and failed catheter ablation. Based on these improved results, there currently is significant interest in developing a hybrid ablation strategy that incorporates the superior transmural robust lesions of surgical ablation, the reliable stroke prevention potential of epicardial left atrial appendage exclusion, and sophisticated mapping and confirmatory catheter-based ablation technology. Such a minimally invasive hybrid strategy for ablation may lead to the development of multidisciplinary "Afib teams" to

  2. de Novo Radio Frequency Ablation Therapy: Application of Unexplored Electromagnetic Spectral Resources of mm-Wave/THz Band in Clinical Ablation Procedures - A Review

    Perambur S. Neelakanta; Sharma, Bharti

    2013-01-01

    Review Focus: General considerations on ablation procedure advocated in clinical contexts using electromagnetic (EM) energy are comprehensively reviewed. Relevant radiofrequency (RF) and/or microwave ablation techniques that have been in vogue and in traditional use across clinical procedures are revisited. Traditionally, RF/microwave ablations have been applied to a variety of pathological states, (in lieu of surgical methods and/or electrocautry procedures) so as to remove unwanted/cancerou...

  3. Paracardioscopic Ex-Maze

    Full Text Available ... indication for heart surgery, and those people would benefit from a minimally invasive paracardioscopic Maze procedure, and they could really have atrial fibrillation of any duration or any frequency. Those patients have often required medical management to take care of their treatment, but have ...

  4. Paracardioscopic Ex-Maze

    Full Text Available ... live paracardioscopic Ex-Maze procedure for treatment of atrial fibrillation. You'll also learn how this minimally invasive ... you. 00:01:26 ANDY C. KISER, MD: Atrial fibrillation is a disease that affects a lot of ...

  5. Post-procedural Dabigatran Versus Interrupted Warfarin Therapy Following Catheter Ablation for Atrial Fibrillation

    Jeffrey Lin, MD; Sharon Shen, MD; Prashant Bhave, MD; Bradley Knight, MD; Martha Bohn, RN, BSN; Evaldas Giedrimas, MD; Taral K. Patel, MD; Alexandru Chicos, MD; Jeffrey Goldberger, MD; Leonard Ilkhanoff, MD, MS; Susan Kim, MD; Albert Lin, MD; Rod Passman, MD, MSCE.

    2014-02-01

    Full Text Available Purpose: Patients undergoing catheter ablation for atrial fibrillation (AF are at a higher risk of thromboembolic events post-procedure and therefore require therapeutic anticoagulation after ablation. Anticoagulation strategies include performing the procedure on or off therapeutic warfarin, though the latter approach requires post-procedure bridging therapy with low molecular-weight heparin (LMWH until a therapeutic INR is achieved. The purpose of this study is to compare the safety and efficacy of post-ablation dabigatran as compared to warfarin with LMWH bridging. Methods: We performed a single-center retrospective analysis of consecutive patients who underwent catheter ablation for AF between January 2010 and December 2012 and received either post-procedure warfarin with a LMWH bridge or dabigatran. Warfarin was started the night of ablation; LMWH was started the next morning and continued until the INR was ≥ 2.0. Dabigatran was started the morning post-ablation. Results: The analysis included 324 patients. Of these, mean age was 60 ± 9 years, 78% were male, 81% had CHADS2 scores of 0 or 1, and 181 (56% received dabigatran post-ablation. Patients who received dabigatran had lower CHADS2 scores and were more likely to be in NYHA Class I. At 30-days post-procedure, there were 0 thromboembolic or bleeding complications in the dabigatran group versus 4 (2.8% in the warfarin group (p=0.037. There were no deaths in either group at 30 days post-ablation. Conclusions: Post-ablation dabigatran appears safe and efficacious compared to an interrupted warfarin strategy with LMWH bridging.

  6. Catheter ablation for atrial fibrillation: results from the first European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA) Part II.

    Chen, Jian; Dagres, Nikolaos; Hocini, Melece; Fauchier, Laurent; Bongiorni, Maria Grazia; Defaye, Pascal; Hernandez-Madrid, Antonio; Estner, Heidi; Sciaraffia, Elena; Blomström-Lundqvist, Carina

    2015-11-01

    The European Snapshot Survey on Procedural Routines in Atrial Fibrillation Ablation (ESS-PRAFA) is a prospective, multicentre snapshot survey collecting patient-based data on current clinical practices during atrial fibrillation (AF) ablation. The participating centres were asked to prospectively enrol consecutive patients during a 6-week period (from September to October 2014). A web-based case report form was employed to collect information of patients and data of procedures. A total of 455 eligible consecutive patients from 13 countries were enrolled (mean age 59 ± 10.8 years, 28.8% women). Distinct strategies and endpoints were collected for AF ablation procedures. Pulmonary vein isolation (PVI) was performed in 96.7% and served as the endpoint in 91.3% of procedures. A total of 52 (11.5%) patients underwent ablation as first-line therapy. The cryoballoon technique was employed in 31.4% of procedures. Procedure, ablation, and fluoroscopy times differed among various types of AF ablation. Divergences in patient selection and complications were observed among low-, medium-, and high-volume centres. Adverse events were observed in 4.6% of AF ablation procedures. In conclusion, PVI was still the main strategy for AF ablation. Procedure-related complications seemed not to have declined. The centre volume played an important role in patient selection, strategy choice, and had impact on the rate of periprocedural complication. PMID:26462700

  7. Paracardioscopic Ex-Maze

    Full Text Available ... not treatment at all, no ablation procedures. About 40 percent of patients are free from A Fib. ... that occurs around the heart. There's about a 40 percent chance of having atrial fibrillation even with ...

  8. Method for evaluation of predictive models of microwave ablation via post-procedural clinical imaging

    Collins, Jarrod A.; Brown, Daniel; Kingham, T. Peter; Jarnagin, William R.; Miga, Michael I.; Clements, Logan W.

    2015-03-01

    Development of a clinically accurate predictive model of microwave ablation (MWA) procedures would represent a significant advancement and facilitate an implementation of patient-specific treatment planning to achieve optimal probe placement and ablation outcomes. While studies have been performed to evaluate predictive models of MWA, the ability to quantify the performance of predictive models via clinical data has been limited to comparing geometric measurements of the predicted and actual ablation zones. The accuracy of placement, as determined by the degree of spatial overlap between ablation zones, has not been achieved. In order to overcome this limitation, a method of evaluation is proposed where the actual location of the MWA antenna is tracked and recorded during the procedure via a surgical navigation system. Predictive models of the MWA are then computed using the known position of the antenna within the preoperative image space. Two different predictive MWA models were used for the preliminary evaluation of the proposed method: (1) a geometric model based on the labeling associated with the ablation antenna and (2) a 3-D finite element method based computational model of MWA using COMSOL. Given the follow-up tomographic images that are acquired at approximately 30 days after the procedure, a 3-D surface model of the necrotic zone was generated to represent the true ablation zone. A quantification of the overlap between the predicted ablation zones and the true ablation zone was performed after a rigid registration was computed between the pre- and post-procedural tomograms. While both model show significant overlap with the true ablation zone, these preliminary results suggest a slightly higher degree of overlap with the geometric model.

  9. Molecular thermometers for potential applications in thermal ablation procedures

    Zhegalova, Natalia G.; Aydt, Alex; Wang, Steven T.; Berezin, Mikhail Y.

    2013-02-01

    Thermal ablation is a promising minimally invasive method for treating tumors without surgical intervention. Thermal ablation uses thermal sources such as lasers, radiowaves or focused ultrasound to increase the temperature of the tumor to levels lethal to cancer cells. This treatment based on heat therapy may be problematic as the temperature of the operation site is unknown. To address this problem, we developed optical molecular thermometers that can potentially measure the temperature on a molecular scale and be compatible with in vivo measurements. The thermometers are centered on a combination of two fluorophores emitting in two distinct spectral ranges and having different temperature-dependent emission properties. In this design, a fluorophore with relatively insensitive temperature-dependent fluorescence serves as a reference while another sensitive fluorophore serves as a sensor. We have demonstrated the feasibility of this approach using a coumarin-rhodamine conjugate. The sensitivity of the construct to the clinically relevant ablation temperatures (20-85 °C) was demonstrated in vitro.

  10. Case report of surgical treatment of abnormal atrial flutter (incisional atrial tachycardia in the patient after mitral valve replacement and radiofrequency modification of Maze procedure

    Revishvili А. Sh.

    2012-12-01

    Conclusion. This type of tachycardia following after an atrial fibrillation surgery may be considered as a failing transmural myocardial damage during the procedure. The catheter method can be used succesfully unless there are no effects of antiarrhythmic therapy. The catheter method enables not only to verify the disconnection between the left atrial pulmonary veins and left atrium myocardium but also to perform the ablation in zones of the atrial myocardium that are anatomic substrates of post surgery tachyarrhythmias.

  11. Paracardioscopic Ex-Maze

    Full Text Available ... to make the procedure better. Are there other things we can add? We talked about catheter ablations as part of this operation. We're clearly waiting to see how outcomes are, but if someone has atrial fibrillation, that's a good tool to have in our material when treating ...

  12. X-ray exposure hazards for physicians performing ablation procedures and device implantation

    Marinskis, Germanas; Bongiorni, Maria Grazia; Dagres, Nikolaos;

    2013-01-01

    The purpose of the survey was to evaluate physician's and authorities policies and clinical practices when using occupational X-ray during ablation procedures and device implantation. This survey shows infrequent use of lead gloves, radiation absorbing pads, and lead glass cabins, but increasing ...... use of three-dimensional mapping systems to decrease X-ray radiation hazards. Digital fluoroscopy with decreased frame rate is not used by approximately one-third of responding centres....

  13. Robust tracking of a virtual electrode on a coronary sinus catheter for atrial fibrillation ablation procedures

    Wu, Wen; Chen, Terrence; Strobel, Norbert; Comaniciu, Dorin

    2012-02-01

    Catheter tracking in X-ray fluoroscopic images has become more important in interventional applications for atrial fibrillation (AF) ablation procedures. It provides real-time guidance for the physicians and can be used as reference for motion compensation applications. In this paper, we propose a novel approach to track a virtual electrode (VE), which is a non-existing electrode on the coronary sinus (CS) catheter at a more proximal location than any real electrodes. Successful tracking of the VE can provide more accurate motion information than tracking of real electrodes. To achieve VE tracking, we first model the CS catheter as a set of electrodes which are detected by our previously published learning-based approach.1 The tracked electrodes are then used to generate the hypotheses for tracking the VE. Model-based hypotheses are fused and evaluated by a Bayesian framework. Evaluation has been conducted on a database of clinical AF ablation data including challenging scenarios such as low signal-to-noise ratio (SNR), occlusion and nonrigid deformation. Our approach obtains 0.54mm median error and 90% of evaluated data have errors less than 1.67mm. The speed of our tracking algorithm reaches 6 frames-per-second on most data. Our study on motion compensation shows that using the VE as reference provides a good point to detect non-physiological catheter motion during the AF ablation procedures.2

  14. One-Dimensional Ablation with Pyrolysis Gas Flow Using a Full Newton's Method and Finite Control Volume Procedure

    Amar, Adam J.; Blackwell, Ben F.; Edwards, Jack R.

    2007-01-01

    The development and verification of a one-dimensional material thermal response code with ablation is presented. The implicit time integrator, control volume finite element spatial discretization, and Newton's method for nonlinear iteration on the entire system of residual equations have been implemented and verified for the thermochemical ablation of internally decomposing materials. This study is a continuation of the work presented in "One-Dimensional Ablation with Pyrolysis Gas Flow Using a Full Newton's Method and Finite Control Volume Procedure" (AIAA-2006-2910), which described the derivation, implementation, and verification of the constant density solid energy equation terms and boundary conditions. The present study extends the model to decomposing materials including decomposition kinetics, pyrolysis gas flow through the porous char layer, and a mixture (solid and gas) energy equation. Verification results are presented for the thermochemical ablation of a carbon-phenolic ablator which involves the solution of the entire system of governing equations.

  15. Harmine treatment enhances short-term memory in old rats: Dissociation of cognition and the ability to perform the procedural requirements of maze testing

    Mennenga, Sarah E.; Gerson, Julia E.; Dunckley, Travis; Bimonte-Nelson, Heather A.

    2014-01-01

    Harmine is a naturally occurring monoamine oxidase inhibitor that has recently been shown to selectively inhibit the dual-specificity tyrosine-(Y)-phosphorylation-regulated kinase 1A (DYRK1A). We investigated the cognitive effects of 1 mg (low) Harmine and 5 mg (high) Harmine using the delayed-match-to-sample (DMS) asymmetrical 3-choice water maze task to evaluate spatial working and recent memory, and the Morris water maze task (MM) to test spatial reference memory. Animals were also tested ...

  16. Is Single-View Fluoroscopy Sufficient in Guiding Cardiac Ablation Procedures?

    Pascal Fallavollita

    2010-01-01

    Full Text Available The CARTO XP ablation system provides real-time data on 3D, color-coded maps of the electrical activity of the heart; however, it is expensive and can only use a dedicated costly magnetic catheter per patient intervention. The purpose of our study is to shorten the duration of the radiofrequency ablation procedure and increase its efficacy by developing an affordable prototype catheter navigation system that simulates the CARTO system. To obtain 3D geometrical data from catheter locations inside the heart chamber, we acquired only single-view images using an Integris Allura fluoroscope and estimated the depth of the mapping electrode using pattern recognition techniques. Validation was performed in ideal and clinical conditions. For phantom experiment, when using a 7-French catheter, the average recovered depth error was 2.05±1.46 mm using a single image. However, when using the 8-French catheter, the average recovered depth error was 1.54±1.29 mm. In clinical experimentation, the standard error of estimate for the estimated depth was about 13.1 mm and 10.1 mm, respectively, for the posterior and lateral views. In conclusion, this paper describes our achievements and shortfalls in developing an affordable fluoroscopic navigation system to guide RF catheter ablation of cardiac arrhythmias.

  17. Acquiring Multiview C-Arm Images to Assist Cardiac Ablation Procedures

    Pascal Fallavollita

    2010-01-01

    Full Text Available CARTO XP is an electroanatomical cardiac mapping system that provides 3D color-coded maps of the electrical activity of the heart; however it is expensive and it can only use a single costly magnetic catheter for each patient intervention. Our approach consists of integrating fluoroscopic and electrical data from the RF catheters into the same image so as to better guide RF ablation, shorten the duration of this procedure, increase its efficacy, and decrease hospital cost when compared to CARTO XP. We propose a method that relies on multi-view C-arm fluoroscopy image acquisition for (1 the 3D reconstruction of the anatomical structure of interest, (2 the robust temporal tracking of the tip-electrode of a mapping catheter between the diastolic and systolic phases and (3 the 2D/3D registration of color coded isochronal maps directly on the 2D fluoroscopy image that would help the clinician guide the ablation procedure much more effectively. The method has been tested on canine experimental data.

  18. Impact of catheter ablation with remote magnetic navigation on procedural outcomes in patients with persistent and long-standing persistent atrial fibrillation

    Jin, Qi; Pehrson, Steen; Jacobsen, Peter Karl;

    2015-01-01

    with RMN. METHODS: A total of 313 patients (275 male, age 59 ± 9.5 years) with PsAF (187/313) or L-PsAF (126/313) undergoing ablation using RMN were included. Patients' disease history, pulmonary venous anatomy, left atrial (LA) volume, procedure time, mapping plus ablation time, radiofrequency (RF......) ablation time, fluoroscopy time, radiation dose, and complications were assessed. Stepwise regression was used to predict which variable could best predict acute restoration from AF to SR by ablation. RESULTS: Compared to PsAF, procedure time and RF ablation time were significantly increased in patients......BACKGROUND: The objectives of this study were to assess the procedural outcomes of persistent and long-standing persistent atrial fibrillation (PsAF and L-PsAF) ablation guided by remote magnetic navigation (RMN), and to detect factors predicting acute restoration of sinus rhythm (SR) by ablation...

  19. Endometrial ablation

    Hysteroscopy-endometrial ablation; Laser thermal ablation; Endometrial ablation-radiofrequency; Endometrial ablation-thermal balloon ablation; Rollerball ablation; Hydrothermal ablation; Novasure ablation

  20. The creativity maze

    Bourgeois-Bougrine, Samira; Glaveanu, Vlad Petre; Botella, Marion;

    2014-01-01

    prepare for this “journey,” create “maps,” and then enter the maze navigating through various true path segments and blind alleys. This maze is seldom traveled alone, the followed path is not linear, and there are several back-and-forth movements before reaching the “exit,” which is represented by the...

  1. The clinical application of DSA and Xper-CT in guiding lung tumor radiofrequency ablation procedure

    Objective: To discuss the clinical application of DSA and Xper-CT in guiding lung tumor radiofrequency ablation (RFA). Methods: Navigated by DSA and Xper-CT images, RFA was performed in 21 patients with lung tumor. The tumors included peripheral lung cancer (n=3) and lung metastases from hepatocellular carcinoma (n=12) or from colorectal cancer (n=6). The lesions were located at left upper lobe (n=5), at left lower lobe (n=2), at right upper lobe (n=5), at right middle lobe (n=6) and at right lower lobe (n=4). One lesion was situated at the right thoracic wall and one lesion was situated at the left thoracic wall. Results: A total of 24 lesions were detected in the 21 patients. Of the 24 lesions, successful puncturing with single procedure was obtained in 22, with a success rate of 91.67%. Two lesions had the diameter less than one cm, and the treatment was accomplished after two times of puncturing. Conclusion: For the treatment of lung tumors, DSA and Xper-CT-guided radiofrequency ablation is clinically - safe and technically - simple with higher localizing accuracy. Therefore, this technique should be recommended in clinical practice. (authors)

  2. Navigation for fluoroscopy-guided cryo-balloon ablation procedures of atrial fibrillation

    Bourier, Felix; Brost, Alexander; Kleinoeder, Andreas; Kurzendorfer, Tanja; Koch, Martin; Kiraly, Attila; Schneider, Hans-Juergen; Hornegger, Joachim; Strobel, Norbert; Kurzidim, Klaus

    2012-02-01

    Atrial fibrillation (AFib), the most common arrhythmia, has been identified as a major cause of stroke. The current standard in interventional treatment of AFib is the pulmonary vein isolation (PVI). PVI is guided by fluoroscopy or non-fluoroscopic electro-anatomic mapping systems (EAMS). Either classic point-to-point radio-frequency (RF)- catheter ablation or so-called single-shot-devices like cryo-balloons are used to achieve electrically isolation of the pulmonary veins and the left atrium (LA). Fluoroscopy-based systems render overlay images from pre-operative 3-D data sets which are then merged with fluoroscopic imaging, thereby adding detailed 3-D information to conventional fluoroscopy. EAMS provide tracking and visualization of RF catheters by means of electro-magnetic tracking. Unfortunately, current navigation systems, fluoroscopy-based or EAMS, do not provide tools to localize and visualize single shot devices like cryo-balloon catheters in 3-D. We present a prototype software for fluoroscopy-guided ablation procedures that is capable of superimposing 3-D datasets as well as reconstructing cyro-balloon catheters in 3-D. The 3-D cyro-balloon reconstruction was evaluated on 9 clinical data sets, yielded a reprojected 2-D error of 1.72 mm +/- 1.02 mm.

  3. Laser Ablation Of Atrial Fibrillation: Mid-term Clinical Experience

    Li Poa, MD

    2009-08-01

    Full Text Available Background: Atrial Fibrillation is known to account for one third of all the strokes caused in the US in the population above the age of 70. Patients treated with the surgical Cox MAZE operation have been shown to have a 150 fold decrease in the incidence of stroke over an 18 year period. However, the original Cox MAZE although extremely successful in treating atrial fibrillation and decreasing the incidence of strokes was not performed widely because of complexity and invasiveness of the procedure. A variety of alternative energy based curative ablation strategies are now available for more minimally invasive therapeutic management of atrial fibrillation (AF. In this communication, we report our clinical experience in AF therapy utilizing laser energy ablation technology. Methods: Fifty two consecutive AF patients underwent concomitant or isolated ablation prior to any coexisting cardiac procedures that included CABG (coronary artery bypass surgery, MV (mitral valve or AV (aortic valve repairs. All patients had an epicardially based ablation pattern with basic lesions being en bloc box type pulmonary vein isolation which included the antral surface of the left atrium, directed ganglionectomies of the the right anterior and inferior ganglions, posteriomedial ablation of the IVC ( inferior vena cava, and a right isthmus ablation. Twenty seven patients had ligation of their left atrial appendage, 14 patients had resection of the ligament of Marshall, and three patients had endocardial placed lesions of a mitral annular connecting type lesion. In order to maintain the patients in normal sinus rhythm (NSR, electrical cardioversion and anti-arrhythmic drugs were employed as required. Results: At a median follow-up of 250 days, 44 of the total 52 patients (84.6% exhibited NSR.. No complications or mortality were reported due to the laser procedure. Conclusion: Laser ablation was successfully and safely used for endocardial and epicardial AF ablation

  4. Paracardioscopic Ex-Maze

    Full Text Available ... However, in the pattern you see on the right, that is an open-chest pattern. That's the ... minimally invasive paracardioscopic Ex-Maze pattern on the right. This pattern is one that's very similar to, ...

  5. Paracardioscopic Ex-Maze

    Full Text Available ... That pattern that he described has been the gold standard to treat all types of atrial fibrillation, ... from A Fib and anti-rhythmic medications. The gold standard at six months, the surgical Maze 3 ...

  6. Paracardioscopic Ex-Maze

    Full Text Available ... ablation line somewhere, that's not contiguous. There's a gap that needs to be fixed. Again, you put ... on the pulmonary vein and because there's a gap, electricity is going across the ablation line and ...

  7. Real-time circumferential mapping catheter tracking for motion compensation in atrial fibrillation ablation procedures

    Brost, Alexander; Bourier, Felix; Wimmer, Andreas; Koch, Martin; Kiraly, Atilla; Liao, Rui; Kurzidim, Klaus; Hornegger, Joachim; Strobel, Norbert

    2012-02-01

    Atrial fibrillation (AFib) has been identified as a major cause of stroke. Radiofrequency catheter ablation has become an increasingly important treatment option, especially when drug therapy fails. Navigation under X-ray can be enhanced by using augmented fluoroscopy. It renders overlay images from pre-operative 3-D data sets which are then fused with X-ray images to provide more details about the underlying soft-tissue anatomy. Unfortunately, these fluoroscopic overlay images are compromised by respiratory and cardiac motion. Various methods to deal with motion have been proposed. To meet clinical demands, they have to be fast. Methods providing a processing frame rate of 3 frames-per-second (fps) are considered suitable for interventional electrophysiology catheter procedures if an acquisition frame rate of 2 fps is used. Unfortunately, when working at a processing rate of 3 fps, the delay until the actual motion compensated image can be displayed is about 300 ms. More recent algorithms can achieve frame rates of up to 20 fps, which reduces the lag to 50 ms. By using a novel approach involving a 3-D catheter model, catheter segmentation and a distance transform, we can speed up motion compensation to 25 fps which results in a display delay of only 40 ms on a standard workstation for medical applications. Our method uses a constrained 2-D/3-D registration to perform catheter tracking, and it obtained a 2-D tracking error of 0.61 mm.

  8. Reinforce the study of treatment of atrial fibrillation by catheter ablation

    HUANG Cong-xin

    2005-01-01

    @@ In the past decade, there is a great progress in the treatment of atrial fibrillation (AF) by transcatheter ablation. The catheter-based procedures have developed from Maze-like linear lesion, focal lesion to segmental electrical isolation of pulmonary veins and circumferential ablation under guidance of anatomical mapping, ablation energy developed from radiofrequency to multiple energy such as radiofrequency, ultrasound and cryoablation; and success rate has risen to 90% from around 30% in the past.1 Catheter ablation has been widely accepted as a treatment of AF and tends to substitute pharmacological therapy and become first-line treatment gradually. It must point out that, however, catheter ablation of AF is not perfect and there are many issues desiderating resolution.

  9. Surgical Ablation of Atrial Fibrillation

    Ramlawi, Basel; Abu Saleh, Walid K.

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions...

  10. Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia guided by magnetic navigation system: a prospective randomized comparison with conventional procedure

    ZHANG Yu-xiao; LU Cai-yi; XUE Qiao; LI Ke; YAN Wei; ZHOU Sheng-hua

    2012-01-01

    Background Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common paroxysmal supraventricular tachyarrhythmias.The aim of the study was to prospectively compare the characteristics of radiofrequency catheter ablation of AVNRT guided by a magnetic navigation system with the conventional procedure.Methods Patients with AVNRT diagnosed by electrophysiological tests were randomized into two groups.In the conventional technique group (CMT),a common 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. In the magnetic navigation system guidance group (MNS), a magnetic 4-mm-tip quadrapolar temperature-controlled ablation catheter was used.The following parameters were collected and compared between the two groups: ablation procedure time,patient fluoroscopy time,operator fluoroscopy time,energy delivery numbers,maximal energy per deployment,success rate,complication rate and operative cost.Results Forty patients were enrolled and randomized into CMT and MNS groups.The age,gender,tachycardia history and basic cardiovascular diseases of the two groups were comparable (P >0.05).All procedures were conducted successfully without complications.No tachycardia recurred during the follow-up period of (9.3±2.6) months.In the MNS group,the patient and operator fluoroscopy times ((11.5±4.3) min,(4.2±1.5) min),energy delivery numbers (3.2±0.9),and maximal energy per deployment ((16.9±3.4) W) were shorter or lower than those of the CMT group ((14.3±6.2) min,(13.6±3.5) min,6.3±2.1,(23.7±1.3) W,respectively) (P <0.05).But the operative cost for the MNS group was higher than that of the CMT group (P <0.01 ).Conclusion Magnetic navigation system guided radiofrequency catheter ablation of AVNRT has the advantages of shorter fluoroscopy time and lower energy delivery numbers and maximal energy per deployment compared to the present conventional ablation technique.

  11. Combined Catheter Ablation for Atrial Fibrillation and Watchman® Left Atrial Appendage Occlusion Procedures: A Single Centre Experience

    Daniel T. Walker B. App Sci

    2012-10-01

    Full Text Available Background Patients with atrial fibrillation (AF may be interested in undergoing concomitant interventions of left atrial catheter ablation and device occlusion of the left atrial appendage (LAA. We report on the feasibility and outcome of combined procedures in a single centre case series. Methods Twenty-six patients underwent either first time or redo pulmonary vein isolation (PVI procedures followed by successful implant of a Watchman? device. Results All procedures were uncomplicated with a mean case time of 233 ? 38 minutes. Maximal LAA orifice dimension was smaller in 3 of 26 patients post PVI (range 1mm than on the pre-procedural transoesophageal echocardiogram (TOE. A new peri-device leak of maximum 3mm was noted in 5 of 26 patients at 6 week follow-up TOE, but resolved in 4 by the 6 month follow-up. Conclusion Combined procedures for catheter ablation for AF and Watchman? LAA implant appear to be feasible and safe with satisfactory occlusion of the LAA maintained at follow-up.

  12. Paracardioscopic Ex-Maze

    Full Text Available ... see the previous ablation line just at that black arrow. So now I can see my previous ... of the diaphragmatic defect. This is the same hole we created to put the paracardioscopic cannula in. ...

  13. Paracardioscopic Ex-Maze

    Full Text Available ... pulmonary veins, be happy, be satisfied that the orientation of the device is into the heart and ... camera, through the chest, that it's in appropriate orientation and it's ablation the left anterior pulmonary veins. ...

  14. Paracardioscopic Ex-Maze

    Full Text Available ... slide, that demonstrates how the VisiTrax ablation device works. It's a suction device. It actually sucks up ... and you can see now how we can work with the assistance of a technician, a nurse, ...

  15. Paracardioscopic Ex-Maze

    Full Text Available ... Wimmer-Greinecker. He's Professor of Surgery at Frankfurt University and Chief of Cardiac and Thoracic Surgery at ... at websites where, in a lot of cases, university medical centers were doing some kind of ablation. ...

  16. Paracardioscopic Ex-Maze

    Full Text Available ... older population, someone who's over 65 years of age will have an increased instance of atrial fibrillation, ... almost three years now. I'm 39 years old and ablation attempt a couple of years ago ...

  17. Paracardioscopic Ex-Maze

    Full Text Available ... you can see the monitor that monitors the energy that we're delivering to create the ablation ... with the heart. Because we do that, the energy can be directed into the heart and create ...

  18. Paracardioscopic Ex-Maze

    Full Text Available ... now how easily you can see the cardiac structures of the heart that are important when you' ... back, you can actually see another very important structure while we're doing ablations and that's the ...

  19. Low rate of asymptomatic cerebral embolism and improved procedural efficiency with the novel pulmonary vein ablation catheter GOLD: results of the PRECISION GOLD trial

    De Greef, Yves; Dekker, Lukas; Boersma, Lucas; Murray, Stephen; Wieczorek, Marcus; Spitzer, Stefan G.; Davidson, Neil; Furniss, Steve; Hocini, Mélèze; Geller, J. Christoph; Csanádi, Zoltan

    2016-01-01

    Aims This prospective, multicentre study (PRECISION GOLD) evaluated the incidence of asymptomatic cerebral embolism (ACE) after pulmonary vein isolation (PVI) using a new gold multi-electrode radiofrequency (RF) ablation catheter, pulmonary vein ablation catheter (PVAC) GOLD. Also, procedural efficiency of PVAC GOLD was compared with ERACE. The ERACE study demonstrated that a low incidence of ACE can be achieved with a platinum multi-electrode RF catheter (PVAC) combined with procedural manoeuvres to reduce emboli. Methods and results A total of 51 patients with paroxysmal atrial fibrillation (AF) (age 57 ± 9 years, CHA2DS2-VASc score 1.4 ± 1.4) underwent AF ablation with PVAC GOLD. Continuous oral anticoagulation using vitamin K antagonists, submerged catheter introduction, and heparinization (ACT ≥ 350 s prior to ablation) were applied. Cerebral magnetic resonance imaging (MRI) scans were performed within 48 h before and 16–72 h post-ablation. Cognitive function assessed by the Mini-Mental State Exam at baseline and 30 days post-ablation. New post-procedural ACE occurred in only 1 of 48 patients (2.1%) and was not detectable on MRI after 30 days. The average number of RF applications per patient to achieve PVI was lower in PRECISION GOLD (20.3 ± 10.0) than in ERACE (28.8 ± 16.1; P = 0.001). Further, PVAC GOLD ablations resulted in significantly fewer low-power (energy modes, respectively). Mini-Mental State Exam was unchanged in all patients. Conclusion Atrial fibrillation ablation with PVAC GOLD in combination with established embolic lowering manoeuvres results in a low incidence of ACE. Pulmonary vein ablation catheter GOLD demonstrates improved biophysical efficiency compared with platinum PVAC. Trial registration ClinicalTrials.gov NCT01767558. PMID:26826134

  20. Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids: Effect of Bowel Interposition on Procedure Feasibility and a Unique Bowel Displacement Technique

    Young-Sun Kim; Hyo Keun Lim; Hyunchul Rhim

    2016-01-01

    Purpose To evaluate the effect of bowel interposition on assessing procedure feasibility, and the usefulness and limiting conditions of bowel displacement techniques in magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. Materials and Methods Institutional review board approved this study. A total of 375 screening MR exams and 206 MR-HIFU ablations for symptomatic uterine fibroids performed between August 2010 and March 2015 were retrosp...

  1. Paracardioscopic Ex-Maze

    Full Text Available ... the bottom, you can see a distinct small wave that the purple arrow is pointing to, which is a P wave. That means that that patient with the EKG ... you can see the monitor that monitors the energy that we're delivering to create the ablation ...

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    Full Text Available ... appropriate orientation and it's ablation the left anterior pulmonary veins. Once that line is completed, we go back to the right chest and you can see now how we can work with the assistance of a technician, a nurse, ...

  3. Paracardioscopic Ex-Maze

    Full Text Available ... find out about what it was, the various types, and what was available in the way of options to have it treated in some fashion. I looked at websites where, in a lot of cases, university medical centers were doing some kind of ablation. They ...

  4. Paracardioscopic Ex-Maze

    Full Text Available ... enhanced procedures and we created a lot of new procedures. One of those procedures was a totally ... fatigued, almost all the time, to an enormous new sense of energy. Certainly I'd say anyone ...

  5. Maze-solving by chemotaxis

    Reynolds, A. M.

    2010-06-01

    Here, we report on numerical simulations showing that chemotaxis will take a body through a maze via the shortest possible route to the source of a chemoattractant. This is a robust finding that does not depend on the geometrical makeup of the maze. The predictions are supported by recent experimental studies which have shown that by moving down gradients in pH , a droplet of organic solvent can find the shortest of multiple possible paths through a maze to an acid-soaked exit. They are also consistent with numerical and experimental evidence that plant-parasitic nematodes take the shortest route through the labyrinth of air-filled pores within soil to preferred host plants that produce volatile chemoattractants. The predictions support the view that maze-solving is a robust property of chemotaxis and is not specific to particular kinds of maze or to the fractal structure of air-filled channels within soils.

  6. Cone-Beam Computed Tomography (CBCT) Versus CT in Lung Ablation Procedure: Which is Faster?

    Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it; Battistuzzi, Jean-Benoit, E-mail: j.battistuzzi@bordeaux.unicancer.fr; Catena, Vittorio, E-mail: vittoriocatena@gmail.com [Institut Bergonié, Department of Radiology (France); Grasso, Rosario Francesco, E-mail: r.grasso@unicampus.it; Zobel, Bruno Beomonte, E-mail: b.zobel@unicampus.it [Università Campus Bio-Medico di Roma, Department of Radiology and Diagnostic Imaging (Italy); Schena, Emiliano, E-mail: e.schena@unicampus.it [Università Campus Bio-Medico di Roma, Unit of Measurements and Biomedical Instrumentations, Biomedical Engineering Laboratory (Italy); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr; Palussiere, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France)

    2015-10-15

    AimTo compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours.Materials and MethodsPatients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10–20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported.ResultsForty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = −9.45, t = −3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %).ConclusionCBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.

  7. Limited posterior left atrial linear radiofrequency ablation for patients with chronic atrial fibrillation undergoing rheumatic valvular heart surgery

    王均志; 杜日映; 丁会霞; 柏本健; 王刚; 崔国方; 钟志欢

    2004-01-01

    @@ Since 1996, we have begun to successfully treat atrial fibrillation (AF) with the maze procedure, replacing surgical incisions with radiofrequency (RF) ablation.1,2 Recent data show that the posterior wall of the left atrium seems to be a critical area for the occurrence and the maintenance of AF in patients with valvular heart disease. The objective of this study was to evaluate whether limited surgical RF ablation of the posterior region of the left atrium is safe and effective in curing chronic AF in patients also suffering from valvular heart disease.

  8. Paracardioscopic Ex-Maze

    Full Text Available ... have chronic atrial fibrillation, who are having a stand-alone atrial fibrillation treatment. If we can go ... other heart procedures, and minimally invasively, as a stand-alone procedure. We have 15 patients that are ...

  9. Impairment of reward-related learning by cholinergic cell ablation in the striatum.

    Kitabatake, Yasuji; Hikida, Takatoshi; Watanabe, Dai; Pastan, Ira; Nakanishi, Shigetada

    2003-06-24

    The striatum in the basal ganglia-thalamocortical circuitry is a key neural substrate that is implicated in motor balance and procedural learning. The projection neurons in the striatum are dynamically modulated by nigrostriatal dopaminergic input and intrastriatal cholinergic input. The role of intrastriatal acetylcholine (ACh) in learning behaviors, however, remains to be fully clarified. In this investigation, we examine the involvement of intrastriatal ACh in different categories of learning by selectively ablating the striatal cholinergic neurons with use of immunotoxin-mediated cell targeting. We show that selective ablation of cholinergic neurons in the striatum impairs procedural learning in the tone-cued T-maze memory task. Spatial delayed alternation in the T-maze learning test is also impaired by cholinergic cell elimination. In contrast, the deficit in striatal ACh transmission has no effect on motor learning in the rota-rod test or spatial learning in the Morris water-maze test or on contextual- and tone-cued conditioning fear responses. We also report that cholinergic cell elimination adaptively up-regulates nicotinic ACh receptors not only within the striatum but also in the cerebral cortex and substantia nigra. The present investigation indicates that cholinergic modulation in the local striatal circuit plays a pivotal role in regulation of neural circuitry involving reward-related procedural learning and working memory. PMID:12802017

  10. Paracardioscopic Ex-Maze

    Full Text Available ... FirstHealth Moore Regional Hospital in Pinehurst, North Carolina. I'm Dr. Andy Kiser, Medical Director of the ... chest procedure to a totally endoscopic procedure and I've been involved in the development of a ...

  11. Paracardioscopic Ex-Maze

    Full Text Available ... heart. Unique to this procedure is actually an access to the heart, through the abdomen. An incision ... very small defect in the diaphragm to gain access to the heart. Here, these instruments that we ...

  12. Paracardioscopic Ex-Maze

    Full Text Available ... to you, Mr. Woods. Coming from Europe, our system is a little bit different. So, what would ... is no, they don't. Actually, also in robotic surgery and in other totally endoscopic procedures we ...

  13. Paracardioscopic Ex-Maze

    Full Text Available ... atrial fibrillation of almost 80 percent. Although our numbers are small, the initial six month data for ... to make the procedure less invasive, decrease the number of incisions, improve the device to make it ...

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    Full Text Available ... I can see the heart, but the unique advantage to this is the patient is asleep, but ... problem at that time, which again is an advantage to this procedure because the patient's laying flat ...

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    Full Text Available ... and some of the slides, some of the data. These are the results of the first 39 ... our numbers are small, the initial six month data for the minimally invasive procedure closely reflects that ...

  16. Paracardioscopic Ex-Maze

    Full Text Available ... notice as we test the pulmonary veins, we should not have capture of the right atrium, so ... say anyone who's a candidate for this procedure should seriously think about having it done. I'm ...

  17. Paracardioscopic Ex-Maze

    Full Text Available ... is getting off medication. It is getting better quality of life, by not having to take so ... t get tired and we don't lose quality in performing those procedures. One question coming from ...

  18. Paracardioscopic Ex-Maze

    Full Text Available ... I can't tell you how much it costs. I can tell you that the procedure is ... people out there who don't have that opportunity because there's not a good treatment option for ...

  19. Paracardioscopic Ex-Maze

    Full Text Available ... off medication. It is getting better quality of life, by not having to take so many medications, ... Mr. Woods would agree, minimally invasive into their life. Because we can do this procedure with the ...

  20. Paracardioscopic Ex-Maze

    Full Text Available ... while we're doing the other procedure. Another group of people are those people who have isolated ... from hospital to hospital. There are diagnostic related groups. This is the way that Medicare pays and ...

  1. Paracardioscopic Ex-Maze

    Full Text Available ... invasively, then you will have the highest success rate. So, one question coming out of Louisiana is, “What is the risk of recurrence after doing this procedure?” Mr. Woods ...

  2. Paracardioscopic Ex-Maze

    Full Text Available ... this minimally invasive procedure has evolved with the help of Dr. Andy Kiser and his colleagues. OR- ... goes across the surface of the heart to help keep it cool on the surface so the ...

  3. Paracardioscopic Ex-Maze

    Full Text Available ... because you know a little bit about my history, I was not a happy camper in A ... Mr. Woods would agree, minimally invasive into their life. Because we can do this procedure with the ...

  4. Paracardioscopic Ex-Maze

    Full Text Available ... 45:48 JON WOODS: A little discomfort. I sleep on my right side. A little discomfort for ... t get tired and we don't lose quality in performing those procedures. One question coming from ...

  5. Arrhythmia Termination Versus Elimination of Dormant Pulmonary Vein Conduction as a Procedural End Point of Catheter Ablation for Paroxysmal Atrial Fibrillation

    Theis, Cathrin; Konrad, Torsten; Mollnau, Hanke; Sonnenschein, Sebastian; Kämpfner, Denise; Potstawa, Maik; Ocete, Blanca Quesada; Bock, Karsten; Himmrich, Ewald; Münzel, Thomas

    2015-01-01

    Background— Pulmonary vein isolation (PVI) is still associated with a substantial number of arrhythmia recurrences in paroxysmal atrial fibrillation (AF). This prospective, randomized study aimed to compare 2 different procedural strategies. Methods and Results— A total of 152 patients undergoing de novo ablation for paroxysmal AF were randomized to 2 different treatment arms. The procedure in group A consisted of PVI exclusively. In this group, all isolated PVs were challenged with adenosine to reveal and ablate dormant conduction. In group B, PVI was performed with the patient either in spontaneous or in induced AF. If AF did not terminate with PVI, ablation was continued by targeting extra-PV AF sources with the desired procedural end point of termination to sinus rhythm. Primary study end point was freedom from arrhythmia during 1-year follow-up. In group A, adenosine provoked dormant conduction in 31 (41%) patients with a mean of 1.6±0.8 transiently recovered PVs per patient. Termination of AF during PVI was observed in 31 (65%) patients, whereas AF persisted afterward in 17 (35%) patients. AF termination occurred in 13 (76%) patients by AF source ablation. After 1-year follow-up, significantly more group B patients were free of arrhythmia recurrences (87 versus 68%; P=0.006). During redo ablation, the rate of PV reconduction did not differ between both groups (group A: 55% versus group B: 61%; P=0.25). Conclusions— Elimination of extra-PV AF sources after PVI is superior to sole PV isolation with the adjunct of abolishing potential dormant conduction. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT02238392. PMID:26297786

  6. Striatal Lesions Interfere with Acquisition of a Complex Maze Task in Rats

    Pistell, Paul J.; Nelson, Chris M.; Miller, Marshall G.; Spangler, Edward L.; Ingram, Donald K.; Devan, Bryan D.

    2008-01-01

    The 14-unit T-maze had proven to be a valuable tool for investigating age-associated memory impairment (AAMI). While another task widely used to evaluate AAMI, the water maze, is primarily used to evaluate allocentric hippocampal-dependent spatial memory, the 14-unit T-maze can assess egocentric procedural memory. Although several brain structures, e.g. hippocampus, parietal cortex, have been implicated in acquisition and retention performance in the 14-unit T-maze, there has been no evaluati...

  7. Paracardioscopic Ex-Maze

    Full Text Available ... of Louisiana is, “What is the risk of recurrence after doing this procedure?” Mr. Woods told us ... re doing afterwards in case there is a recurrence. We want to make sure that we catch ...

  8. Paracardioscopic Ex-Maze

    Full Text Available ... for treatment of atrial fibrillation. You'll also learn how this minimally invasive procedure has evolved with ... OR-Live makes it easy for you to learn more. Just click on the “Request Information” button ...

  9. Paracardioscopic Ex-Maze

    Full Text Available ... very important in this procedure. Over my left shoulder, you can see two cameras – the two cameras ... the incisions to help control any post-operative pain. 00:34:43 GERHARD WIMMER-GREINECKER, MD, PhD: ...

  10. Paracardioscopic Ex-Maze

    Full Text Available ... t empty that blood in the atrium very well and it causes the ventricle to beat irregularly. ... 00:07:10 GERHARD WIMMER-GREINECKER, MD, PhD: Well, it was really interesting to take this procedure ...

  11. Paracardioscopic Ex-Maze

    Full Text Available ... you want to take this procedure. 00:55:40 ANDY C. KISER, MD: There's always room for improvement. Clearly we want to continue to follow our data and see if the 100 percent at a year continues to work. Hopefully that will. We want to get more ...

  12. Paracardioscopic Ex-Maze

    Full Text Available ... Canada.” Another question coming from Michigan is “Will insurance pay?” 00:51:03 ANDY C. KISER, MD: ... diagnostic related groups. This is the way that Medicare pays and defines payment for procedures like this. ...

  13. Second Language Learning with the Story Maze Task: Examining the Training Effect of Weaving through Stories

    Enkin, Elizabeth

    2016-01-01

    The maze task is a psycholinguistic experimental procedure that measures real-time incremental sentence processing. The task has recently been tested as a language learning tool with promising results. Therefore, the present study examines the merits of a contextualized version of this task: the story maze. The findings are consistent with…

  14. Quantitative modeling of the accuracy in registering preoperative patient-specific anatomic models into left atrial cardiac ablation procedures

    Rettmann, Maryam E., E-mail: rettmann.maryam@mayo.edu; Holmes, David R.; Camp, Jon J.; Cameron, Bruce M.; Robb, Richard A. [Biomedical Imaging Resource, Mayo Clinic College of Medicine, Rochester, Minnesota 55905 (United States); Kwartowitz, David M. [Department of Bioengineering, Clemson University, Clemson, South Carolina 29634 (United States); Gunawan, Mia [Department of Biochemistry and Molecular and Cellular Biology, Georgetown University, Washington D.C. 20057 (United States); Johnson, Susan B.; Packer, Douglas L. [Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905 (United States); Dalegrave, Charles [Clinical Cardiac Electrophysiology, Cardiology Division Hospital Sao Paulo, Federal University of Sao Paulo, 04024-002 Brazil (Brazil); Kolasa, Mark W. [David Grant Medical Center, Fairfield, California 94535 (United States)

    2014-02-15

    Purpose: In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure. Both clinical and animal studies have investigated registration and targeting accuracy when using preoperative models; however, the effect of various error sources on registration accuracy has not been quantitatively evaluated. Methods: Data from phantom, canine, and patient studies are used to model and evaluate registration accuracy. In the phantom studies, data are collected using a magnetically tracked catheter on a static phantom model. Monte Carlo simulation studies were run to evaluate both baseline errors as well as the effect of different sources of error that would be present in a dynamicin vivo setting. Error is simulated by varying the variance parameters on the landmark fiducial, physical target, and surface point locations in the phantom simulation studies. In vivo validation studies were undertaken in six canines in which metal clips were placed in the left atrium to serve as ground truth points. A small clinical evaluation was completed in three patients. Landmark-based and combined landmark and surface-based registration algorithms were evaluated in all studies. In the phantom and canine studies, both target registration error and point-to-surface error are used to assess accuracy. In the patient studies, no ground truth is available and registration accuracy is quantified using point-to-surface error only. Results: The phantom simulation studies demonstrated that combined landmark and surface-based registration improved

  15. Quantitative modeling of the accuracy in registering preoperative patient-specific anatomic models into left atrial cardiac ablation procedures

    Purpose: In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure. Both clinical and animal studies have investigated registration and targeting accuracy when using preoperative models; however, the effect of various error sources on registration accuracy has not been quantitatively evaluated. Methods: Data from phantom, canine, and patient studies are used to model and evaluate registration accuracy. In the phantom studies, data are collected using a magnetically tracked catheter on a static phantom model. Monte Carlo simulation studies were run to evaluate both baseline errors as well as the effect of different sources of error that would be present in a dynamicin vivo setting. Error is simulated by varying the variance parameters on the landmark fiducial, physical target, and surface point locations in the phantom simulation studies. In vivo validation studies were undertaken in six canines in which metal clips were placed in the left atrium to serve as ground truth points. A small clinical evaluation was completed in three patients. Landmark-based and combined landmark and surface-based registration algorithms were evaluated in all studies. In the phantom and canine studies, both target registration error and point-to-surface error are used to assess accuracy. In the patient studies, no ground truth is available and registration accuracy is quantified using point-to-surface error only. Results: The phantom simulation studies demonstrated that combined landmark and surface-based registration improved

  16. High risk in atrial fibrillation following an ablation procedure: the wide usefulness of the CHADS(2) score.

    Fauchier, Laurent; Taillandier, Sophie; Clementy, Nicolas

    2012-09-01

    Evaluation of: Chao TF, Ambrose K, Tsao HM et al. Relationship between the CHADS(2) score and risk of very late recurrences after catheter ablation of paroxysmal atrial fibrillation. Heart Rhythm 9(8), 1185-1191 (2012). Limited data are available on the predictors of adverse events and recurrences in patients with atrial fibrillation (AF) after catheter ablation. In a retrospective analysis of 238 patients with paroxysmal AF treated with catheter ablation, it was found that the congestive heart failure, hypertension, age >75 years, diabetes and previous stroke/transient ischemic attack (CHADS(2)) score was an independent predictor of AF recurrences. Moreover, among patients without recurrences at 2 years post-ablation, future recurrence rate during the subsequent follow-up was 64% in those with a CHADS(2) score of less than three, while it was only 3% in patients with a CHADS(2) score of zero. Patients with a higher CHADS(2) score have a different substrate, a more marked disease in the atrium and this may explain the higher rate of recurrence observed after AF ablation. Several more complex scores are available to separately identify the risk of different events in AF: stroke and embolic events, bleeding events, AF recurrences and progression to more sustained forms of AF. Whether it is a better strategy to use the simple CHADS(2) score to rapidly identify a global risk of all future events in AF more widely remains to be determined. PMID:23013122

  17. Endogenous anxiety and stress responses in water maze and Barnes maze spatial memory tasks

    Harrison, F. E.; Hosseini, A.H.; McDonald, M.P.

    2008-01-01

    The effects of abnormally high or low stress on learning are well established. The Barnes maze and Morris water maze are two commonly-used tests of spatial memory, of which the water maze is considered more stressful; however, until now this has not been demonstrated empirically. In the present study, mice matched for performance on commonly-used anxiety tasks were trained on either the Barnes maze or water maze or received no cognitive testing. Water-maze training induced greater increases i...

  18. Percutaneous radiofrequency ablation: relationship between different probe types and procedure time on length and extent of osteonecrosis in dog long bones

    We have been using radiofrequency ablation for the percutaneous treatment of osteoid osteoma since 2001. Frequently, lesions are located near the joint surface, involve the vertebral body or are close to major nerves. We seek to determine whether radiofrequency ablation (RFA) can be used safely in these cases. A total of 65 lesions were induced in 4 dogs. Each dog underwent RFA on the diaphysis of long bones, as well as femoral and humeral heads. Four different sessions were carried out by using 1- and 2-cm probes with or without a cool-tip system and by varying the timing of the procedure. Plain film, CT, and MRI were obtained. All bone samples were examined histologically. The dogs' activity after the procedure was normal. No pathologic fractures occurred despite unrestricted activity of the animals. Cortical bone was always respected; therefore, articular cartilage has not been damaged. Radiological findings were characteristic. There were no significant differences in lesion size, probe type, and the duration of the procedure. The mean lesion diameter perpendicular to the electrode was 18.5 mm. Our study confirms the insulative effect of cortical bone. RFA can be safely performed close to the joint surface without damaging the cartilage. (orig.)

  19. Percutaneous radiofrequency ablation: relationship between different probe types and procedure time on length and extent of osteonecrosis in dog long bones

    Martel, J.; Bueno, A. [Fundacion Hospital Alcorcon, Departamento de Diagnostico por Imagen, Alcorcon, Madrid (Spain); Dominguez, M.P. [Fundacion Hospital Alcorcon, Departamento de Patologia, Alcorcon, Madrid (Spain); Llorens, P.; Quiros, J.; Delgado, C. [Universidad Complutense, Facultad de Veterinaria, Madrid (Spain)

    2008-02-15

    We have been using radiofrequency ablation for the percutaneous treatment of osteoid osteoma since 2001. Frequently, lesions are located near the joint surface, involve the vertebral body or are close to major nerves. We seek to determine whether radiofrequency ablation (RFA) can be used safely in these cases. A total of 65 lesions were induced in 4 dogs. Each dog underwent RFA on the diaphysis of long bones, as well as femoral and humeral heads. Four different sessions were carried out by using 1- and 2-cm probes with or without a cool-tip system and by varying the timing of the procedure. Plain film, CT, and MRI were obtained. All bone samples were examined histologically. The dogs' activity after the procedure was normal. No pathologic fractures occurred despite unrestricted activity of the animals. Cortical bone was always respected; therefore, articular cartilage has not been damaged. Radiological findings were characteristic. There were no significant differences in lesion size, probe type, and the duration of the procedure. The mean lesion diameter perpendicular to the electrode was 18.5 mm. Our study confirms the insulative effect of cortical bone. RFA can be safely performed close to the joint surface without damaging the cartilage. (orig.)

  20. Elevated Plus Maze for Mice

    Komada, Munekazu; Takao, Keizo; Miyakawa, Tsuyoshi

    2008-01-01

    Although the mouse genome is now completely sequenced, the functions of most of the genes expressed in the brain are not known. The influence of a given gene on a specific behavior can be determined by behavioral analysis of mutant mice. If a target gene is expressed in the brain, behavioral phenotype of the mutant mice could elucidate the genetic mechanism of normal behaviors. The elevated plus maze test is one of the most widely used tests for measuring anxiety-like behavior. The test is ba...

  1. Navigating mazes in a virtual environment

    Browse, Roger A.; Skillicorn, David B.; Middleman, Darren

    2003-06-01

    In this research we are concerned with computer interfaces with which subjects navigate through maze simulations which are essentially buildings, with corridors and intersections, such as frequently encountered in computer games and simulations. We wish to determine if virtual reality interfaces introduce a performance enhancement that might be expected for display configurations which mimic natural perceptual experiences. We have experimented primarily with two display conditions for presentation of and navigation through the mazes. Subjects either view the maze on a desktop computer monitor, turning and moving within the maze with the mouse in a way that is similar to the configurations used in most first-person role playing computer games, or they viewed the maze from a standing position with a head-mounted display, being free to direct the view of the maze through body and head movements, and using the depression of a mouse button to effect movement in the direction that they were facing. Head-tracking was required for this latter condition. As expected there are striking individual differences in subjects" abilities to learn to traverse the mazes. Across a variety of maze configuration parameters which significantly do influence performance, the results indicate that the virtual reality enhancements have no effect subjects' ability to learn the mazes, either as route knowledge or as cognitive maps.

  2. Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids: Effect of Bowel Interposition on Procedure Feasibility and a Unique Bowel Displacement Technique.

    Young-Sun Kim

    Full Text Available To evaluate the effect of bowel interposition on assessing procedure feasibility, and the usefulness and limiting conditions of bowel displacement techniques in magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU ablation of uterine fibroids.Institutional review board approved this study. A total of 375 screening MR exams and 206 MR-HIFU ablations for symptomatic uterine fibroids performed between August 2010 and March 2015 were retrospectively analyzed. The effect of bowel interposition on procedure feasibility was assessed by comparing pass rates in periods before and after adopting a unique bowel displacement technique (bladder filling, rectal filling and subsequent bladder emptying; BRB maneuver. Risk factors for BRB failure were evaluated using logistic regression analysis.Overall pass rates of pre- and post-BRB periods were 59.0% (98/166 and 71.7% (150/209, and in bowel-interposed cases they were 14.6% (7/48 and 76.4% (55/72, respectively. BRB maneuver was technically successful in 81.7% (49/60. Through-the-bladder sonication was effective in eight of eleven BRB failure cases, thus MR-HIFU could be initiated in 95.0% (57/60. A small uterus on treatment day was the only significant risk factor for BRB failure (B = 0.111, P = 0.017.The BRB maneuver greatly reduces the fraction of patients deemed ineligible for MR-HIFU ablation of uterine fibroids due to interposed bowels, although care is needed when the uterus is small.

  3. Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

    Magnetic resonance angiography (MRA) is a safe and non-invasive imaging method that can readily depict the pulmonary veins (PV), whose imaging has acquired momentum with the advent of new techniques for radiofrequency ablation of atrial fibrillation (AF). We evaluated whether virtual endoscopy from 3D MRA images (MRA-VE) is feasible in studying the morphology of PV. Fifty patients with AF underwent pre-ablative MRA (1.5 T). Images were acquired with axial T-2 weighted and 3D-SPGR sequences after intravenous administration of Gd-DTPA and automatic triggering. Postprocessing was performed by an experienced radiologist with maximum intensity projection (MIP) and virtual endoscopy software (Navigator, GEMS). The venoatrial junction was visualized with MRA-VE in 49 of 50 patients (98.0%). Twenty-seven patients (55.1%) had two ostia on both sides, 13 patients (26.5%) had two ostia on the right and a single common ostium on the left, 5 patients (10.2%) had accessory PV and 4 patients (8.2%) had both an accessory right PV and a single common ostium on the left. Flythrough navigation showed the number and spatial disposition of second-order PV branches in 48 out of 49 patients (98.0%). MRA-VE is an excellent tool for at-a-glance visualization of ostia morphology, navigation of second-generation PV branches and easy endoluminal assessment of left atrial structures in pre-ablative imaging. (orig.)

  4. Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation

    Cirillo, S.; Tosetti, Irene; Giuseppe, M.De; Longo, M.; Regge, D. [Institute for Cancer Research and Treatment (IRCC), Unit of Radiology, Candiolo (Torino) (Italy); Bonamini, R. [University of Torino, Department of Cardiology, Torino (Italy); Gaita, F.; Bianchi, F.; Vivalda, L. [Ospedale Mauriziano Umberto I, Department of Cardiology, Torino (Italy)

    2004-11-01

    Magnetic resonance angiography (MRA) is a safe and non-invasive imaging method that can readily depict the pulmonary veins (PV), whose imaging has acquired momentum with the advent of new techniques for radiofrequency ablation of atrial fibrillation (AF). We evaluated whether virtual endoscopy from 3D MRA images (MRA-VE) is feasible in studying the morphology of PV. Fifty patients with AF underwent pre-ablative MRA (1.5 T). Images were acquired with axial T-2 weighted and 3D-SPGR sequences after intravenous administration of Gd-DTPA and automatic triggering. Postprocessing was performed by an experienced radiologist with maximum intensity projection (MIP) and virtual endoscopy software (Navigator, GEMS). The venoatrial junction was visualized with MRA-VE in 49 of 50 patients (98.0%). Twenty-seven patients (55.1%) had two ostia on both sides, 13 patients (26.5%) had two ostia on the right and a single common ostium on the left, 5 patients (10.2%) had accessory PV and 4 patients (8.2%) had both an accessory right PV and a single common ostium on the left. Flythrough navigation showed the number and spatial disposition of second-order PV branches in 48 out of 49 patients (98.0%). MRA-VE is an excellent tool for at-a-glance visualization of ostia morphology, navigation of second-generation PV branches and easy endoluminal assessment of left atrial structures in pre-ablative imaging. (orig.)

  5. Sex Differences in a Human Analogue of the Radial Arm Maze: The ''17-Box Maze Test''

    Rahman, Q.; Abrahams, S.; Jussab, F.

    2005-01-01

    This study investigated sex differences in spatial memory using a human analogue of the Radial Arm Maze: a revision on the Nine Box Maze originally developed by Abrahams, Pickering, Polkey, and Morris (1997) called the 17-Box Maze Test herein. The task encourages allocentric spatial processing, dissociates object from spatial memory, and…

  6. Estimating Effective Dose from Phantom Dose Measurements in Atrial Fibrillation Ablation Procedures and Comparison of MOSFET and TLD Detectors in a Small Animal Dosimetry Setting

    Anderson-Evans, Colin David

    Two different studies will be presented in this work. The first involves the calculation of effective dose from a phantom study which simulates an atrial fibrillation (AF) ablation procedure. The second involves the validation of metal-oxide semiconducting field effect transistors (MOSFET) for small animal dosimetry applications as well as improved characterization of the animal irradiators on Duke University's campus. Atrial Fibrillation is an ever increasing health risk in the United States. The most common type of cardiac arrhythmia, AF is associated with increased mortality and ischemic cerebrovascular events. Managing AF can include, among other treatments, an interventional procedure called catheter ablation. The procedure involves the use of biplane fluoroscopy during which a patient can be exposed to radiation for as much as two hours or more. The deleterious effects of radiation become a concern when dealing with long fluoroscopy times, and because the AF ablation procedure is elective, it makes relating the risks of radiation ever more essential. This study hopes to quantify the risk through the derivation of dose conversion coefficients (DCCs) from the dose-area product (DAP) with the intent that DCCs can be used to provide estimates of effective dose (ED) for typical AF ablation procedures. A bi-plane fluoroscopic and angiographic system was used for the simulated AF ablation procedures. For acquisition of organ dose measurements, 20 diagnostic MOSFET detectors were placed at selected organs in a male anthropomorphic phantom, and these detectors were attached to 4 bias supplies to obtain organ dose readings. The DAP was recorded from the system console and independently validated with an ionization chamber and radiochromic film. Bi-plane fluoroscopy was performed on the phantom for 10 minutes to acquire the dose rate for each organ, and the average clinical procedure time was multiplied by each organ dose rate to obtain individual organ doses. The

  7. Radiofrequency ablation in dermatology

    Sachdeva Silonie

    2007-01-01

    Full Text Available Radiofreqeuency ablation is a versatile dermatosurgical procedure used for surgical management of skin lesions by using various forms of alternating current at an ultra high frequency. The major modalities in radiofrequency are electrosection, electrocoagulation, electrodessication and fulguration. The use of radiofrequency ablation in dermatosurgical practice has gained importance in recent years as it can be used to treat most of the skin lesions with ease in less time with clean surgical field due to adequate hemostasis and with minimal side effects and complications. This article focuses on the major tissue effects and factors influencing radiofrequency ablation and its application for various dermatological conditions.

  8. Repeat procedure using radiofrequency energy for recurrence of atrial fibrillation after initial cryoballoon ablation: a 2-year follow-up

    Conte, G.; Chierchia, G.B.; Sieira, J.; Levinstein, M.; Casado-Arroyo, R.; Asmundis, C. de; Sarkozy, A.; Rodriguez-Manero, M.; Giovanni, G.; Baltogiannis, G.; Wauters, K.; Brugada, P.

    2013-01-01

    AIMS: The ideal energy source needed to perform 're-isolation' of the pulmonary veins (PVs) during a repeat procedure for recurrence of paroxysmal atrial fibrillation (AF) has not been established yet. In this study we analysed the outcome of repeat procedure using radiofrequency (RF) energy after i

  9. Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

    Al Asiri M

    2016-05-01

    Full Text Available Mushabbab Al Asiri,1,* Mutahir A Tunio,1,* Reham Abdulmoniem,2,*1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2Radiation Oncology, National Cancer Institute, Cairo, Egypt *These authors contributed equally to this work Background: A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods: The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results: Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (P<0.00001 and increase in progression-free survival in patients treated with RT-OA (P<0.00001. However, there was no difference in overall survival (P=0.37. The majority of patients were treated with larger field sizes with parallel-opposed anteroposterior and posteroanterior pelvic fields. RT-OA was generally well tolerated. Radiotherapy doses of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions were associated with excellent amenorrhea rates. The resultant funnel plot showed no publication bias (Egger test P=0.16. Conclusion: RT-OA is cost-effective and can safely be used in pre/perimenopausal women with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies

  10. Bone and Soft Tissue Ablation

    Foster, Ryan C.B.; Joseph M Stavas

    2014-01-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft...

  11. Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

    Asiri, Mushabbab Al; Tunio, Mutahir A; Abdulmoniem, Reham

    2016-01-01

    Background A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA) on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (Pwomen with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies. However, further studies incorporating three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are warranted. PMID:27307764

  12. Navigating the system governance maze.

    Savage, T J

    1987-01-01

    Health care system governance today is a complex maze of concerns that assume a unique character in Catholic-sponsored multi-institutional systems. Most Catholic health care systems began with a common sponsor or mission and several shared services and gradually moved from separately incorporated entities to a system with few centralized operating functions but a governing body between the local facilities and the sponsoring religious institute. The next step was development of a managed system with consolidated services and centralized decision making. Now, many systems are attempting the most important and difficult effort--systemwide strategic planning. The phases described have required a rethinking of governance structures, and conflicts often arise during restructuring. Such turmoil requires many Catholic health care systems to develop a clearer sense of direction and purpose. To achieve their objectives, system leaders can use a governance compass that has five key points: Information. Boards must determine what they need to know, where to secure this information, and what form the information should take. Agenda. Boards must make reflective and intentional use of their agenda by reviewing and categorizing agenda items discussed in the past 12 months and establishing an agenda plan for the next 12 months. Structural mechanisms. Boards must decide structural issues such as relationships between system board and local boards, sizes of boards, and kinds of committees needed. Culture. Boards should reflect on their culture--values and traditions that have characterized them in the past--to assess whether changes are needed to strengthen or improve the culture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10280354

  13. Analytical procedure for characterization of medieval wall-paintings by X-ray fluorescence spectrometry, laser ablation inductively coupled plasma mass spectrometry and Raman spectroscopy

    Analytical procedure for the comprehensive chemical characterization of samples from medieval Nubian wall-paintings by means of portable X-ray fluorescence (pXRF), laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) and Raman spectroscopy (RS) was proposed in this work. The procedure was used for elemental and molecular investigations of samples from archeological excavations in Nubia (modern southern Egypt and northern Sudan). Numerous remains of churches with painted decorations dated back to the 7th–14th century were excavated in the region of medieval kingdoms of Nubia but many aspects of this art and its technology are still unknown. Samples from the selected archeological sites (Faras, Old Dongola and Banganarti) were analyzed in the form of transfers (n = 26), small fragments collected during the excavations (n = 35) and cross sections (n = 15). XRF was used to collect data about elemental composition, LA-ICPMS allowed mapping of selected elements, while RS was used to get the molecular information about the samples. The preliminary results indicated the usefulness of the proposed analytical procedure for distinguishing the substances, from both the surface and sub-surface domains of the wall-paintings. The possibility to identify raw materials from the wall-paintings will be used in the further systematic, archeometric studies devoted to the detailed comparison of various historic Nubian centers. - Highlights: • The analytical procedure for examination of unique wall paintings was proposed. • Identification of pigments and supporting layers of wall-paintings was obtained. • Heterogeneous samples were mapped with the use of LA-ICPMS. • Anatase in the sub-surface regions of samples was detected by Raman spectroscopy

  14. Analytical procedure for characterization of medieval wall-paintings by X-ray fluorescence spectrometry, laser ablation inductively coupled plasma mass spectrometry and Raman spectroscopy

    Syta, Olga; Rozum, Karol; Choińska, Marta [Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw (Poland); Zielińska, Dobrochna [Institute of Archaeology, University of Warsaw, Krakowskie Przedmieście 26/28, 00-927 Warsaw (Poland); Żukowska, Grażyna Zofia [Chemical Faculty, Warsaw University of Technology, Noakowskiego 3, 00-664 Warsaw (Poland); Kijowska, Agnieszka [National Museum in Warsaw, Aleje Jerozolimskie 3, 00-495 Warsaw (Poland); Wagner, Barbara, E-mail: barbog@chem.uw.edu.pl [Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw (Poland)

    2014-11-01

    Analytical procedure for the comprehensive chemical characterization of samples from medieval Nubian wall-paintings by means of portable X-ray fluorescence (pXRF), laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) and Raman spectroscopy (RS) was proposed in this work. The procedure was used for elemental and molecular investigations of samples from archeological excavations in Nubia (modern southern Egypt and northern Sudan). Numerous remains of churches with painted decorations dated back to the 7th–14th century were excavated in the region of medieval kingdoms of Nubia but many aspects of this art and its technology are still unknown. Samples from the selected archeological sites (Faras, Old Dongola and Banganarti) were analyzed in the form of transfers (n = 26), small fragments collected during the excavations (n = 35) and cross sections (n = 15). XRF was used to collect data about elemental composition, LA-ICPMS allowed mapping of selected elements, while RS was used to get the molecular information about the samples. The preliminary results indicated the usefulness of the proposed analytical procedure for distinguishing the substances, from both the surface and sub-surface domains of the wall-paintings. The possibility to identify raw materials from the wall-paintings will be used in the further systematic, archeometric studies devoted to the detailed comparison of various historic Nubian centers. - Highlights: • The analytical procedure for examination of unique wall paintings was proposed. • Identification of pigments and supporting layers of wall-paintings was obtained. • Heterogeneous samples were mapped with the use of LA-ICPMS. • Anatase in the sub-surface regions of samples was detected by Raman spectroscopy.

  15. Reversão da fibrilação atrial crônica pela técnica do labirinto com aplicação de radiofreqüência e ultra-som transoperatórios Chronic atrial fibrillation reversion by a modified Cox Maze procedure using radiofrequency and transoperatory ultrasound

    Alexandre Visconti BRICK

    1999-10-01

    Full Text Available A técnica do labirinto, idealizada por Cox (Maze procedure, tem sido utilizada, prioritariamente, para reversão ao ritmo sinusal, em pacientes com fibrilação atrial crônica (FAC e doenças cardíacas de indicação cirúrgica. As incisões atriais, para formação do labirinto, são realizadas por dissecção, seguida de sutura, o que eleva o tempo cirúrgico, aumentando a probabilidade de complicações pós-operatórias. Em vista disso, idealizamos a realização destas linhas pela aplicação transcirúrgica de radiofreqüência (RF ou ultra-som, na parede atrial, o que proporciona uma redução acentuada do tempo cirúrgico. Foram operados, nos anos de 1998 e 1999, 5 pacientes, sendo 3 do sexo feminino, com média de idades de 45,8 anos, portadores de lesão orovalvar mitral e FAC. Durante o ato cirúrgico, os pacientes foram monitorizados com ECG das derivações periféricas. Após a instalação da circulação extracorpórea convencional, sem cardioplegia, foi aberto o átrio direito e aplicado RF, realizando as linhas, de acordo com a técnica do labirinto modificada (Maze procedure. Ao término da aplicação da RF, no átrio direito, observou-se a regularização do R-R da FAC e o aumento das ondas "F", dando a impressão de flutter atípico. Em seguida ao pinçamento da aorta e abertura do átrio esquerdo, procedeu-se ao isolamento da aurícula esquerda e à realização das linhas do átrio esquerdo.Com a liberação da aorta, o coração voltou a contrair-se, espontaneamente, com retorno ao ritmo sinusal, observando-se a contração dos átrios. Após as trocas valvares e redução do átrio esquerdo, o ECG continuava a registrar o ritmo sinusal. Nos 2 últimos pacientes foi utilizado o ultra-som, que nos pareceu, além de facilitar a realização das linhas, produzir lesões mais profundas. Todos evoluíram bem no pós-operatório imediato e tardio, mantendo-se em ritmo sinusal. Com a finalidade de remodelação atrial, usou

  16. Optimization of Apparatus Design and Behavioral Measures for the Assessment of Visuo-Spatial Learning and Memory of Mice on the Barnes Maze

    O'Leary, Timothy P.; Brown, Richard E.

    2013-01-01

    We have previously shown that apparatus design can affect visual-spatial cue use and memory performance of mice on the Barnes maze. The present experiment extends these findings by determining the optimal behavioral measures and test procedure for analyzing visuo-spatial learning and memory in three different Barnes maze designs. Male and female…

  17. Just add water: cannabinoid discrimination in a water T-maze with FAAH(-/-) and FAAH(+/+) mice.

    Wiley, Jenny L; Lefever, Timothy W; Pulley, Nikita S; Marusich, Julie A; Cravatt, Benjamin F; Lichtman, Aron H

    2016-08-01

    Incomplete overlap in the discriminative stimulus effects of Δ-tetrahydrocannabinol (THC) and the endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol has been reported in food-reinforced tasks. The aim of this study was to examine cannabinoid discriminative stimulus effects in a nonappetitive procedure. Adult male mice lacking the gene for AEA's major metabolic enzyme, fatty acid amide hydrolase (FAAH), and FAAH mice were trained to discriminate THC or AEA in a water T-maze, in which the response was swimming to an escape platform on the injection-appropriate side. JZL184, a monoacylglycerol lipase inhibitor, was also tested. FAAH mice showed faster acquisition than FAAH mice. THC and AEA fully substituted, with only minor cross-procedure potency variations. Incomplete substitution of JZL184 was observed in THC-trained FAAH mice in the water-maze task, as contrasted with full substitution in a food-reinforced nose-poke procedure. Stress-induced changes in AEA and/or 2-arachidonoylglycerol concentrations in the brain may have mediated this attenuation. JZL184 also partially substituted in AEA-trained FAAH mice in the water maze, suggesting incomplete overlap in the stimulus effects of AEA and JZL184. Through the use of a novel water-maze procedure, the present study supports the work of previous behavioral pharmacologists in showing the robustness of the discrimination paradigm. PMID:27385208

  18. Cognitive and Neural Determinants of Response Strategy in the Dual-Solution Plus-Maze Task

    De Leonibus, Elvira; Costantini, Vivian J. A.; Massaro, Antonio; Mandolesi, Georgia; Vanni, Valentina; Luvisetto, Siro; Pavone, Flaminia; Oliverio, Alberto; Mele, Andrea

    2011-01-01

    Response strategy in the dual-solution plus maze is regarded as a form of stimulus-response learning. In this study, by using an outcome devaluation procedure, we show that it can be based on both action-outcome and stimulus-response habit learning, depending on the amount of training that the animals receive. Furthermore, we show that…

  19. Factors related to sinus rhythm at discharge after radiofrequency ablation of permanent atrial fibrillation in patients undergoing mitral valve surgery.

    Rostagno, Carlo; Gelsomino, Sandro; Capecchi, Irene; Rossi, Alessandra; Montesi, Gian Franco; Stefàno, Pier Luigi

    2016-04-01

    Late recovery of sinus rhythm is unusual in patients with permanent AF treated by (radiofrequency) RF maze procedure during mitral valve surgery. Identification of clinical and instrumental preoperative factors predictive of early success of RF ablation in patients with permanent AF undergoing mitral valve surgery may improve selection of subjects to obtain long-term results. Hundred and thirty consecutive patients with permanent AF and mitral valve disease underwent modified RF maze procedure during concomitant mitral valve surgery. Rheumatic valve disease (61 pts) and mitral valve prolapse (41 pts) were the more common aetiology of valve abnormalities. Mitral valve replacement was performed in 54 % of patients and mitral valve repair in the remaining 46 %. Four patients died after surgery. At discharge, 87 patients (69 %) were in sinus rhythm (group 1) and 43 patients in AF persisted (group 2). At an average 24-month follow-up, sinus rhythm was present in 67 % of patients, and 33 % were in atrial fibrillation. In this period, late recovery of sinus rhythm was observed only in five patients, while eight discharged in sinus rhythm developed again atrial fibrillation. Among preoperative parameters at univariate analysis female sex, atrial fibrillation >24 months, left atrial diameter >54 mm, left atrial area >24 cm(2), rheumatic valve disease and NYHA class were associated with persistence of AF. At Cox regression multivariate analysis, increased left atrial area (OR 1.07 per unit increase-95 % CI 1.01-1.131) and rheumatic aetiology of valve disease (OR 4.52, 95 % CI 1.65-12.4) were associated with persistence of AF at hospital discharge. Persistence of AF after RF ablation in patients undergoing mitral valve surgery is related to aetiology, e.g. rheumatic valve disease, and to increasing left atrial diameter. Due to low rate of late recovery of sinus rhythm, indication to RF ablation associated with MV surgery should be carefully considered in patients with large

  20. Guiding brine shrimp through mazes by solving reaction diffusion equations

    Singal, Krishma; Fenton, Flavio

    Excitable systems driven by reaction diffusion equations have been shown to not only find solutions to mazes but to also to find the shortest path between the beginning and the end of the maze. In this talk we describe how we can use the Fitzhugh-Nagumo model, a generic model for excitable media, to solve a maze by varying the basin of attraction of its two fixed points. We demonstrate how two dimensional mazes are solved numerically using a Java Applet and then accelerated to run in real time by using graphic processors (GPUs). An application of this work is shown by guiding phototactic brine shrimp through a maze solved by the algorithm. Once the path is obtained, an Arduino directs the shrimp through the maze using lights from LEDs placed at the floor of the Maze. This method running in real time could be eventually used for guiding robots and cars through traffic.

  1. Ablative and fractional ablative lasers.

    Brightman, Lori A; Brauer, Jeremy A; Anolik, Robert; Weiss, Elliot; Karen, Julie; Chapas, Anne; Hale, Elizabeth; Bernstein, Leonard; Geronemus, Roy G

    2009-10-01

    The field of nonsurgical laser resurfacing for aesthetic enhancement continues to improve with new research and technological advances. Since its beginnings in the 1980s, the laser-resurfacing industry has produced a multitude of devices employing ablative, nonablative, and fractional ablative technologies. The three approaches largely differ in their method of thermal damage, weighing degrees of efficacy, downtime, and side effect profiles against each other. Nonablative technologies generate some interest, although only for those patient populations seeking mild improvements. Fractional technologies, however, have gained dramatic ground on fully ablative resurfacing. Fractional laser resurfacing, while exhibiting results that fall just short of the ideal outcomes of fully ablative treatments, is an increasingly attractive alternative because of its far more favorable side effect profile, reduced recovery time, and significant clinical outcome. PMID:19850197

  2. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    Baek, Jung Hwan; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Valcavi, Roberto [Endocrinology Division and Thyroid Disease Center, Arcispedale Santa Maria Nuova, Reggio Emilia (Italy); Pacella, Claudio M. [Diagnostic Imaging and Interventional Radiology Department, Ospedale Regina Apostolorum, Albano Laziale-Rome (IT); Rhim, Hyun Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Na, Dong Kyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of)

    2011-10-15

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  3. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    Baek, Jung Hwan; Lee, Jeong Hyun; Valcavi, Roberto; Pacella, Claudio M.; Rhim, Hyunchul; Na, Dong Gyu

    2011-01-01

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  4. Photoacoustic Characterization of Radiofrequency Ablation Lesions

    Bouchard, Richard; Dana, Nicholas; Di Biase, Luigi; Natale, Andrea; Emelianov, Stanislav

    2012-01-01

    Radiofrequency ablation (RFA) procedures are used to destroy abnormal electrical pathways in the heart that can cause cardiac arrhythmias. Current methods relying on fluoroscopy, echocardiography and electrical conduction mapping are unable to accurately assess ablation lesion size. In an effort to better visualize RFA lesions, photoacoustic (PA) and ultrasonic (US) imaging were utilized to obtain co-registered images of ablated porcine cardiac tissue. The left ventricular free wall of fresh ...

  5. Moderne Technologien in der Ablation des Vorhofflimmerns

    Haegeli, L; Duru, F.; Lüscher, T F

    2010-01-01

    Catheter ablation for atrial fibrillation has become an accepted therapy. The arrhythmia affects around 6% of the population over the age of 65 years. Electrical isolation of the pulmonary veins from the left atrium is the central strategy in catheter ablation for paroxysmal atrial fibrillation. However, procedural outcomes and efficacy using sequential “point-by-point” radiofrequency lesion creation with a conventional ablation catheter are operator-dependent and time-consuming. Moreover, re...

  6. T-Maze Learning in Weanling Lambs

    Johnson, Timothy B.; Stanton, Mark E.; Goodlett, Charles R.; Cudd, Timothy A.

    2011-01-01

    A major advantage of sheep models in experimental studies of neurodevelopmental disorders (e.g., with prenatal neurotoxicant exposure) is that the equivalent of all three trimesters of human brain development occurs in sheep entirely in utero. However, studies of learning and memory in sheep are limited. The goal of this study was to extend the analysis of spatial learning and memory in adolescent sheep using several traditional T-maze tasks. Both 9- and 14-week-old lambs acquired a delayed n...

  7. Cardiac Remodeling After Atrial Fibrillation Ablation

    Li-Wei Lo, MD; Shih-Ann Chen, MD

    2013-06-01

    Full Text Available Radiofrequency catheter ablation procedures are considered a reasonable option for patients with symptomatic, drug refractory atrial fibrillation (AF. Ablation procedures have been reported to effectively restore sinus rhythm and provide long-term relief of symptoms. Both electrical and structural remodeling occurs with AF. A reversal of the electrical remodeling develops within 1 week after restoration to sinus rhythm following the catheter ablation. The recovery rate is faster in the right atrium than the left atrium. Reverse structural remodeling takes longer and is still present 2 to 4 months after restoration of sinus rhythm. The left atrial transport function also improves after successful catheter ablation of AF. Left atrial strain surveys from echocardiography are able to identify patients who respond to catheter ablation with significant reverse remodeling after ablation. Pre-procedural delayed enhancement magnetic resonance imaging is also able to determine the degree of atrial fibrosis and is another tool to predict the reverse remodeling after ablation. The remodeling process is complex if recurrence develops after ablation. Recent evidence shows that a combined reverse electrical and structural remodeling occurs after ablation of chronic AF when recurrence is paroxysmal AF. Progressive electrical remodeling without any structural remodeling develops in those with recurrence involving chronic AF. Whether progressive atrial remodeling is the cause or consequence during the recurrence of AF remains obscure and requires further study.

  8. Memory-Enhancing Activity of Palmatine in Mice Using Elevated Plus Maze and Morris Water Maze

    Dinesh Dhingra

    2012-01-01

    Full Text Available The present study was designed to evaluate the effect of palmatine on memory of Swiss young male albino mice. Palmatine (0.1, 0.5, 1 mg/kg, i.p. and physostigmine (0.1 mg/kg, i.p. per se were administered for 10 successive days to separate groups of mice. Effect of drugs on learning and memory of mice was evaluated using elevated plus maze and Morris water maze. Brain acetylcholinesterase activity was also estimated. Effect of palmatine on scopolamine- and diazepam-induced amnesia was also investigated. Palmatine (0.5 and 1 mg/kg and physostigmine significantly improved learning and memory of mice, as indicated by decrease in transfer latency using elevated plus maze, and decrease in escape latency during training and increase in time spent in target quadrant during retrieval using Morris water maze. The drugs did not show any significant effect on locomotor activity of the mice. Memory-enhancing activity of palmatine (1 mg/kg was comparable to physostigmine. Palmatine (1 mg/kg significantly reversed scopolamine- and diazepam-induced amnesia in mice. Palmatine and physostigmine also significantly reduced brain acetylcholinesterase activity of mice. Thus, palmatine showed memory-enhancing activity in mice probably by inhibiting brain acetylcholinesterase activity, through involvement of GABA-benzodiazepine pathway, and due to its antioxidant activity.

  9. Comparing energy sources for surgical ablation of atrial fibrillation: a Bayesian network meta-analysis of randomized, controlled trials.

    Phan, Kevin; Xie, Ashleigh; Kumar, Narendra; Wong, Sophia; Medi, Caroline; La Meir, Mark; Yan, Tristan D

    2015-08-01

    Simplified maze procedures involving radiofrequency, cryoenergy and microwave energy sources have been increasingly utilized for surgical treatment of atrial fibrillation as an alternative to the traditional cut-and-sew approach. In the absence of direct comparisons, a Bayesian network meta-analysis is another alternative to assess the relative effect of different treatments, using indirect evidence. A Bayesian meta-analysis of indirect evidence was performed using 16 published randomized trials identified from 6 databases. Rank probability analysis was used to rank each intervention in terms of their probability of having the best outcome. Sinus rhythm prevalence beyond the 12-month follow-up was similar between the cut-and-sew, microwave and radiofrequency approaches, which were all ranked better than cryoablation (respectively, 39, 36, and 25 vs 1%). The cut-and-sew maze was ranked worst in terms of mortality outcomes compared with microwave, radiofrequency and cryoenergy (2 vs 19, 34, and 24%, respectively). The cut-and-sew maze procedure was associated with significantly lower stroke rates compared with microwave ablation [odds ratio <0.01; 95% confidence interval 0.00, 0.82], and ranked the best in terms of pacemaker requirements compared with microwave, radiofrequency and cryoenergy (81 vs 14, and 1, <0.01% respectively). Bayesian rank probability analysis shows that the cut-and-sew approach is associated with the best outcomes in terms of sinus rhythm prevalence and stroke outcomes, and remains the gold standard approach for AF treatment. Given the limitations of indirect comparison analysis, these results should be viewed with caution and not over-interpreted. PMID:25391388

  10. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis;

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...

  11. Analysis of iodinated contrast delivered during thermal ablation: is material trapped in the ablation zone?

    Wu, Po-hung; Brace, Chris L.

    2016-08-01

    Intra-procedural contrast-enhanced CT (CECT) has been proposed to evaluate treatment efficacy of thermal ablation. We hypothesized that contrast material delivered concurrently with thermal ablation may become trapped in the ablation zone, and set out to determine whether such an effect would impact ablation visualization. CECT images were acquired during microwave ablation in normal porcine liver with: (A) normal blood perfusion and no iodinated contrast, (B) normal perfusion and iodinated contrast infusion or (C) no blood perfusion and residual iodinated contrast. Changes in CT attenuation were analyzed from before, during and after ablation to evaluate whether contrast was trapped inside of the ablation zone. Visualization was compared between groups using post-ablation contrast-to-noise ratio (CNR). Attenuation gradients were calculated at the ablation boundary and background to quantitate ablation conspicuity. In Group A, attenuation decreased during ablation due to thermal expansion of tissue water and water vaporization. The ablation zone was difficult to visualize (CNR  =  1.57  ±  0.73, boundary gradient  =  0.7  ±  0.4 HU mm‑1), leading to ablation diameter underestimation compared to gross pathology. Group B ablations saw attenuation increase, suggesting that iodine was trapped inside the ablation zone. However, because the normally perfused liver increased even more, Group B ablations were more visible than Group A (CNR  =  2.04  ±  0.84, boundary gradient  =  6.3  ±  1.1 HU mm‑1) and allowed accurate estimation of the ablation zone dimensions compared to gross pathology. Substantial water vaporization led to substantial attenuation changes in Group C, though the ablation zone boundary was not highly visible (boundary gradient  =  3.9  ±  1.1 HU mm‑1). Our results demonstrate that despite iodinated contrast being trapped in the ablation zone, ablation visibility

  12. Monitoring of tumor radio frequency ablation using derivative spectroscopy

    Spliethoff, J.W.; Tanis, E.; Evers, Daniel James; Hendriks, B.H.; Prevoo, W.; Ruers, T.J.M.

    2014-01-01

    Despite the widespread use of radio frequency (RF) ablation, an effective way to assess thermal tissue damage during and after the procedure is still lacking. We present a method for monitoring RF ablation efficacy based on thermally induced methemoglobin as a marker for full tissue ablation. Diffus

  13. Role of Remote Navigation Systems in AF Ablation

    Boris Schmidt, MD

    2011-02-01

    Full Text Available During the past decade atrial fibrillation (AF ablation has developed from being an experimental treatment option to an evidence based therapy implemented in current guidelines.1-2 Irrigated radiofrequency current guided ablations remain the golden standard of pulmonary vein isolation (PVI procedures. Although practiced more frequently, it remains a demanding procedure requiring skilful operators. Novel technologies such as balloon based catheters or remote navigation (RN systems have been developed to overcome the pitfalls of manual ablation procedures.

  14. Tactile maze solving in congenitally blind individuals

    Gagnon, Léa; Kupers, Ron; Schneider, Fabien C;

    2010-01-01

    Vision is undoubtedly important for navigation although not essential as blind individuals outperform their blindfolded seeing counterparts in a variety of navigational tasks. It is believed that the blind's superior performance is because of their efficient use of proprioceptive signals and...... environmental cues such as temperature and echolocation. We hypothesize that by limiting these cues, blind individuals will lose their advantage compared with controls in spatial navigation tasks. We therefore evaluated the performance of blind and sighted individuals in small-scale, tactile multiple T mazes....... Our results show that blindfolded sighted controls outperformed blind participants in the route-learning tasks. This suggests that, contrary to indoor large-scale spaces, navigational skills inside small-scale spaces benefit from visual experience....

  15. Use of maze in cyclotron hoppers

    Introduction: the increasing number of cyclotrons in Brazil due to constitutional amendment 49 /06 that enabled the production of radiopharmaceuticals with a short half - life by private companies. The radionuclides used for PET - CT require production centers near or within the diagnostic centers. In order to minimize maintenance and operating risks, gaining efficiency, our facility was the first in Brazil to use the access to a cyclotron bunker via maze, rather than armored door stopper type. Materials: the design calculations were based on the Monte Carlo method (MCNP5 - Monte Carlo N-Particletransportcode version 5). At the ends of the labyrinth are installed a door of polyethylene, for thermalization of neutrons, and other of wood for limiting access. Both legs of the maze have wall thickness of 100cm. In inspection Brazilian CNEN realize measures of dose rate for neutrons and gamma 9 points: 7 around the bunker, 1 over the bunker and 1 in the exhaust with the cyclotron operating with maximum load, double beam of 50uA for 2 hours. After commissioning were carried out around the bunker, the following measures: cumulative dose in three months with dosimeters for neutron rate dose with a gas proportional detector type filled with 3He and polyethylene neutron moderator and dose rate with a Geiger - Mueller detector for gamma radiation. Readings with neutron detectors were classified as background radiation and dose rates were always below the limits established in standard EN 3.01, and the calculation of the predicted regardless of the intensity of irradiation inside the bunker. Conclusion: the use of labyrinths as a way to access the bunkers cyclotron has been shown to be effective as the radiation shielding and efficient by allowing quick and easy access, virtually eliminating the maintenance

  16. Symptomatic improvement after radiofrequency catheter ablation for typical atrial flutter

    O'Callaghan, P.; Meara, M; Kongsgaard, E; Poloniecki, J.; Luddington, L; Foran, J; Camm, A; Rowland, E; Ward, D.

    2001-01-01

    OBJECTIVE—To assess the changes in quality of life, arrhythmia symptoms, and hospital resource utilisation following catheter ablation of typical atrial flutter.
DESIGN—Patient questionnaire to compare the time interval following ablation with a similar time interval before ablation.
SETTING—Tertiary referral centre.
PATIENTS—63 consecutive patients were studied. Four patients subsequently underwent an ablate and pace procedure, two died of co-morbid illnesses, and two were lost to follow up....

  17. Quantifying Local Stiffness Variations in Radiofrequency Ablations with Dynamic Indentation

    DeWall, Ryan J.; Varghese, Tomy; Brace, Christopher L.

    2011-01-01

    Elastographic imaging can be used to monitor ablation procedures, however confident and clear determination of the ablation boundary is essential to ensure complete treatment of the pathological target. To investigate the potential for ablation boundary representation on elastographic images, local variations in the viscoelastic properties in radiofrequency ablated regions that were formed in vivo in porcine liver tissue were quantified using dynamic indentation. Spatial stiffness maps were t...

  18. Ablation of lung tumours

    Gillams, Alice

    2012-01-01

    Abstract Radiofrequency, laser, microwave and cryotherapy have all been used for the ablation of lung tumours. However, radiofrequency ablation (RFA) and microwave ablation are the most widely used technologies. RFA has been successfully applied to tumour measuring from

  19. Percutaneous thermal ablation of renal neoplasms

    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  20. Design, development, and evaluation of focused ultrasound arrays for transesophageal cardiac ablations

    Lee, Hotaik

    The ultimate purpose of this dissertation is the evaluation of the feasibility of transesophageal cardiac surgery in arrhythmia treatment, using therapeutic ultrasound energy without the requirement for surgical incisions or blood contact. Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting over 2.2 million Americans. One effective treatment is cardiac ablation, which shows a high rate of success in treating paroxysmal AF. As a prevailing modality for this treatment, catheter ablation using radiofrequency has been effective, but there is measurable morbidity and significant costs and time associated with this invasive procedure for permanent or persistent AF. To address these issues, a transesophageal ultrasound applicator for noninvasive cardiac ablations has been designed, developed and evaluated in this dissertation. Focused ultrasound for thermal ablation has gained interest for decades due to its noninvasive characteristics. Since the esophagus is close to the posterior of the left atrium, its position makes it attractive for the incision-less surgery of the selected area of the heart using ultrasound. The overall goal of this study is to bring an applicator as closely as possible to the heart in order to effectively deliver ultrasound energy, and create electrically isolating lesions in myocardial tissue, replicating the currently used Maze procedure. The Maze procedure is a surgical operation that treats AF by creating a grid of incisions resulting in non-conductive scar tissue in the atria. The initial design of an ultrasound applicator capable of creating atrial lesions from the esophagus, involved evaluating sound pressure fields within layers of the esophagus and myocardium. Based on the multiple factors of the simulation results of transducer arrays, current transesophageal medical devices, and the throat anatomy, a focused ultrasound transducer that can be inserted into the esophagus has been designed and tested. In this study, a

  1. Pellet ablation and ablation model development

    A broad survey of pellet ablation is given, based primarily on information presented at this meeting. The implications of various experimental observations for ablation theory are derived from qualitative arguments of the physics involved. The major elements of a more complete ablation theory are then outlined in terms of these observations. This is followed by a few suggestions on improving the connections between theory and experimental results through examination of ablation data. Although this is a rather aggressive undertaking for such a brief (and undoubtedly incomplete) assessment, some of the discussion may help us advance the understanding of pellet ablation. 17 refs

  2. Totally thorascopic surgical ablation of persistent AF and long-standing persistent atrial fibrillation using the "Dallas" lesion set.

    Edgerton, James R; Jackman, Warren M; Mahoney, Cecile; Mack, Michael J

    2009-12-01

    Minimally invasive surgery consisting of bipolar radiofrequency pulmonary vein (PV) isolation and limited ganglionated plexus ablation is effective in eliminating atrial fibrillation (AF) in patients with paroxysmal AF but is less effective in those with persistent AF or long-standing persistent AF. The purpose of this study was examine the results of minimally invasive surgery incorporating an additional set of radiofrequency ablation lines replicating a left-sided Cox maze III procedure. Thirty patients with persistent AF (n = 10) or long-standing persistent AF (n = 20) underwent minimally invasive surgery with an extended lesion set and PV isolation for a minimum follow-up of 6 months. Linear lesions were created at the roof line, at the anterior line, and between the roof line and the left atrial appendage. All patients underwent limited ganglionated plexus ablation and left atrial appendage excision as well as PV isolation verification. Block across the roof and anterior lines was confirmed in 29 (96.6%) of the 30 patients. Follow-up included 2-week event monitoring with auto-trigger in 21 patients, pacemaker interrogation in 8, and ECG in 1 who was in AF and refused longer-term monitoring. No operative mortality or major morbidity occurred. At 6 months, 24 (80%) of the 30 patients were free of AF: 15 (75%) with long-standing persistent AF and 9 (90%) with persistent AF. Among the six failures, burden of AF was low: one had 1 episode >15 seconds, two had 4 episodes, one had 6 episodes, one had >50 episodes, and one had AF on ECG and refused further monitoring. Early results of minimally invasive surgery with a new extended linear lesion set suggest increased efficacy over PV isolation and limited ganglionated plexus ablation in patients with persistent AF or long-standing persistent AF. PMID:19959146

  3. Emerging Local Ablation Techniques

    Stone, Michael J.; Wood, Bradford J.

    2006-01-01

    Local ablation technologies for hepatic malignancy have developed rapidly in the past decade, with advances in several percutaneous or externally delivered treatment methods including radiofrequency ablation, microwave ablation, laser ablation, and high-intensity focused ultrasound. Research has focused on increasing the size of the ablation zone and minimizing heat-sink effects. More recent developments include improvements in treatment planning and navigation with integration of several ima...

  4. Advances in Imaging for Atrial Fibrillation Ablation

    Over the last fifteen years, our understanding of the pathophysiology of atrial fibrillation (AF) has paved the way for ablation to be utilized as an effective treatment option. With the aim of gaining more detailed anatomical representation, advances have been made using various imaging modalities, both before and during the ablation procedure, in planning and execution. Options have flourished from procedural fluoroscopy, electro anatomic mapping systems, pre procedural computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and combinations of these technologies. Exciting work is underway in an effort to allow the electro physiologist to assess scar formation in real time. One advantage would be to lessen the learning curve for what are very complex procedures. The hope of these developments is to improve the likelihood of a successful ablation procedure and to allow more patients access to this treatment

  5. Development of a 2D laser ablation inductively coupled plasma mass spectrometry mapping procedure for mercury in maize (Zea mays L.) root cross-sections

    Graphical abstract: -- Highlights: •LA-ICP-MS mapping to study the distribution of Hg in plant root cross-sections. •Sorption of LA-generated Hg vapour leads to serious memory effects. •Spot analysis with a delay time of 10 s in between spots alleviates memory effects. •Ablation straight through the sample simplifies calibration. •Hg2+ does not cross the endodermal root barrier of maize plants. -- Abstract: A LA-ICP-MS method based on a 213 nm Nd:YAG laser and a quadrupole ICP-MS has been developed for mapping of mercury in root cross-sections of maize (Zea mays L.) to investigate the mechanism of mercury uptake from soil and its potential translocation to the edible parts. Conventional rastering was found to be unusable due to sorption of mercury onto the internal parts of the LA device, giving rising to memory effects resulting in serious loss of resolution and inaccurate quantification. Spot analysis on a virtual grid on the surface of the root sections using washout times of 10 s in between spots greatly alleviated problems related to these memory effects. By ablating straight through the root sections on a poly(methyl methacrylate) support the calibration process was simplified as internal standardization and matrix-matching could be circumvented. Mercury-spiked freeze-drying embedding medium, sectioned similarly to the root sections, was used for the preparation of the standards. Standards and root sections were subjected to spot analysis using the following operational parameters: beam diameter, 15 μm; laser fluence, 2.5 J cm−2; repetition rate, 20 Hz; dwell time, 1 s; acquisition time, 0.1 s. The mercury peaks for standards and roots sections could be consistently integrated for quantification and construction of the 2D mercury maps for the root sections. This approach was successfully used to investigate the mercury distribution in root sections of maize grown in soil spiked to a level of 50 mg kg−1 DW HgCl2. It was found that at given Hg

  6. Development of a 2D laser ablation inductively coupled plasma mass spectrometry mapping procedure for mercury in maize (Zea mays L.) root cross-sections

    Debeljak, Marta [Analytical Chemistry Laboratory, National Institute of Chemistry, Hajdrihova 19, SI-1000 Ljubljana (Slovenia); Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna Pot 111, SI-1000 Ljubljana (Slovenia); Elteren, Johannes T. van, E-mail: elteren@ki.si [Analytical Chemistry Laboratory, National Institute of Chemistry, Hajdrihova 19, SI-1000 Ljubljana (Slovenia); Vogel-Mikuš, Katarina [Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna Pot 111, SI-1000 Ljubljana (Slovenia)

    2013-07-17

    Graphical abstract: -- Highlights: •LA-ICP-MS mapping to study the distribution of Hg in plant root cross-sections. •Sorption of LA-generated Hg vapour leads to serious memory effects. •Spot analysis with a delay time of 10 s in between spots alleviates memory effects. •Ablation straight through the sample simplifies calibration. •Hg{sup 2+} does not cross the endodermal root barrier of maize plants. -- Abstract: A LA-ICP-MS method based on a 213 nm Nd:YAG laser and a quadrupole ICP-MS has been developed for mapping of mercury in root cross-sections of maize (Zea mays L.) to investigate the mechanism of mercury uptake from soil and its potential translocation to the edible parts. Conventional rastering was found to be unusable due to sorption of mercury onto the internal parts of the LA device, giving rising to memory effects resulting in serious loss of resolution and inaccurate quantification. Spot analysis on a virtual grid on the surface of the root sections using washout times of 10 s in between spots greatly alleviated problems related to these memory effects. By ablating straight through the root sections on a poly(methyl methacrylate) support the calibration process was simplified as internal standardization and matrix-matching could be circumvented. Mercury-spiked freeze-drying embedding medium, sectioned similarly to the root sections, was used for the preparation of the standards. Standards and root sections were subjected to spot analysis using the following operational parameters: beam diameter, 15 μm; laser fluence, 2.5 J cm{sup −2}; repetition rate, 20 Hz; dwell time, 1 s; acquisition time, 0.1 s. The mercury peaks for standards and roots sections could be consistently integrated for quantification and construction of the 2D mercury maps for the root sections. This approach was successfully used to investigate the mercury distribution in root sections of maize grown in soil spiked to a level of 50 mg kg{sup −1} DW HgCl{sub 2}. It was

  7. Navigating virtual mazes : The benefits of audiovisual landmarks

    Werkhoven, P.; Erp, J.B.F. van; Philippi, T.G.

    2014-01-01

    It has been shown that multisensory presentation can improve perception, attention, and object memory compared with unisensory presentation. Consequently, we expect that multisensory presentation of landmarks can improve spatial memory and navigation. In this study we tested the effect of visual, auditory and combined landmark presentations in virtual mazes on spatial memory and spatial navigation. Nineteen participants explored four different virtual mazes consisting of nodes with landmarks ...

  8. Studies of ablation pressure, ablative acceleration and ablative implosions

    Time and space resolved X-ray spectroscopy have been used to measure ablation rate and ablation pressure on plane targets irradiated by the first and second harmonics of Nd glass laser light. Streaked X-ray shadowgraphy has been applied to the study of ablatively imploded spherical shell targets uniformly irradiated by six 1.05 μm laser beams. The results give a direct measurement of shell acceleration and thus of ablation pressure and show evidence of fluid instability increasing as the shell ratio is varied from 10 to 100. A direct determination of implosion core density is also obtained. (author)

  9. Atrioventricular Junction Ablation for Atrial Fibrillation.

    Patel, Dilesh; Daoud, Emile G

    2016-04-01

    Atrioventricular junction (AVJ) ablation is an effective therapy in patients with symptomatic atrial fibrillation who are intolerant to or unsuccessfully managed with rhythm control or medical rate control strategies. A drawback is that the procedure mandates a pacing system. Overall, the safety and efficacy of AVJ ablation is high with a majority of the patients reporting significant improvement in symptoms and quality-of-life measures. Risk of sudden cardiac death after device implantation is low, especially with an appropriate postprocedure pacing rate. Mortality benefit with AVJ ablation has been shown in patients with heart failure and cardiac resynchronization therapy devices. PMID:26968669

  10. How I do it: Radiofrequency ablation

    Over the past decade, image-guided tumor ablation using thermal energy has emerged as a promising technique for treating focal, primary or secondary, nonoperable tumors. Radiofrequency ablation (RFA) is minimally invasive and requires less resources, time, and recovery period and is, moreover, relatively inexpensive. RFA has been used to treat tumors located in the liver, lung, bone, kidneys, brain, thyroid, breast, and pancreas. This article will describe how to choose an appropriate case; precisely place the needle into the tumor; the precautions to be taken before, during, and after the procedure; probable complications; and the follow-up of patients undergoing ablation

  11. Developmental treatment with the dopamine D2/3 agonist quinpirole selectively impairs spatial learning in the Morris water maze.

    Vorhees, Charles V; Johnson, Holly L; Burns, Lindsey N; Williams, Michael T

    2009-01-01

    Developmental exposure to the dopamine D2/3 receptor agonist quinpirole is reported to induce D2 priming, impair Morris water maze performance, reduce acoustic startle prepulse inhibition (PPI), and alter locomotor activity. We treated rats from postnatal days 1-21 with the dose reported to induce these effects, 1.0 mg/kg/day, and two higher doses, 2.0 and 4.0 mg/kg/day, or saline. Offspring were tested in the Morris water maze, PPI, exploratory locomotor activity, activity after quinpirole and (+)-methamphetamine challenge, elevated zero maze, light-dark box, marble burying, straight channel swimming, and Cincinnati water maze. In the Morris water maze, all quinpirole groups had longer latencies on test days 3-5 of acquisition, but no effects on reversal or shifted-reduced platform trials. The quinpirole 4.0 mg/kg group had significantly reduced mean search distances on probe trials when combined across the 3 phases of testing but not separately. The male 4.0 mg/kg quinpirole group showed a greater increase in methamphetamine-stimulated activity during the first 10 min after drug challenge but not in the remainder of the 2 h test. No quinpirole effects were found for light-dark box, marble burying, exploratory locomotor activity, straight channel, Cincinnati water maze, or locomotor activity after quinpirole challenge. No effects were found on most measures in the elevated zero maze however the quinpirole 4.0 mg/kg females had longer latencies to enter an open quadrant. The results partially support prior Morris maze deficits induced by developmental quinpirole treatment but little evidence of dopamine D2/3 priming was found using locomotor activity with quinpirole or methamphetamine challenge or acoustic startle/PPI. The limited comparability to published data using developmental quinpirole exposure may be attributable to differences in experimental procedures or may be the result of quinpirole having limited effects. The data suggest that caution is warranted

  12. The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

    Elad Anter, MD

    2009-10-01

    Full Text Available Radiofrequency catheter ablation of pulmonary veins has emerged as an effective therapy for patients with symptomatic atrial fibrillation. Advances in real-time intracardiac echocardiography with 2D and Doppler color flow imaging have led to it integration in atrial fibrillation ablation procedures. It allows imaging of the left atrium and pulmonary veins, including identification of anatomic variations. It has an important role in guiding transseptal catheterization, imaging the pulmonary vein ostia, assisting in accurate placement of mapping and ablation catheters, monitoring lesion morphology and flow changes in the ablated pulmonary veins, hence allowing titration of energy delivery. Importantly, it allows instant detection of procedural complications.

  13. The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

    Elad Anter

    2009-10-01

    Full Text Available Radiofrequency catheter ablation of pulmonary veins has emerged as an effective therapy for patients with symptomatic atrial fibrillation. Advances in real-time intracardiac echocardiography with 2D and Doppler color flow imaging have led to its integration in atrial fibrillation ablation procedures. It allows imaging of the left atrium and pulmonary veins, including identification of anatomic variations. It has an important role in guiding transseptal catheterization, imaging the pulmonary vein ostia, assisting in accurate placement of mapping and ablation catheters, monitoring lesion morphology and flow changes in the ablated pulmonary veins, hence allowing titration of energy delivery. Importantly, it allows instant detection of procedural complications.

  14. CT-guided Bipolar and Multipolar Radiofrequency Ablation (RF Ablation) of Renal Cell Carcinoma: Specific Technical Aspects and Clinical Results

    Purpose. This study was designed to evaluate the clinical efficacy of CT-guided bipolar and multipolar radiofrequency ablation (RF ablation) of renal cell carcinoma (RCC) and to analyze specific technical aspects between both technologies. Methods. We included 22 consecutive patients (3 women; age 74.2 ± 8.6 years) after 28 CT-guided bipolar or multipolar RF ablations of 28 RCCs (diameter 2.5 ± 0.8 cm). Procedures were performed with a commercially available RF system (Celon AG Olympus, Berlin, Germany). Technical aspects of RF ablation procedures (ablation mode [bipolar or multipolar], number of applicators and ablation cycles, overall ablation time and deployed energy, and technical success rate) were analyzed. Clinical results (local recurrence-free survival and local tumor control rate, renal function [glomerular filtration rate (GFR)]) and complication rates were evaluated. Results. Bipolar RF ablation was performed in 12 procedures and multipolar RF ablation in 16 procedures (2 applicators in 14 procedures and 3 applicators in 2 procedures). One ablation cycle was performed in 15 procedures and two ablation cycles in 13 procedures. Overall ablation time and deployed energy were 35.0 ± 13.6 min and 43.7 ± 17.9 kJ. Technical success rate was 100 %. Major and minor complication rates were 4 and 14 %. At an imaging follow-up of 15.2 ± 8.8 months, local recurrence-free survival was 14.4 ± 8.8 months and local tumor control rate was 93 %. GFR did not deteriorate after RF ablation (50.8 ± 16.6 ml/min/1.73 m2 before RF ablation vs. 47.2 ± 11.9 ml/min/1.73 m2 after RF ablation; not significant). Conclusions. CT-guided bipolar and multipolar RF ablation of RCC has a high rate of clinical success and low complication rates. At short-term follow-up, clinical efficacy is high without deterioration of the renal function.

  15. Developmental D-methamphetamine treatment selectively induces spatial navigation impairments in reference memory in the Morris water maze while sparing working memory.

    Williams, Michael T; Morford, LaRonda L; Wood, Sandra L; Wallace, Tanya L; Fukumura, Masao; Broening, Harry W; Vorhees, Charles V

    2003-06-01

    In previous studies, we have shown that P11-20 treatment with D-methamphetamine (MA) (10 mg/kg x 4/day at 2-h intervals) induces impairments in spatial learning and memory in the Morris water maze after the offspring reach adulthood. Using a split-litter, multiple dose, design (0, 5, 10, and 15 mg/kg MA administered s.c. 4/day at 2-h intervals), the spatial learning effect was further explored with a multiple shifted platform (reversal), reference memory-based procedure and a working memory procedure. Prior to spatial learning, animals were first tested for swimming ability (in a straight swimming channel), sequential learning (in the Cincinnati multiple-T water maze), and proximal cue learning (in the Morris water maze). Rats were then assessed in the hidden platform, reference memory-based spatial version of the Morris maze for acquisition and on five subsequent phases in which the platform was moved to new locations. After the reference memory-based, fixed platform position learning phases, animals were tested in the trial-dependent, matching-to-sample, working memory version of the Morris maze. No group differences were found in straight channel, sequential maze, or cued Morris maze performance. By contrast, all MA groups were impaired in spatial learning during acquisition, multiple shift, and shifted with a reduced platform phases of reference memory-based learning. In addition, MA animals were impaired on memory (probe) trials during the acquisition and shifted with a reduced platform phases of learning. No effects on trial-dependent, matching-to-sample, working memory were found. The findings demonstrate that neonatal treatment with MA induces a selective impairment of reference memory-based spatial learning while sparing sequential, cued, and working memory-based learning. PMID:12645039

  16. Risk analysis on postoperative recurrence of atrial fibrillation after bipolar radiofrequency ablation undergoing open heart procedures%心内直视房颤射频消融术前危险因素与术后转律关系

    韦俊; 张大发; 刘志勇; 陆启同; 刘德森

    2012-01-01

    Objective Surgical radiofrequency (RF) ablation has recently been one of the most effective means to treat chronic atrial fibrillation(AF).However,about 20% to 30% patients have shown recurrence of AF during the follow-up period.This study retrospectively analyzed AF recurrence rate in those patients who underwent valve replacement procedures combined with RF ablation to treat AF in our department during the last three years.We compared the information and clinical date in the sinus rhythm(SR) group with in the AF recurrence group to analyze the relationship between various preoperative risk factors and operation failure.The aim of this study is to provide evidences to select patients who can benefit most from this type of surgery and to reduce their surgical risk and hospital charges.Methods From June 2006 to June 2009,52 patients with rheumatic heart disease (RHD) and chronic AF underwent RF ablation concomitant with valve replacement in our department by a same surgeon with the same method.Preoperative and intraoperative data was retrospectively collected and all patients were followed up longer than six months to determine the type of heart rhythm.Operation failure was defined as showing any rhythm except normal sinus rhythm by electrocardiogram.We divided all patients to the SR grope and AF grope.Univariate and multivariate statistical analysis was used to compare the data between the two groups in pre-,intra- and postoperative period.Results There was only one case in-hospital mortality ( 1.9% ).None mortality,re-exploration for bleeding and pacemaker implantation for malignant arrhythmia was shown during the mean follow-up period of 14 months (9-35 months).At the last follow-up,sinus rhythm was shown in 71.2% (37/52) patients.In univariaye analysis,the left atrial diameter,AF duration,left ventricular end diastolic volume and aortic cross-clamp were predictors of recurrence of AF.Age,left ventricular ejection factor,cardiopulmonary bypass time showed

  17. Radiofrequency ablation of liver metastases

    The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI]), transarterial chemoembolisation [TACE] in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases. (orig.)

  18. Hippocampal GluR1 Associates with Behavior in the Elevated Plus Maze and Shows Sex Differences

    Xiang, Xiaojun; Huang, Wen; Haile, Colin N.; Therese A Kosten

    2011-01-01

    The hippocampus is involved in anxiety as well as spatial memory formation and is sexually dimorphic. Female rats typically show less anxiety in elevated plus maze procedure (EPM), a standard animal model of anxiety. Many intracellular proteins, including α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunit GluR1 and the cyclic AMP response element-binding protein (CREB), in hippocampus contribute to memory formation. However, less is known about the roles for hippocam...

  19. Neuropsychological Decline After Catheter Ablation of Atrial Fibrillation

    Schwarz, N

    2011-09-01

    Full Text Available The article “Neuropsychological decline after cath- eter ablation of atrial fibrillation” by Schwarz et al. is the first publication that focused on cognitive side effects of elective circumferential pulmonary vein isolation (PVI.1 Adverse neuropsychological changes after left atrial catheter ablation, as report- ed in this paper, were found in verbal memory and the result, conjoined with ischemic brain lesions, might represent cerebral side-effects of the ablation procedure.

  20. A review of the safety aspects of radio frequency ablation

    Abhishek Bhaskaran

    2015-09-01

    Full Text Available In light of recent reports showing high incidence of silent cerebral infarcts and organized atrial arrhythmias following radiofrequency (RF atrial fibrillation (AF ablation, a review of its safety aspects is timely. Serious complications do occur during supraventricular tachycardia (SVT ablations and knowledge of their incidence is important when deciding whether to proceed with ablation. Evidence is emerging for the probable role of prophylactic ischemic scar ablation to prevent VT. This might increase the number of procedures performed. Here we look at the various complications of RF ablation and also the methods to minimize them. Electronic database was searched for relevant articles from 1990 to 2015. With better awareness and technological advancements in RF ablation the incidence of complications has improved considerably. In AF ablation it has decreased from 6% to less than 4% comprising of vascular complications, cardiac tamponade, stroke, phrenic nerve injury, pulmonary vein stenosis, atrio-esophageal fistula (AEF and death. Safety of SVT ablation has also improved with less than 1% incidence of AV node injury in AVNRT ablation. In VT ablation the incidence of major complications was 5–11%, up to 3.4%, up to 1.8% and 4.1–8.8% in patients with structural heart disease, without structural heart disease, prophylactic ablations and epicardial ablations respectively. Vascular and pericardial complications dominated endocardial and epicardial VT ablations respectively. Up to 3% mortality and similar rates of tamponade were reported in endocardial VT ablation. Recent reports about the high incidence of asymptomatic cerebral embolism during AF ablation are concerning, warranting more research into its etiology and prevention.

  1. The regulatory maze of quality control

    The appropriateness of specific procedures within a quality control program becomes difficult to assess when an attempt is made to collate all of the available information. This task is discussed from the perspective of the Joint Commission (JCAH Accreditation Manual), HHS(quality assurance program recommendations), equipment manufacturers maintenance schedules, and radiology administrative cost concerns

  2. Neural Ablation and Regeneration in Pain Practice.

    Choi, Eun Ji; Choi, Yun Mi; Jang, Eun Jung; Kim, Ju Yeon; Kim, Tae Kyun; Kim, Kyung Hoon

    2016-01-01

    A nerve block is an effective tool for diagnostic and therapeutic methods. If a diagnostic nerve block is successful for pain relief and the subsequent therapeutic nerve block is effective for only a limited duration, the next step that should be considered is a nerve ablation or modulation. The nerve ablation causes iatrogenic neural degeneration aiming only for sensory or sympathetic denervation without motor deficits. Nerve ablation produces the interruption of axonal continuity, degeneration of nerve fibers distal to the lesion (Wallerian degeneration), and the eventual death of axotomized neurons. The nerve ablation methods currently available for resection/removal of innervation are performed by either chemical or thermal ablation. Meanwhile, the nerve modulation method for interruption of innervation is performed using an electromagnetic field of pulsed radiofrequency. According to Sunderland's classification, it is first and foremost suggested that current neural ablations produce third degree peripheral nerve injury (PNI) to the myelin, axon, and endoneurium without any disruption of the fascicular arrangement, perineurium, and epineurium. The merit of Sunderland's third degree PNI is to produce a reversible injury. However, its shortcoming is the recurrence of pain and the necessity of repeated ablative procedures. The molecular mechanisms related to axonal regeneration after injury include cross-talk between axons and glial cells, neurotrophic factors, extracellular matrix molecules, and their receptors. It is essential to establish a safe, long-standing denervation method without any complications in future practices based on the mechanisms of nerve degeneration as well as following regeneration. PMID:26839664

  3. Image-Guided Spinal Ablation: A Review.

    Tsoumakidou, Georgia; Koch, Guillaume; Caudrelier, Jean; Garnon, Julien; Cazzato, Roberto Luigi; Edalat, Faramarz; Gangi, Afshin

    2016-09-01

    The image-guided thermal ablation procedures can be used to treat a variety of benign and malignant spinal tumours. Small size osteoid osteoma can be treated with laser or radiofrequency. Larger tumours (osteoblastoma, aneurysmal bone cyst and metastasis) can be addressed with radiofrequency or cryoablation. Results on the literature of spinal microwave ablation are scarce, and thus it should be used with caution. A distinct advantage of cryoablation is the ability to monitor the ice-ball by intermittent CT or MRI. The different thermal insulation, temperature and electrophysiological monitoring techniques should be applied. Cautious pre-procedural planning and intermittent intra-procedural monitoring of the ablation zone can help reduce neural complications. Tumour histology, patient clinical-functional status and life-expectancy should define the most efficient and least disabling treatment option. PMID:27329231

  4. Laser ablation in analytical chemistry - A review

    Russo, Richard E.; Mao, Xianglei; Liu, Haichen; Gonzalez, Jhanis; Mao, Samuel S.

    2001-10-10

    Laser ablation is becoming a dominant technology for direct solid sampling in analytical chemistry. Laser ablation refers to the process in which an intense burst of energy delivered by a short laser pulse is used to sample (remove a portion of) a material. The advantages of laser ablation chemical analysis include direct characterization of solids, no chemical procedures for dissolution, reduced risk of contamination or sample loss, analysis of very small samples not separable for solution analysis, and determination of spatial distributions of elemental composition. This review describes recent research to understand and utilize laser ablation for direct solid sampling, with emphasis on sample introduction to an inductively coupled plasma (ICP). Current research related to contemporary experimental systems, calibration and optimization, and fractionation is discussed, with a summary of applications in several areas.

  5. Tests of the Aversive Summation Hypothesis in Rats: Effects of Restraint Stress on Consummatory Successive Negative Contrast and Extinction in the Barnes Maze

    Ortega, Leonardo A.; Prado-Rivera, Mayerli A.; Cardenas-Poveda, D. Carolina; McLinden, Kristina A.; Glueck, Amanda C.; Gutierrez, German; Lamprea, Marisol R.; Papini, Mauricio R.

    2013-01-01

    The present research explored the effects of restraint stress on two situations involving incentive downshift: consummatory successive negative contrast (cSNC) and extinction of escape behavior in the Barnes maze. First, Experiment 1 confirmed that the restraint stress procedure used in these experiments increased levels of circulating…

  6. Aspects of procedural memory are differentially impaired in Huntington's disease.

    Bylsma, F W; Brandt, J; Strauss, M E

    1990-01-01

    Procedural memory encompasses several phenomena, including motor and perceptual learning, cognitive rule learning and priming. These subclasses are differentially affected by differing neuropathologies, suggesting their functional independence and reliance upon different neural substrates. To test this hypothesis, performance on a maze learning task was compared in 15 Huntington's disease (HD) patients and 15 normal controls (NC) to assess specific route learning, cognitive skill learning and the effects of route predictability on performance. Results revealed that the HD group: (1) showed normal learning curves for a specific maze route; (2) are deficient in generalizing the cognitive skills across mazes; and, (3) fail to improve performance on a maze with a predictable route relative to mazes with unpredictable routes. These results are interpreted as supporting the independence of procedural memory subclasses. The basal ganglia are suggested as important structures in mediating the ability to generalize skills and appreciate patterned organization in to-be-acted-upon stimuli. PMID:14589688

  7. Mazes and Maps: Can Young Children Find Their Way?

    Jirout, Jamie J.; Newcombe, Nora S.

    2014-01-01

    Games provide important informal learning activities for young children, and spatial game play (e.g., puzzles and blocks) has been found to relate to the development of spatial skills. This study investigates 4- and 5-year-old children's use of scaled and unscaled maps when solving mazes, asking whether an important aspect of spatial…

  8. Mitral valve perforation appearing years after radiofrequency ablation

    Fisch-Thomsen, Marie; Jensen, Jesper K; Egeblad, Henrik;

    2011-01-01

    The case is reported of a young adult with Wolff-Parkinson-White (WPW) syndrome who, three years after a complicated radiofrequency (RF) catheter ablation procedure, developed dyspnea on exertion. Echocardiography revealed severe mitral valve regurgitation caused by a perforation of the posterior...... leaflet. Echocardiographic follow up is recommended after a complicated course of left-sided catheter ablation....

  9. Development of procedures and instrumentation for use of the Nd:YAG laser in the ablation of metastases from colorectal cancer

    Bartels, Kenneth E.; Mellow, Mark H.; Kostolich, Marilyn; Henry, George A.; Barnes, Bradley R.; Durville, Frederic M.; Schafer, Steven A.; Krasinski, Jerzy S.; Powell, Richard C.

    1992-06-01

    While many colon cancers are curable, curability relates closely to stage. Once disease is spread beyond the confines of the colon and adjacent lymph nodes, cure is clearly the exception rather than the rule. Recently, surgical resection of solitary liver metastases has been effective in treatment of colon cancer, producing long term survival in approximately 20% of treatable patients. Surgery, however, is technically complex and there is a high perioperative morbidity and substantial perioperative mortality. For patients with multiple hepatic metastases in whom surgical extirpation is not possible, the outlook is dismal. Other modalities including chemotherapy have also resulted in limited success. Recently, a number of investigators have evaluated the effect of low power interstitial Nd:YAG laser irradiation for inducing hyperthermia and coagulative necrosis is hepatic tissue. In treating multiple or large hepatic metastases, the use of a lower power (1 - 5 watts), long duration (50 - 2400 seconds), single fiber laser delivery system has limitations. A computer controlled continuous wave Nd:YAG (1064 nm) laser system using a single fiber 'coupled' to a multiple array of fibers (4 to 6) has been developed for the delivery of low power laser irradiation to hepatic tissue. The advantage of laser energy being delivered simultaneously through multiple fibers is that it expands the area of tissue that can be treated over a given time. Through the use of interventional techniques including percutaneous ultrasound and/or CAT scan directed treatment, laser induced interstitial hyperthermia for large or multiple metastatic lesions could be initiated without the morbidity associated with open surgical procedures.

  10. Imaging in percutaneous ablation for atrial fibrillation

    Maksimovic, Ruzica [Erasmus Medical Center, Department of Radiology, GD Rotterdam (Netherlands); Institute for Cardiovascular Diseases of the University Medical Center, Belgrade (Czechoslovakia); Dill, Thorsten [Kerckhoff-Heart Center, Department of Cardiology, Bad Nauheim (Germany); Ristic, Arsen D.; Seferovic, Petar M. [Institute for Cardiovascular Diseases of the University Medical Center, Belgrade (Czechoslovakia)

    2006-11-15

    Percutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant incidence of pulmonary vein (PV) stenosis and other rare complications. Clinical workup of AF patients includes imaging before and after ablative treatment using different noninvasive and invasive techniques such as conventional angiography, transoesophageal and intracardiac echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI), which offer different information with variable diagnostic accuracy. Evaluation before percutaneous ablation involves assessment of PVs (PV pattern, branching pattern, orientation and ostial size) to facilitate position and size of catheters and reduce procedure time as well as examining the left atrium (presence of thrombi, dimensions and volumes). Imaging after the percutaneous ablation is important for assessment of overall success of the procedure and revealing potential complications. Therefore, imaging methods enable depiction of PVs and the anatomy of surrounding structures essential for preprocedural management and early detection of PV stenosis and other ablation-related procedures, as well as long-term follow-up of these patients. (orig.)

  11. Imaging in percutaneous ablation for atrial fibrillation

    Percutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant incidence of pulmonary vein (PV) stenosis and other rare complications. Clinical workup of AF patients includes imaging before and after ablative treatment using different noninvasive and invasive techniques such as conventional angiography, transoesophageal and intracardiac echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI), which offer different information with variable diagnostic accuracy. Evaluation before percutaneous ablation involves assessment of PVs (PV pattern, branching pattern, orientation and ostial size) to facilitate position and size of catheters and reduce procedure time as well as examining the left atrium (presence of thrombi, dimensions and volumes). Imaging after the percutaneous ablation is important for assessment of overall success of the procedure and revealing potential complications. Therefore, imaging methods enable depiction of PVs and the anatomy of surrounding structures essential for preprocedural management and early detection of PV stenosis and other ablation-related procedures, as well as long-term follow-up of these patients. (orig.)

  12. Nonequilibrium Ablation of Phenolic Impregnated Carbon Ablator

    Milos, Frank S.; Chen, Yih K.; Gokcen, Tahir

    2012-01-01

    In previous work, an equilibrium ablation and thermal response model for Phenolic Impregnated Carbon Ablator was developed. In general, over a wide range of test conditions, model predictions compared well with arcjet data for surface recession, surface temperature, in-depth temperature at multiple thermocouples, and char depth. In this work, additional arcjet tests were conducted at stagnation conditions down to 40 W/sq cm and 1.6 kPa. The new data suggest that nonequilibrium effects become important for ablation predictions at heat flux or pressure below about 80 W/sq cm or 10 kPa, respectively. Modifications to the ablation model to account for nonequilibrium effects are investigated. Predictions of the equilibrium and nonequilibrium models are compared with the arcjet data.

  13. Numerical modeling of ultrashort-pulse laser ablation of silicon

    Silicon ablation by a single ultrashort laser pulse is simulated through a computer model. The agreement between results obtained through the model and experimental data found in the literature supports the hypothesis made by the authors in considering thermal evaporation as the dominant ablation mechanism in silicon. Two distinctive thresholds are defined for the ablation procedure leading to a better interpretation of experimental data. The dependence of ablation fluence thresholds on both wavelength and pulse width is discussed. An approximate analytical model describing the crater formation process is proposed and indicative results are presented.

  14. Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application

    Ji Hoon Shin

    2012-01-01

    Full Text Available Radiofrequency (RF ablation has been gaining popularity as a minimally invasive treatment for benign thyroid nodules regardless of the extent of the solid component. RF ablation of benign nodules demonstrated volume reductions of 33–58% after one month and 51–85% after six months, while solving nodule-related clinical problems. RF ablation has recently shown positive short-term results for locoregional control as well as symptom improvement in patients with recurrent thyroid cancers. This paper reviews the basic physics, indications, patient preparation, devices, procedures, clinical results, and complications of RF ablation.

  15. Atrium-atrioventricular node block: an unusual complication during catheter ablation of persistent atrial fibrillation

    MIAO Cheng-long; SANG Cai-hua; DONG Jian-zeng; MA Chang-sheng

    2011-01-01

    Ablation of persistent atrial fibrillation is still a challenge for the ablationist. Extensive ablation is required under some conditions and could lead to some unintended complications. Here we report a case of atrium-atrioventricular node block complicating multiple catheter ablation procedures for persistent atrial fibrillation. After extensive ablation, including circumferential pulmonary vein ablation, linear ablation at the left atrial roof, mitral isthmus, atrial septum, cavotricuspid isthmus, and complex fractionated atrial electrogram ablation, conduction obstacle was found, and sinus impulse could not travel from the right atrium, atrial septum and left atrium to atrioventricular node. The case indicated that intensive ablation at some key sites, especially the interatrial septum, should be careful during ablation of atrial fibrillation.

  16. Radiofrequency thermal ablation of malignant hepatic tumors: post-ablation syndrome

    To evaluate post-ablation syndrome after radiofrequency thermal ablation of malignant hepatic tumors. Forty-two patients with primary (n=3D29) or secondary (n=3D13) hepatic tumors underwent radiofrequency thermal ablation. A total of 65 nodules ranging in size from 1.1 to 5.0 (mean, 3.1) cm were treated percutaneously using a 50W RF generator with 15G expandable needle electrodes. We retrospectively evaluated the spectrum of post-ablation syndrome including pain, fever (≥3D 38 deg C), nausea, vomiting, right shoulder pain, and chest discomfort according to frequency, intensity and duration, and the findings were correlated with tumor location and number of ablations. We also evaluated changes in pre-/post-ablation serum aminotransferase (ALT/AST) and prothrombin time, and correlated these findings with the number of ablations. Post-ablation syndrome was noted in 29 of 42 patients (69.0%), and most symptoms improved with conservative treatment. The most important of these were abdominal plan (n=3D20, 47.6%), fever (n=3D8, 19.0%), and nausea (n=3D7, 16.7%), and four of 42 (9.5%) patients complained of severe pain. The abdominal pain lasted from 3 hours to 5.5 days (mean; 20.4 hours), the fever from 6 hours to 5 days (mean; 63.0 hours). And the nausea from 1 hours to 4 days (mean; 21.0 hours). Other symptoms were right shoulder pain (n=3D6, 14.3%), chest discomfort (n=3D3, 7.1%), and headache (n=3D3, 7.1%). Seventeen of 20 patients (85%) with abdominal pain had subcapsular tumor of the liver. There was significant correlation between pain, location of the tumor, and a number of ablations. After ablation, ALT/AST was elevated more than two-fold in 52.6%/73.7% of patients, respectively but there was no significant correlation with the number of ablation. Post-ablation syndrome is a frequent and tolerable post-procedural process after radiofrequency thermal ablation. The spectrum of this syndrome provides a useful guideline for the post-ablation management. (author)

  17. Radiofrequency thermal ablation of malignant hepatic tumors: post-ablation syndrome

    Choi, Jung Bin; Rhim, Hyunchul; Kim, Yongsoo; Koh, Byung Hee; Cho, On Koo; Seo, Heung Suk; Lee, Seung Ro [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2000-07-01

    To evaluate post-ablation syndrome after radiofrequency thermal ablation of malignant hepatic tumors. Forty-two patients with primary (n=3D29) or secondary (n=3D13) hepatic tumors underwent radiofrequency thermal ablation. A total of 65 nodules ranging in size from 1.1 to 5.0 (mean, 3.1) cm were treated percutaneously using a 50W RF generator with 15G expandable needle electrodes. We retrospectively evaluated the spectrum of post-ablation syndrome including pain, fever ({>=}3D 38 deg C), nausea, vomiting, right shoulder pain, and chest discomfort according to frequency, intensity and duration, and the findings were correlated with tumor location and number of ablations. We also evaluated changes in pre-/post-ablation serum aminotransferase (ALT/AST) and prothrombin time, and correlated these findings with the number of ablations. Post-ablation syndrome was noted in 29 of 42 patients (69.0%), and most symptoms improved with conservative treatment. The most important of these were abdominal plan (n=3D20, 47.6%), fever (n=3D8, 19.0%), and nausea (n=3D7, 16.7%), and four of 42 (9.5%) patients complained of severe pain. The abdominal pain lasted from 3 hours to 5.5 days (mean; 20.4 hours), the fever from 6 hours to 5 days (mean; 63.0 hours). And the nausea from 1 hours to 4 days (mean; 21.0 hours). Other symptoms were right shoulder pain (n=3D6, 14.3%), chest discomfort (n=3D3, 7.1%), and headache (n=3D3, 7.1%). Seventeen of 20 patients (85%) with abdominal pain had subcapsular tumor of the liver. There was significant correlation between pain, location of the tumor, and a number of ablations. After ablation, ALT/AST was elevated more than two-fold in 52.6%/73.7% of patients, respectively but there was no significant correlation with the number of ablation. Post-ablation syndrome is a frequent and tolerable post-procedural process after radiofrequency thermal ablation. The spectrum of this syndrome provides a useful guideline for the post-ablation management. (author)

  18. Lung Ablation: Whats New?

    Xiong, Lillian; Dupuy, Damian E

    2016-07-01

    Lung cancer had an estimated incidence of 221,200 in 2015, making up 13% of all cancer diagnoses. Tumor ablation is an important treatment option for nonsurgical lung cancer and pulmonary metastatic patients. Radiofrequency ablation has been used for over a decade with newer modalities, microwave ablation, cryoablation, and irreversible electroporation presenting as additional and possibly improved treatment options for patients. This minimally invasive therapy is best for small primary lesions or favorably located metastatic tumors. These technologies can offer palliation and sometimes cure of thoracic malignancies. This article discusses the current available technologies and techniques available for tumor ablation. PMID:27050331

  19. Air-kerma evaluation at the maze entrance of HDR brachytherapy facilities

    In the absence of procedures for evaluating the design of brachytherapy (BT) facilities for radiation protection purposes, the methodology used for external beam radiotherapy facilities is often adapted. The purpose of this study is to adapt the NCRP 151 methodology for estimating the air-kerma rate at the door in BT facilities. Such methodology was checked against Monte Carlo (MC) techniques using the code Geant4. Five different facility designs were studied for 192Ir and 60Co HDR applications to account for several different bunker layouts. For the estimation of the lead thickness needed at the door, the use of transmission data for the real spectra at the door instead of the ones emitted by 192Ir and 60Co will reduce the lead thickness by a factor of five for 192Ir and ten for 60Co. This will significantly lighten the door and hence simplify construction and operating requirements for all bunkers. The adaptation proposed in this study to estimate the air-kerma rate at the door depends on the complexity of the maze: it provides good results for bunkers with a maze (i.e. similar to those used for linacs for which the NCRP 151 methodology was developed) but fails for less conventional designs. For those facilities, a specific Monte Carlo study is in order for reasons of safety and cost-effectiveness. (paper)

  20. Ablative Thermal Protection System Fundamentals

    Beck, Robin A. S.

    2013-01-01

    This is the presentation for a short course on the fundamentals of ablative thermal protection systems. It covers the definition of ablation, description of ablative materials, how they work, how to analyze them and how to model them.

  1. Percutaneous thermal ablation of renal neoplasms; Perkutane Thermoablation von Nierentumoren

    Tacke, J. [Inst. fuer Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau (Germany); Mahnken, A.H.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum Aachen (Germany)

    2005-12-15

    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  2. Automated planning of ablation targets in atrial fibrillation treatment

    Keustermans, Johannes; De Buck, Stijn; Heidbüchel, Hein; Suetens, Paul

    2011-03-01

    Catheter based radio-frequency ablation is used as an invasive treatment of atrial fibrillation. This procedure is often guided by the use of 3D anatomical models obtained from CT, MRI or rotational angiography. During the intervention the operator accurately guides the catheter to prespecified target ablation lines. The planning stage, however, can be time consuming and operator dependent which is suboptimal both from a cost and health perspective. Therefore, we present a novel statistical model-based algorithm for locating ablation targets from 3D rotational angiography images. Based on a training data set of 20 patients, consisting of 3D rotational angiography images with 30 manually indicated ablation points, a statistical local appearance and shape model is built. The local appearance model is based on local image descriptors to capture the intensity patterns around each ablation point. The local shape model is constructed by embedding the ablation points in an undirected graph and imposing that each ablation point only interacts with its neighbors. Identifying the ablation points on a new 3D rotational angiography image is performed by proposing a set of possible candidate locations for each ablation point, as such, converting the problem into a labeling problem. The algorithm is validated using a leave-one-out-approach on the training data set, by computing the distance between the ablation lines obtained by the algorithm and the manually identified ablation points. The distance error is equal to 3.8+/-2.9 mm. As ablation lesion size is around 5-7 mm, automated planning of ablation targets by the presented approach is sufficiently accurate.

  3. Laser ablation principles and applications

    1994-01-01

    Laser Ablation provides a broad picture of the current understanding of laser ablation and its many applications, from the views of key contributors to the field. Discussed are in detail the electronic processes in laser ablation of semiconductors and insulators, the post-ionization of laser-desorbed biomolecules, Fourier-transform mass spectroscopy, the interaction of laser radiation with organic polymers, laser ablation and optical surface damage, laser desorption/ablation with laser detection, and laser ablation of superconducting thin films.

  4. Microwave ablation versus laser ablation in occluding lateral veins in goats.

    Wang, Xu-hong; Wang, Xiao-ping; Su, Wen-juan; Yuan, Yuan

    2016-02-01

    Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats. PMID:26838749

  5. Ablation of Atrial Fibrillation: Patient Selection, Periprocedural Anticoagulation, Techniques, and Preventive Measures After Ablation.

    Link, Mark S; Haïssaguerre, Michel; Natale, Andrea

    2016-07-26

    Atrial fibrillation (AF) is the most common arrhythmia encountered by cardiologists and is a major cause of morbidity and mortality. Risk factors for AF include age, male sex, genetic predisposition, hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, heart failure, and possibly excessive exercise. The management of AF involves decisions about rate versus rhythm control. Asymptomatic patients are generally managed with rate control and anticoagulation. Symptomatic patients will desire rhythm control. Rhythm control options are either antiarrhythmic agents or ablation, with each having its own risks and benefits. Ablation of AF has evolved from a rare and complex procedure to a common electrophysiological technique. Selection of patients to undergo ablation is an important aspect of AF care. Patients with the highest success rates of ablation are those with normal structural hearts and paroxysmal AF, although those with congestive heart failure have the greatest potential benefit of the procedure. Although pulmonary vein isolation of any means/energy source is the approach generally agreed on for those with paroxysmal AF, optimal techniques for the ablation of nonparoxysmal AF are not yet clear. Anticoagulation reduces thromboembolic complications; the newer anticoagulants have eased management for both the patient and the cardiologist. Aggressive management of modifiable risk factors (hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, and possibly excessive exercise) after ablation reduces the odds of recurrent AF and is an important element of care. PMID:27462054

  6. Evidence for social cooperation in rodents by automated maze

    Avi Avital; Shlomit Aga-Mizrachi; Salman Zubedat

    2016-01-01

    Social cooperation is defined as a joint action for mutual benefit that depends on the individual and the counterparts’ behaviors. To gain valid evidence for social cooperation behavior we conducted a series of experiments in our suggested fully automated non-conditioned maze and depicted three major findings: (i) During 18 days of training the rats showed a progressive social learning curve as well as latent social learning; (ii) Examining the perceptual communication between the cooperating...

  7. Optimal Navigation of Self-Propelled Colloids in Microstructured Mazes

    Yang, Yuguang; Bevan, Michael

    Controlling navigation of self-propelled microscopic `robots' subject to random Brownian motion in complex microstructured environments (e.g., porous media, tumor vasculature) is important to many emerging applications (e.g., enhanced oil recovery, drug delivery). In this work, we design an optimal feedback policy to navigate an active self-propelled colloidal rod in complex mazes with various obstacle types. Actuation of the rods is modelled based on a light-controlled osmotic flow mechanism, which produces different propulsion velocities along the rod's long axis. Actuator-parameterized Langevin equations, with soft rod-obstacle repulsive interactions, are developed to describe the system dynamics. A Markov decision process (MDP) framework is used for optimal policy calculations with design goals of colloidal rods reaching target end points in minimum time. Simulations show that optimal MDP-based policies are able to control rod trajectories to reach target regions order-of-magnitudes faster than uncontrolled rods, which diverges as maze complexity increases. An efficient multi-graph based implementation for MDP is also presented, which scales linearly with the maze dimension.

  8. Evidence for social cooperation in rodents by automated maze.

    Avital, Avi; Aga-Mizrachi, Shlomit; Zubedat, Salman

    2016-01-01

    Social cooperation is defined as a joint action for mutual benefit that depends on the individual and the counterparts' behaviors. To gain valid evidence for social cooperation behavior we conducted a series of experiments in our suggested fully automated non-conditioned maze and depicted three major findings: (i) During 18 days of training the rats showed a progressive social learning curve as well as latent social learning; (ii) Examining the perceptual communication between the cooperating partners, we found a correlation between the available perceptual modalities and the social cooperation performance; and (iii) Investigating contextual learning as a competing process to the social cooperation, we found that additional contextual cues impaired the social cooperation performance. In conclusion, our suggested automated cooperation maze is designed to further our understanding of social cooperation under normal conditions, such as decision-making, and to examine the neural basis of social cooperation. A variety of neuropsychiatric disorders are characterized by disruptions in social behavior and social cognition, including depression, autism spectrum disorders, obsessive-compulsive disorder, and schizophrenia. Thus, on the pathological end, our maze for social cooperation evaluation can contribute significantly to the investigation of a wide range of social cooperation impairments in a rodent model. PMID:27378418

  9. Effects of intrastriatal blockade of glutamatergic transmission on the acquisition of T-maze and radial maze tasks

    Hauber, Wolfgang; Schmidt, Werner J.

    1989-01-01

    Prefrontal cortex and neostriatum constituting the prefrontal system are connected by glutamatergic neurones. The involvement of this corticostriatal projection in control of maze performance of rats was investigated. Glutamatergic transmission mediated by N-methyl-D-aspartate (NMDA) receptors was blocked by intrastriatal injections of dl-2-amino-5-phosphonovaleric acid (AP-5) (50 nmole in 0.5 Mgrl). In experiment 1, intrastriatal AP-5 was found to increase the number of errors during acquisi...

  10. CT-guided radiofrequency tumor ablation in children

    Botsa, Evanthia [National and Kapodistrian University of Athens, First Pediatric Clinic, Agia Sofia Children' s Hospital, Athens (Greece); Poulou, Loukia S.; Koundouraki, Antonia; Thanos, Loukas [Sotiria General Hospital for Chest Diseases, Department of Medical Imaging and Interventional Radiology, Athens (Greece); Koutsogiannis, Ioannis [General Military Hospital NIMTS, Department of Medical Imaging, Athens (Greece); Ziakas, Panayiotis D. [Warren Alpert Medical School of Brown University Rhode Island Hospital, Division of Infectious Diseases, Providence, RI (United States); Alexopoulou, Efthimia [Attikon University Hospital, Second Department of Radiology, Athens University School of Medicine, Athens (Greece)

    2014-11-15

    Image-guided radiofrequency ablation is a well-accepted technique of interventional oncology in adults. To evaluate the efficacy and safety of CT-guided radiofrequency ablation as a minimally invasive treatment for metastatic neoplasms in children. A total of 15 radiofrequency ablation sessions were performed in 12 children and young adults (median age 9.5; range 5-18 years) with metastatic malignancies. Seven children and young adults had secondary hepatic lesions, three had pulmonary and two had bone lesions. Radiofrequency ablation was performed under conscious sedation. The median lesion size was 1.7 cm (range 1.3-2.8 cm). The median time for ablation was 8 min (range 7-10 min). Radiofrequency procedures were technically successful in all tumors. Postablation imaging immediately after, and 1 month and 3 months after radiofrequency ablation showed total necrosis in all patients. At 6-month follow-up, three patients (all with lesion size >2 cm) had local recurrence and underwent a second radiofrequency ablation session. At 2-year follow-up no patient had recurrence of the treated tumor. Post-ablation syndrome occurred in four children. No major complication occurred. CT-guided radiofrequency tumor ablation was safe and efficient for palliative treatment in our cohort of patients. (orig.)

  11. Delayed Development of Pneumothorax After Pulmonary Radiofrequency Ablation

    Acute pneumothorax is a frequent complication after percutaneous pulmonary radiofrequency (RF) ablation. In this study we present three cases showing delayed development of pneumothorax after pulmonary RF ablation in 34 patients. Our purpose is to draw attention to this delayed complication and to propose a possible approach to avoid this major complication. These three cases occurred subsequent to 44 CT-guided pulmonary RF ablation procedures (6.8%) using either internally cooled or multitined expandable RF electrodes. In two patients, the pneumothorax, being initially absent at the end of the intervention, developed without symptoms. One of these patients required chest drain placement 32 h after RF ablation, and in the second patient therapy remained conservative. In the third patient, a slight pneumothorax at the end of the intervention gradually increased and led into tension pneumothorax 5 days after ablation procedure. Underlying bronchopleural fistula along the coagulated former electrode track was diagnosed in two patients. In conclusion, delayed development of pneumothorax after pulmonary RF ablation can occur and is probably due to underlying bronchopleural fistula, potentially leading to tension pneumothorax. Patients and interventionalists should be prepared for delayed onset of this complication, and extensive track ablation following pulmonary RF ablation should be avoided.

  12. Nonfluoroscopic Ablation of Atrial Fibrillation Using Cryoballoon

    Mansour Razminia, M.D., F.A.C.C.; Hany Demo, M.D.; Carlos Arrieta-Garcia, M.D.;

    2014-10-01

    Full Text Available Background: The conventional method of cryoballoon ablation of atrial fibrillation involves the use of fluoroscopy for visual guidance. The use of fluoroscopy is accompanied by significant radiation risks to the patient and the medical staff. Herein, we report our experience in performing successful nonfluoroscopic pulmonary vein isolation using cryoballoon ablation in 5 consecutive patients with paroxysmal atrial fibrillation Methods and Results: Five consecutive patients with paroxysmal atrial fibrillation underwent cryoballoon ablation for pulmonary vein isolation using a nonfluoroscopic approach. Pre-procedural cardiac computed tomography or cardiac magnetic resonance imaging was not performed in any patient. A total of twenty pulmonary veins were identified and successfully isolated (100% with the guidance of intracardiac echocardiography and 3-dimensional electroanatomic mapping. No fluoroscopy was used for the procedures. There were no major procedural adverse events. Conclusion: In an unselected group of patients undergoing cryoballoon ablation, a nonfluoroscopic approach is feasible and can be performed safely and effectively while eliminating the risks associated with radiation to both the patient and the medical staff.

  13. Collateral damage from Catheter Ablation of Atrial Fibrillation

    Wanwarang Wongcharoen, MD

    2013-04-01

    Full Text Available Atrial fibrillation (AF is the most common sustained arrhythmia, contributing to a significant morbidity and mortality. Catheter ablation of the pulmonary veins (PVs and left atrium (LA has been shown to be an effective strategy for the treatment of symptomatic AF. Regardless of technological advances and technique improvement, catheter ablation for AF remains a highly complex procedure and the risk of procedural complications is not negligible. The major complications have been reported to occur in up to 5.2% of procedures. A systematic investigation among 32,569 patients undergoing catheter ablation for AF has demonstrated that mortality is around 0.1%. Nevertheless, the true prevalence of complications is possibly underestimated in retrospective surveys because of recollection bias and other factors. This article will focus on the management of serious complications of catheter AF ablation including PV stenosis, atrioesophageal fistula, cardiac tamponade, stroke and thromboembolic complication

  14. Contact force sensing during atrial fibrillation ablation: clinical experience and effects on outcomes.

    Liang, Jackson J; Santangeli, Pasquale

    2016-06-01

    Catheter ablation is an effective treatment option for atrial fibrillation (AF), and pulmonary vein isolation (PVI) is the cornerstone of AF ablation. When AF recurs after ablation, PV reconnection is frequently seen during repeat ablation. As such, achieving durable chronic PVI by delivering effective, transmural lesions during the index ablation is key to optimize long-term outcomes. The development of contact force (CF) sensing technologies integrated into ablation catheters now allow for real-time visualization of applied CF during PVI and have been shown to improve ablation efficacy and safety. The aim of this review is to describe the CF technology, summarize the literature on the outcomes of CF-guided ablation, and to discuss procedural aspects that are crucial when using CF. PMID:26998886

  15. Percutaneous Microwave Ablation of Renal Angiomyolipomas

    PurposeTo evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML).Materials and MethodsFrom January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4–4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits.ResultsAll ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60–70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3–8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8 % (3.4–3.3 cm) and 1.7 % (27.5–26.3 cm3), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9–47) demonstrated mean tumor diameter and volume decreases of 29 % (3.4–2.4 cm) and 47 % (27.5–12.1 cm3), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation.ConclusionOur early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs

  16. Percutaneous Microwave Ablation of Renal Angiomyolipomas

    Cristescu, Mircea, E-mail: mcristescu@uwhealth.org [University of Wisconsin, Department of Radiology (United States); Abel, E. Jason, E-mail: abel@urology.wisc.edu [University of Wisconsin, Department of Urology (United States); Wells, Shane, E-mail: swells@uwhealth.org; Ziemlewicz, Timothy J., E-mail: tziemlewicz@uwhealth.org [University of Wisconsin, Department of Radiology (United States); Hedican, Sean P., E-mail: hedican@surgery.wisc.edu [University of Wisconsin, Department of Urology (United States); Lubner, Megan G., E-mail: mlubner@uwhealth.org; Hinshaw, J. Louis, E-mail: jhinshaw@uwhealth.org; Brace, Christopher L., E-mail: cbrace@uwhealth.org; Lee, Fred T., E-mail: flee@uwhealth.org [University of Wisconsin, Department of Radiology (United States)

    2016-03-15

    PurposeTo evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML).Materials and MethodsFrom January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4–4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits.ResultsAll ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60–70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3–8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8 % (3.4–3.3 cm) and 1.7 % (27.5–26.3 cm{sup 3}), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9–47) demonstrated mean tumor diameter and volume decreases of 29 % (3.4–2.4 cm) and 47 % (27.5–12.1 cm{sup 3}), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation.ConclusionOur early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.

  17. Unexplained liver laceration after metastasis radiofrequency ablation

    Esther U(n)a; Javier Trueba; Jose Manuel Montes

    2009-01-01

    Many studies have established the role of radiofrequency (RF) ablation as a minimally invasive treatment for liver metastases. Although relatively safe, several complications have been reported with the increased use of RF ablation. We describe here a case of unexplained liver laceration after a RF procedure. A woman who presented a solitary metachronous liver metastasis underwent RF ablation treatment for this lesion. Six hours later the patient displayed fatigue and pallor.Emergency blood tests showed a haemoglobin level of < 7 g/dL and markedly elevated transaminase levels.A computed tomography examination revealed two areas of liver laceration with haematoma, one of them following the path of the needle and the other leading away from the first. Following a blood transfusion, the patient was haemodynamically stable and completely recovered 24 h later. The patient remained in bed for 1 wk. No surgical intervention was required, and she was discharged 1 wk later.

  18. Role of Intracardiac echocardiography in Atrial Fibrillation Ablation

    Antonio Dello Russo, MD PhD

    2013-04-01

    Full Text Available In the recent years, several new evidences support catheter-based ablation as a treatment modality of atrial fibrillation (AF. Based on a plenty of different applications, intracardiac echocardiography (ICE is now a well-established technology in complex electrophysiological procedures, in particular in AF ablation. ICE contributes to improve the efficacy and safety of such procedures defining the anatomical structures involved in ablation procedures and monitoring in real time possible complications. In particular ICE allows: a correct identification of the endocardial structures; a guidance of transseptal puncture; an assessment of accurate placement of the circular mapping catheter; an indirect evaluation of evolving lesions during radiofrequency (RF energy delivery via visualization of micro and macrobubbles tissue heating; assessment of catheter contact with cardiac tissues. Recently, also the feasibility of the integration of electroanatomical mapping (EAM and intracardiac echocardiography has been demonstrated, combining accurate real time anatomical information with electroanatomical data. As a matter of fact, different techniques and ablation strategies have been developed throughout the years. In the setting of balloon-based ablation systems, recently adopted by an increasing number of centers, ICE might have a role in the choice of appropriate balloon size and to confirm accurate occlusion of pulmonary veins. Furthermore, in the era of minimally fluoroscopic ablation, ICE has successfully provided a contribute in reducing fluoroscopy time. The purpose of this review is to summarize the current applications of ICE in catheter based ablation strategies of atrial fibrillation, focusing-on electronically phased-array ICE.

  19. MR Guided RF Ablation and Thermometery

    Sara Eskandari

    2009-01-01

    Full Text Available "nIntroduction: Liver metastasis is detected in more than one million people in each year. Only 10% of them are eligible for surgery. Radiofrequency ablation is the most popular local ablation technique for the management of the other 90% of the metastases. Complete ablation of the lesion with a safe margin is the goal of such a local ablative method. There is no routine available technique for monitoring the treatment process. MRI is the only method which can monitor tissue ablation in real time however interaction of radiofrequency energy by MRI acquisition makes it impossible for clinical use. "nMaterials and Methods: In our in-vitro study, the effect of bipolar needles were evaluated on the signal intensity of theliver parenchyma. This evaluation was repeated 15 times. A calibration curve was also calculated from the in-vitro measurement of tissue temperature with an interstitial NTC sensor with dedicated data collecting software written by our team. Finally the correlation between temperature and signal intensity was prepared and during the RF ablation, the temperature map could be created in an almost real time manner. "nResults: Our results show an exponential calibration curve for sensors and a linear reduction of the signal intensities during the RF procedure. "nConclusion: We introduce a method for calibration of the MRI signal intensity with tissue temperature between alternative RF pulses. This method brings MR monitoring as the practical method in clinical use. By this innovative technique it is possible for all the hospitals and clinics to use their routine MR scanner for monitoring this ablative technique without any additional hardware.  

  20. Photoacoustic characterization of radiofrequency ablation lesions

    Bouchard, Richard; Dana, Nicholas; Di Biase, Luigi; Natale, Andrea; Emelianov, Stanislav

    2012-02-01

    Radiofrequency ablation (RFA) procedures are used to destroy abnormal electrical pathways in the heart that can cause cardiac arrhythmias. Current methods relying on fluoroscopy, echocardiography and electrical conduction mapping are unable to accurately assess ablation lesion size. In an effort to better visualize RFA lesions, photoacoustic (PA) and ultrasonic (US) imaging were utilized to obtain co-registered images of ablated porcine cardiac tissue. The left ventricular free wall of fresh (i.e., never frozen) porcine hearts was harvested within 24 hours of the animals' sacrifice. A THERMOCOOLR Ablation System (Biosense Webster, Inc.) operating at 40 W for 30-60 s was used to induce lesions through the endocardial and epicardial walls of the cardiac samples. Following lesion creation, the ablated tissue samples were placed in 25 °C saline to allow for multi-wavelength PA imaging. Samples were imaged with a VevoR 2100 ultrasound system (VisualSonics, Inc.) using a modified 20-MHz array that could provide laser irradiation to the sample from a pulsed tunable laser (Newport Corp.) to allow for co-registered photoacoustic-ultrasound (PAUS) imaging. PA imaging was conducted from 750-1064 nm, with a surface fluence of approximately 15 mJ/cm2 maintained during imaging. In this preliminary study with PA imaging, the ablated region could be well visualized on the surface of the sample, with contrasts of 6-10 dB achieved at 750 nm. Although imaging penetration depth is a concern, PA imaging shows promise in being able to reliably visualize RF ablation lesions.

  1. Liver tumor ablation

    Minimal-invasive techniques for ablation of primary and secondary hepatic tumors gain increasingly clinical importance. This is especially true since surgical resection and classic chemotherapy is successful only in a limited number of patients. Local ablative methods incorporate chemo- (percutaneous alcohol instillation, transarterial chemoembolization), thermo- (radiofrequency-, laser-, microwave-, cryoablation, high intensive focused ultrasound) and radio-ablative techniques (interstitial brachytherapy, selective internal radiotherapy). Regarding their implementation and specific effects these methods are varying widely, nevertheless all of them have a high therapeutical efficacy together with a low complication rate in common - correct application presumed. The knowledge on specific indications and contraindications is crucial to implement these methods into multimodality therapy concepts. (orig.)

  2. Microwave Ablation of Hepatic Malignancy

    Lubner, Meghan G.; Brace, Christopher L.; Ziemlewicz, Tim J.; Hinshaw, J. Louis; Lee, Fred. T.

    2013-01-01

    Microwave ablation is an extremely promising heat-based thermal ablation modality that has particular applicability in treating hepatic malignancies. Microwaves can generate very high temperatures in very short time periods, potentially leading to improved treatment efficiency and larger ablation zones. As the available technology continues to improve, microwave ablation is emerging as a valuable alternative to radiofrequency ablation in the treatment of hepatic malignancies. This article rev...

  3. Cows in the Maze And other mathematical explorations

    Stewart, Ian

    2010-01-01

    From the mathematics of mazes, to cones with a twist, and the amazing sphericon - and how to make one - Ian Stewart is back with more mathematical stories and puzzles that are as quirky as they are fascinating, and each from the cutting edge of the world of mathematics. We find out about the mathematics of time travel, explore the shape of teardrops (which are not tear-drop shaped, but something much, much more strange!), dance with dodecahedra, and play the game of Hex, amongst many more strange and delightful mathematical diversions.

  4. femtosecond laser ablation

    Margetic, Vanja

    2003-01-01

    Femtosecond laser ablation was investigated as a solid sampling method for elemental chemical analysis. In comparison to the sampling with longer laser pulses, two aspects could be improved by using ultrashort pulses: elimination of the elemental fractionation from the ablation crater, which is necessary for an accurate quantitative analysis, and better control of the material removal (especially for metals), which increases the spatial resolution of microanalysis. Basic aspects of ultrashort...

  5. Ablation of Myocardial Tissue With Nanosecond Pulsed Electric Fields

    Xie, Fei; Varghese, Frency; Pakhomov, Andrei G.; Semenov, Iurii; Xiao, Shu; Philpott, Jonathan; Zemlin, Christian

    2015-01-01

    Background Ablation of cardiac tissue is an essential tool for the treatment of arrhythmias, particularly of atrial fibrillation, atrial flutter, and ventricular tachycardia. Current ablation technologies suffer from substantial recurrence rates, thermal side effects, and long procedure times. We demonstrate that ablation with nanosecond pulsed electric fields (nsPEFs) can potentially overcome these limitations. Methods We used optical mapping to monitor electrical activity in Langendorff-perfused New Zealand rabbit hearts (n = 12). We repeatedly inserted two shock electrodes, spaced 2–4 mm apart, into the ventricles (through the entire wall) and applied nanosecond pulsed electric fields (nsPEF) (5–20 kV/cm, 350 ns duration, at varying pulse numbers and frequencies) to create linear lesions of 12–18 mm length. Hearts were stained either with tetrazolium chloride (TTC) or propidium iodide (PI) to determine the extent of ablation. Some stained lesions were sectioned to obtain the three-dimensional geometry of the ablated volume. Results In all animals (12/12), we were able to create nonconducting lesions with less than 2 seconds of nsPEF application per site and minimal heating (< 0.2°C) of the tissue. The geometry of the ablated volume was smoother and more uniform throughout the wall than typical for RF ablation. The width of the lesions could be controlled up to 6 mm via the electrode spacing and the shock parameters. Conclusions Ablation with nsPEFs is a promising alternative to radiofrequency (RF) ablation of AF. It may dramatically reduce procedure times and produce more consistent lesion thickness than RF ablation. PMID:26658139

  6. Ablation of Myocardial Tissue With Nanosecond Pulsed Electric Fields.

    Fei Xie

    Full Text Available Ablation of cardiac tissue is an essential tool for the treatment of arrhythmias, particularly of atrial fibrillation, atrial flutter, and ventricular tachycardia. Current ablation technologies suffer from substantial recurrence rates, thermal side effects, and long procedure times. We demonstrate that ablation with nanosecond pulsed electric fields (nsPEFs can potentially overcome these limitations.We used optical mapping to monitor electrical activity in Langendorff-perfused New Zealand rabbit hearts (n = 12. We repeatedly inserted two shock electrodes, spaced 2-4 mm apart, into the ventricles (through the entire wall and applied nanosecond pulsed electric fields (nsPEF (5-20 kV/cm, 350 ns duration, at varying pulse numbers and frequencies to create linear lesions of 12-18 mm length. Hearts were stained either with tetrazolium chloride (TTC or propidium iodide (PI to determine the extent of ablation. Some stained lesions were sectioned to obtain the three-dimensional geometry of the ablated volume.In all animals (12/12, we were able to create nonconducting lesions with less than 2 seconds of nsPEF application per site and minimal heating (< 0.2°C of the tissue. The geometry of the ablated volume was smoother and more uniform throughout the wall than typical for RF ablation. The width of the lesions could be controlled up to 6 mm via the electrode spacing and the shock parameters.Ablation with nsPEFs is a promising alternative to radiofrequency (RF ablation of AF. It may dramatically reduce procedure times and produce more consistent lesion thickness than RF ablation.

  7. Penentuan Nilai Motorik Halus Anak Dengan Game Magic Maze Menggunakan Metode Mamdani

    Fadly, Muhammad

    2015-01-01

    Motor development is a very important factor in the development of the whole child. fine motor skills are very important because it affects the other terms of learning in early childhood. Therefore, it made the game Magic Maze to assess motor skills early childhood. Game Magic Maze in this study using Mamdani method in determining the values to a child's fine motor skills. Maze game will be made on the PC. 081402045

  8. Contact Force and Atrial Fibrillation Ablation

    Waqas Ullah; Richard Schilling; Tom Wong

    2016-02-01

    Full Text Available Catheters able to measure the force and vector of contact between the catheter tip and myocardium are now available. Pre-clinical work has established that the degree of contact between the radiofrequency ablation catheter and myocardium correlates with the size of the delivered lesion. Excess contact is associated with steam pops and perforation. Catheter contact varies within the left atrium secondary to factors including respiration, location, atrial rhythm and the trans-septal catheter delivery technology used. Compared with procedures performed without contact force (CF-sensing, the use of this technology has, in some studies, been found to improve complication rates, procedure and fluoroscopy times, and success rates. However, for each of these parameters there are also studies suggesting a lack of difference from the availability of CF data. Nevertheless, CF-sensing technology has been adopted as a standard of care in many institutions. It is likely that use of CF-sensing technology will allow for the optimization of each individual radiofrequency application to maximize efficacy and procedural safety. Recent work has attempted to define what these optimal targets should be, and approaches to do this include assessing for sites of pulmonary vein reconnection after ablation, or comparing the impedance response to ablation. Based on such work, it is apparent that factors including mean CF, force time integral (the area under the force-time curve and contact stability are important determinants of ablation efficacy. Multicenter prospective randomized data are lacking in this field and required to define the CF parameters required to produce optimal ablation.

  9. Preoperative study of the surface ECG for the prognosis of atrial fibrillation maze surgery outcome at discharge

    The Cox-maze surgery is an effective procedure for terminating atrial fibrillation (AF) in patients requiring open-heart surgery associated with another heart disease. After the intervention, regardless of the patient's rhythm, all are treated with oral anticoagulants and antiarrhythmic drugs prior to discharge. Furthermore, patients maintaining AF before discharge could also be treated with electrical cardioversion (ECV). In view of this, a preoperative prognosis of the patient's rhythm at discharge would be helpful for optimizing drug therapy planning as well as for advancing ECV therapy. This work analyzes 30 preoperative electrocardiograms (ECGs) from patients suffering from AF in order to predict the Cox-maze surgery outcome at discharge. Two different characteristics of the AF pattern have been studied. On the one hand, the atrial activity (AA) organization, which provides information about the number of propagating wavelets in the atria, was investigated. AA organization has been successfully used in previous studies related to spontaneous reversion of paroxysmal AF and to the outcome of ECV. To assess organization, the dominant atrial frequency (DAF) and sample entropy (SampEn) have been computed. On the other hand, the second characteristic studied was the fibrillatory wave (f-wave) amplitude, which has been demonstrated to be a valuable indicator of the Cox-maze surgery outcome in previous studies. Moreover, this parameter has been obtained through a new methodology, based on computing the f-wave average power (fWP). Finally, all the computed indices were combined in a decision tree in order to improve prediction capability. Results for the DAF yielded a sensitivity (Se), a specificity (Sp) and an accuracy (Acc) of 61.54%, 82.35% and 73.33%, respectively. For SampEn the values were 69.23%, 76.00% and 73.33%, respectively, and for fWP they were 92.31%, 82.35% and 86.67%, respectively. Finally, the decision tree combining the three parameters

  10. Elevated mazes as animal models of anxiety: effects of serotonergic agents

    Simone H. Pinheiro; Hélio Zangrossi-Jr.; Cristina M Del-Ben; Graeff, Frederico G.

    2007-01-01

    This article reviews reported results about the effects of drugs that act upon the serotonergic neurotransmission measured in three elevated mazes that are animal models of anxiety. A bibliographic search has been performed in MEDLINE using different combinations of the key words X-maze, plus-maze, T-maze, serotonin and 5-HT, present in the title and/or the abstract, with no time limit. From the obtained abstracts, several publications were excluded on the basis of the following criteria: rev...

  11. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation

    AIM: To investigate the therapeutic efficacy of thermal ablation for treatment of hepatocellular carcinoma (HCC) using microwave and radiofrequency (RF) energy application. MATERIALS AND METHODS: A total of 190 nodules in 97 patients (84 male, 13 female; mean age 53.4 years, range 24-74 years) with HCC were treated with microwave or RF ablation in the last 4 years. The applicators were introduced into the tumours under conscious analgesic sedation by intravenous administration of fentanyl citrate and droperidol and local anaesthesia in both thermal ablation procedures. The patients were then followed up with contrast-enhanced computed tomography (CT) to evaluate treatment response. Survival was analysed using the Kaplan-Meier method. RESULTS: Complete ablation was obtained in 92.6% (176/190) nodules. The complete ablation rates were 94.6% (106/112) in microwave ablation and 89.7% (70/78) in RF ablation. The complete ablation rates in tumours≤2.0, 2.1-3.9 and ≥4.0 cm were 93.1, 93.8 and 86.4%, respectively. Local recurrence was found in 9.5% nodules and the rates in tumours≤2.0, 2.1-3.9 and ≥4.0 cm in diameter were 3.4, 9.9 and 31.8%, respectively. In the follow-up period, 7.1% nodules ablated by microwave and 12.8% by RF presented local recurrence. The 1, 2 and 3-year distant recurrence-free survivals were 47.2, 34.9 and 31.0%, respectively. Estimated mean survival was 32 months, and 1, 2 and 3-year cumulative survivals were 75.6, 58.5, and 50.0%, respectively. One and 2 years survivals of Child-Pugh class A, B and C patients were 83.8 and 70.4%, 78.2 and 53.2%, 36.3 and 27.3%, respectively. CONCLUSION: Thermal ablation therapy by means of microwave and RF energy application is an effective and safe therapeutic technique for hepatocellular carcinoma. Large tumours can be completely ablated, but have a significantly higher risk of local recurrence at follow-up

  12. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation

    Xu, H.-X.; Xie, X.-Y.; Lu, M.-D. E-mail: lumd@21cn.com; Chen, J.-W.; Yin, X.-Y.; Xu, Z.-F.; Liu, G.-J

    2004-01-01

    AIM: To investigate the therapeutic efficacy of thermal ablation for treatment of hepatocellular carcinoma (HCC) using microwave and radiofrequency (RF) energy application. MATERIALS AND METHODS: A total of 190 nodules in 97 patients (84 male, 13 female; mean age 53.4 years, range 24-74 years) with HCC were treated with microwave or RF ablation in the last 4 years. The applicators were introduced into the tumours under conscious analgesic sedation by intravenous administration of fentanyl citrate and droperidol and local anaesthesia in both thermal ablation procedures. The patients were then followed up with contrast-enhanced computed tomography (CT) to evaluate treatment response. Survival was analysed using the Kaplan-Meier method. RESULTS: Complete ablation was obtained in 92.6% (176/190) nodules. The complete ablation rates were 94.6% (106/112) in microwave ablation and 89.7% (70/78) in RF ablation. The complete ablation rates in tumours{<=}2.0, 2.1-3.9 and {>=}4.0 cm were 93.1, 93.8 and 86.4%, respectively. Local recurrence was found in 9.5% nodules and the rates in tumours{<=}2.0, 2.1-3.9 and {>=}4.0 cm in diameter were 3.4, 9.9 and 31.8%, respectively. In the follow-up period, 7.1% nodules ablated by microwave and 12.8% by RF presented local recurrence. The 1, 2 and 3-year distant recurrence-free survivals were 47.2, 34.9 and 31.0%, respectively. Estimated mean survival was 32 months, and 1, 2 and 3-year cumulative survivals were 75.6, 58.5, and 50.0%, respectively. One and 2 years survivals of Child-Pugh class A, B and C patients were 83.8 and 70.4%, 78.2 and 53.2%, 36.3 and 27.3%, respectively. CONCLUSION: Thermal ablation therapy by means of microwave and RF energy application is an effective and safe therapeutic technique for hepatocellular carcinoma. Large tumours can be completely ablated, but have a significantly higher risk of local recurrence at follow-up.

  13. Improving Students’ English Pronunciation Ability Through Go Fish Game and Maze Game

    Dwi Astuti Wahyu Nurhayati

    2015-12-01

    Full Text Available The problem highlighted in this research is the low pronunciation ability of Kindergarten students in Al-Irsyad  Madiun  that is caused by (1 the uninteresting activities in learning English; (2 the students' difficulties in pronunciating English words; (3 the students' low motivation in learning. The theoretical review includes the young learners characteristics, games in language, games for young learners. The procedure of the research consists of identifying the problem, planning the action, implementing the action, observing the action, and reflecting the result of the research. In this research, the researcher acts as the teacher who conducts the action research in the classroom and she is helped by the classsroom teacher. In collecting the data, the researcher uses observational technique supported with tests. In analyzing the data, the researcher uses the field notes, teacher's diaries, students ‘work supported with the cassette recording and photograph,then also compares the result of the students' pre-test and post-test to answer the research questions. There is significant improvement in the result of pre-test and post-test of cycle 1 and 2. In cycle 1, t0 (2.55734 is higher than tt (1.73 and in cycle 2, t0 (6.765738 is also higher than tt (1.73. From these two results, therefore, h0 is rejected and the alternative hypothesis (ha is accepted. They practice their pronunciation through taking turn and asking each other for cards to match those they have in their hands, arranging a word and sticking on alphabet, pronunciating the word, giving the meaning, hen making a sentence such as Go Fish Game and Maze Game. By conducting these games, using interesting media, creating various interesting tasks and activities can increase the students' motivation in learning English and pronunciation ability.Keywords: Improving, pronunciation, ability,  go fish and Maze games

  14. Goal representation heuristic dynamic programming on maze navigation.

    Ni, Zhen; He, Haibo; Wen, Jinyu; Xu, Xin

    2013-12-01

    Goal representation heuristic dynamic programming (GrHDP) is proposed in this paper to demonstrate online learning in the Markov decision process. In addition to the (external) reinforcement signal in literature, we develop an adaptively internal goal/reward representation for the agent with the proposed goal network. Specifically, we keep the actor-critic design in heuristic dynamic programming (HDP) and include a goal network to represent the internal goal signal, to further help the value function approximation. We evaluate our proposed GrHDP algorithm on two 2-D maze navigation problems, and later on one 3-D maze navigation problem. Compared to the traditional HDP approach, the learning performance of the agent is improved with our proposed GrHDP approach. In addition, we also include the learning performance with two other reinforcement learning algorithms, namely Sarsa(λ) and Q-learning, on the same benchmarks for comparison. Furthermore, in order to demonstrate the theoretical guarantee of our proposed method, we provide the characteristics analysis toward the convergence of weights in neural networks in our GrHDP approach. PMID:24805221

  15. AF Termination: the Holy Grail of Persistent AF Ablation?

    Dennis H. Lau, MBBS

    2010-06-01

    Full Text Available The optimal catheter ablation approach for longstanding persistent atrial fibrillation (AF remains elusive despite significant advances made in our understanding of this arrhythmia. A recent systematic review highlighted the significant variation in procedural success rate both within and between techniques, necessitating repeat ablation procedures and anti-arrhythmic drugs to achieve improved outcomes in those with long-standing persistent AF.1 Indeed, current expert consensus statement recommended ablation beyond ostial pulmonary vein isolation for these patients.2 Despite incorporating various substrate modification techniques which commonly include linear lesions and targeting of complex fractionated electrograms, the reported success rates from various laboratories are still below par to those in paroxysmal AF patients.1 Perhaps the often dilated and chronically remodeled atria in longstanding persistent AF patients harbor complex structural substrates capable of maintaining the arrhythmia beyond amelioration even with extensive catheter ablation in some. Certainly, this reflects our incomplete understanding of the complex mechanisms underlying this arrhythmia.

  16. Ablation characteristics of quantum square pulse mode dental erbium laser

    Lukač, Nejc; Suhovršnik, Tomaž; Lukač, Matjaž; Jezeršek, Matija

    2016-01-01

    Erbium lasers are by now an accepted tool for performing ablative medical procedures, especially when minimal invasiveness is desired. Ideally, a minimally invasive laser cutting procedure should be fast and precise, and with minimal pain and thermal side effects. All these characteristics are significantly influenced by laser pulse duration, albeit not in the same manner. For example, high cutting efficacy and low heat deposition are characteristics of short pulses, while vibrations and ejected debris screening are less pronounced at longer pulse durations. We report on a study of ablation characteristics on dental enamel and cementum, of a chopped-pulse Er:YAG [quantum square pulse (QSP)] mode, which was designed to reduce debris screening during an ablation process. It is shown that in comparison to other studied standard Er:YAG and Er,Cr:YSGG laser pulse duration modes, the QSP mode exhibits the highest ablation drilling efficacy with lowest heat deposition and reduced vibrations, demonstrating that debris screening has a considerable influence on the ablation process. By measuring single-pulse ablation depths, we also show that tissue desiccation during the consecutive delivery of laser pulses leads to a significant reduction of the intrinsic ablation efficacy that cannot be fully restored under clinical settings by rehydrating the tooth using an external water spray.

  17. Laser ablation of tumors: current concepts and recent developments

    Purpose. The purpose of this paper is to present technical innovations and clinical results of percutaneous interventional laser ablation of tumors using new techniques. Methods. Laser ablation was performed in 182 patients (liver tumors: 131, non hepatic tumors - bone, lung, others: 51) after interdisciplinary consensus was obtained. The procedure was done using a combination of imaging modalities (CT/MRI, CT/US) or only closed high field MRI (1.5 T). All patients received an MRI-scan immediately after laser ablation. Results. In 90.9% of the patients with liver tumors, a complete ablation was achieved. Major events occurred in 5.4%. The technical success rate of laser ablation in non-hepatic tumors was high, clinical results differed depending on the treated organ. Conclusions. The treatment of tumors of the liver and other organs up to 5 cm by laser ablation was a safe procedure with a low rate of complications and side effects. Image guidance by MRI is advantageous for precise tumor visualization in all dimensions, therapy monitoring, and control of laser ablation results. (orig.)

  18. Role of Percutaneous Microwave Ablation in Treatment of Hepatocellular Carcinoma

    Ahmed Tharwat Sayed *, Sahar M El Fiky*,

    2014-07-01

    Full Text Available Introduction: Hepatocellular carcinoma (HCC is one of the most common malignancies worldwide with an annual occurrence of one million new cases. An etiologic association between HBV infection and the development of HCC has been established. Hepatitis C virus is also proving an important predisposing factor for this malignancy, the use of minimally invasive Percutaneous ablative technique (e.g. Radiofrequency (RF and Microwave ablation (MW has gained great momentum and because of the drawbacks of RF ablation, several groups have successfully proved the efficacious nature of Microwave ablation in the treatment of hepatocellular carcinoma. Aim of the Work: The aim of this work is to highlight the role, the principles and the applications of percutaneous Microwave Ablation in Hepatocellular carcinoma. Methods: The studied group included 30 patients (25 men and 5 women with hepatocellular carcinoma. All patients underwent microwave ablation for the hepatocellular carcinoma. Results: The results of the procedures will be assessed as regarding sizeand enhancement of the lesion (s on triphasic CT abdomen before the procedure and at the follow up at one month as well as the Alpha fetoprotein levels. Conclusion: MWA technique represents a safe, fast and efficacious way to perform hepatic ablation in patients with HCC. Initial results are encouraging; however, longer follow-up is needed for further classification of our results.

  19. CT imaging of complications of catheter ablation for atrial fibrillation

    The complication rate following radiofrequency catheter ablation for atrial fibrillation is low (<5%). Complications include pericardial effusion, cardiac tamponade, pulmonary vein stenosis, oesophageal ulceration or perforation, atrio-oesophageal fistula formation, stroke/transient ischaemic attack, phrenic nerve injury, haematoma at the puncture site, and femoral arteriovenous fistula. Among available imaging tools, computed tomography (CT) can be very useful in diagnosing complications of the procedure, particularly in the subacute and delayed stages after ablation. This review illustrates CT imaging of several of the common and uncommon complications of radiofrequency catheter ablation

  20. Sex-Specific Effects of Gonadectomy and Hormone Treatment on Acquisition of a 12-Arm Radial Maze Task by Sprague Dawley Rats

    Gibbs, Robert B; Johnson, David A.

    2008-01-01

    The effects of gonadectomy and hormone treatment on spatial learning were evaluated in adult male and female rats using a modified version of a 12-arm radial maze task. In this version, procedures were used to minimize the effectiveness of strategies less reliant on working and reference memory. Results demonstrate significant sex differences favoring male performance on the working memory component of the task. In contrast, females performed slightly better than males on the reference memory...

  1. Are Balloon Based Strategies Better Than Conventional Radiofrequency Catheter Ablation: Exploring New Frontiers In The Treatment Of Atrial Fibrillation

    Alexander Fuernkranz MD

    2009-02-01

    Full Text Available Paroxysmal atrial fibrillation can be eliminated with continuous circular linear lesions around the pulmonary veins using radiofrequency ablation. Due to the technical complexity of this procedure balloon-based devices have been developed to simplify pulmonary vein isolation. Cryoballoon ablation provides excellent safety and is technically less demanding when compared to radiofrequency catheter ablation in selected patients. In this review, advantages as well as drawbacks of this emerging technology in relation to standard catheter ablation are discussed.

  2. CORRECTION OF MYOPIA USING CORNEA SPARING LASIK (ABLATION ON FLAP)

    Nikhilesh; Vikas; Atul; Sudha,; Chitra

    2015-01-01

    Cornea sparing lasik is useful tool allowing surgeons to preserve the posterior stroma. The study comprised of prospective evaluation of 17 eyes treated with CSL – Cornea Sparing Lasik at Mahatme Eye Bank Eye Hospital , N agpur India. Our results show that the laser ablation on the corneal flap is safe and effective procedure. The refractive , efficacy and safety outcomes were similar to those in routine Lasik ablation on posterior stroma.

  3. CORRECTION OF MYOPIA USING CORNEA SPARING LASIK (ABLATION ON FLAP

    Nikhilesh

    2015-02-01

    Full Text Available Cornea sparing lasik is useful tool allowing surgeons to preserve the posterior stroma. The study comprised of prospective evaluation of 17 eyes treated with CSL – Cornea Sparing Lasik at Mahatme Eye Bank Eye Hospital , N agpur India. Our results show that the laser ablation on the corneal flap is safe and effective procedure. The refractive , efficacy and safety outcomes were similar to those in routine Lasik ablation on posterior stroma.

  4. Thermal Ablation for the Treatment of Abdominal Tumors

    Brace, Christopher L.; Hinshaw, J. Louis; Lubner, Meghan G.

    2011-01-01

    Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ablation procedure, a thin applicator is guided into the target tumor under imaging guidance. Energy is then applied to the tissue until temperatures rise to cytotoxic levels (50-60 °C). Various energy sources are available to heat biological tissues, including radiofrequency (RF) electrical current, microwaves, laser light and ultrasonic waves...

  5. Tumor ablation with irreversible electroporation.

    Bassim Al-Sakere

    Full Text Available We report the first successful use of irreversible electroporation for the minimally invasive treatment of aggressive cutaneous tumors implanted in mice. Irreversible electroporation is a newly developed non-thermal tissue ablation technique in which certain short duration electrical fields are used to permanently permeabilize the cell membrane, presumably through the formation of nanoscale defects in the cell membrane. Mathematical models of the electrical and thermal fields that develop during the application of the pulses were used to design an efficient treatment protocol with minimal heating of the tissue. Tumor regression was confirmed by histological studies which also revealed that it occurred as a direct result of irreversible cell membrane permeabilization. Parametric studies show that the successful outcome of the procedure is related to the applied electric field strength, the total pulse duration as well as the temporal mode of delivery of the pulses. Our best results were obtained using plate electrodes to deliver across the tumor 80 pulses of 100 micros at 0.3 Hz with an electrical field magnitude of 2500 V/cm. These conditions induced complete regression in 12 out of 13 treated tumors, (92%, in the absence of tissue heating. Irreversible electroporation is thus a new effective modality for non-thermal tumor ablation.

  6. Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation

    Purpose: To evaluate the incidence and cause of hypertension prospectively during adrenal radiofrequency ablation (RFA). Methods: For this study, approved by our institutional review board, written informed consent was obtained from all patients. Patients who received RFA for adrenal tumors (adrenal ablation) and other abdominal tumors (nonadrenal ablation) were included in this prospective study. Blood pressure was monitored during RFA. Serum adrenal hormone levels including epinephrine, norepinephrine, dopamine, and cortisol levels were measured before and during RFA. The respective incidences of procedural hypertension (systolic blood pressure >200 mmHg) of the two patient groups were compared. Factors correlating with procedural systolic blood pressure were evaluated by regression analysis.ResultsNine patients underwent adrenal RFA and another 9 patients liver (n = 5) and renal (n = 4) RFA. Asymptomatic procedural hypertension that returned to the baseline by injecting calcium blocker was found in 7 (38.9%) of 18 patients. The incidence of procedural hypertension was significantly higher in the adrenal ablation group (66.7%, 6/9) than in the nonadrenal ablation group (11.1%, 1/9, P 2 = 0.68, P 2 = 0.72, P < 0.0001) levels during RFA. The other adrenal hormones did not show correlation with procedural systolic blood pressure. Conclusion: Hypertension occurs frequently during adrenal RFA because of the release of catecholamine.

  7. [Radiofrequency ablation of accessory pathways in pre-excitation syndrome].

    Pfeiffer, D; Tebbenjohanns, J; Jung, W; Manz, M; Lüderitz, B

    1993-04-16

    Various parameters relating to the radio-frequency ablation of accessory pathways were studied in 53 patients (27 males, 26 females: mean age 38.5 [14-64] years) with a history of paroxysmal tachycardia (over 1 month to 50 years), shown to be caused by an accessory pathway (Wolff-Parkinson-White syndrome). In all patients the following values were obtained: (1) number of procedures necessary to achieve permanent blockage of the accessory pathway (1-4); (2) duration of each procedure (45-420 min); (3) duration of fluoroscopy (5-102 min); (4) number of necessary radio-frequency applications (1-48); and (5) cumulative energy per procedure. To ablate left-lateral pathways (n = 10) required fewer procedures, shorter duration per procedure, shorter fluoroscopy time, fewer current applications and less total energy than coagulation of right-sided pathways (n = 10). Those various parameters were greatest for ablation of septal and para-septal pathways (n = 9). Pathways which conducted only retrogradely (n = 15) were more difficult to ablate than those with anterograde conduction (n = 38). There were two complications. In one case a tension pneumothorax occurred after faulty puncture of the subclavian vein; in the other, the left ventricle was perforated causing an acute tamponade which required pericardiocentesis with subsequent suture closure of the perforation. It is concluded that, in principle, all accessory pathways, regardless of their conduction potential and site, can be ablated by a radio-frequency current. PMID:8472633

  8. Branched chain amino acids improve radial-arm maze acquisition and water maze forced-choice learning in rat offspring exposed in utero to hyperphenylalaninemia.

    Vorhees, C V; Acuff-Smith, K D; Weisenburger, W P; Minck, D R; Berry, H K

    1992-01-01

    Maternal phenylketonuria results in a high incidence of children born mentally retarded. We showed that the large neutral amino acids valine, isoleucine, and leucine (VIL) ameliorate the effects of intrauterine hyperphenylalaninemia in rats on a test of complex maze learning. To further test the ameliorative effects of VIL on intrauterine CNS development during hyperphenylalaninemia, gravid rats were administered a phenylalanine/p-chlorophenylalanine (index group) supplemented diet with or without VIL added. Controls were given standard diet with or without VIL. All groups were pair-fed to the index group. As adults, the progeny exposed in utero to hyperphenylalaninemia showed characteristic learning impairments in a complex water (Cincinnati) maze on forced and elective-choice phases of the task and deficits in radial-arm maze and Morris maze acquisition, whereas those exposed to hyperphenylalaninemia combined with VIL showed no deficits in the forced-choice phase of Cincinnati maze learning and no evidence of radial-arm maze deficits. However, the improvement was not complete, with no ameliorative effects obtained on the elective-choice phase of the Cincinnati maze or on the Morris hidden platform test. No deficits were seen on phases containing test trials for memory function (Olton and Morris mazes). The acquisition differences occurred in the absence of any effects of VIL on maternal weight gain during gestation, maternal serum amino acid concentrations of phenylalanine or tyrosine, or effects on offspring growth. VIL alone produced no adverse or enhancing effects on learning or memory. Based on these data it was concluded that the VIL supplement continues to show promise as a potential treatment for intrauterinely acquired mental deficiency associated with maternal phenylketonuria. PMID:1593977

  9. Dopamine Depletion In Either The Dorsomedial Or Dorsolateral Striatum Impairs Egocentric Cincinnati Water Maze Performance While Sparing Allocentric Morris Water Maze Learning

    Braun, Amanda A.; Amos-Kroohs, Robyn M.; Guetierez, Arnold; Lundgren, Kerstin H.; Seroogy, Kim B.; Skelton, Matthew R.; Vorhees, Charles V.; Williams, Michael T.

    2014-01-01

    Both egocentric route-based learning and spatial learning, as assessed by the Cincinnati water maze (CWM) and Morris water maze (MWM), respectively, are impaired following an 80% dopamine (DA) loss in the neostriatum after 6-hydroxydopamine (6-OHDA) administration in rats. The dorsolateral striatum (DLS) and the dorsomedial striatum (DMS) are implicated in different navigational learning types, namely the DLS is implicated in egocentric learning while the DMS is implicated in spatial learning...

  10. Transient Ablation of Teflon Hemispheres

    Arai, Norio; Karashima, Kei-ichi; Sato, Kiyoshi

    1997-01-01

    For high-speed entry of space vehicles into atmospheric environments, ablation is a practical method for alleviating severe aerodynamic heating. Several studies have been undertaken on steady or quasi-steady ablation. However, ablation is a very complicated phenomenon in which a nonequilibrium chemical process is associated with an aerodynamic process that involves changes in body shape with time. Therefore, it seems realistic to consider that ablation is an unsteady phenomenon. In the design of an ablative heat-shield system, since the ultimate purpose of the heat shield is to keep the internal temperature of the space vehicle at a safe level during entry, the transient heat conduction characteristics of the ablator may be critical in the selection of the material and its thickness. This note presents an experimental study of transient ablation of Teflon, with particular emphasis on the change in body shape, the instantaneous internal temperature distribution, and the effect of thermal expansion on ablation rate.

  11. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review.

    Paiella, Salvatore; Salvia, Roberto; Ramera, Marco; Girelli, Roberto; Frigerio, Isabella; Giardino, Alessandro; Allegrini, Valentina; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC) accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures. PMID:26981115

  12. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation: A Review

    Salvatore Paiella

    2016-01-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA and Irreversible Electroporation (IRE are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures.

  13. Power Laser Ablation Symposia

    Phipps, Claude

    2007-01-01

    Laser ablation describes the interaction of intense optical fields with matter, in which atoms are selectively driven off by thermal or nonthermal mechanisms. The field of laser ablation physics is advancing so rapidly that its principal results are seen only in specialized journals and conferences. This is the first book that combines the most recent results in this rapidly advancing field with authoritative treatment of laser ablation and its applications, including the physics of high-power laser-matter interaction. Many practical applications exist, ranging from inertial confinement fusion to propulsion of aerostats for pollution monitoring to laser ignition of hypersonic engines to laser cleaning nanoscale contaminants in high-volume computer hard drive manufacture to direct observation of the electronic or dissociative states in atoms and molecules, to studying the properties of materials during 200kbar shocks developed in 200fs. Selecting topics which are representative of such a broad field is difficu...

  14. The Use of the Arabic CBM Maze among Three Levels of Achievers in Jordan

    Abu-Hamour, Bashir

    2013-01-01

    This study examined the applicability of the Arabic version of the Curriculum Based Measurement Maze (CBM Maze) for Jordanian students. A sample of 150 students was recruited from two public primary schools in Jordan. The students were ranked into high, moderate, and low achievers in terms of their performance in the Arabic course. Then all of…

  15. The water maze paradigm in experimental studies of chronic cognitive disorders: Theory, protocols, analysis, and inference.

    Kapadia, Minesh; Xu, Josie; Sakic, Boris

    2016-09-01

    An instrumental step in assessing the validity of animal models of chronic cognitive disorders is to document disease-related deficits in learning/memory capacity. The water maze (WM) is a popular paradigm because of its low cost, relatively simple protocol and short procedure time. Despite being broadly accepted as a spatial learning task, inference of generalized, bona fide "cognitive" dysfunction can be challenging because task accomplishment is also reliant on non-cognitive processes. We review theoretical background, testing procedures, confounding factors, as well as approaches to data analysis and interpretation. We also describe an extended protocol that has proven useful in detecting early performance deficits in murine models of neuropsychiatric lupus and Alzheimer's disease. Lastly, we highlight the need for standardization of inferential criteria on "cognitive" dysfunction in experimental rodents and exclusion of preparations of a limited scientific merit. A deeper appreciation for the multifactorial nature of performance in WM may also help to reveal other deficits that herald the onset of neurodegenerative brain disorders. PMID:27229758

  16. Changes in brain oxidative metabolism induced by water maze training.

    Conejo, N M; González-Pardo, H; Vallejo, G; Arias, J L

    2007-03-16

    Although the hippocampus has been shown to be essential for spatial memory, the contribution of associated brain regions is not well established. Wistar rats were trained to find a hidden escape platform in the water maze during eight days. Following training, the oxidative metabolism in different brain regions was evaluated using cytochrome oxidase histochemistry. Metabolic activations were found in the prelimbic cortex, cornu ammonis (CA) 1 subfield of the dorsal hippocampus and the anterior thalamic nuclei, relative to yoked swim controls and naïve rats. In addition, many cross-correlations in brain metabolism were observed among the latter regions. These results support the implication of a hippocampal-prefrontal-thalamic system to spatial memory in rats. PMID:17222984

  17. A duct-streaming formula for neutrons in mazes

    A semiempirical formula D(chi)/D(O)proportionalphi(O)=R(chi)=[1-(1+αchi-2)sup(-1/2)]exp(-βchi) is proposed, where D(chi) is the thermal-neutron dose and phi(chi) is the thermal-neutron flux at 'reduced centerline length' chi=∫sub(o)sup(z)dz[S(z)]sup(-1/2) with z being the actual centerline length measured from the mouth of a maze or from a bend and S(z) the cross-sectional area. The formula fits well to the experimental results of the authors, Price et al., and Maerker and Muckenthaler with suitable choice of the values of the parameters α and β. (orig.)

  18. Cognitive Evaluation Using Morris Water Maze in Neurotrauma.

    Deng-Bryant, Ying; Leung, Lai Yee; Caudle, Krista; Tortella, Frank; Shear, Deborah

    2016-01-01

    The Morris water maze (MWM) task is one of the most widely used and versatile tools in behavioral neuroscience for evaluating spatial learning and memory. With regard to detecting cognitive deficits following central nervous system (CNS) injuries, MWM has been commonly utilized in various animal models of neurotrauma, such as fluid percussion injury (FPI), cortical controlled impact (CCI) injury, weight-drop impact injury, and penetrating ballistic-like brain injury (PBBI). More importantly, it serves as a therapeutic index for assessing the efficacy of treatment interventions on cognitive performance following neurotrauma. Thus, it is critical to design an MWM testing paradigm that is sensitive yet discriminating for the purpose of evaluating potential therapeutic interventions. In this chapter, we discuss how multiple test manipulations, including the size of platform, numbers of trials per day, the frequency of retesting intervals, and the texture of platform surface, impact MWM's ability to detect cognitive deficits using a rat model of PBBI. PMID:27604737

  19. Shielding of radiation fields generated by 252Cf in a concrete maze. Part 1: Experiment

    A concrete room with a single-legged maze was constructed in order to simulate a medical accelerator room. Gamma and neutron measurements were performed along the maze with (a) a 252Cf source and (b) a tungsten-moderated 252Cf source placed inside the room. The measurements were repeated after placing an inner borated polyethylene door of varying thickness (2.54--10.16 cm) at 2 different locations. Measurements were also performed after lining the inside of the maze with different neutron moderating materials. The following results are reported: (1) the variation and contributions of individual components of the radiation fields as a function of distance along the maze, (2) the attenuation of neutron dose equivalent and reduction of capture gamma rays as a function of borated polyethylene (BPE) inner door thickness and location of the inner door; and (3) the effect of lining the maze corner with different neutron moderating materials

  20. Effectiveness of custom neutron shielding in the maze of radiotherapy accelerators

    An investigation was performed to examine the neutron dose equivalent in a radiotherapy maze lined with a customised neutron shielding material. The accelerator investigated was a Varian Clinac 2100C/D using 18 MV photons, and the neutron shielding utilised at this centre was PremadexTM commercially available neutron shielding. Based on Monte Carlo simulations, properly installed customised neutron shielding may reduce the neutron dose equivalent by up to a factor of 8 outside the maze, depending upon the installation. In addition, it was determined that the neutron dose near the entrance to the maze may be reduced by approximately 40% by using customised neutron shielding in the maze, as compared with a facility not using this shielding. This would have a positive dose-saving effect in doorless maze designs. (author)

  1. Catheter Ablation without Fluoroscopy: Current Techniques and Future Direction

    Amee M. Bigelow, MD; Grace Smith, MD; John M. Clark, MD

    2014-04-01

    Full Text Available Background: Catheter ablation is the treatment of choice for most forms of SVT. Traditionally, fluoroscopy has been the primary tool for visualizing catheter position. However, newer, 3-dimensional mapping technologies offer multiple options for minimizing fluoroscopy use. We review our 8 year experience of a zero-fluoroscopy approach using the Ensite system, and discuss our current techniques. Methods: From January 2006 to October 2013, we performed 524 catheter ablation procedures with a zero-fluoroscopy approach. The Ensite system was used exclusively. Early in the study, NavX mode was employed. In the later time period, Velocity mode was used. The Ensite system allowed easy access to all right sided arrhythmias. For left sided arrhythmias, TEE was added to aid with transseptal puncture. Results: Reviewing 524 consecutive procedures, mean age was 14 years (range 7 weeks to 65 years. Mean weight was 60.7 kg (range 3 to 174 kg. Mean procedure time was 142 minutes (range 42 – 402 minutes. There were no complications. Twenty -five patients required the use of fluoroscopy, mostly as part of simultaneous diagnostic or interventional cath procedures. There was only one instance in which fluoroscopy was used when not anticipated at the start of the procedure. With this data available, and seeing that fluoroscopy is rarely needed unexpectedly, we hypothesized that catheter ablation no longer requires a traditional cath lab. We present our early approach to ablation outside the catheterization lab. Conclusion: Three dimensional mapping systems can eliminate fluoroscopy use in virtually all routine ablation procedures. As technology improves, ablation procedures will shift beyond the traditional cath lab.

  2. Optical-vortex laser ablation

    Hamazaki, Junichi; Morita, Ryuji; Chujo, Keisuke; Kobayashi, Yusuke; Tanda, Satoshi; Omatsu, Takashige

    2010-01-01

    Laser ablation of Ta plates using nanosecond optical vortex pulses was carried out, for the first time. It was suggested that owing to orbital angular momentum of optical vortex, clearer and smoother processed surfaces were obtained with less ablation threshold fluence, in comparison with the ablation by a nonvortex annular beam modified from a spatially Gaussian beam.

  3. Healthcare Utilization and Clinical Outcomes after Catheter Ablation of Atrial Flutter

    Dewland, Thomas A.; Glidden, David V.; Marcus, Gregory M

    2014-01-01

    Atrial flutter ablation is associated with a high rate of acute procedural success and symptom improvement. The relationship between ablation and other clinical outcomes has been limited to small studies primarily conducted at academic centers. We sought to determine if catheter ablation of atrial flutter is associated with reductions in healthcare utilization, atrial fibrillation, or stroke in a large, real world population. California Healthcare Cost and Utilization Project databases were u...

  4. Slab model for Rayleigh--Taylor stabilization by vortex shedding, compressibility, thermal conduction, and ablation

    Analytical models are derived for stabilization of the Rayleigh--Taylor instability of an ablatively accelerated slab. The procedure is to conserve mass, momentum, and energy flux across a perturbed interface through which plasma flows. In various regimes, the stabilization mechanism can be described as vortex shedding, compressibility, thermal conduction, and ablation. Comparisons are made with recent fluid simulations, and simple laws relevant to laser-driven ablative acceleration are derived

  5. Actual role of radiofrequency ablation of liver metastases

    Pereira, Philippe L. [Eberhard-Karls-University of Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany)

    2007-08-15

    The liver is, second only to lymph nodes, the most common site for metastatic disease irrespective of the primary tumour. More than 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improved survival in patients with colorectal metastases, only approximately 20% of patients are eligible for surgery. Thermal ablation and especially radiofrequency ablation emerge as an important additional therapy modality for the treatment of liver metastases. RF ablation shows a benefit in life expectancy and may lead in a selected patient group to cure. Percutaneous RF ablation appears safer (versus cryotherapy), easier (versus laser), and more effective (versus ethanol instillation and transarterial chemoembolisation) compared with other minimally invasive procedures. RF ablation can be performed by a percutaneous, laparoscopical or laparotomic approach, and may be potentially combined with chemotherapy and surgery. At present ideal candidates have tumours with a maximum diameter less than 3.5 cm. An untreatable primary tumour or a systemic disease represents contraindications for performing local therapies. Permanent technical improvements of thermal ablation devices and a better integration of thermal ablation in the overall patient care may lead to prognosis improvement in patients with liver metastases. (orig.)

  6. Actual role of radiofrequency ablation of liver metastases

    The liver is, second only to lymph nodes, the most common site for metastatic disease irrespective of the primary tumour. More than 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improved survival in patients with colorectal metastases, only approximately 20% of patients are eligible for surgery. Thermal ablation and especially radiofrequency ablation emerge as an important additional therapy modality for the treatment of liver metastases. RF ablation shows a benefit in life expectancy and may lead in a selected patient group to cure. Percutaneous RF ablation appears safer (versus cryotherapy), easier (versus laser), and more effective (versus ethanol instillation and transarterial chemoembolisation) compared with other minimally invasive procedures. RF ablation can be performed by a percutaneous, laparoscopical or laparotomic approach, and may be potentially combined with chemotherapy and surgery. At present ideal candidates have tumours with a maximum diameter less than 3.5 cm. An untreatable primary tumour or a systemic disease represents contraindications for performing local therapies. Permanent technical improvements of thermal ablation devices and a better integration of thermal ablation in the overall patient care may lead to prognosis improvement in patients with liver metastases. (orig.)

  7. Nogo-A downregulation impairs place avoidance in the Carousel maze but not spatial memory in the Morris water maze

    Petrásek, Tomáš; Prokopová, Iva; Bahník, Štěpán; Schönig, K.; Berger, S.; Valeš, Karel; Tews, B.; Schwab, M. E.; Bartsch, D.; Stuchlík, Aleš

    2014-01-01

    Roč. 107, Jan 2014 (2014), s. 42-49. ISSN 1074-7427 R&D Projects: GA ČR(CZ) GCP303/10/J032; GA ČR(CZ) GBP304/12/G069; GA MZd(CZ) NT13386; GA ČR(CZ) GA14-03627S Grant ostatní: Rada Programu interní podpory projektů mezinárodní spolupráce AV ČR(CZ) M200111204; Univerzita Karlova(CZ) 365911 Institutional support: RVO:67985823 Keywords : Nogo-A * spatial navigation * cognitive coordination * spatial mazes * transgenic rat model Subject RIV: FH - Neurology Impact factor: 3.652, year: 2014

  8. Use of an Eight-arm Radial Water Maze to Assess Working and Reference Memory Following Neonatal Brain Injury

    stephanie c penley; Gaudet, Cynthia M.; Threlkeld, Steven W.

    2013-01-01

    Working and reference memory are commonly assessed using the land based radial arm maze. However, this paradigm requires pretraining, food deprivation, and may introduce scent cue confounds. The eight-arm radial water maze is designed to evaluate reference and working memory performance simultaneously by requiring subjects to use extra-maze cues to locate escape platforms and remedies the limitations observed in land based radial arm maze designs. Specifically, subjects are required to avoid ...

  9. Spark ablation device

    Schmidt-Ott, A.; Pfeiffer, T.V.

    2013-01-01

    A spark ablation device for generating nanoparticles comprising a spark generator; the spark generator comprising first and second electrodes, wherein the spark generator further comprises at least one power source which is arranged to be operative at a first energy level for maintaining a discharge

  10. Tumor ablations in IMRI

    Roberto Blanco Sequeiros

    2002-01-01

    @@ IntroductionMagnetic resonance imaging based guidance control and monitoring of minimally invasive intervention has developed from a hypothetical concept to a practical possibility. Magnetic-resonance-guided interstitial therapy in principle is defined as a treatment technique for ablating deepseated tumors in the human body.

  11. Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes

    Tasso Julio Lobo

    2015-01-01

    Full Text Available Background: Heart failure and atrial fibrillation (AF often coexist in a deleterious cycle. Objective: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF ablation. Methods: Patients with ventricular systolic dysfunction [ejection fraction (EF <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class and echocardiographic (EF, left atrial diameter data were compared (McNemar test and t test before and after ablation. Results: 31 patients (6 women, 25 men, aged 37 to 77 years (mean, 59.8±10.6, underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%. During a mean follow-up of 20.3±17 months, 24 patients (77% were in sinus rhythm, 11 (35% being on amiodarone. Eight patients (26% underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures. Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001. The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005 and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026. No major complications occurred. Conclusion: Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.

  12. Radiofrequency ablation for neuroendocrine liver metastases: a systematic review.

    Mohan, Helen; Nicholson, Patrick; Winter, Des C; O'Shea, Donal; O'Toole, Dermot; Geoghegan, Justin; Maguire, Donal; Hoti, Emir; Traynor, Oscar; Cantwell, Colin P

    2015-07-01

    To determine the efficacy of radiofrequency (RF) ablation in neuroendocrine tumor (NET) liver metastases. A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight studies were included (N = 301). Twenty-six percent of RF ablation procedures were percutaneous (n = 156), with the remainder conducted at surgery. Forty-eight percent of patients had a concomitant liver resection. Fifty-four percent of patients presented with symptoms, with 92% reporting symptom improvement following RF ablation (alone or in combination with surgery). The median duration of symptom improvement was 14-27 months. However, recurrence was common (63%-87%). RF ablation can provide symptomatic relief in NET liver metastases alone or in combination with surgery. PMID:25840836

  13. Laser ablation in analytical chemistry-a review.

    Russo, Richard E; Mao, Xianglei; Liu, Haichen; Gonzalez, Jhanis; Mao, Samuel S

    2002-05-24

    Laser ablation is becoming a dominant technology for direct solid sampling in analytical chemistry. Laser ablation refers to the process in which an intense burst of energy delivered by a short laser pulse is used to sample (remove a portion of) a material. The advantages of laser ablation chemical analysis include direct characterization of solids, no chemical procedures for dissolution, reduced risk of contamination or sample loss, analysis of very small samples not separable for solution analysis, and determination of spatial distributions of elemental composition. This review describes recent research to understand and utilize laser ablation for direct solid sampling, with emphasis on sample introduction to an inductively coupled plasma (ICP). Current research related to contemporary experimental systems, calibration and optimization, and fractionation is discussed, with a summary of applications in several areas. PMID:18968642

  14. A tubular electrode for radiofrequency ablation therapy

    Antunes, Carlos Lemos Lemos Lemos

    2012-07-06

    Purpose – Due to its good mechanical and biocompatibility characteristics, nitinol SEMS is a popular endoprothesis used for relieving stricture problems in hollow organs due to carcinomas. Besides its mechanical application, SEMS can be regarded as well as potential electrode for performing RF ablation therapy on the tumor. The purpose of this work is to perform numerical and experimental analyses in order to characterize the lesion volume induced in biological tissue using this kind of tubular electrode. Design/methodology/approach – Data concerning electrical conductivity and dimension of the damaged tissue after RF ablation procedure were obtained from ex vivo samples. Next, numerical models using 3D finite element method were obtained reassembling the conditions considered at experimentation setup and results were compared. Findings – Numerical and experimental results show that a regular volume of damaged tissue can be obtained considering this type of electrode. Also, results obtained from numerical simulation are close to those obtained by experimentation. Originality/value – SEMSs, commonly used as devices to minimize obstruction problems due to the growth of tumors, may still be considered as an active electrode for RF ablation procedures. A method considering this observation is presented in this paper. Also, numerical simulation can be regarded in this case as a tool for determining the lesion volume.

  15. Percutaneous radiofrequency ablation for benign nodules of the thyroid gland

    We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83 ± SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83 ± SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland

  16. Percutaneous radiofrequency ablation for benign nodules of the thyroid gland

    Baek, Jung Hwan; Jeong, Hyun Jo; Kim, Yoon Suk; Kwak, Min Sook; Chang, Sun Hee [Daerim St. Mary' s Hospital, Seoul (Korea, Republic of); Rhim, Hyun Chul [Hanyang University Hospital, Seoul (Korea, Republic of)

    2005-07-15

    We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83 {+-} SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83 {+-} SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland.

  17. Administration of D,L-fenfluramine to rats produces learning deficits in the Cincinnati water maze but not the Morris water maze: relationship to adrenal cortical output.

    Williams, Michael T; Morford, LaRonda L; McCrea, Anne E; Wood, Sandra L; Vorhees, Charles V

    2002-01-01

    Fenfluramine (FEN) is an amphetamine derivative with anorectic properties similar to amphetamine, but without the stimulatory or abuse potential. Administration of FEN produces an immediate release of serotonin as well as inhibits reuptake; ultimately FEN produces a decrease in serotonin stores in the central nervous system. We have previously shown that the administration of FEN to rats results in increased adrenal cortical hormones under resting conditions, without simultaneous elevations in adrenocorticotropin hormone (ACTH). We hypothesized that the adrenal output would be altered following stress and that the altered adrenal output would affect learning and memory, since the adrenal hormones influence learning and memory capability. In this series of experiments, we administered D,L-FEN (15 mg/kg) four times every 2 h on a single day to rats and investigated the effect on hormonal output following forced swim and the effect on sequential learning in the Cincinnati water maze and spatial learning in the Morris maze beginning 3 days after FEN administration. Animals that received FEN had increased corticosterone and aldosterone titers following forced swim relative to control animals, although no differences in ACTH or testosterone were noted. Animals exposed to FEN had lasting deficits in the Cincinnati water maze but not in the Morris water maze, regardless of testing order. These deficits in the Cincinnati water maze appear to be mediated by the elevation in adrenal output since adrenalectomy abolished the effect of FEN. Corticosterone levels were shown to be elevated during the behavioral testing period in animals exposed to FEN. PMID:12460661

  18. When to go epicardially during ventricular tachycardia ablation? Role of surface electrocardiogram

    Ozcan, Emin Evren; Széplaki, Gábor; Tahin, Tamás; Osztheimer, István; SZILÁGYI Szabolcs; Merkely, Béla; Gellér, László

    2013-01-01

    Early recognition of ventricular tachycardias (VTs) with epicardial circuits is crucial. Surface electrocardiogram (ECG) suggesting an epicardial origin could guide ablation procedures and increase success rates. A 35-year-old female patient with VT treated by combined epicardial and endocardial ablation approach is presented in this report, and the role of surface electrocardiogram and timing of epicardial access is discussed.

  19. Palliative Radiofrequency Ablation for Recurrent Prostate Cancer

    Percutaneous radiofrequency ablation (RFA) is a minimally invasive local therapy for cancer. Its efficacy is now becoming well documented in many different organs, including liver, kidney, and lung. The goal of RFA is typically complete eradication of a tumor in lieu of an invasive surgical procedure. However, RFA can also play an important role in the palliative care of cancer patients. Tumors which are surgically unresectable and incompatible for complete ablation present the opportunity for RFA to be used in a new paradigm. Cancer pain runs the gamut from minor discomfort relieved with mild pain medication to unrelenting suffering for the patient, poorly controlled by conventional means. RFA is a tool which can potentially palliate intractable cancer pain. We present here a case in which RFA provided pain relief in a patient with metastatic prostate cancer with pain uncontrolled by conventional methods

  20. Ultra-high field parallel imaging of the superior parietal lobule during mental maze solving

    Jerde, Trenton A.; Lewis, Scott M.; Goerke, Ute; Gourtzelidis, Pavlos; Tzagarakis, Charidimos; Lynch, Joshua; Moeller, Steen; Van de Moortele, Pierre-François; Adriany, Gregor; Trangle, Jeran; Uğurbil, Kâmil; Georgopoulos, Apostolos P.

    2008-01-01

    We used ultra-high field (7 T) fMRI and parallel imaging to scan the superior parietal lobule (SPL) of human subjects as they mentally traversed a maze path in one of four directions (up, down, left, right). A counterbalanced design for maze presentation and a quasi-isotropic voxel (1.46 × 1.46 × 2 mm thick) collection were implemented. Fifty-one percent of single voxels in the SPL were tuned to the direction of the maze path. Tuned voxels were distributed throughout the SPL, bilaterally. A n...

  1. Recent progress in radiofrequency ablation therapy for hepatocellular carcinoma.

    Ikeda, Kenji; Osaki, Yukio; Nakanishi, Hiroyuki; Nasu, Akihiro; Kawamura, Yusuke; Jyoko, Koji; Sano, Takatomo; Sunagozaka, Hajime; Uchino, Koji; Minami, Yasunori; Saito, Yu; Nagai, Kazumasa; Inokuchi, Ryosuke; Kokubu, Shigehiro; Kudo, Masatoshi

    2014-01-01

    In order to attain better ablation and more effective management of hepatocellular carcinoma (HCC), new approaches and devices in radiofrequency ablation (RFA) therapy were presented and discussed in a workshop at the 50th Annual Meeting of the Liver Cancer Study Group of Japan. A novel bipolar RFA apparatus was introduced in Japan in January 2013. Hundreds of subjects with HCC were treated with multipolar RFA with varied devices and plans. Among these, no-touch ablation was one of the most useful procedures in the treatment of HCC with the apparatus. In RFA therapy, a few assisting devices and techniques were applied for convenience and improvement of the thermal ablation procedure. Contrast-enhanced ultrasonography and three-dimensional fusion imaging technique using volume data of CT or MRI could improve exact targeting and shorten the treatment time for RFA procedures under ultrasonographic guidance. A more complicated method using a workstation was also reported as being helpful in planning the ablated shape and volume in multineedle RFA. The effective use of sedatives and antianalgesics as well as a novel microwave apparatus with a cooled-tip electrode was also discussed. PMID:25427736

  2. Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: A comparison of the safety of cryoablation and radiofrequency ablation

    Purpose: To compare the safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis. Materials and methods: This retrospective HIPAA-compliant study received institutional review board approval. Forty-two adult patients with cirrhosis underwent image-guided percutaneous ablation of hepatocellular carcinoma from 2003 to 2011. Twenty-five patients underwent 33 cryoablation procedures to treat 39 tumors, and 22 underwent 30 radiofrequency ablation procedures to treat 39 tumors. Five patients underwent both cryoablation and radiofrequency ablation procedures. Complication rates and severity per procedure were compared between the ablation groups. Potential confounding patient, procedure, and tumor-related variables were also compared. Statistical analyses included Kruskal–Wallis, Wilcoxon rank sum, and Fisher's exact tests. Two-sided P-values <0.05 were considered significant. Results: The overall complication rates, 13 (39.4%) of 33 cryoablation procedures versus eight (26.7%) of 30 radiofrequency ablation procedures and severe/fatal complication rates, two (6.1%) of 33 cryoablation procedures versus one (3.3%) of 30 radiofrequency ablation procedures, were not significantly different between the ablation groups (both P = 0.26). Severe complications included pneumothoraces requiring chest tube insertion during two cryoablation procedures. One death occurred within 90 days of a radiofrequency ablation procedure; all other complications were managed successfully. Conclusion: No significant difference was seen in the overall safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis

  3. Maze learning by a hybrid brain-computer system.

    Wu, Zhaohui; Zheng, Nenggan; Zhang, Shaowu; Zheng, Xiaoxiang; Gao, Liqiang; Su, Lijuan

    2016-01-01

    The combination of biological and artificial intelligence is particularly driven by two major strands of research: one involves the control of mechanical, usually prosthetic, devices by conscious biological subjects, whereas the other involves the control of animal behaviour by stimulating nervous systems electrically or optically. However, to our knowledge, no study has demonstrated that spatial learning in a computer-based system can affect the learning and decision making behaviour of the biological component, namely a rat, when these two types of intelligence are wired together to form a new intelligent entity. Here, we show how rule operations conducted by computing components contribute to a novel hybrid brain-computer system, i.e., ratbots, exhibit superior learning abilities in a maze learning task, even when their vision and whisker sensation were blocked. We anticipate that our study will encourage other researchers to investigate combinations of various rule operations and other artificial intelligence algorithms with the learning and memory processes of organic brains to develop more powerful cyborg intelligence systems. Our results potentially have profound implications for a variety of applications in intelligent systems and neural rehabilitation. PMID:27619326

  4. Barnes maze performance of Octodon degus is gender dependent.

    Popović, Natalija; Madrid, Juan Antonio; Rol, María Angeles; Caballero-Bleda, María; Popović, Miroljub

    2010-10-15

    Gender differences in spatial navigation have been widely reported in nocturnal rodent species. Here, for the first time we report gender differences in spatial learning and memory of Octodon degus, a long-lived diurnal hystricomorph rodent. In the present study, 16 months old male and female O. degus were tested in the 18-holes Barnes circular maze. The acquisition session consisted of four daily 4 min trials, during 10 days. Seven days later, the retention test was performed. To avoid the effect of hormonal fluctuation on spatial navigation, both the acquisition and the retention tests, were performed in 21-day regular cycling females in a period that corresponds to the diestrus phase of the estrus cycle. At the beginning of the acquisition, female degus were significantly slower than males to find the escape hole, but the situation reversed afterwards. Moreover, during the course of acquisition, females made significantly less reference memory errors, working memory errors as well as omission errors, than males. In both sexes, motivation and learning ceiling effects were reached at days 5-6 of the training. During the acquisition, females used more frequently a spatial strategy, while males preferably applied either serial, random or opposite strategies. The observed cognitive differences between male and female O. degus existed only during the acquisition period but not during the retention, indicating that acquisition and consolidation are differently influenced by gender. PMID:20385170

  5. Does Radio Frequency Ablation (RFA) Epiphysiodesis Affect Joint Cartilage?

    Shiguetomi Medina, Juan Manuel; Abood, Ahmed Abdul-Hussein; Rahbek, Ole;

    Background: Epiphysiodesis made with RFA has resulted, in animal models, an effective procedure that disrupts the growth plate and induces LLD. This procedure involves an increase of temperature (>92°C) of the targeted region causing thermal damage. To our knowledge, no study that investigates...... the effect of this procedure in the adjacent joint articular cartilage has been reported Purpose / Aim of Study: Proof of concept that epiphysiodesis made with RFA is a safe procedure that disrupts the growth plate without damaging the adjacent joint articular cartilage Materials and Methods: RFA...... Epiphysiodesis RFA was done for 8 minutes in vivo in 40 growing pig tibia physis. In addition, three tibiae were ablated for 16 minutes, and three more for 24 minutes. As a damage reference, 6 tibiae were ablated on the joint articular cartilage for 8 minutes. MRI was done ex vivo after the procedure to evaluate...

  6. Unconscious sedation/analgesia with propofol versus conscious sedation with fentanyl/midazolam for catheter ablation of atrial fibrillation: a prospective, randomized study

    TANG Ri-bo; MA Chang-sheng; DONG Jian-zeng; ZHAO Wen-du; LIU Xing-peng; KANG Jun-ping; LONG De-yong; YU Rong-hui; HU Fu-li; LIU Xiao-hui

    2007-01-01

    @@ Catheter ablation of atrial fibrillation (AF) has been increased dramatically recently.1 However, it is an unpleasant procedure with intolerable pain without sedation. Propofol and fentanyl/midazolam have been widely used in painful clinical examination and cardiovascular procedures with established safety and efficacy.2,3 Propofol, alfentanyl and midazolam were administrated for catheter ablation in some electrophysiological labs for a less painful procedure.4However, there is few published work on the sedation regimen for catheter ablation of AF.

  7. Meteoroid ablation models

    Popova, Olga

    2004-12-01

    The fate of entering meteoroids in atmosphere is determined by their size, velocity and substance properties. Material from ablation of small-sized meteors (roughly R≤0.01-1 cm) is mostly deposited between 120 and 80 km altitudes. Larger bodies (up to meter sizes) penetrate deeper into the atmosphere (down to 20 km altitude). Meteoroids of cometary origin typically have higher termination altitude due to substance properties and higher entry velocity. Fast meteoroids ( V>30-40 km/s) may lose a part of their material at higher altitudes due to sputtering. Local flow regime realized around the falling body determines the heat transfer and mass loss processes. Classic approach to meteor interaction with atmosphere allows describing two limiting cases: - large meteoroid at relatively low altitude, where shock wave is formed (hydrodynamical models); - small meteoroid/or high altitudes - free molecule regime of interaction, which assumes no collisions between evaporated meteoroid particles. These evaporated particles form initial train, which then spreads into an ambient air due to diffusion. Ablation models should make it possible to describe physical conditions that occur around meteor body. Several self-consistent hydrodynamical models are developed, but similar models for transition and free molecule regimes are still under study. This paper reviews existing ablation models and discusses model boundaries.

  8. Ablation, Thermal Response, and Chemistry Program for Analysis of Thermal Protection Systems

    Milos, Frank S.; Chen, Yih-Kanq

    2010-01-01

    In previous work, the authors documented the Multicomponent Ablation Thermochemistry (MAT) and Fully Implicit Ablation and Thermal response (FIAT) programs. In this work, key features from MAT and FIAT were combined to create the new Fully Implicit Ablation, Thermal response, and Chemistry (FIATC) program. FIATC is fully compatible with FIAT (version 2.5) but has expanded capabilities to compute the multispecies surface chemistry and ablation rate as part of the surface energy balance. This new methodology eliminates B' tables, provides blown species fractions as a function of time, and enables calculations that would otherwise be impractical (e.g. 4+ dimensional tables) such as pyrolysis and ablation with kinetic rates or unequal diffusion coefficients. Equations and solution procedures are presented, then representative calculations of equilibrium and finite-rate ablation in flight and ground-test environments are discussed.

  9. AF Termination: the Holy Grail of Persistent AF Ablation?

    Dennis H. Lau

    2010-05-01

    Full Text Available The optimal catheter ablation approach for long-standing persistent atrial fibrillation (AF remains elusive despite significant advances made in our understanding of this arrhythmia. A recent systematic review highlighted the significant variation in procedural success rate both within and between techniques, necessitating repeat ablation procedures and anti-arrhythmic drugs to achieve improved outcomes in those with long-standing persistent AF . Indeed, current expert consensus statement recommended ablation beyond ostial pulmonary vein isolation for these patients . Despite incorporating various substrate modification techniques which commonly include linear lesions and targeting of complex fractionated electrograms, the reported success rates from various laboratories are still below par to those in paroxysmal AF patients.

  10. The effect of radiofrequency ablation on different organs: Ex vivo and in vivo comparative studies

    Kim, Yoo Na [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Rhim, Hyunchul, E-mail: rhimhc@skku.edu [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Choi, Dongil; Kim, Young-sun; Lee, Min Woo; Chang, Ilsoo; Lee, Won Jae; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)

    2011-11-15

    Objective: The purposes of this study are to evaluate the ex vivo and in vivo efficacy of radiofrequency ablation (RFA) on different porcine tissues by the ablation of three different sites simultaneously. Materials and methods: A multichannel RFA system, enables three separate tumors to be ablated simultaneously, was used. RFA procedures were applied to normal porcine liver, kidney, and muscle together ex vivo (n = 12) and in vivo (n = 17). Pre-impedances, defined as baseline systemic impedances of tissues before beginning RFA, and the areas of ablation zones were measured and compared. Results: The areas of ablation zones among three organs had a significant difference in decreasing order as follows: liver, muscle, and kidney in the ex vivo study (p = 0.001); muscle, liver, and kidney in the in vivo study (p < 0.0001). The areas of ablation zones between ex vivo and in vivo had a significant difference in the liver and muscle (each p < 0.05). There was no significant correlation between the areas of ablation zones and pre-impedances in both studies. Conclusions: Renal RFA produced the smallest ablation zone in both in vivo and ex vivo studies. Muscular RFA demonstrated the largest ablation zone in the in vivo study, and hepatic RFA showed the largest ablation zone in the ex vivo study. This variability in the tissues should be considered for performing an optimized RFA for each organ site.

  11. Fast escape of a quantum walker from an integrated photonic maze

    Caruso, Filippo; Crespi, Andrea; Ciriolo, Anna Gabriella; Sciarrino, Fabio; Osellame, Roberto

    2016-06-01

    Escaping from a complex maze, by exploring different paths with several decision-making branches in order to reach the exit, has always been a very challenging and fascinating task. Wave field and quantum objects may explore a complex structure in parallel by interference effects, but without necessarily leading to more efficient transport. Here, inspired by recent observations in biological energy transport phenomena, we demonstrate how a quantum walker can efficiently reach the output of a maze by partially suppressing the presence of interference. In particular, we show theoretically an unprecedented improvement in transport efficiency for increasing maze size with respect to purely quantum and classical approaches. In addition, we investigate experimentally these hybrid transport phenomena, by mapping the maze problem in an integrated waveguide array, probed by coherent light, hence successfully testing our theoretical results. These achievements may lead towards future bio-inspired photonics technologies for more efficient transport and computation.

  12. Slime mould solves maze in one pass ... assisted by gradient of chemo-attractants

    Adamatzky, Andrew

    2011-01-01

    Plasmodium of Physarum polycephalum is a large cell, visible by unaided eye, which exhibits sophisticated patterns of foraging behaviour. The plasmodium's behaviour is well interpreted in terms of computation, where data are spatially extended configurations of nutrients and obstacles, and results of computation are networks of protoplasmic tubes formed by the plasmodium. In laboratory experiments and numerical simulation we show that if plasmodium of Physarum is inoculated in a maze's peripheral channel and an oat flake (source of attractants) in a the maze's central chamber then the plasmodium grows toward target oat flake and connects the flake with the site of original inoculation with a pronounced protoplasmic tube. The protoplasmic tube represents a path in the maze. The plasmodium solves maze in one pass because it is assisted by a gradient of chemo-attractants propagating from the target oat flake.

  13. Correlations among central serotonergic parameters and age-related emotional and cognitive changes assessed through the elevated T-maze and the Morris water maze

    Oliveira, Luciana; Graeff, Frederico G.; Pereira, Silvia R. C.; Oliveira-Silva, Ieda F.; Franco, Glaura C.; Ribeiro, Angela Maria

    2010-01-01

    Emotion and spatial cognitive aspects were assessed in adult and middle-aged rats using the elevated T-maze (ETM) and the Morris water maze (MWM) tasks. Both adult and middle-aged rats were able to acquire inhibitory avoidance behaviour, though the middle-aged subjects showed larger latencies along the trials, including the baseline, which was significantly longer than that showed by adult rats. Further, compared to adult rats, middle-aged rats had longer escape latency. In spite of the worse...

  14. Prediction of Primary Slow-Pathway Ablation Success Rate According to the Characteristics of Junctional Rhythm Developed during the Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia

    Maryam Moshkani Farahani

    2011-02-01

    Full Text Available Background: Nowadays, developed junctional rhythm (JR that occurs during slow-pathway radiofrequency (RF catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT has been focused upon as a highly sensitive surrogate end point for successful radiofrequency ablation. This study was conducted to assess the relationship between the presence and pattern of developed JR during the RF ablation of AVNRT and a successful outcome.Methods: Seventy-five patients aged between 14 and 88 who underwent slow-pathway RF ablation due to symptomatic AVNRT were enrolled into the study and received a total of 162 RF energy applications. Combined anatomic and electrogram mapping approach was used for slow-pathway RF ablation. The ablation procedure consisted of 60-second, 60 °C temperature-controlled energy delivery. After each ablation pulse, successful ablation was assessed according to the loss of AVNRT inducibility via isoproterenol infusion. Four different patterns were considered for the developed JR, namely sparse, intermittent, continuous, and transient block. Success ablation rate was assessed with respect to the position, pattern, and number of junctional beats.Results: Successful RF ablation with a loss of AVNRT inducibility was achieved in 43 (57.3% patients using 119 RF energy applications (73.5%. JR developed in 133 of the 162 (82.1% applications with a given sensitivity of 90.8% and low specificity of 41.9% as an end point of successful RF ablation, with a negative predictive value of 62.1%. The mean number of the developed junctional beats was significantly higher in the successful ablations (p value < 0.001, and the ROC analysis revealed that the best cut-off point of the cumulative junctional beats for identifying accurate AVNRT ablation therapy is 14 beats with 90.76 % sensitivity and 90.70% specificity. There were no significant differences in terms of successful ablation rates according to the four different patterns of JR and its

  15. Effects of an Early Experience Involving Training in a T-Maze Under either Denial or Receipt of Expected Reward through Maternal Contact.

    Stamatakis, Antonios; Diamantopoulou, Anastasia; Panagiotaropoulos, Theofanis; Raftogianni, Androniki; Stylianopoulou, Fotini

    2013-01-01

    The mother is the most salient stimulus for the developing pups and a number of early experience models employ manipulation of the mother-infant interaction. We have developed a new model which in addition to changes in maternal behavior includes a learning component on the part of the pups. More specifically, pups were trained in a T-maze and either received (RER rats) or were denied (DER) the reward of maternal contact, during postnatal days 10-13. Pups of both experimental groups learn the T-maze, but the RER do so more efficiently utilizing a procedural-type of learning and memory with activation of the dorsal basal ganglia. On the other hand, the DER experience leads to activation of the hippocampus, prefrontal cortex, and amygdala in the pups. In adulthood, male DER animals exhibit better mnemonic abilities in the Morris water maze and higher activation of the hippocampus, while they have decreased brain serotonergic activity, exhibit a depressive-like phenotype and proactive aggressive behavior in the resident-intruder test. While male RER animals assume a reactive coping style in this test, and showed increased freezing during both contextual and cued memory recall following fear conditioning. PMID:24298269

  16. Effects of an early experience involving training in a T-maze under either denial or receipt of expected reward through maternal contact.

    Antonios eStamatakis

    2013-11-01

    Full Text Available The mother is the most salient stimulus for the developing pups and a number of early experience models employ manipulation of the mother-infant interaction. We have developed a new model which in addition to changes in maternal behavior includes a learning component on the part of the pups. More specifically, pups were trained in a T-maze and either received (RER rats or were denied (DER the reward of maternal contact, during postnatal days 10—13.Pups of both experimental groups learn the T-maze, but the RER do so more efficiently utilizing a procedural-type of learning and memory with activation of the dorsal basal ganglia. On the other hand, the DER experience leads to activation of the hippocampus, prefrontal cortex and amygdala in the pups.In adulthood, male DER animals exhibit better mnemonic abilities in the Morris water maze and higher activation of the hippocampus, while they have decreased brain serotonergic activity, exhibit a depressive-like phenotype and proactive aggressive behavior in the resident-intruder test. On the other hand, male RER animals assume a reactive coping style in this test, showed increased emotionality as well as freezing in the memory test following both contextual and cued fear conditioning.

  17. Evaluation of neurotransmitters involved in the anxiolytic and panicolytic effect of the aqueous fraction of Paullinia cupana (guaraná in elevated T maze

    Marcel P. Rangel

    2013-04-01

    Full Text Available This study investigated the effects of repeatedly administration of an aqueous fraction of Paullinia cupana Kunth, Sapindaceae (guaraná seeds (8 mg/kg on rats submitted to the elevated T-maze, model of generalized anxiety and panic disorders. The selective serotonin reuptake inhibitor paroxetine (3 mg/kg, was used as a positive control. To evaluate possible neurotransmissions involvement, ineffective doses of metergoline (3 mg/kg - non-selective serotonin receptor antagonist, sulpiride (20 mg/kg - non-selective dopaminergic receptor antagonist or ketamine (0.125 mg/kg - non-selective glutamate receptor antagonist were acutely administered in association with the aqueous fraction of P. cupana. Both aqueous fraction and paroxetine decrease the inhibitory avoidance latencies of the elevated T-maze, indicating anxiolytic effect and increased one-way escape latencies from the open arm of the elevated T-maze, indicating a panicolytic effect. The pre-treatment with metergoline, sulpiride and ketamine blocked the anxiolytic effect of aqueous fraction. The panicolytic effect of aqueous fraction was blocked by both metergoline and sulpiride. These results show that the serotonergic, dopaminergic and glutamatergic neurotransmission systems are involved in anxiolytic effect promoted by aqueous fraction, whereas only the serotonergic and the dopaminergic neurotransmission systems are involved in the panicolytic effect promoted by aqueous fraction of P. cupana. The effects produced by paroxetine, were blocked only by metergoline, validating this experimental procedure.

  18. Exploring the T-Maze: Evolving Learning-Like Robot Behaviors using CTRNNs

    Blynel, J.; D. Floreano

    2003-01-01

    This paper explores the capabilities of continuous time recurrent neural networks (CTRNNs) to display reinforcement learning-like abilities on a set of T-Maze and double T-Maze navigation tasks, where the robot has to locate and "remember'' the position of a reward-zone. The "learning'' comes about without modifications of synapse strengths, but simply from internal network dynamics, as proposed by [12]. Neural controllers are evolved in simulation and in the simple case evalua...

  19. Screening for Reading Problems in Middle School: Maze and STAR Reading Assessment

    Kowalko, Lisa Christine

    2013-01-01

    This study examined the relationship between the curriculum-based measurement Maze task and the Standardized Test for the Assessment of Reading (STAR-R) and California Standards Test (CST) scores. Participants included 1,479 sixth, seventh, and eighth grade students across three public middle schools in an urban school district in southern California. The results indicated a significant correlation between Maze scores in the winter and in the spring, but failed to find a significant correla...

  20. Radial Maze Analog for Pigeons: Evidence for Flexible Coding Strategies May Result from Faulty Assumptions

    Gipson, Cassandra D.; DiGian, Kelly A.; Miller, Holly C.; Zentall, Thomas R

    2008-01-01

    Previous research with the radial maze has found evidence that rats can remember both places that they have already been (retrospective coding) and places they have yet to visit (prospective coding; Cook, Brown, & Riley, 1985). Such dual coding also has been found in pigeons using a radial maze analog in which insertion of a delay at different points during a trial affects performance differentially depending on where in the trial it is inserted. When a delay is interpolated either early or l...

  1. Detailed classification of swimming paths in the Morris Water Maze: multiple strategies within one trial

    Tiago V. Gehring; Gediminas Luksys; Carmen Sandi; Eleni Vasilaki

    2015-01-01

    The Morris Water Maze is a widely used task in studies of spatial learning with rodents. Classical performance measures of animals in the Morris Water Maze include the escape latency, and the cumulative distance to the platform. Other methods focus on classifying trajectory patterns to stereotypical classes representing different animal strategies. However, these approaches typically consider trajectories as a whole, and as a consequence they assign one full trajectory to one class, whereas a...

  2. Characteristics of P wave in Patients with Sinus Rhythm after Maze Operation

    Park, Hyo Eun; Kim, Kyung-Hwan; Kim, Ki-Bong; Ahn, Hyuk; Choi, Yun-Shik; Oh, Seil

    2010-01-01

    Maze operation could alter P wave morphology in electrocardiogram (ECG), which might prevent exact diagnosis of the cardiac rhythm of patients. However, characteristics of P wave in patients with sinus rhythm after the operation have not been elucidated systematically. Consecutive patients who underwent the modified Cox Maze operation from January to December 2007 were enrolled. The standard 12-lead ECG and echocardiography were evaluated in patients who had sinus rhythm at 6 months after the...

  3. Image-guided radiofrequency ablation of hepatocellular carcinoma (HCC): Is MR guidance more effective than CT guidance?

    Clasen, Stephan, E-mail: stephan.clasen@med.uni-tuebingen.de [University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen (Germany); Rempp, Hansjörg, E-mail: hansjoerg.rempp@med.uni-tuebingen.de [University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen (Germany); Hoffmann, Rüdiger, E-mail: ruediger.hoffmann@med.uni-tuebingen.de [University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen (Germany); Graf, Hansjörg, E-mail: hansjoerg.graf@med.uni-tuebingen.de [University Hospital, Department of Diagnostic and Interventional Radiology, Section of Experimental Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen (Germany); Pereira, Philippe L., E-mail: Philippe.Pereira@slk-kliniken.de [SLK Clinic Heilbronn, Clinic for Radiology, Minimal-invasive Therapies, and Nuclear Medicine, Am Gesundbrunnen 20-26, 74078 Heilbronn (Germany); Claussen, Claus D., E-mail: claus.claussen@med.uni-tuebingen.de [University Hospital, Department of Diagnostic and Interventional Radiology, Hoppe-Seyler Str. 3, 72076 Tübingen (Germany)

    2014-01-15

    Objectives: The purpose of the study was to retrospectively compare technique effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). Materials and methods: In 35 consecutive patients 53 CT-guided (n = 29) or MR-guided (n = 24) ablation procedures were performed in the treatment of 56 (CT: 29; MR: 27) HCC. The entire ablation procedure was performed at a multislice CT-scanner or an interventional 0.2-Tesla MR-scanner. Assessment of treatment response was based on dynamic MR imaging at 1.5 Tesla. The mean follow-up was 22.9 months. Primary technique effectiveness was assessed 4 months after ablation therapy. Secondary technique effectiveness was assessed 4 months after a facultative second ablation procedure. Primary and secondary technique effectiveness of CT-guided and MR-guided RF ablation was compared by using Chi-Square (likelihood ratio) test. Results: Primary technique effectiveness after a single session was achieved in 26/27 (96.3%) HCC after MR-guided RF ablation and 23/29 (79.3%) HCC after CT-guided RF ablation (Chi-Square: p = 0.04). Secondary technique effectiveness was achieved in 26/27 (96.3%) HCC after MR-guided RF ablation and in 26/29 (89.7%) HCC after CT-guided RF ablation (Chi-Square: p = 0.32). A local tumor progression was detected in 8/52 (15.4%) tumors after initial technique effectiveness. Major complications were detected after 3/53 (5.7%) ablation procedures. Conclusions: CT-guided and MR-guided RF ablations are locally effective therapies in the treatment of HCC. Due to a higher rate of primary technique effectiveness MR-guided RF ablation may reduce the number of required sessions for complete tumor treatment.

  4. Radiofrequency Ablation for Chronic Low Back Pain: A Systematic Review of Randomized Controlled Trials

    Laura E Leggett

    2014-01-01

    Full Text Available BACKGROUND: Radiofrequency ablation (RFA, a procedure using heat to interrupt pain signals in spinal nerves, is an emerging treatment option for chronic low back pain. Its clinical efficacy has not yet been established.

  5. Endoscopic ultrasound guided radiofrequency ablation in pancreas

    Seicean, Andrada; Tefas, Cristian; Ungureanu, Bogdan;

    2014-01-01

    Radiofrequency ablation of the pancreas represents a more effective tumor-destruction method compared to other ablation techniques. The endoscopic ultrasound guided radiofrequency ablation is indicated for locally advanced, non-metastatic pancreatic adenocarcinoma, without the need of general...

  6. Catheter ablation of persistent atrial fibrillation in a patient with dextrocardia

    XUE Zeng-ming; SANG Cai-hua; DONG Jian-zeng; MA Chang-sheng

    2012-01-01

    The technique of catheter ablation for atrial fibrillation (AF) has advanced rapidly over the last ten years.Catheter ablation of AF with special anatomy like dextrocardia was seldomly reported,1,2 which may be difficult for its complex anatomy.Three-dimensional electroanatomical mapping system and image integration system may be helpful during the procedure.We report a case with drug refractory persistent AF and dextrocardia,who underwent an ablation procedure.%Dextrocardia is a rare anomaly where the heart is located on the right side of the chest instead of the normal left side.Ablation of atrial fibrillation (AF) with such an inverted anatomy may be challenging for the manipulation of the catheters.Here we report a case of dextrocardia who underwent ablation for persistent AF guided by image integration system.

  7. New Empirical Formula for Neutron Dose Level at the Maze of Medical Linear Accelerator Facilities

    With the trend of using medical accelerators of higher energy in radiation therapy, neutron dose rates at the treatment room facilities, particularly at the doorways to the maze entrance, get more attention since photoneutron production increases significantly above around 10 MV. This paper derives an easily applicable empirical formula for the photoneutron dose potential at the maze entrance of a 15 MV medical accelerator treatment. Firstly, the photoneutron energy fluences and doses around accelerator heads were simulated with a geometry model fully describing the details of the Varian accelerator head by use of the Monte Carlo particle transport code MCNPX. The simulation process was validated by comparing the calculated neutron dose equivalent with dose measured by the bubble detectors at 10 positions around the head operating at 10 MV and 15 MV. The majority of the calculated results based on the same dose equivalent conversion factors as those of bubble detectors agreed within the standard deviations of the measurements. The maximum dose equivalent rates were observed in case of 20 x 20 cm2 field size so that further transport calculation can be done with the source term based on this field size. At this field size, the average neutron energies at the isocenter were 0.58 MeV for 10 MV and 0.74 MeV for 15 MV. Then, for an accelerator operating at 15 MV with 20 x 20 cm2 field, neutron dose equivalent rates at the outer maze entrances were estimated by extending neutron transport calculations down to maze doorways in the typical treatment rooms having a single-leg maze of various configurations. Two modes of gantry rotational planes were considered: parallel and perpendicular to the maze walls. Higher neutron doses at the doorway, in most cases, were found when the gantry rotational plane was parallel to the maze walls and the beams were directing to the wall facing the door and further calculations were made for this rotational mode. Repeated calculations of

  8. Osteoid Osteoma Treated with Radiofrequency Ablation

    Murat Çakar

    2015-01-01

    Full Text Available Purpose. Our aim is to evaluate the results of treatment with computed tomography (CT guided percutaneous radiofrequency ablation for osteoid osteomas which were localized in a difficult area for operation. Materials and Methods. Glenoid, distal tibia, humerus shaft, proximal humerus, and in third finger of the hand proximal phalanx were involved in one patient. Proximal femur was involved in three patients, distal femur was involved in three patients, and proximal tibia was involved in two patients. 9 males and 4 females were aged 4 to 34 years (mean age: 18.5 years. All patients had pain and were evaluated with X-rays, CT, bone scintigraphy, and MRI. In all patients, RF ablation was performed with local anesthesia. The lesion heated to 90°C for 6 minutes. Results. All of the patients achieved complete pain relief after ablation and were fully weight bearing without any support. In all patients, there was soft tissue edema after the procedure. During follow-up, all patients were free from the pain and there was no sign about the tumor. There was no other complication after the process. Conclusion. CT guided RFA is a minimally invasive, safe, and cost-effective treatment for osteoid osteoma placed in difficult area for surgery.

  9. Emergency bypass post percutaneous atrial ablation: a case report.

    Hargrove, M

    2010-11-01

    A 34-year-old male undergoing percutaneous atrial ablation procedure for paroxysmal fibrillation required emergency sternotomy for cardiac tamponade. The patient had been anticoagulated and had received plavix and aspirin prior to and during the ablation procedure. Seven units of red cell concentrate had been transfused in the cardiac catherisation laboratory. On arrival in theatre, the patient was hypotensive, but was awake on induction of anaesthesia. No recordable blood pressure with non-invasive monitoring was observed. A sternotomy was immediately performed and, on evacuation of the pericardium, a bleeding site was not visible. The patient was commenced on cardiopulmonary bypass. Bleeding site was identified and the defect closed. The patient was weaned from cardiopulmonary bypass with minimal inotropic support and made an uneventful recovery. Bypass time was 38 minutes. A literature review showed a 1% incidence of post-ablation bleeding(1). The incidence of reverting to bypass for such an event has not been reported previously. During these procedures, it might be wise to have the cardiothoracic team notified while atrial ablation procedures are being performed in the cardiac catheterization laboratory.

  10. Percutaneous Renal Tumor Ablation: Radiation Exposure During Cryoablation and Radiofrequency Ablation

    IntroductionOnce reserved solely for non-surgical cases, percutaneous ablation is becoming an increasingly popular treatment option for a wider array of patients with small renal masses and the radiation risk needs to be better defined as this transition continues.Materials and MethodsRetrospective review of our renal tumor ablation database revealed 425 patients who underwent percutaneous ablation for treatment of 455 renal tumors over a 5-year time period. Imparted radiation dose information was reviewed for each procedure and converted to effective patient dose and skin dose using established techniques. Statistical analysis was performed with each ablative technique.ResultsFor the 331 cryoablation procedures, the mean DLP was 6987 mGycm (SD = 2861) resulting in a mean effective dose of 104.7 mSv (SD = 43.5) and the mean CTDIvol was 558 mGy (SD = 439) resulting in a mean skin dose of 563.2 mGy (SD = 344.1). For the 124 RFA procedures, the mean DLP was 3485 mGycm (SD = 1630) resulting in a mean effective dose of 50.3 mSv (SD = 24.0) and the mean CTDIvol was 232 mGy (SD = 149) resulting in a mean skin dose of 233.2 mGy (SD = 117.4). The difference in patient radiation exposure between the two renal ablation techniques was statistically significant (p < 0.001).ConclusionBoth cryoablation and RFA imparted an average skin dose that was well below the 2 Gy deterministic threshold for appreciable sequela. Renal tumor cryoablation resulted in a mean skin and effective radiation dose more than twice that for RFA. The radiation exposure for both renal tumor ablation techniques was at the high end of the medical imaging radiation dose spectrum

  11. Percutaneous Renal Tumor Ablation: Radiation Exposure During Cryoablation and Radiofrequency Ablation

    McEachen, James C., E-mail: james.mceachen2@gmail.com [Mayo Clinic, Division of Preventive, Occupational, and Aerospace Medicine (United States); Leng, Shuai; Atwell, Thomas D. [Mayo Clinic, Department of Radiology (United States); Tollefson, Matthew K. [Mayo Clinic, Department of Urology (United States); Friese, Jeremy L. [Mayo Clinic, Department of Radiology (United States); Wang, Zhen; Murad, M. Hassan [Mayo Clinic, Division of Preventive, Occupational, and Aerospace Medicine (United States); Schmit, Grant D. [Mayo Clinic, Department of Radiology (United States)

    2016-02-15

    IntroductionOnce reserved solely for non-surgical cases, percutaneous ablation is becoming an increasingly popular treatment option for a wider array of patients with small renal masses and the radiation risk needs to be better defined as this transition continues.Materials and MethodsRetrospective review of our renal tumor ablation database revealed 425 patients who underwent percutaneous ablation for treatment of 455 renal tumors over a 5-year time period. Imparted radiation dose information was reviewed for each procedure and converted to effective patient dose and skin dose using established techniques. Statistical analysis was performed with each ablative technique.ResultsFor the 331 cryoablation procedures, the mean DLP was 6987 mGycm (SD = 2861) resulting in a mean effective dose of 104.7 mSv (SD = 43.5) and the mean CTDI{sub vol} was 558 mGy (SD = 439) resulting in a mean skin dose of 563.2 mGy (SD = 344.1). For the 124 RFA procedures, the mean DLP was 3485 mGycm (SD = 1630) resulting in a mean effective dose of 50.3 mSv (SD = 24.0) and the mean CTDI{sub vol} was 232 mGy (SD = 149) resulting in a mean skin dose of 233.2 mGy (SD = 117.4). The difference in patient radiation exposure between the two renal ablation techniques was statistically significant (p < 0.001).ConclusionBoth cryoablation and RFA imparted an average skin dose that was well below the 2 Gy deterministic threshold for appreciable sequela. Renal tumor cryoablation resulted in a mean skin and effective radiation dose more than twice that for RFA. The radiation exposure for both renal tumor ablation techniques was at the high end of the medical imaging radiation dose spectrum.

  12. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

    Pacella, Claudio M. [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)], E-mail: claudiomaurizio.pacella@fastwebnet.it; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)

    2008-04-15

    Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival.

  13. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

    Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival

  14. Pulmonary vein triggers, focal sources, rotors and atrial cardiomyopathy: implications for the choice of the most effective ablation therapy.

    Pison, L; Tilz, R; Jalife, J; Haïssaguerre, M

    2016-05-01

    Understanding of the pathophysiological mechanism(s) underlying atrial fibrillation (AF) is the foundation on which current ablation strategies are built. In the vast majority of patients with paroxysmal AF, the ablation procedure should target the pulmonary veins. In patients with nonparoxysmal AF, however, pulmonary vein isolation alone seems to be insufficient to prevent the arrhythmia. Several recent clinical trials have investigated the concept that rotors (re-entry based on a meandering central core from which spiral waves emanate) might be the mechanism responsible for sustaining AF. Ablation of these localized AF sources is an important step towards substrate-driven procedures in persistent AF. Hybrid AF ablation procedures, based on the integration of endocardial transcatheter and epicardial off-pump surgical techniques, have been introduced to overcome their mutual shortcomings. The long-term results are encouraging, especially in currently challenging settings such as nonparoxysmal AF and failed endocardial catheter ablation procedures. PMID:26991806

  15. Topography-guided custom ablation treatment for treatment of keratoconus

    Rohit Shetty

    2013-01-01

    Full Text Available Keratoconus is a progressive ectatic disorder of the cornea which often presents with fluctuating refraction and high irregular astigmatism. Correcting the vision of these patients is often a challenge because glasses are unable to correct the irregular astigmatism and regular contact lenses may not fit them very well. Topography-guided custom ablation treatment (T-CAT is a procedure of limited ablation of the cornea using excimer laser with the aim of regularizing the cornea, improving the quality of vision and possibly contact lens fit. The aim of the procedure is not to give a complete refractive correction. It has been tried with a lot of success by various groups of refractive surgeons around the world but a meticulous and methodical planning of the procedure is essential to ensure optimum results. In this paper, we attempt to elucidate the planning for a T-CAT procedure for various types of cones and asphericities.

  16. In Vivo Guidance and Assessment of Liver Radiofrequency Ablation with Acoustic Radiation Force Elastography

    Fahey, Brian J.; Nelson, Rendon C.; Hsu, Stephen J.; Bradway, David P.; Dumont, Douglas M.; Trahey, Gregg E.

    2008-01-01

    The initial results from clinical trials investigating the utility of Acoustic Radiation Force Impulse(ARFI) imaging for use with radiofrequency ablation (RFA) procedures in the liver are presented. To date, data have been collected from 6 RFA procedures in 5 unique patients. Large displacement contrast was observed in ARFI images of both pre-ablation malignancies (mean 7.5 dB, range 5.7 – 11.9 dB) and post-ablation thermal lesions (mean 6.2 dB, range 5.1 – 7.5 dB). In general, ARFI images pr...

  17. Cerebral embolization during AF ablation �Pathophysiology, Prevention and Management

    Nasir Shariff, MD

    2013-04-01

    Full Text Available Catheter based ablation therapy has evolved as an invaluable tool in the management of symptomatic patients with atrial fibrillation (AF. The procedure of AF ablation requires instrumentation in the systemic circulation predisposing to various concerns that can result in systemic embolization. We will describe the reported incidence of these events and refer to the various pathophysiologic explanations for their occurrence. Details on the risk factors and the relevant studies will also be reviewed. Preventive and treatment strategies in patients undergoing the ablation procedure will be discussed.

  18. LASER ABLATION STUDIES OF CONCRETE

    Laser ablation was studied as a means of removing radioactive contaminants from the surface and near-surface regions of concrete. We present the results of ablation tests on cement and concrete samples using a 1.6 kW pulsed Nd:YAG laser with fiber optic beam delivery. The laser-s...

  19. Radiofrequency ablation of locally advanced pancreatic adenocarcinoma:An overview

    Mirko; D’Onofrio; Emilio; Barbi; Roberto; Girelli; Enrico; Martone; Anna; Gallotti; Roberto; Salvia; Paolo; Tinazzi; Martini; Claudio; Bassi; Paolo; Pederzoli; Roberto; Pozzi; Mucelli

    2010-01-01

    Radiofrequency ablation(RFA)of pancreatic neoplasms is restricted to locally advanced,non-resectable but nonmetastatic tumors.RFA of pancreatic tumors is nowadays an ultrasound-guided procedure performed during laparotomy in open surgery.Intraoperative ultrasound covers the mandatory role of staging,evaluation of feasibility,guidance and monitoring of the procedure.Different types of needle can be used.The first aim in the evaluation of RFA as a treatment for locally advanced pancreatic ductal adenocarcinom...

  20. Comparison of the Outcomes of Monopolar and Bipolar Radiofrequency Ablation in Surgical Treatment of Atrial Fibrillation

    Wei-zhao Huang; Ying-meng Wu; Hong-yu Ye; Hai-ming Jiang

    2014-01-01

    Objective To compare the therapeutic effects and safety of monopolar and bipolar radiofrequency (RF) ablation used during cardiac surgery to treat atrial fibrillation. Methods We retrospectively studied a total of 81 patients with chronic atrial fibrillation who underwent open cardiac surgery with concomitant RF ablation between January 2007 and March 2011. Fifty-eight patients received bipolar RF ablation and 23 received monopolar RF ablation, respectively. The sinus rhythm restoration rate, the procedural duration, the frequency of severe perioperative complications, and mortality were compared between the two groups. Results The sinus rhythm restoration rate did not differ significantly between the two groups after follow-up of 15.1 ± 12.6 months (P=0.199). The frequencies of severe perioperative complications and mortality were also similar in the two groups. The total procedural time using bipolar RF ablation was significantly shorter than that using monopolar ablation (19.7±4.6 minutes vs. 28.1±8.5 minutes, P Conclusions Both monopolar and bipolar RF ablation are safe and effective in treating chronic atrial fibrillation patients during open cardiac surgery, but bipolar RF ablation is more convenient in practice.

  1. Catheter ablation of atrial fibrillation without radiation exposure using a 3D mapping system

    Marco Scaglione, MD; Elisa Ebrille, MD; Francesca Di Clemente, MD; Fiorenzo Gaita, MD Meet the expert doctor Doctor Do You want to talk to a Electro physiologist about your AFIB..?? Then ask now! Now It's Free* Dr. Y Madhu Reddy, MD, FACC, FHRS Introduction to AFib Click here for more Videos..! Upcoming Events

    2015-02-01

    Full Text Available ranscatheter ablation procedures have been traditionally performed under fluoroscopic guidance. However, x-ray exposure is afflicted by the risk of developing malignancies as well as other deterministic effects of radiation. For this reason, radiation doses in the interventional laboratory should be reduced “As Low As Reasonably Achievable”, with respect to the safety of the patients and the medical staff. This is of utmost importance in atrial fibrillation (AF ablations, which are usually lengthy procedures. With the improvement of technology, the development of additional imaging tools and the widespread of 3D electroanatomic mapping systems (EAM, near-zero fluoroscopy AF ablation procedure is becoming a reality, limiting fluoroscopy use mainly to guide transseptal puncture. In the present paper we reviewed the risks to health related to x-ray exposure and we discussed the current state of knowledge of catheter ablation of AF without fluoroscopy in the 3D EAM system era.

  2. Investigation of radiation streaming and maze design for the Taiwan Photon Source.

    Sheu, Rong-Jiun; Liu, Joseph

    2010-04-01

    This study investigates the radiation streaming through the personnel access maze designed for the Taiwan Photon Source, with special interest in the characteristics of radiation fields along the labyrinth and the comparison of different estimation methods. The effect of maze orientation with respect to the beam direction has also been examined in detail. The FLUKA Monte Carlo code was used to simulate the radiation production and transport for a beam loss occurring near a typical three-legged maze. In addition, we have also tested three factorized approximation formulae for the neutron and gamma-ray attenuation in our maze design. It was found that Cossairt's expression fits better and can predict satisfactory results for the neutron attenuation along the maze. We accordingly proposed a set of fitting parameters used with Cossairt's formulae for estimating the gamma-ray attenuation in labyrinths for high-energy electron accelerators. The information presented here will be valuable for our further design revisions and may be useful to those performing similar studies. PMID:20220363

  3. Acute stress switches spatial navigation strategy from egocentric to allocentric in a virtual Morris water maze.

    van Gerven, Dustin J H; Ferguson, Thomas; Skelton, Ronald W

    2016-07-01

    Stress and stress hormones are known to influence the function of the hippocampus, a brain structure critical for cognitive-map-based, allocentric spatial navigation. The caudate nucleus, a brain structure critical for stimulus-response-based, egocentric navigation, is not as sensitive to stress. Evidence for this comes from rodent studies, which show that acute stress or stress hormones impair allocentric, but not egocentric navigation. However, there have been few studies investigating the effect of acute stress on human spatial navigation, and the results of these have been equivocal. To date, no study has investigated whether acute stress can shift human navigational strategy selection between allocentric and egocentric navigation. The present study investigated this question by exposing participants to an acute psychological stressor (the Paced Auditory Serial Addition Task, PASAT), before testing navigational strategy selection in the Dual-Strategy Maze, a modified virtual Morris water maze. In the Dual-Strategy maze, participants can chose to navigate using a constellation of extra-maze cues (allocentrically) or using a single cue proximal to the goal platform (egocentrically). Surprisingly, PASAT stress biased participants to solve the maze allocentrically significantly more, rather than less, often. These findings have implications for understanding the effects of acute stress on cognitive function in general, and the function of the hippocampus in particular. PMID:27174311

  4. A Seven-year Experience for The Surgical Radiofrequency Ablation in Patients With Atrial Fibrillation

    Bin XIE; Hui-ming GUO; Ruo-bin WU; Cong LU

    2009-01-01

    Objective A 7-year experience for the treatment strategy using mono- and bi-polar radiofrequency (RF) ablation procedures in a heterogeneous group of patients was reported. Methods Between July 2003 and May 2009, the data of 314 consecutive patients aged 13 -75 (48. 70 + 11.09)undergone the radiofrequency ablation procedure for atrial fibrillation (AF) associated with concomitant cardiac surgery were analyzed. Monopolar was used for 91 patients; Medtronic bi-polar RF ablation procedure for 92 patients and Atricure RF ablation procedure for 131 patients. All patients were combined with valve surgery. Regular follow-ups were performed at 3, 6 month after surgery. Results Hospital mortality after combined open heart and surgical RF ablation was 0 %. The success rates for sinus rhythm con-version with monopolar RF were 73.6 % immediately, 74. 7 % at 3 months, 79. 1% at 6 months; with Medtronic bi-polar RF, the rates were 78.3 % immediately, 82. 8 % at 3 months, 84 % at 6 months; with Atricure bi-polar RF, the rates were 82. 4 % immediately, 84. 1% at 3 months, 83.9 % at 6 months. Conclusions The use of RF ablation pro-cedures is a safe and efficient option to cure AF during open heart surgery in a selective group of patients.

  5. Irrigated Tip Catheters for Radiofrequency Ablation in Ventricular Tachycardia

    Andreas Müssigbrodt

    2015-01-01

    Full Text Available Radiofrequency (RF ablation with irrigated tip catheters decreases the likelihood of thrombus and char formation and enables the creation of larger lesions. Due to the potential dramatic consequences, the prevention of thromboembolic events is of particular importance for left-sided procedures. Although acute success rates of ventricular tachycardia (VT ablation are satisfactory, recurrence rate is high. Apart from the progress of the underlying disease, reconduction and the lack of effective transmural lesions play a major role for VT recurrences. This paper reviews principles of lesion formation with radiofrequency and the effect of tip irrigation as well as recent advances in new technology. Potential areas of further development of catheter technology might be the improvement of mapping by better substrate definition and resolution, the introduction of bipolar and multipolar ablation techniques into clinical routine, and the use of alternative sources of energy.

  6. Value of water mazes for assessing spatial and egocentric learning and memory in rodent basic research and regulatory studies.

    Vorhees, Charles V; Williams, Michael T

    2014-01-01

    Maneuvering safely through the environment is central to survival of all animals. The ability to do this depends on learning and remembering locations. This capacity is encoded in the brain by two systems: one using cues outside the organism (distal cues), allocentric navigation, and one using self-movement, internal cues and sometimes proximal cues, egocentric navigation. Allocentric navigation involves the hippocampus, entorhinal cortex, and surrounding structures (e.g., subiculum); in humans this system encodes declarative memory (allocentric, semantic, and episodic, i.e., memory for people, places, things, and events). This form of memory is assessed in laboratory animals by many methods, but predominantly the Morris water maze (MWM). Egocentric navigation involves the dorsal striatum and connected structures; in humans this system encodes routes and integrated paths and when over-learned becomes implicit or procedural memory. Several allocentric methods for rodents are reviewed and compared with the MWM with particular focus on the Cincinnati water maze (CWM). MWM advantages include minimal training, no food deprivation, ease of testing, reliable learning, insensitivity to differences in body weight and appetite, absence of non-performers, control methods for performance effects, repeated testing capability and other factors that make this test well-suited for regulatory studies. MWM limitations are also reviewed. Evidence-based MWM design and testing methods are presented. On balance, the MWM is arguably the preferred test for assessing learning and memory in basic research and regulatory studies and the CWM is recommended if two tests can be accommodated so that both allocentric (MWM) and egocentric (CWM) learning and memory can be effectively and efficiently assessed. PMID:25116937

  7. Lesion size in relation to ablation site during radiofrequency ablation

    Petersen, H H; Chen, X; Pietersen, A;

    1998-01-01

    performed during two different flow-velocities in a tissue bath, while electrode contact pressure and position were unchanged. Target temperature was 80 degrees C. Obtained tip temperature, power consumption and lesion dimensions were measured. In vivo lesion volume, depth and width were found significantly...... convective cooling by induction of a flow around the electrode tip increases lesion dimensions and power consumptions. Furthermore we conclude that for the given target temperature the power consumption is positively correlated with lesion volume (p <0.001), whereas the obtained tip temperature is not.......This study was designed to investigate the effect of the convective cooling of the tip of the ablation electrode during temperature controlled radiofrequency ablation. In vivo two different application sites in the left ventricle of anaesthetised pigs were ablated and in vitro ablation was...

  8. Percutaneous Local Ablation Therapy in Small Hepatocellular Carcinoma

    Deng-Yn Lin

    2003-05-01

    Full Text Available Periodic screening programs conducted in various countries, applying sonography andserum alfa-fetoprotein to patients with chronic liver disease, have identified numerous smallhepatocellular carcinoma (HCC. Although surgical resection is generally preferred forcurative ablation, the long-term survival rates following resection are no better than thosefollowing local ablation. Current local ablation modalities are typically easily performed,safe and repeatable procedures, and include percutaneous ethanol injection (PEI, percutaneousacetic acid injection (PAI, radiofrequency ablation (RFA and microwave coagulationtherapy (MCT. The mechanisms of PEI or PAI are based on the dehydration, intracellularprotein damage, and thrombo-ischemic effects of absolute ethanol or acetic acid on thetumor cells. Meanwhile, the mechanisms of RFA or MCT are based on the generation offriction heat between the tissue and electric current or microwave emitted by an RF ormicrowave electrode into the tumor. The heat causes coagulation, followed by cellular deathas soon as the temperature in the target area exceeds 60oC. From previous comparativestudies of these procedures, RFA may be superior to PEI, PAI or MCT owing to its largerablation volume, fewer treatment sessions and more predictable ablation size. The rate ofcomplete necrosis of the target tumors was approximately 90-98% by RFA, 80-95% by PEI,90-95% by PAI and 94% by MCT. Moreover, the survival rates of these four modalitieswere approximately 90% at 1 year, 70% at 3 years, and 40-50% at 5 years. In tentativeconclusion, RFA is the preferred local ablation therapy for most small HCC. However, PEIis a useful alternative where RFA is unavailable.

  9. Model testing of a 1-kg high-explosive-cell maze

    The basement of the proposed High Explosives Applications Facility (Building 353) at the Lawrence Livermore National Laboratory includes several explosive test cells for the assembly and/or storage of up to 10 kg of high explosive (HE). This document reports 1/8-scale and 1/4-scale model tests conducted to confirm maze design criteria, to determine the cell explosive weight limit based on an allowable 10 psi reflected shock pressure at the hallway-maze doorway, and to specify permissible areas for handling HE within the cell. The integrity of cube-root scaling of the explosive charges detonated in the 1/8-scale model was verified by explosive testing in a comparable 1/4-scale model. Reflected shock pressures in the hallway adjacent to the maze and the effect of HE charge orientation were investigated and are also reported

  10. Ion acceleration enhanced by target ablation

    Laser proton acceleration can be enhanced by using target ablation, due to the energetic electrons generated in the ablation preplasma. When the ablation pulse matches main pulse, the enhancement gets optimized because the electrons' energy density is highest. A scaling law between the ablation pulse and main pulse is confirmed by the simulation, showing that for given CPA pulse and target, proton energy improvement can be achieved several times by adjusting the target ablation

  11. Initial experience with circumferential pulmonary vein ablation guided by fusion of magnetic resonance imaging with three-dimensional electroanatomic mapping

    TANG Kai; MA Jian; MA Fu-sheng; JlA Yu-he; ZHANG Shu

    2006-01-01

    @@ Catheter ablation for the treatment of atrial fibrillation (AF) has been a focal target of electrophysiological study in recent years. Up to date,circumferential pulmonary vein ablation (CPVA)guided by three-dimensional (3-D) electroanatomic mapping (Carto, USA) has been one of the most favourable procedures for the treatment of AF.

  12. Conformal needle-based ultrasound ablation using EM-tracked conebeam CT image guidance

    Burdette, E. Clif; Banovac, Filip; Diederich, Chris J.; Cheng, Patrick; Wilson, Emmanuel; Cleary, Kevin R.

    2011-03-01

    Numerous studies have demonstrated the efficacy of interstitial ablative approaches for the treatment of renal and hepatic tumors. Despite these promising results, current systems remain highly dependent on operator skill, and cannot treat many tumors because there is little control of the size and shape of the zone of necrosis, and no control over ablator trajectory within tissue once insertion has taken place. Additionally, tissue deformation and target motion make it extremely difficult to accurately place the ablator device into the target. Irregularly shaped target volumes typically require multiple insertions and several sequential thermal ablation procedures. This study demonstrated feasibility of spatially tracked image-guided conformal ultrasound (US) ablation for percutaneous directional ablation of diseased tissue. Tissue was prepared by suturing the liver within a pig belly and 1mm BBs placed to serve as needle targets. The image guided system used integrated electromagnetic tracking and cone-beam CT (CBCT) with conformable needlebased high-intensity US ablation in the interventional suite. Tomographic images from cone beam CT were transferred electronically to the image-guided tracking system (IGSTK). Paired-point registration was used to register the target specimen to CT images and enable navigation. Path planning is done by selecting the target BB on the GUI of the realtime tracking system and determining skin entry location until an optimal path is selected. Power was applied to create the desired ablation extent within 7-10 minutes at a thermal dose (>300eqm43). The system was successfully used to place the US ablator in planned target locations within ex-vivo kidney and liver through percutaneous access. Targeting accuracy was 3-4 mm. Sectioned specimens demonstrated uniform ablation within the planned target zone. Subsequent experiments were conducted for multiple ablator positions based upon treatment planning simulations. Ablation zones in

  13. Medial Prefrontal Administration of MK-801 Impairs T-maze Discrimination Reversal Learning in Weanling Rats

    Watson, Deborah J.; Stanton, Mark E.

    2009-01-01

    Several executive functions rely on the medial prefrontal cortex (mPFC) in the rat. Aspiration and neurotoxic lesions of the mPFC impair reversal learning in adult rats [1, 16, 34, 55]. Systemic administration of MK-801, an NMDA receptor antagonist, impairs T-maze reversal learning in weanling rats but the role of mPFC NMDA receptor antagonism in this effect is not known in either adult or young animals. This set of studies showed that mPFC NMDA receptors are specifically involved in T-maze d...

  14. Field enhancement induced laser ablation

    Fiutowski, Jacek; Maibohm, Christian; Kjelstrup-Hansen, Jakob;

    Sub-diffraction spatially resolved, quantitative mapping of strongly localized field intensity enhancement on gold nanostructures via laser ablation of polymer thin films is reported. Illumination using a femtosecond laser scanning microscope excites surface plasmons in the nanostructures...

  15. Laser ablation in analytical chemistry.

    Russo, Richard E; Mao, Xianglei; Gonzalez, Jhanis J; Zorba, Vassilia; Yoo, Jong

    2013-07-01

    In 2002, we wrote an Analytical Chemistry feature article describing the Physics of Laser Ablation in Microchemical Analysis. In line with the theme of the 2002 article, this manuscript discusses current issues in fundamental research, applications based on detecting photons at the ablation site (LIBS and LAMIS) and by collecting particles for excitation in a secondary source (ICP), and directions for the technology. PMID:23614661

  16. Ablative therapy for liver tumours

    Dick, E A; Taylor-Robinson, S D; Thomas, H C; Gedroyc, W M W

    2002-01-01

    Established ablative therapies for the treatment of primary and secondary liver tumours, including percutaneous ethanol injection, cryotherapy, and radiofrequency ablation, are discussed. Newer techniques such as magnetic resonance imaging guided laser interstitial thermal therapy of liver tumours has produced a median survival rate of 40.8 months after treatment. The merits of this newly emerging technique are discussed, together with future developments, such as focused ultrasound therapy, ...

  17. Percutaneous Ablation of Hepatic Tumors

    McCarley, James R.; Soulen, Michael C.

    2010-01-01

    The liver is a common site of both primary and secondary malignancy resulting in significant morbidity and mortality. Careful patient evaluation and triage allows for optimal utilization of all oncologic therapies, including radiation, systemic chemotherapy, surgery, transarterial therapies, and ablation. Although the role of interventional oncologists in the management of hepatic malignancies continues to evolve, the use of percutaneous ablation therapies has proven to be an effective and mi...

  18. Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma.

    Poulou, Loukia S; Botsa, Evanthia; Thanou, Ioanna; Ziakas, Panayiotis D; Thanos, Loukas

    2015-05-18

    Hepatocellular cancer ranks fifth among cancers and is related to chronic viral hepatitis, alcohol abuse, steatohepatitis and liver autoimmunity. Surgical resection and orthotopic liver transplantation have curative potential, but fewer than 20% of patients are suitable candidates. Interventional treatments are offered to the vast majority of patients. Radiofrequency (RFA) and microwave ablation (MWA) are among the therapeutic modalities, with similar indications which include the presence of up to three lesions, smaller than 3 cm in size, and the absence of extrahepatic disease. The therapeutic effect of both methods relies on thermal injury, but MWA uses an electromagnetic field as opposed to electrical current used in RFA. Unlike MWA, the effect of RFA is partially limited by the heat-sink effect and increased impedance of the ablated tissue. Compared with RFA, MWA attains a more predictable ablation zone, permits simultaneous treatment of multiple lesions, and achieves larger coagulation volumes in a shorter procedural time. Major complications of both methods are comparable and infrequent (approximately 2%-3%), and they include haemorrhage, infection/abscess, visceral organ injury, liver failure, and pneumothorax. RFA may incur the additional complication of skin burns. Nevertheless, there is no compelling evidence for differences in clinical outcomes, including local recurrence rates and survival. PMID:26052394

  19. Detached tip of a transseptal sheath during left atrial ablation.

    El-Damaty, Ahmed; Love, Michael; Parkash, Ratika

    2012-02-15

    Left atrial ablation has become more commonplace with the advent of catheter ablation for atrial fibrillation. A number of transseptal sheaths have been produced to enhance safe and efficient catheter manipulation in the left atrium (LA) for these procedures. Some of the sheaths have been subject to recall due to partial or complete detachment of its radiopaque tip. We report a case of a 46 year-old female diagnosed with idiopathic dilated cardiomyopathy that presented with atypical left atrial flutter. During electrophysiologic study, a Swartz braided SL1 (SL-1) transseptal sheath was used to introduce the ablation catheter to the left atrium. During left atrial mapping, the radiopaque tip of the sheath detached from the rest of the sheath and was seen floating in the LA. After exchanging the SL-1 sheath with a deflectable sheath, the detached segment was retrieved out of the LA and eventually out of the vascular system using an angioplasty balloon advanced over a wire and inflated distal to the lumen of the detached tip. The root cause of this malfunction was found to be lack of a secondary bonding process that these sheaths generally undergo during the manufacturing process. We describe the case of a left atrial ablation procedure where a novel percutaneous method was able to successfully retrieve the detached tip of a transseptal sheath from the vascular system, thereby avoiding a potential catastrophic complication or thoracotomy. This method may be useful in other cases where similar circumstances may present. PMID:22162088

  20. Dynamics of tissue shrinkage during ablative temperature exposures

    There is a lack of studies that examine the dynamics of heat-induced shrinkage of organ tissues. Clinical procedures such as radiofrequency ablation, microwave ablation or high-intensity focused ultrasound, use heat to treat diseases such as cancer and cardiac arrhythmia. When heat is applied to tissues, shrinkage occurs due to protein denaturation, dehydration and contraction of collagen at temperatures greater 50 °C. This is particularly relevant for image-guided procedures such as tumor ablation, where pre- and post-treatment images are compared and any changes in dimensions must be considered to avoid misinterpretations of the treatment outcome. We present data from ex vivo, isothermal shrinkage tests in porcine liver tissue, where axial changes in tissue length were recorded during 15 min of heating to temperatures between 60 and 95 °C. A mathematical model was developed to accurately describe the time and temperature-dependent shrinkage behavior. The shrinkage dynamics had the same characteristics independent of temperature; the estimated relative shrinkage, adjusted for time since death, after 15 min heating to temperatures of 60, 65, 75, 85 and 95 °C, was 12.3, 13.8, 16.6, 19.2 and 21.7%, respectively. Our results demonstrate the shrinkage dynamics of organ tissues, and suggest the importance of considering tissue shrinkage for thermal ablative treatments. (paper)

  1. Percutaneous radiofrequency ablation for osteoid osteoma: How we do it

    To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment. We evaluated 40 patients in whom RFA was performed for osteoid osteomas between October 2005 and February 2008. The lesions were located in the femur (n = 22), tibia (n = 10), humerus (n = 2), acetabulum (n = 2), radius (n = 1), fibula (n = 1), patella (n = 1), and calcaneum (n = 1). The procedure was performed using a standard technique. Technical success was achieved in all patients, with intranidal localization of the needle and complete ablation. All patients were fully weight bearing 2–3 h after the procedure. Successful pain relief was achieved in all patients within 48 h. Immediate complications included a case of minor thermal skin burn and a small cortical chip fracture, which healed on its own. There were no delayed complications. The average follow-up period was 12 months. Two patients (5% of cases) had recurrence of pain after intervals of 5 and 8 months, respectively, following the ablation; this was due to recurrence of the lesion. Complete pain relief was however achieved after a second ablation in both cases. Thus, our primary and secondary clinical success rates were 95 and 100%, respectively. RFA is a safe, quick, minimally invasive, and extremely effective method for the management of osteoid osteomas

  2. Image and pathological changes after microwave ablation of breast cancer: A pilot study

    Zhou, Wenbin [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Jiang, Yanni [Department of Radiology, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Chen, Lin; Ling, Lijun; Liang, Mengdi; Pan, Hong [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Wang, Siqi [Department of Radiology, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Ding, Qiang [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Liu, Xiaoan, E-mail: liuxiaoan@126.com [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China); Wang, Shui, E-mail: ws0801@hotmail.com [Department of Breast Surgery, The First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029 (China)

    2014-10-15

    Highlights: • We report successful experience of MWA in breast cancer under local anesthesia. • We report MR imaging evaluation of microwave ablation zone in breast cancer. • Pathological changes after microwave ablation in breast cancer was reported. • 2 min MWA caused an ablation zone with three diameters > 2 cm in breast cancer. - Abstract: Purpose: To prospectively assess MR imaging evaluation of the ablation zone and pathological changes after microwave ablation (MWA) in breast cancer. Materials and methods: Twelve enrolled patients, diagnosed with non-operable locally advanced breast cancer (LABC), were treated by MWA and then neoadjuvant chemotherapy, followed by surgery. MR imaging was applied to evaluate the effect of MWA. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were applied to analyze the ablated area. Results: All MWA procedures were performed successfully under local anesthesia. For a mean duration of 2.15 min, the mean largest, middle and smallest diameters in the ablated zone 24-h post-ablation in MR imaging were 2.98 cm ± 0.53, 2.51 cm ± 0.41 and 2.23 cm ± 0.41, respectively. The general shape of the ablation zone was close to a sphere. The ablated area became gradually smaller in MR imaging. No adverse effects related to MWA were noted in all 12 patients during and after MWA. HE staining could confirm the effect about 3 months after MWA, which was confirmed by TEM. Conclusions: 2 min MWA can cause an ablation zone with three diameters larger than 2 cm in breast cancer, which may be suitable for the local treatment of breast cancer up to 2 cm in largest diameter. However, the long-term effect of MWA in the treatment of small breast cancer should be determined in the future.

  3. Image and pathological changes after microwave ablation of breast cancer: A pilot study

    Highlights: • We report successful experience of MWA in breast cancer under local anesthesia. • We report MR imaging evaluation of microwave ablation zone in breast cancer. • Pathological changes after microwave ablation in breast cancer was reported. • 2 min MWA caused an ablation zone with three diameters > 2 cm in breast cancer. - Abstract: Purpose: To prospectively assess MR imaging evaluation of the ablation zone and pathological changes after microwave ablation (MWA) in breast cancer. Materials and methods: Twelve enrolled patients, diagnosed with non-operable locally advanced breast cancer (LABC), were treated by MWA and then neoadjuvant chemotherapy, followed by surgery. MR imaging was applied to evaluate the effect of MWA. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were applied to analyze the ablated area. Results: All MWA procedures were performed successfully under local anesthesia. For a mean duration of 2.15 min, the mean largest, middle and smallest diameters in the ablated zone 24-h post-ablation in MR imaging were 2.98 cm ± 0.53, 2.51 cm ± 0.41 and 2.23 cm ± 0.41, respectively. The general shape of the ablation zone was close to a sphere. The ablated area became gradually smaller in MR imaging. No adverse effects related to MWA were noted in all 12 patients during and after MWA. HE staining could confirm the effect about 3 months after MWA, which was confirmed by TEM. Conclusions: 2 min MWA can cause an ablation zone with three diameters larger than 2 cm in breast cancer, which may be suitable for the local treatment of breast cancer up to 2 cm in largest diameter. However, the long-term effect of MWA in the treatment of small breast cancer should be determined in the future

  4. Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases

    Gillams, Alice, E-mail: alliesorting@gmail.com [The London Clinic, Radiology Department (United Kingdom); Khan, Zahid [Countess of Chester Hospital (United Kingdom); Osborn, Peter [Queen Alexandra Hospital (United Kingdom); Lees, William [University College London Medical School (United Kingdom)

    2013-06-15

    Purpose. To analyze the factors associated with favorable survival in patients with inoperable colorectal lung metastases treated with percutaneous image-guided radiofrequency ablation. Methods. Between 2002 and 2011, a total of 398 metastases were ablated in 122 patients (87 male, median age 68 years, range 29-90 years) at 256 procedures. Percutaneous CT-guided cool-tip radiofrequency ablation was performed under sedation/general anesthesia. Maximum tumor size, number of tumors ablated, number of procedures, concurrent/prior liver ablation, previous liver or lung resection, systemic chemotherapy, disease-free interval from primary resection to lung metastasis, and survival from first ablation were recorded prospectively. Kaplan-Meier analysis was performed, and factors were compared by log rank test. Results. The initial number of metastases ablated was 2.3 (range 1-8); the total number was 3.3 (range 1-15). The maximum tumor diameter was 1.7 (range 0.5-4) cm, and the number of procedures was 2 (range 1-10). The major complication rate was 3.9 %. Overall median and 3-year survival rate were 41 months and 57 %. Survival was better in patients with smaller tumors-a median of 51 months, with 3-year survival of 64 % for tumors 2 cm or smaller versus 31 months and 44 % for tumors 2.1-4 cm (p = 0.08). The number of metastases ablated and whether the tumors were unilateral or bilateral did not affect survival. The presence of treated liver metastases, systemic chemotherapy, or prior lung resection did not affect survival. Conclusion. Three-year survival of 57 % in patients with inoperable colorectal lung metastases is better than would be expected with chemotherapy alone. Patients with inoperable but small-volume colorectal lung metastases should be referred for ablation.

  5. Variance in Broad Reading Accounted for by Measures of Reading Speed Embedded within Maze and Comprehension Rate Measures

    Hale, Andrea D.; Skinner, Christopher H.; Wilhoit, Brian; Ciancio, Dennis; Morrow, Jennifer A.

    2012-01-01

    Maze and reading comprehension rate measures are calculated by using measures of reading speed and measures of accuracy (i.e., correctly selected words or answers). In sixth- and seventh-grade samples, we found that the measures of reading speed embedded within our Maze measures accounted for 50% and 39% of broad reading score (BRS) variance,…

  6. The Utility of Maze Accurate Response Rate in Assessing Reading Comprehension in Upper Elementary and Middle School Students

    McCane-Bowling, Sara J.; Strait, Andrea D.; Guess, Pamela E.; Wiedo, Jennifer R.; Muncie, Eric

    2014-01-01

    This study examined the predictive utility of five formative reading measures: words correct per minute, number of comprehension questions correct, reading comprehension rate, number of maze correct responses, and maze accurate response rate (MARR). Broad Reading cluster scores obtained via the Woodcock-Johnson III (WJ III) Tests of Achievement…

  7. A robust animal model of state anxiety : fear-potentiated behaviour in the elevated plus-maze

    Korte, SM; De Boer, SF

    2003-01-01

    Fear (i.e., decreased percentage time spent on open-arm exploration) in the elevated plus-maze can be potentiated by prior inescapable stressor exposure, but not by escapable stress. The use of fear-potentiated plus-maze behaviour has several advantages as compared to more traditional animal models

  8. A robust animal model of state anxiety: fear-potentiated behaviour in the elevated plus-maze

    Korte, S.M.; Boer, de S.F.

    2003-01-01

    Fear (i.e., decreased percentage time spent on open-arm exploration) in the elevated plus-maze can be potentiated by prior inescapable stressor exposure, but not by escapable stress. The use of fear-potentiated plus-maze behaviour has several advantages as compared to more traditional animal models

  9. Una técnica para la extirpación de los órganos vomeronasales en el armadillo Chaetophractus villosus. Abordaje desde la cavidad bucal - A surgical procedure for the ablation of the Vomeronasal Organs in the armadillo Chaetophractus villosus. Approach from oral cavity

    Iodice, O. H.

    2010-03-01

    Full Text Available ResumenSe describen los pasos de un procedimiento quirúrgico para la extirpación bilateral de los órganos vomeronasales del armadillo Chaetophractus villosus (Mammalia, Xenarthra. Cada órgano está ubicado en el piso de la cavidad nasal, adosado a cada lado del tabique nasal. Los órganos se abordan a través de unaabertura practicada en el techo de la cavidad bucal. Este procedimiento se realiza bajo lupa estereoscópica y permite una visualización directa de los órganos Los mismos se destruyen por medio de una fresa accionada por un torno. De este modo se tiene la certeza de una ablación total. La posterior verificación por mediode cortes histológicos no es por lo tanto necesaria. Esto representa una ventaja importante puesto que las características físicas del hueso de estos animales requieren períodos largos de ablandamiento (generalmente alrededor tres meses. SummaryA surgical procedure for the bilateral ablation of the vomeronasal organs of the armadillo Chaetophractus villosus (Mammalia, Xenarthra is described. The organs are approached from the roof of the oral cavity through a longitudinal slit performed with a dental drill. This procedure is performed under magnifying stereoscopic lens and permits the direct visualization of the organs. Those structures are then destroyed with the dental drill. This provides certainty of totalablation. As a consequence, verification by means of histological sections is not needed. This represents an important advantage since the physical characteristics of the bone of these animals require long periods of softening (usually around three months.

  10. Percutaneous radiofrequency ablation for lung tumors beneath the rib under CT fluoroscopic guidance with gantry tilt

    Suzuki, Takanobu; Yamagami, Takuji; Tanaka, Osamu; Yoshimatsu, Rika; Miura, Hiroshi; Nishimura, Tsunehiko (Dept. of Radiology, Graduate School of Medical Science, Kyoto Prefectural Univ. of Medicine, Kamigyo, Kyoto (Japan)), e-mail: yamagami@koto.kpu-m.ac.jp

    2010-05-15

    Background: Radiofrequency (RF) ablation of lung tumors has become a treatment of choice, especially for unresectable cases. However, RF ablation of small lung lesions located just beneath the rib is difficult. Purpose: To evaluate the efficacy and safety of gantry tilting for the performance of RF ablation of peripheral lesions located beneath the rib. Material and Methods: Our study was based on 18 of 293 lesions in the lung for which RF ablation was performed under CT scan fluoroscopic guidance at our institution between October 2004 and March 2009. For these 18 lesions, RF ablation was performed with gantry tilting because a rib blocked visualization of the RF ablation route even after other attempts had been made to change the relationship between the target and the rib. Results: All RF needles, with only one exception, were successfully advanced to hit the tumor. The commonest complication was a pneumothorax, which occurred in seven procedures. No serious complications occurred. The progression-free rates were 82.4% at 6 months, 62.5% at 12 months, and 30% at 24 months. Mean local progression-free duration was 17.6+-11.6 months (range 4-36 months). Conclusion: RF ablation under CT scan fluoroscopic guidance with gantry tilt is a useful and safe technique for RF ablation of lung nodules located beneath the rib

  11. Fundamental Mechanisms of Pulsed Laser Ablation of Biological Tissue

    Albagli, Douglas

    The ability to cut and remove biological tissue with short pulsed laser light, a process called laser ablation, has the potential to revolutionize many surgical procedures. Ablation procedures using short pulsed lasers are currently being developed or used in many fields of medicine, including cardiology, ophthalmology, dermatology, dentistry, orthopedics, and urology. Despite this, the underlying physics of the ablation process is not well understood. In fact, there is wide disagreement over whether the fundamental mechanism is primarily photothermal, photomechanical, or photochemical. In this thesis, both experimental and theoretical techniques are developed to explore this issue. The photothermal model postulates that ablation proceeds through vaporization of the target material. The photomechanical model asserts that ablation is initiated when the laser-induced tensile stress exceeds the ultimate tensile strength of the target. I have developed a three dimensional model of the thermoelastic response of tissue to short pulsed laser irradiation which allows the time dependent stress distribution to be calculated given the optical, thermal and mechanical properties of the target. A complimentary experimental technique has been developed to verify this model, measure the needed physical properties of the tissue, and record the thermoelastic response of the tissue at the onset of ablation. The results of this work have been widely disseminated to the international research community and have led to significant findings which support the photomechanical model of ablation of tissue. First, the energy deposited in tissue is an order of magnitude less than that required for vaporization. Second, unlike the one-dimensional thermoelastic model of laser-induced stress generation that has appeared in the literature, the full three-dimensional model predicts the development of significant tensile stresses on the surface of the target, precisely where ablation is observed to

  12. Follow-up results of laser saphenous ablation

    Mehmet Erdem Memetoğlu

    2012-09-01

    Full Text Available Objectives: This retrospective study aimed to evaluatethe efficacy and durability of endovenous laser ablationwith 940 nanometer wavelength with at least one-yearfollow-up.Materials and methods: Between December 2009 andFebruary 2012, a total of 68 incompetent great saphenousveins and 4 small saphenous veins were treated byendovenous laser ablation, using 940 nanometer wavelengths.Patients underwent standard clinical and duplexfollow-up examinations with a mean of 18 months (range12 to 26 months after endovenous laser ablation. Patientsatisfaction regarding the procedure was assessed withthe use of a visual analog scale (range 1 to 100.Results: Post-procedural duplex scans showed total occlusionof the treated great saphenous veins in 56 patients(97% and sub-total occlusion in 2 (3% patients.For small saphenous veins, post-procedural duplex scansshowed total occlusion in 4 (100% patients.The average pre-procedure modified clinical picture, etiology,anatomic distribution and pathophysiology clinicalscore improved significantly after 12 months. Complicationsfrom our series included swelling and induration in3 patients (5%, skin pigmentation in 3 patients (5%. Patientsatisfaction with the surgical outcome was 83.2 %(±11.8, n=58.Conclusions: Our results seem to be satisfying, and thisstudy has reaffirmed the effectiveness and durability ofendovenous laser ablation with 940 wavelengths in thetreatment of great saphenous vein insufficiency.Key words: Duplex ultrasound, endovenous technique,saphenous vein, venous insufficiency.

  13. Impact of Tricuspid Regurgitation on the Success of Atrioventricular Node Ablation for Rate Control in Patients With Atrial Fibrillation: The Node Blast Study.

    Reddy, Yeruva Madhu; Gunda, Sampath; Vallakati, Ajay; Kanmanthareddy, Arun; Pillarisetti, Jayasree; Atkins, Donita; Bommana, Sudharani; Emert, Martin P; Pimentel, Rhea; Dendi, Raghuveer; Berenbom, Loren D; Lakkireddy, Dhanunjaya

    2015-09-15

    Atrioventricular node (AVN) ablation is an effective treatment for symptomatic patients with atrial arrhythmias who are refractory to rhythm and rate control strategies where optimal ventricular rate control is desired. There are limited data on the predictors of failure of AVN ablation. Our objective was to identify the predictors of failure of AVN ablation. This is an observational single-center study of consecutive patients who underwent AVN ablation in a large academic center. Baseline characteristics, procedural variables, and outcomes of AVN ablation were collected. AVN "ablation failure" was defined as resumption of AVN conduction resulting in recurrence of either rapid ventricular response or suboptimal biventricular pacing. A total of 247 patients drug refractory AF who underwent AVN ablation at our center with a mean age of 71 ± 12 years with 46% being males were included. Ablation failure was seen in 11 (4.5%) patients. There were no statistical differences between patients with "ablation failure" versus "ablation success" in any of the baseline clinical variables. Patients with moderate-to-severe tricuspid regurgitation (TR) were much more likely to have ablation failure than those with ablation success (8 [73%] vs 65 [27%]; p = 0.003). All 11 patients with ablation failure had a successful redo procedure, 9 with right and 2 with the left sided approach. On multivariate analysis, presence of moderate-to-severe TR was found to be the only predictor of failure of AVN ablation (odds ratio 9.1, confidence interval 1.99 to 42.22, p = 0.004). In conclusion, moderate-to-severe TR is a strong and independent predictor of failure of AVN ablation. PMID:26174606

  14. The role of catheter ablation in the management of atrial fibrillation.

    Ang, Richard; Earley, Mark J

    2016-06-01

    Atrial fibrillation is driven by spontaneous electrical activation emerging from the pulmonary veins. Catheter ablation using either radiofrequency or cryothermal energy electrically isolates these veins from the left atrium, both reducing the burden of atrial fibrillation episodes and improving the patient's symptoms. Catheter ablation is superior to antiarryhthmic drugs when patients are carefully selected. Underlying medical problems - including obesity, hypertension and obstructive sleep apnoea - should be optimally treated before considering ablation. Although this treatment has the potential to cure patients of their symptoms, they should be aware of the important associated procedural complications. PMID:27251918

  15. Ablation of incessant ventricular tachycardia by epicardial approach. A case report

    A ventricular tachycardia (VT) is relentless when it persists longer than 24 hours despite completing treatment with at least two antiarrhythmic drugs, electrical cardioversion (CEV) or overstimulation. It is a dramatic clinical situation, with high mortality. Catheter ablation endocardial using radio frequency is the treatment of choice, although it is a highly complex and procedure with a success rate of between 45% and 75% in different publications. One reason for these results, sometimes discouraging of endocardial ablation, is that circuits of re-entry, basic mechanism of this arrhythmia, often are subepicardicos. We present a case of incessant TV referred to our service in which an epicardial ablation was performed

  16. Radial Maze Analog for Pigeons: Evidence for Flexible Coding Strategies May Result from Faulty Assumptions

    Gipson, Cassandra D.; DiGian, Kelly A.; Miller, Holly C.; Zentall, Thomas R.

    2008-01-01

    Previous research with the radial maze has found evidence that rats can remember both places that they have already been (retrospective coding) and places they have yet to visit (prospective coding; Cook, R. G., Brown, M. F., & Riley, D. A. (1985). Flexible memory processing by rats: Use of prospective and retrospective information in the radial…

  17. Incremental Sentence Processing in Japanese: A Maze Investigation into Scrambled and Control Sentences

    Witzel, Jeffrey; Witzel, Naoko

    2016-01-01

    This study investigates preverbal structural and semantic processing in Japanese, a head-final language, using the maze task. Two sentence types were tested--simple scrambled sentences (Experiment 1) and control sentences (Experiment 2). Experiment 1 showed that even for simple, mono-clausal Japanese sentences, (1) there are online processing…

  18. OpenControl: a free opensource software for video tracking and automated control of behavioral mazes.

    Aguiar, Paulo; Mendonça, Luís; Galhardo, Vasco

    2007-10-15

    Operant animal behavioral tests require the interaction of the subject with sensors and actuators distributed in the experimental environment of the arena. In order to provide user independent reliable results and versatile control of these devices it is vital to use an automated control system. Commercial systems for control of animal mazes are usually based in software implementations that restrict their application to the proprietary hardware of the vendor. In this paper we present OpenControl: an opensource Visual Basic software that permits a Windows-based computer to function as a system to run fully automated behavioral experiments. OpenControl integrates video-tracking of the animal, definition of zones from the video signal for real-time assignment of animal position in the maze, control of the maze actuators from either hardware sensors or from the online video tracking, and recording of experimental data. Bidirectional communication with the maze hardware is achieved through the parallel-port interface, without the need for expensive AD-DA cards, while video tracking is attained using an inexpensive Firewire digital camera. OpenControl Visual Basic code is structurally general and versatile allowing it to be easily modified or extended to fulfill specific experimental protocols and custom hardware configurations. The Visual Basic environment was chosen in order to allow experimenters to easily adapt the code and expand it at their own needs. PMID:17681380

  19. Activation of the hippocampal complex during tactile maze solving in congenitally blind subjects

    Gagnon, Léa; Schneider, Fabien C; Siebner, Hartwig R;

    2012-01-01

    hippocampus and parahippocampus, occipital cortex and fusiform gyrus. Blindfolded sighted controls did not show increased BOLD responses in these areas; instead they activated the caudate nucleus and thalamus. Both groups activated the precuneus during tactile maze navigation. We conclude that cross...

  20. MAZE, Input Generator for Program DYNA2D and NIKE2D

    Description of program or function: MAZE is an interactive input generator for two-dimensional finite element codes. MAZE has three phases. In the first phase, lines and parts are defined. The first phase is terminated by the 'ASSM' or 'PASSM' command which merges all parts. In the second phase, boundary conditions may be specified, slide-lines may be defined, parts may be merged to eliminate nodes along common interfaces, boundary nodes may be moved for graded zoning, the mesh may be smoothed, and load curves may be defined. The second phase is terminated by the 'WBCD' command which causes MAZE to write the output file as soon as the 'T' terminate command is typed. In the third phase, material properties may be defined. Commands that apply to the first phase may not be used in the second or third; likewise, commands that apply in the second may not be used in the first and third, or commands that apply in the third in the first and second. Nine commands - TV, Z, GSET, PLOTS, GRID, NOGRID, FRAME, NOFRAME, and RJET are available in all phases. Comments may be added anywhere in the input stream by prefacing the comment with 'C'. Any DYNA2D or NIKE2D material and equation-of- state model may be defined via the MAT and EOS commands respectively. Maze may be terminated after phase two; it is not necessary to define the materials

  1. MK-801 induced amnesia for the elevated plus-maze in mice

    Hliňák, Zdeněk; Krejčí, I.

    2002-01-01

    Roč. 131, 1-2 (2002), s. 221-225. ISSN 0166-4328 R&D Projects: GA ČR GA309/00/1644 Institutional research plan: CEZ:AV0Z5011922 Keywords : amnesia * elevated plus-maze * MK-801 Subject RIV: FH - Neurology Impact factor: 2.791, year: 2002

  2. Esophageal papilloma: Flexible endoscopic ablation byradiofrequency

    Gianmattia del Genio; Federica del Genio; Pietro Schettino; Paolo Limongelli; Salvatore Tolone; Luigi Brusciano; Manuela Avellino; Chiara Vitiello; Giovanni Docimo; Angelo Pezzullo; Ludovico Docimo

    2015-01-01

    Squamous papilloma of the esophagus is a rare benignlesion of the esophagus. Radiofrequency ablation is anestablished endoscopic technique for the eradication ofBarrett esophagus. No cases of endoscopic ablation ofesophageal papilloma by radiofrequency ablation (RFA)have been reported. We report a case of esophagealpapilloma successfully treated with a single sessionof radiofrequency ablation. Endoscopic ablation ofthe lesion was achieved by radiofrequency using anew catheter inserted through the working channelof endoscope. The esophageal ablated tissue wasremoved by a specifically designed cup. Completeablation was confirmed at 3 mo by endoscopy withbiopsies. This case supports feasibility and safety of asa new potential indication for BarrxTM RFA in patientswith esophageal papilloma.

  3. Durable Pulmonary Vein Isolation: The Holy Grail of Atrial Fibrillation Ablation

    Duy Thai Nguyen; William H. Sauer

    2010-10-01

    Full Text Available The inability to achieve durable pulmonary vein isolation remains a major limitation to catheter ablation for the treatment of atrial fibrillation (AF. In this review, we discuss the research performed over the past decade investigating methods to improve lesion permanence for the goal of durable pulmonary vein isolation (PVI. Investigations evaluating procedural techniques, adjunctive pharmacologic therapy, and newer energy sources designed to improve ablation lesion permanence are discussed.

  4. Entwicklung und Validierung eines Therapieplanungssystems für die in-situ-Ablation maligner Lebertumore

    Lehmann, Kai

    2014-01-01

    Surgical resection is the established curative treatment of liver metastases. However, only few patients are eligible for resection. In thermal in-situ ablation techniques, such as laser-induced thermotherapy (LITT) and radiofrequency ablation (RFA), a liver tumor is punctured with a needle-like applicator and is destroyed by thermal energy in-situ. These procedures are characterized by a less invasive application and repeatable therapy. Currently, the technique is mostly used in palliative i...

  5. Ablation of hippocampal neurogenesis impairs contextual fear conditioning and synaptic plasticity in the dentate gyrus

    Saxe, Michael D.; Battaglia, Fortunato; Wang, Jing-wen; Malleret, Gael; David, Denis J.; Monckton, James E.; Garcia, A. Denise R.; Sofroniew, Michael V.; Kandel, Eric R.; Santarelli, Luca; Hen, René; Drew, Michael R.

    2006-01-01

    Although hippocampal neurogenesis has been described in many adult mammals, the functional impact of this process on physiology and behavior remains unclear. In the present study, we used two independent methods to ablate hippocampal neurogenesis and found that each procedure caused a limited behavioral deficit and a loss of synaptic plasticity within the dentate gyrus. Specifically, focal X irradiation of the hippocampus or genetic ablation of glial fibrillary acidic protein-positive neural ...

  6. Durable Pulmonary Vein Isolation: The Holy Grail of Atrial Fibrillation Ablation

    Darrat Y; Morales G; Shah J; Di Biase L; Natale A; Elayi CS

    2014-04-01

    Full Text Available The inability to achieve durable pulmonary vein isolation (PVI remains a major limitation to catheter ablation for the treatment of atrial fibrillation (AF, potentially resulting in AF recurrence. In this review, we discuss the research performed investigating methods to improve lesion permanence for the goal of durable PVI. Investigations evaluating procedural techniques, various catheters utilized, adjunctive pharmacologic therapy, and novel energy sources designed to improve ablation lesion permanence are discussed.

  7. Percutaneous ablation of functioning adenoma in a patient with a single adrenal gland

    Nunes, Thiago Franchi; Szejnfeld, Denis; Xavier, Ana Carolina Wanderley; Goldman, Suzan Menasce

    2013-01-01

    The conventional treatment of functioning adrenal adenomas is laparoscopic resection. Since the 1990s, radiofrequency ablation has been increasingly applied to the treatment of tumours of the liver, lungs and musculoskeletal system. However, the use of radiofrequency ablation to treat adrenal nodules is still an uncommon procedure, particularly in aldosterone-producing adenomas. We report the case of a 35-year-old male patient with resistant hypertension, hypokalaemia and aldosterone-producin...

  8. HIFU Tissue Ablation: Concept and Devices.

    Ter Haar, Gail

    2016-01-01

    High intensity focused ultrasound (HIFU) is rapidly gaining clinical acceptance as a technique capable of providing non-invasive heating and ablation for a wide range of applications. Usually requiring only a single session, treatments are often conducted as day case procedures, with the patient either fully conscious, lightly sedated or under light general anesthesia. HIFU scores over other thermal ablation techniques because of the lack of necessity for the transcutaneous insertion of probes into the target tissue. Sources placed either outside the body (for treatment of tumors or abnormalities of the liver, kidney, breast, uterus, pancreas brain and bone), or in the rectum (for treatment of the prostate), provide rapid heating of a target tissue volume, the highly focused nature of the field leaving tissue in the ultrasound propagation path relatively unaffected. Numerous extra-corporeal, transrectal and interstitial devices have been designed to optimize application-specific treatment delivery for the wide-ranging areas of application that are now being explored with HIFU. Their principle of operation is described here, and an overview of their design principles is given. PMID:26486329

  9. Radiofrequency Ablation of Intrahepatic Cholangiocarcinoma: Preliminary Experience

    The purpose of this study was to evaluate the safety and efficacy of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) in patients with intrahepatic cholangiocarcinoma (ICCA) in a small, nonrandomized series. From February 2004 to July 2008, six patients (four men and two women; mean age 69.8 years [range 48 to 83]) with ICCA underwent percutaneous US-guided RFA. Preintervetional transarterial embolization was performed in two cases to decrease heat dispersion during RFA in order to increase the area of ablation. The efficacy of RFA was evaluated using contrast-enhanced dynamic computed tomography (CT) 1 month after treatment and then every 3 months thereafter. Nine RFA sessions were performed for six solid hepatic tumors in six patients. The duration of follow-up ranged from 13 to 21 months (mean 17.5). Posttreatment CT showed total necrosis in four of six tumors after one or two RFA sessions. Residual tumor was observed in two patients with larger tumors (5 and 5.8 cm in diameter). All patients tolerated the procedure, and there with no major complications. Only 1 patient developed post-RFA syndrome (pain, fever, malaise, and leukocytosis), which resolved with oral administration of acetaminophen. Percutaneous RFA is a safe and effective treatment for patients with hepatic tumors: It is ideally suited for those who are not eligible for surgery. Long-term follow-up data regarding local and systemic recurrence and survival are still needed.

  10. Radiofrequency ablation of intrahepatic cholangiocarcinoma: preliminary experience.

    Carrafiello, Gianpaolo; Laganà, Domenico; Cotta, Elisa; Mangini, Monica; Fontana, Federico; Bandiera, Francesca; Fugazzola, Carlo

    2010-08-01

    The purpose of this study was to evaluate the safety and efficacy of percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) in patients with intrahepatic cholangiocarcinoma (ICCA) in a small, nonrandomized series. From February 2004 to July 2008, six patients (four men and two women; mean age 69.8 years [range 48 to 83]) with ICCA underwent percutaneous US-guided RFA. Preintervetional transarterial embolization was performed in two cases to decrease heat dispersion during RFA in order to increase the area of ablation. The efficacy of RFA was evaluated using contrast-enhanced dynamic computed tomography (CT) 1 month after treatment and then every 3 months thereafter. Nine RFA sessions were performed for six solid hepatic tumors in six patients. The duration of follow-up ranged from 13 to 21 months (mean 17.5). Posttreatment CT showed total necrosis in four of six tumors after one or two RFA sessions. Residual tumor was observed in two patients with larger tumors (5 and 5.8 cm in diameter). All patients tolerated the procedure, and there with no major complications. Only 1 patient developed post-RFA syndrome (pain, fever, malaise, and leukocytosis), which resolved with oral administration of acetaminophen. Percutaneous RFA is a safe and effective treatment for patients with hepatic tumors: It is ideally suited for those who are not eligible for surgery. Long-term follow-up data regarding local and systemic recurrence and survival are still needed. PMID:20411389

  11. Idiopathic ventricular tachycardia: transcatheter ablation or antiarrhythmic drugs?

    Claudio Tondo; Corrado Carbucicchio; Antonio Dello Russo; Benedetta Majocchi; Martina Zucchetti; Francesca Pizzamiglio; Fabrizio Bologna; Fabio Cattaneo; Daniele Colombo; Eleonora Russo; Michela Casella

    2015-02-01

    Full Text Available Introduction Ventricular tachycardia or frequent premature ventricular contractions (PVCs can occur in the absence of any detectable structural heart disease. In this clinical setting, these arrhythmias are termed idiopathic. Usually, they carry a benign prognosis and any potential ablative intervention is carried out if patients are highly symptomatic or, more importantly, if frequent ventricular arrhythmias can lead to ventricular dysfunction. Methods In this paper, different forms of idiopathic ventricular tachycardia are reviewed. Outflow tract ventricular tachycardia from the right ventricle is the most frequent form of the so-called idiopathic ventricular tachycardia. Other forms of idiopathic ventricular arrhythmias include ventricular tachycardia/PVCs arising from tricuspid annulus, from the mitral annulus, inter-fascicular ventricular tachycardia and papillary muscle ventricular tachycardia. When interventional treatment is deemed necessary, detailed mapping ( earliest activation during VT/PVC, pace mapping is crucial as to identify the successful ablation site. Catheter ablation more than antiarrhythmic drug treatment is usually highly effective in eliminating idiopathic ventricular arrhythmias and providing prevention of recurrence. Conclusion Idiopathic VTs are not considered life-threatening arrhythmias and, prevention of recurrences is often achieved by means of catheter ablation that provides an improvement of quality of life. The overall acute success rate of catheter ablation is about 85-90% with a long–term prevention of arrhythmia recurrence of about 75-80%. It is advisable that the procedure is carried out by electrophysiologists with expertise in VT catheter ablation and extensive knowledge of cardiac anatomy as to ensure a high success rate and reduce the likelihood of major complications.

  12. Laparoscopic Ultrasound-Guided Radiofrequency Ablation of Uterine Fibroids

    Four patients with symptomatic uterine fibroids measuring less than 6 cm underwent laparoscopic ultrasound-guided radiofrequency ablation (RFA) using multiprobe-array electrodes. Follow-up of the treated fibroids was performed with gadolinium-enhanced magnetic resonance imaging (MRI) and patients' symptoms were assessed by telephone interviews. The procedure was initially technically successful in 3 of the 4 patients and MRI studies at 1 month demonstrated complete fibroid ablation. Symptom improvement, including a decrease in menstrual bleeding and pain, was achieved in 2 patients at 3 months. At 7 months, 1 of these 2 patients experienced symptom worsening which correlated with recurrent fibroid on MRI. The third, initially technically successfully treated patient did not experience any symptom relief after the procedure and was ultimately diagnosed with adenomyosis. Our preliminary results suggest that RFA is a technically feasible treatment for symptomatic uterine fibroids in appropriately selected patients

  13. Pulmonary Thermal Ablation: Comparison of Radiofrequency and Microwave Devices by Using Gross Pathologic and CT Findings in a Swine Model

    Brace, Christopher L.; Hinshaw, J. Louis; Laeseke, Paul F.; Sampson, Lisa A.; Lee, Fred T.

    2009-01-01

    Purpose: To compare the performance of equivalently sized radiofrequency and microwave ablation applicators in a normal porcine lung model. Materials and Methods: All experiments were approved by an institutional animal care and use committee. A total of 18 ablations were performed in vivo in normal porcine lungs. By using computed tomographic (CT) fluoroscopic guidance, a 17-gauge cooled triaxial microwave antenna (n = 9) and a 17-gauge cooled radiofrequency (RF) electrode (n = 9) were placed percutaneously. Ablations were performed for 10 minutes by using either 125 W of microwave power or 200 W of RF power delivered with an impedance-based pulsing algorithm. CT images were acquired every minute during ablation to monitor growth. Animals were sacrificed after the procedure. Ablation zones were then excised and sectioned transverse to the applicator in 5-mm increments. Minimum and maximum diameter, cross-sectional area, length, and circularity were measured from gross specimens and CT images. Comparisons of each measurement were performed by using a mixed-effects model; P microwave ablation and mean cross-sectional area (8.25 cm2 ± 0.92 vs 5.45 cm2 ± 1.14, P microwave ablation, compared with RF ablation. With microwave ablation, the zones of ablation were also significantly more circular in cross section (mean circularity, 0.90 ± 0.06 vs 0.82 ± 0.09; P Microwave ablation with a 17-gauge high-power triaxial antenna creates larger and more circular zones of ablation than does a similarly sized RF applicator in a preclinical animal model. Microwave ablation may be a more effective treatment of lung tumors. © RSNA, 2009 PMID:19336667

  14. Local thermal ablation of renal cell carcinoma

    Purpose: With evolving local thermal ablation technology, the clinical application of thermal ablation has been actively investigated in the treatment for renal cell carcinoma. We review the evolution and current status of radiofrequency ablation and microwave ablation for renal cell carcinoma. Materials and methods: All articles published in English on radiofrequency ablation or microwave ablation as a treatment for renal cell carcinoma were identified with a MEDLINE® and PubMed® search from 1990 to 2010. Results: Local thermal ablation has several advantages, including keeping more normal renal units, relatively simple operation, easy tolerance, fewer complications, a shorter hospitalization and convalescence period. Long-term data has determined radiofrequency ablation is responsible for poor surgical candidates with renal cell carcinoma, however, tumor size, location and shape might affect the efficacy of radiofrequency ablation. Microwave ablation can induce large ablation volumes and yield good local tumor control. Associated complications appear to be low. Conclusions: Local ablative approaches seem to represent an attractive alternative to extirpative surgery for the treatment of small renal neoplasms in select patients. Potential developments include concepts to improve the accuracy and effectiveness of thermal ablation by improving the guiding, monitoring capabilities and detection capacity of multi-center lesions to provide at least equivalent cancer control to conventional surgery.

  15. Skin Burn at the Site of Indifferent Electrode after Radiofrequency Catheter Ablation of AV Node for Atrial Fibrillation

    Subba Reddy Vanga, MBBS

    2008-07-01

    Full Text Available Radiofrequency Ablation of AV node with permanent pacemaker has been used to achieve rate control in persistent symptomatic atrial fibrillation. Although RF Ablation is safe, complications may occur in up to 3% of the procedures. A rare complication of 2nd degree skin burn at indifferent electrode site has been described here. This report highlights the rare but possible complication in patients undergoing such a procedure and help in preventing by taking appropriate measures.

  16. Skin Burn at the Site of Indifferent Electrode after Radiofrequency Catheter Ablation of AV Node for Atrial Fibrillation.

    Dhanunjaya R Lakkireddy

    2008-07-01

    Full Text Available Radiofrequency Ablation of AV node with permanent pacemaker has been used to achieve rate control in persistent symptomatic atrial fibrillation. Although RF Ablation is safe, complications may occur in up to 3% of the procedures. A rare complication of 2nd degree skin burn at indifferent electrode site has been described here. This report highlights the rare but possible complication in patients undergoing such a procedure and help in preventing by taking appropriate measures.

  17. Increased preference of surface ablation over laser in situ keratomileusis between 2008–2011 is correlated to risk of ecatasia

    Moisseiev, Elad; Sela, Tzahi; Minkev, Liza; Varssano, David

    2013-01-01

    Purpose To evaluate the trends in corneal refractive procedure selection for the correction of myopia, focusing on the relative proportions of laser in situ keratomileusis (LASIK) and surface ablation procedures. Methods Only eyes that underwent LASIK or surface ablation for the correction of myopia between 2008–2011 were included in this retrospective study. Additional recorded parameters included patient age, preoperative manifest refraction, corneal thickness, and calculated residual corne...

  18. How anatomy can guide ablation in isthmic atrial flutter

    Cabrera Rodríguez, José Ángel; Ho, Siew Yen; Sánchez-Quintana, Damián

    2009-01-01

    Although most ablative procedures undertaken for common atrial flutter target the inferior right atrial isthmus, comparative studies of the morphology of this area are lacking. Our study examines its angiographic anatomy, making correlations with postmortem specimens, to provide a better understanding of the anatomic substrate of this arrhythmia. The gross morphological features and dimensions of the area between the orifice of the inferior caval vein and the attachment of the septal leafl...

  19. Role of Optical Coherence Tomography on Corneal Surface Laser Ablation

    Ventura, Bruna V.; Moraes, Haroldo V.; Newton Kara-Junior; Santhiago, Marcony R.

    2012-01-01

    This paper focuses on reviewing the roles of optical coherence tomography (OCT) on corneal surface laser ablation procedures. OCT is an optical imaging modality that uses low-coherence interferometry to provide noninvasive cross-sectional imaging of tissue microstructure in vivo. There are two types of OCTs, each with transverse and axial spatial resolutions of a few micrometers: the time-domain and the fourier-domain OCTs. Both have been increasingly used by refractive surgeons and have spec...

  20. LAPAROSCOPIC NEPHRECTOMY USING RADIOFREQUENCY THERMAL ABLATION

    B. Ya. Alekseev

    2014-08-01

    Full Text Available The wide use of current diagnostic techniques, such as ultrasound study, computed tomography, and magnetic resonance imaging, has led to significantly increased detection rates for disease in its early stages. This gave rise to a change in the standards for the treatment of locally advanced renal cell carcinoma (RCC. Laparoscopic nephrectomy (LN has recently become the standard treatment of locally advanced RCC in the clinics having much experience with laparoscopic surgery. The chief drawback of LN is difficulties in maintaining intraoperative hemostasis and a need for creating renal tissue ischemia. The paper gives the intermediate results of application of the new procedure of LN using radiofrequency thermal ablation in patients with non-ischemic early-stage RCC.

  1. Surgical ablation devices for atrial fibrillation.

    Lall, Shelly C; Damiano, Ralph J

    2007-12-01

    The introduction of ablation technology has revolutionized the surgical treatment of atrial fibrillation (AF). It has greatly simplified surgical approaches and has significantly increased the number of procedures being performed. Various energy sources have been used clinically, including cryoablation, radiofrequency, microwave, laser, and high-frequency ultrasound. The goal of these devices is to create conduction block to either block activation wavefronts or to isolate the triggers of AF. All present devices have been shown to have clinical efficacy in some patients. The devices each have their unique advantages and disadvantages. It is important that surgeons develop accurate dose-response curves for new devices in clinically relevant models on both the arrested and beating heart. This will allow the appropriate use of technology to facilitate AF surgery. PMID:18175210

  2. Microwave ablation of hepatocellular carcinoma.

    Poggi, Guido; Tosoratti, Nevio; Montagna, Benedetta; Picchi, Chiara

    2015-11-01

    Although surgical resection is still the optimal treatment option for early-stage hepatocellular carcinoma (HCC) in patients with well compensated cirrhosis, thermal ablation techniques provide a valid non-surgical treatment alternative, thanks to their minimal invasiveness, excellent tolerability and safety profile, proven efficacy in local disease control, virtually unlimited repeatability and cost-effectiveness. Different energy sources are currently employed in clinics as physical agents for percutaneous or intra-surgical thermal ablation of HCC nodules. Among them, radiofrequency (RF) currents are the most used, while microwave ablations (MWA) are becoming increasingly popular. Starting from the 90s', RF ablation (RFA) rapidly became the standard of care in ablation, especially in the treatment of small HCC nodules; however, RFA exhibits substantial performance limitations in the treatment of large lesions and/or tumors located near major heat sinks. MWA, first introduced in the Far Eastern clinical practice in the 80s', showing promising results but also severe limitations in the controllability of the emitted field and in the high amount of power employed for the ablation of large tumors, resulting in a poor coagulative performance and a relatively high complication rate, nowadays shows better results both in terms of treatment controllability and of overall coagulative performance, thanks to the improvement of technology. In this review we provide an extensive and detailed overview of the key physical and technical aspects of MWA and of the currently available systems, and we want to discuss the most relevant published data on MWA treatments of HCC nodules in regard to clinical results and to the type and rate of complications, both in absolute terms and in comparison with RFA. PMID:26557950

  3. Femtosecond laser ablation of dentin

    The surface morphology, structure and composition of human dentin treated with a femtosecond infrared laser (pulse duration 500 fs, wavelength 1030 nm, fluences ranging from 1 to 3 J cm-2) was studied by scanning electron microscopy, x-ray diffraction, x-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy. The average dentin ablation threshold under these conditions was 0.6 ± 0.2 J cm-2 and the ablation rate achieved in the range 1 to 2 µm/pulse for an average fluence of 3 J cm-2. The ablation surfaces present an irregular and rugged appearance, with no significant traces of melting, deformation, cracking or carbonization. The smear layer was entirely removed by the laser treatment. For fluences only slightly higher than the ablation threshold the morphology of the laser-treated surfaces was very similar to the dentin fracture surfaces and the dentinal tubules remained open. For higher fluences, the surface was more porous and the dentin structure was partially concealed by ablation debris and a few resolidified droplets. Independently on the laser processing parameters and laser processing method used no sub-superficial cracking was observed. The dentin constitution and chemical composition was not significantly modified by the laser treatment in the processing parameter range used. In particular, the organic matter is not preferentially removed from the surface and no traces of high temperature phosphates, such as the β-tricalcium phosphate, were observed. The achieved results are compatible with an electrostatic ablation mechanism. In conclusion, the high beam quality and short pulse duration of the ultrafast laser used should allow the accurate preparation of cavities, with negligible damage of the underlying material. (paper)

  4. Microwave ablation of hepatocellular carcinoma

    2015-01-01

    Although surgical resection is still the optimal treatmentoption for early-stage hepatocellular carcinoma(HCC) in patients with well compensated cirrhosis,thermal ablation techniques provide a valid nonsurgicaltreatment alternative, thanks to their minimalinvasiveness, excellent tolerability and safety profile,proven efficacy in local disease control, virtuallyunlimited repeatability and cost-effectiveness. Differentenergy sources are currently employed in clinics asphysical agents for percutaneous or intra-surgicalthermal ablation of HCC nodules. Among them, radiofrequency(RF) currents are the most used, whilemicrowave ablations (MWA) are becoming increasinglypopular. Starting from the 90s', RF ablation (RFA) rapidlybecame the standard of care in ablation, especially inthe treatment of small HCC nodules; however, RFAexhibits substantial performance limitations in thetreatment of large lesions and/or tumors located nearmajor heat sinks. MWA, first introduced in the FarEastern clinical practice in the 80s', showing promisingresults but also severe limitations in the controllabilityof the emitted field and in the high amount of poweremployed for the ablation of large tumors, resultingin a poor coagulative performance and a relativelyhigh complication rate, nowadays shows better resultsboth in terms of treatment controllability and of overallcoagulative performance, thanks to the improvementof technology. In this review we provide an extensiveand detailed overview of the key physical and technicalaspects of MWA and of the currently available systems,and we want to discuss the most relevant published dataon MWA treatments of HCC nodules in regard to clinicalresults and to the type and rate of complications, both inabsolute terms and in comparison with RFA.

  5. Radiofrequency ablation of liver metastases; Radiofrequenzablation von Lebermetastasen

    Pereira, P.L.; Clasen, S.; Schmidt, D.; Wiskirchen, J.; Tepe, G.; Claussen, C.D. [Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Boss, A. [Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Sektion fuer Experimentelle Radiologie der Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Gouttefangeas, C. [Abt. Immunologie des Inst. fuer Zellbiologie, Eberhard-Karls-Univ. Tuebingen (Germany); Burkart, C. [Zentrum fuer gastroenterologische Onkologie der Medizinischen Klinik, Eberhard-Karls-Univ. Tuebingen (Germany)

    2004-04-01

    The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI]), transarterial chemoembolisation [TACE] in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases. (orig.) [German] Die Leber ist unabhaengig vom Primaertumor nach den Lymphknoten die zweithaeufigste Lokalisation von Metastasen. Bis zu 50% aller Patienten mit malignen Erkrankungen werden im Verlauf ihrer Erkrankung Lebermetastasen entwickeln, die mit einer signifikanten Morbiditaet und Mortalitaet verbunden sind. Obwohl die chirurgische Resektion zu einer verlaengerten Ueberlebenszeit fuehrt, sind nur ca. 20% der Patienten fuer einen chirurgischen Eingriff geeignet. Die Radiofrequenz-(RF-)Ablation stellt derzeit eine der effektivsten Alternativen und komplementaeren Methoden bei der Therapie von Lebermetastasen dar. In einem selektierten Patientengut fuehrt die RF-Ablation ueber den palliativen Einsatz hinaus zu einer

  6. Transhemangioma Ablation of Hepatocellular Carcinoma

    Radiofrequency ablation (RFA) is a well-established treatment modality in the treatment of early hepatocellular carcinoma (HCC) [1]. Safe trajectory of the RFA probe is crucial in decreasing collateral tissue damage and unwarranted probe transgression. As a percutaneous technique, however, the trajectory of the needle is sometimes constrained by the available imaging plane. The presence of a hemangioma beside an HCC is uncommon but poses the question of safety related to probe transgression. We hereby describe a case of transhemangioma ablation of a dome HCC.

  7. Transhemangioma Ablation of Hepatocellular Carcinoma

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2012-12-15

    Radiofrequency ablation (RFA) is a well-established treatment modality in the treatment of early hepatocellular carcinoma (HCC) [1]. Safe trajectory of the RFA probe is crucial in decreasing collateral tissue damage and unwarranted probe transgression. As a percutaneous technique, however, the trajectory of the needle is sometimes constrained by the available imaging plane. The presence of a hemangioma beside an HCC is uncommon but poses the question of safety related to probe transgression. We hereby describe a case of transhemangioma ablation of a dome HCC.

  8. Ablation of Solid Hydrogen in a Plasma

    Jørgensen, L. W.; Sillesen, Alfred Hegaard

    1979-01-01

    Several hydrogen pellet ablation models based on the formation of a shielding neutral cloud have been reported by different authors. The predicted ablation rates are shown to follow almost the same scaling law and this is used to explain the authors' ablation experiment....

  9. Soft thrombus formation in radiofrequency catheter ablation

    Demolin, JM; Eick, OJ; Munch, K; Koullick, E; Nakagawa, H; Wittkampf, FHM

    2002-01-01

    During RF catheter ablation, local temperature elevation can result in coagulum formation on the ablation electrode, resulting in impedance rise. A recent study has also demonstrated the formation of a so-called soft thrombus during experimental ablations. This deposit poorly adhered to the catheter

  10. Laser ablation at the hydrodynamic regime

    Gojani Ardian B.

    2013-01-01

    Laser ablation of several metals and PVC polymer by high energy nanosecond laser pulses is investigated experimentaly. Visualization by shadowgraphy revealed the dynamics of the discontinuities in ambient air and ablation plume above the target surface, while surface profiling allowed for determination of the ablated mass.

  11. Regional pericarditis status post cardiac ablation: A case report

    Joseph Orme

    2014-01-01

    Full Text Available Context: Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction. Case report: A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient′s presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine. Conclusion: This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation.

  12. Robotic-assisted thermal ablation of liver tumours

    This study aimed to assess the technical success, radiation dose, safety and performance level of liver thermal ablation using a computed tomography (CT)-guided robotic positioning system. Radiofrequency and microwave ablation of liver tumours were performed on 20 patients (40 lesions) with the assistance of a CT-guided robotic positioning system. The accuracy of probe placement, number of readjustments and total radiation dose to each patient were recorded. The performance level was evaluated on a five-point scale (5-1: excellent-poor). The radiation doses were compared against 30 patients with 48 lesions (control) treated without robotic assistance. Thermal ablation was successfully completed in 20 patients with 40 lesions and confirmed on multiphasic contrast-enhanced CT. No procedure related complications were noted in this study. The average number of needle readjustment was 0.8 ± 0.8. The total CT dose (DLP) for the entire robotic assisted thermal ablation was 1382 ± 536 mGy.cm, while the CT fluoroscopic dose (DLP) per lesion was 352 ± 228 mGy.cm. There was no statistically significant (p > 0.05) dose reduction found between the robotic-assisted versus the conventional method. This study revealed that robotic-assisted planning and needle placement appears to be safe, with high accuracy and a comparable radiation dose to patients. (orig.)

  13. Catheter ablation of atrial fibrillation in the elderly

    Louiza Lioni; Konstantinos P Letsas; Michael Efremidis; Konstantinos Vlachos; Georgios Giannopoulos; Vasileios Kareliotis; Spyridon Deftereos; Antonios Sideris

    2014-01-01

    Background Atrial fibrillation (AF) catheter ablation has emerged as a promising treatment strategy for AF, but has not been widely adopted in the elderly population. The present study aimed to determine the safety and efficacy of AF catheter ablation in the elderly popula-tion. Methods and Results The study population consisted of 316 patients with paroxysmal AF who underwent left atrial ablation. Ninety-five patients were≥65 years (48 males, mean age 68.9 ± 3.0 years old) and 221 patients were<65 years old (130 males, mean age 52.5 ± 10.4 years old). After a mean follow-up period of 34.0 ± 15.1 months, 55 (57.9%) patients in the elderly group were free from ar-rhythmia recurrence compared with 149 (67.4%) patients in the younger group (P=0.169). Procedural complications were uncommon in both study groups. In logistic regression analysis, left atrial diameter (P=0.003), hypertension (P=0.001), dyslipidemia (P=0.039), and coronary artery disease (P=0.018) were independent predictors of AF recurrence in the elderly population. Conclusions Catheter ablation of AF is safe and effective in older patients. Invasive strategies should be considered as an alternative choice in symptomatic elderly patients with AF.

  14. Robotic-assisted thermal ablation of liver tumours

    Abdullah, Basri Johan Jeet; Yeong, Chai Hong [University of Malaya, Department of Biomedical Imaging and University of Malaya Research Imaging Centre, Faculty of Medicine, Kuala Lumpur (Malaysia); University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Goh, Khean Lee [University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Yoong, Boon Koon [University of Malaya, Department of Surgery, Faculty of Medicine, Kuala Lumpur (Malaysia); Ho, Gwo Fuang [University of Malaya, Department of Oncology, Faculty of Medicine, Kuala Lumpur (Malaysia); Yim, Carolyn Chue Wai [University of Malaya, Department of Anesthesia, Faculty of Medicine, Kuala Lumpur (Malaysia); Kulkarni, Anjali [Perfint Healthcare Corporation, Florence, OR (United States)

    2015-01-15

    This study aimed to assess the technical success, radiation dose, safety and performance level of liver thermal ablation using a computed tomography (CT)-guided robotic positioning system. Radiofrequency and microwave ablation of liver tumours were performed on 20 patients (40 lesions) with the assistance of a CT-guided robotic positioning system. The accuracy of probe placement, number of readjustments and total radiation dose to each patient were recorded. The performance level was evaluated on a five-point scale (5-1: excellent-poor). The radiation doses were compared against 30 patients with 48 lesions (control) treated without robotic assistance. Thermal ablation was successfully completed in 20 patients with 40 lesions and confirmed on multiphasic contrast-enhanced CT. No procedure related complications were noted in this study. The average number of needle readjustment was 0.8 ± 0.8. The total CT dose (DLP) for the entire robotic assisted thermal ablation was 1382 ± 536 mGy.cm, while the CT fluoroscopic dose (DLP) per lesion was 352 ± 228 mGy.cm. There was no statistically significant (p > 0.05) dose reduction found between the robotic-assisted versus the conventional method. This study revealed that robotic-assisted planning and needle placement appears to be safe, with high accuracy and a comparable radiation dose to patients. (orig.)

  15. T-maze Forced Alternation and Left-right Discrimination Tasks for Assessing Working and Reference Memory in Mice

    Shoji, Hirotaka; Hagihara, Hideo; Takao, Keizo; Hattori, Satoko; Miyakawa, Tsuyoshi

    2012-01-01

    Forced alternation and left-right discrimination tasks using the T-maze have been widely used to assess working and reference memory, respectively, in rodents. In our laboratory, we evaluated the two types of memory in more than 30 strains of genetically engineered mice using the automated version of this apparatus. Here, we present the modified T-maze apparatus operated by a computer with a video-tracking system and our protocols in a movie format. The T-maze apparatus consists of runways pa...

  16. Dopamine depletion in either the dorsomedial or dorsolateral striatum impairs egocentric Cincinnati water maze performance while sparing allocentric Morris water maze learning.

    Braun, Amanda A; Amos-Kroohs, Robyn M; Gutierrez, Arnold; Lundgren, Kerstin H; Seroogy, Kim B; Skelton, Matthew R; Vorhees, Charles V; Williams, Michael T

    2015-02-01

    Both egocentric route-based learning and spatial learning, as assessed by the Cincinnati water maze (CWM) and Morris water maze (MWM), respectively, are impaired following an 80% dopamine (DA) loss in the neostriatum after 6-hydroxydopamine (6-OHDA) administration in rats. The dorsolateral striatum (DLS) and the dorsomedial striatum (DMS) are implicated in different navigational learning types, namely the DLS is implicated in egocentric learning while the DMS is implicated in spatial learning. This experiment tested whether selective DA loss through 6-OHDA lesions in the DMS or DLS would impair one or both types of navigation. Both DLS and DMS DA loss significantly impaired route-based CWM learning, without affecting spatial or cued MWM performance. DLS 6-OHDA lesions produced a 75% DA loss in this region, with no changes in other monoamine levels in the DLS or DMS. DMS 6-OHDA lesions produced a 62% DA loss in this region, without affecting other monoamine levels in the DMS or DLS. The results indicate a role for DA in DLS and DMS regions in route-based egocentric but not spatial learning and memory. Spatial learning deficits may require more pervasive monoamine reductions within each region before deficits are exhibited. This is the first study to implicate DLS and DMS DA in route-based egocentric navigation. PMID:25451306

  17. Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The Recurrent Veins after Thermal Ablation Study

    R. G. Bush

    2014-01-01

    Full Text Available Background. The goal of this retrospective cohort study (REVATA was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF and laser ablation. Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV, small saphenous vein (SSV, or anterior accessory great saphenous vein (AAGSV. From a specific designed study tool, the etiology of recurrence was identified. Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently. Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients. Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.

  18. Percutaneous laser ablation of hepatocellular carcinoma in patients with liver cirrhosis awaiting liver transplantation

    Pompili, Maurizio, E-mail: mpompili@rm.unicatt.i [Department of Internal Medicine, Universita Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma (Italy); Pacella, Claudio Maurizio, E-mail: claudiomauriziopacella@gmail.co [Department of Diagnostic Imaging and Interventional Radiology, Ospedale Regina Apostolorum, Via S. Francesco D' Assisi, 50, 00041 Albano Laziale (RM) (Italy); Francica, Giampiero, E-mail: giampierofrancica@tin.i [Department of Interventional Ultrasound, Presidio Ospedaliero Camilliani, S. Maria della Pieta, Via S. Rocco, 9, 80026 Casoria (Namibia) (Italy); Angelico, Mario, E-mail: angelico@med.uniroma2.i [Hepatology Unit, Universita di Tor Vergata, Viale Oxford, 81, 00133 Rome (Italy); Tisone, Giuseppe, E-mail: tisone@med.uniroma2.i [Transplant and General Surgery Unit, Universita di Tor Vergata, Ospedale S. Eugenio, Piazzale dell' Umanesimo 10-00144 Rome (Italy); Craboledda, Paolo, E-mail: paolo.craboledda@virgilio.i [Department of Pathology, Ospedale S. Eugenio, Piazzale dell' Umanesimo, 10-00144 Rome (Italy); Nicolardi, Erica; Rapaccini, Gian Ludovico; Gasbarrini, Giovanni [Department of Internal Medicine, Universita Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma (Italy)

    2010-06-15

    Objective: The aim of this study was to determine the effectiveness and safety of percutaneous laser ablation for the treatment of cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation. Materials and methods: The data of 9 male cirrhotic patients (mean age 50 years, range 45-60 years) with 12 biopsy proven nodules of hepatocellular carcinoma (mean diameter 2.0 cm, range 1.0-3.0 cm) treated by laser ablation before liver transplantation between June 2000 and January 2006 were retrospectively reviewed. Laser ablation was carried out by inserting 300 nm optical fibers through 21-Gauge needles (from two to four) positioned under ultrasound guidance into the target lesions. A continuous wave Neodymium:Yttrium Aluminium Garnet laser was used. Transarterial chemoembolization prior to liver transplantation was performed in two incompletely ablated tumors. Results: No procedure-related major complications were recorded. During the waiting time to liver transplantation local tumor progression after ablation occurred in 3 nodules (25%). At histological examination of the explanted livers complete necrosis was found in 8 nodules (66.7%, all treated exclusively with laser ablation), partial necrosis >50% in 3 nodules (25%), and partial necrosis <50% in 1 nodule. Conclusion: In patients with cirrhotic livers awaiting liver transplantation, percutaneous laser ablation is safe and effective for the management of small hepatocellular carcinoma.

  19. Percutaneous laser ablation of hepatocellular carcinoma in patients with liver cirrhosis awaiting liver transplantation

    Objective: The aim of this study was to determine the effectiveness and safety of percutaneous laser ablation for the treatment of cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation. Materials and methods: The data of 9 male cirrhotic patients (mean age 50 years, range 45-60 years) with 12 biopsy proven nodules of hepatocellular carcinoma (mean diameter 2.0 cm, range 1.0-3.0 cm) treated by laser ablation before liver transplantation between June 2000 and January 2006 were retrospectively reviewed. Laser ablation was carried out by inserting 300 nm optical fibers through 21-Gauge needles (from two to four) positioned under ultrasound guidance into the target lesions. A continuous wave Neodymium:Yttrium Aluminium Garnet laser was used. Transarterial chemoembolization prior to liver transplantation was performed in two incompletely ablated tumors. Results: No procedure-related major complications were recorded. During the waiting time to liver transplantation local tumor progression after ablation occurred in 3 nodules (25%). At histological examination of the explanted livers complete necrosis was found in 8 nodules (66.7%, all treated exclusively with laser ablation), partial necrosis >50% in 3 nodules (25%), and partial necrosis <50% in 1 nodule. Conclusion: In patients with cirrhotic livers awaiting liver transplantation, percutaneous laser ablation is safe and effective for the management of small hepatocellular carcinoma.

  20. Reducing Ionizing Radiation Associated with Atrial Fibrillation Ablation: An Ultrasound-Guided Approach

    Nisha L. Bhatia, MD

    2010-12-01

    Full Text Available Radiation exposure with cardiac interventional procedures is an emerging concern. Patients receiving radiofrequency ablation for atrial fibrillation (AF still routinely undergo pre-ablation computed tomography (CT scans for definition of left atrial and pulmonary vein anatomy, as well as creation of a surrogate geometry. In an effort to decrease ionizing radiation associated with AF ablation, an ultrasound-guided surrogate geometry approach is proposed as an alternative to routine CT imaging. Ten patients underwent AF ablation using intracardiac ultrasound for the creation of a surrogate left atrial geometry (CartoSound, Biosense Webster, CA; and ten control-cases who had conventional CT-guided imaging (CartoMerge, Biosense Webster, CA were matched for age, gender, and type of catheter ablation. Sources of radiation included 1 intraprocedural fluoroscopy (CartoSound: 151 ± 43 mGray*cm^2, CartoMerge: 174 ± 130 mGray*cm^2; p=0.6 and 2 CT ionizing radiation (CartoSound: 0 mSv, CartoMerge 9.4 ± 2.3 mSv/CT scan. When comparing clinical success rates after a trial of previously ineffective anti-arrhythmic drugs, ultrasound-guided AF ablation was non-inferior to a CT-guided approach. This potentially obviates the need for CT-guided imaging, therefore reducing doses of ionizing radiation by nearly 10 mSv per AF catheter ablation.

  1. The Autonomic Nervous System and Atrial Fibrillation: The Roles of Pulmonary Vein Isolation and Ganglionated Plexi Ablation

    Benjamin J. Scherlag

    2009-08-01

    Full Text Available After the sequential successes of catheter ablation for the treatment of pre-excitation syndromes (WPW, junctional reentry (AVNRT atrial flutter (AFL and ventricular arrhythmias, clinical electrophysiologists have focused on the myocardial basis of atrial fibrillation (AF. Thus, the strategy for ablation of drug and cardioversion refractory AF was to isolate the myocardial connections from the focal firing pulmonary veins (PVs in addition to altering the atrial substrate maintaining AF. However, the overall success rates have not achieved those of the other types of ablation procedures. In this review we have summarized the favorable aspects and drawbacks of pulmonary vein isolation (PVI. As for the role of the Intrinsic Cardiac Autonomic Nervous System (ICANS, both basic and clinical evidence has shown that ganglionated plexi (GP stimulation promotes initiation and maintenance of AF, and that GP ablation reduces recurrence of AF following catheter or surgical ablation of these structures. Based on these findings, the GP Hyperactivity Hypothesis has been proposed to explain, at least in part, the mechanistic basis for the focal form of AF. For example, PV isolation may not always be necessary for elimination of AF, as in the early stages of paroxysmal AF. GP ablation alone, in these cases, may suffice for focal AF termination. In the persistent and long standing persistent forms the substrate for AF may be more extensive and therefore require GP ablation plus PV isolation and/or CFAE ablations. Clinical reports, both catheter based as well as minimally invasive surgical procedures, which include PVI plus GP ablation have shown relatively long-term success rates much closer to or equal to those achieved by myocardial ablation procedures in patients with WPW, AVNRT and AFL.

  2. The Autonomic Nervous System and Atrial Fibrillation:The Roles of Pulmonary Vein Isolation and Ganglionated Plexi Ablation

    Benjamin J. Scherlag, PhD

    2009-08-01

    Full Text Available After the sequential successes of catheter ablation for the treatment of pre-excitation syndromes (WPW, junctional reentry (AVNRT atrial flutter (AFL and ventricular arrhythmias, clinical electrophysiologists have focused on the myocardial basis of atrial fibrillation (AF. Thus, the strategy for ablation of drug and cardioversion refractory AF was to isolate the myocardial connections from the focal firing pulmonary veins (PVs in addition to altering the atrial substrate maintaining AF. However, the overall success rates have not achieved those of the other types of ablation procedures. In this review we have summarized the favorable aspects and drawbacks of pulmonary vein isolation (PVI. As for the role of the Intrinsic Cardiac Autonomic Nervous System (ICANS, both basic and clinical evidence has shown that ganglionated plexi (GP stimulation promotes initiation and maintenance of AF, and that GP ablation reduces recurrence of AF following catheter or surgical ablation of these structures. Based on these findings, the GP Hyperactivity Hypothesis has been proposed to explain, at least in part, the mechanistic basis for the focal form of AF. For example, PV isolation may not always be necessary for elimination of AF, as in the early stages of paroxysmal AF. GP ablation alone, in these cases, may suffice for focal AF termination. In the persistent and long standing persistent forms the substrate for AF may be more extensive and therefore require GP ablation plus PV isolation and/or CFAE ablations. Clinical reports, both catheter based as well as minimally invasive surgical procedures, which include PVI plus GP ablation have shown relatively long-term success rates much closer to or equal to those achieved by myocardial ablation procedures in patients with WPW, AVNRT and AFL.

  3. Modern Advances in Ablative TPS

    Venkatapathy, Ethiraj

    2013-01-01

    Topics covered include: Physics of Hypersonic Flow and TPS Considerations. Destinations, Missions and Requirements. State of the Art Thermal Protection Systems Capabilities. Modern Advances in Ablative TPS. Entry Systems Concepts. Flexible TPS for Hypersonic Inflatable Aerodynamic Decelerators. Conformal TPS for Rigid Aeroshell. 3-D Woven TPS for Extreme Entry Environment. Multi-functional Carbon Fabric for Mechanically Deployable.

  4. Radial-arm-maze behavior of the red-footed tortoise (Geochelone carbonaria).

    Mueller-Paul, Julia; Wilkinson, Anna; Hall, Geoffrey; Huber, Ludwig

    2012-08-01

    The radial-arm maze is an established method for testing an animal's spatial win-shift behavior. Research on mammals, birds, and fish has shown that the mastery of this task is commonly mediated, to different degrees, by two types of strategy: those based on external cues and those based on response stereotypy. In the present study we trained four red-footed tortoises (Geochelone carbonaria) to navigate an eight-arm radial maze while providing different levels of access to visual room cues. The results indicate that response stereotypy is the more prevalent mechanism in these tortoises, although navigation based on landmarks can also occur if learned initially. The findings suggest that tortoise spatial navigation may be more similar to that observed in mammals and birds than previously thought. PMID:22390619

  5. Shielding of radiation fields generated by 252Cf in a concrete maze. Part 2 -- Simulation

    A streaming experiment performed in a concrete maze of shape and size typical of a radiotherapy room was simulated with the Monte Carlo program FLUKA. The purpose of the calculation was to test the performance of the code in the low energy neutron range, and at the same time to provide additional information which could help in optimizing shielding of medical facilities. Instrument responses were calculated at different maze locations for several experimental configurations and were compared with measurements. In addition, neutron and gamma fluence, ambient dose equivalent and effective dose were calculated at the same positions. Both sources used in the experiment, namely a bare 252Cf source and one shielded by a tungsten shell 5 cm thick, were considered in the simulation

  6. Model testing of a 10-kg high explosive blast attenuation maze

    The basement area of the proposed High Explosive Applications Facility (HEAF) at the Lawrence Livermore National Laboratory includes 10-kg HE assembly and process cells, and a 10-kg corridor for the transport of up to 10 kg of HE from the receiving dock to the cells and to the experimental firing tanks. Previous model experiments developed a process cell-maze configuration that attenuated the effects of an accidental 10-kg detonation to acceptable levels (maximum of 10 to 11 psi reflected). This document reports 1/8-scale model tests conducted to confirm the maze design and to determine the blast pressures in adjacent areas in the final HEAF building configuration. In addition, pressure/time information was obtained at selected points in the model expansion chamber to provide the architect-engineer with information for structural design

  7. EVALUATION OF ANXIOLYTIC ACTIVITY OF CARUM COPTICUM BY USING ELEVATED PLUS MAZE AND OPEN FIELD METHOD

    Kharade SM

    2011-04-01

    Full Text Available The clinical applications of benzodiazepines as anxiolytics are limited by their unwanted side effects. Therefore, the development of new pharmacological agents is well justified. Among medicinal plants, Carum copticum has been recommended for relief of anxiety and insomnia in Iranian folk medicine. Nevertheless, no pharmacological studies have thus far evaluated its effects on central nervous system. Therefore, the aim of this study was to examine if the aqueous extract of Carum copticum seeds has anxiolytics effect in mice. The anxiolytic effect of aqueous extract (200, 400mg/kg was examined in male albino mice using elevated plus-maze and open field as an animal model of anxiety. In the elevated plus-maze, aqueous extract at 200 mg/kg showed an anxiolytic effect by increasing the time spent on open arms and the percentage of open arm entries, compared to control group. These results suggest that the aqueous extract of Carum copticum seeds has anxiolytic effect.

  8. A numerical simulation of ablation controlled arcs

    Godin, D.; Trepanier, J.Y. [Ecole Polytechnique, Dept. of Mechanical Engineering, Montreal, PQ (Canada); Eby, S.D. [Ecole Polytechnique, Centre de Recherche en Calcul Applique, Montreal, PQ (Canada); Robin-Jouan, P. [GEC-Alsthom T and D, Villeurbanne, (France)

    1998-09-01

    An approach to model the ablation phenomenon of ablation controlled arcs using computational fluid dynamics was presented. Ablation controlled arcs are found in high voltage electrical equipment such as fuses and circuit-breakers. A qualitative prediction of the ablation level is critical from an industrial point of view because deliberate use of ablation is made to increase the pressure in a circuit-breaker chamber to allow for an efficient extinction when the current returns to zero. The numerical model was validated by comparing results of published experimental data. 7 refs., 10 figs.

  9. Slime mould solves maze in one pass ... assisted by gradient of chemo-attractants

    Adamatzky, Andrew

    2011-01-01

    Plasmodium of Physarum polycephalum is a large cell, visible by unaided eye, which exhibits sophisticated patterns of foraging behaviour. The plasmodium's behaviour is well interpreted in terms of computation, where data are spatially extended configurations of nutrients and obstacles, and results of computation are networks of protoplasmic tubes formed by the plasmodium. In laboratory experiments and numerical simulation we show that if plasmodium of Physarum is inoculated in a maze's periph...

  10. Effect of Food Deprivation on a Delayed Nonmatch-to-place T-maze Task

    Jang, Eun-Hae; Ahn, Seo-Hee; Lee, Ye-Seul; Lee, Hye-Ryeon; Kaang, Bong-Kiun

    2013-01-01

    Food deprivation can affect performance on difficult cognitive task, such as the delayed nonmatch-to-place T-maze task (DNMT). The importance of food deprivation on maintaining high motivation for DNMT task has been emphasized, but not many studies have investigated the optimal conditions for depriving rodents to maximize performance. Establishing appropriate conditions for food deprivation is necessary to maintain DNMT task motivation. We applied different conditions of food deprivation (1-h...

  11. Long-term impoverished housing effects on morris maze performance after a fimbria lesion

    Gispen, W. H.; Rijzingen, I.M.S.; Doremalen, E. van; Spruijt, B. M.

    1996-01-01

    Male Wistar rats received bilateral Fimbria lesions and were postoperatively housed in either standard social conditions or in impoverished conditions (one rat per cage) for 2 weeks in experiment I, and for 7 months in experiment II. The effects of lesion and housing conditions were investigated in the Morris maze spatial orientation task. Fimbria lesions increased the latency to reach the platform during acquisition in both experiments, which indicates that functional recovery of the Morris ...

  12. Effects of emotional reactivity on inhibitory avoidance in the elevated T-maze

    Conde, C; Costa, V.; Tomaz, C

    2000-01-01

    The possibility of the presence of inter-individual emotional differences and the memory performance of rats was examined in the elevated T-maze. Two kinds of aversively motivated behaviors, inhibitory avoidance and escape learning, were measured. Based on the number of trials to achieve a learning criterion, rats were divided into two subgroups with either low or high avoidance reactivity (LAR or HAR, respectively). Retention test avoidance latencies showed that HAR animals had better avoida...

  13. Place and direction learning in a spatial T-maze task by neonatal piglets

    Elmore, Monica R. P.; Dilger, Ryan N.; Johnson, Rodney W.

    2012-01-01

    Pigs are a valuable animal model for studying neurodevelopment in humans due to similarities in brain structure and growth. The development and validation of behavioral tests to assess learning and memory in neonatal piglets are needed. The present study evaluated the capability of 2-wk old piglets to acquire a novel place and direction learning spatial T-maze task. Validity of the task was assessed by the administration of scopolamine, an anti-cholinergic drug that acts on the hippocampus an...

  14. An automated maze task for assessing hippocampus-sensitive memory in mice ☆

    Pioli, Elsa Y.; Gaskill, Brianna N.; Gilmour, Gary; Tricklebank, Mark D; Dix, Sophie L.; Bannerman, David; Garner, Joseph P

    2014-01-01

    Memory deficits associated with hippocampal dysfunction are a key feature of a number of neurodegenerative and psychiatric disorders. The discrete-trial rewarded alternation T-maze task is highly sensitive to hippocampal dysfunction. Normal mice have spontaneously high levels of alternation, whereas hippocampal-lesioned mice are dramatically impaired. However, this is a hand-run task and handling has been shown to impact crucially on behavioural responses, as well as being labour-intensive an...

  15. Neutron dose equivalent measured at the maze door with various openings for the jaws and MLC

    Purpose: This study was undertaken to explore the effects of the jaws and the MLC openings on the neutron dose equivalent (DE) at the maze door and neutron flux at the patient plane. Methods: The neutron dose equivalent was measured at the maze entrance door of a 15 MV therapy linear accelerator room. All measurements were performed using various field sizes up to 40 cm x 40 cm. Activation detectors constructed from natural Indium (In) were exposed at Cd envelope to neutrons in order to estimate relative changes of epithermal neutron fluences in the patient plane. Results: Our study showed that the dose equivalent at the maze door is at the highest when the jaw are closed and that maximal jaws opening reduces the DE by more than 20%. The neutron dose equivalent at the maze door measured for radiation fields defined by jaws do not differ significantly from the DE measured when MLC determines the same size radiation field. The epithermal capture reaction rate measured using different jaw openings differs by approximately 10%. When an MLC leaf is inserted into a fixed geometry for one opening of the jaws, an increase of the epithermal neutron capture reaction rate in Indium activation detectors was observed. Conclusions: There is no significant difference in the neutron DE when MLC defines radiation field instead of jaws. This leads to the conclusion that the overall number of neutrons remains similar and it does not depend on how primary photon beam was stopped--by the jaws or the MLC. An increase of the fast neutron capture reaction rate when MLC leaves are inserted probably originates from the neutron scattering.

  16. Photoperiod interacts with food restriction on performance in the Barnes maze in female California mice

    Steinman, Michael Q.; Crean, Katie K.; Trainor, Brian C.

    2010-01-01

    Food restriction has been reported to have positive effects on cognition. This study examines how another environmental factor, daylength, can alter the impact of food restriction on the brain and behavior. Female California mice (Peromyscus californicus), housed on either long days (16L:8D) or short days (8L:16D) were restricted to 80% of their normal baseline food intake or provided food ad libitum. Testing in a Barnes maze revealed that the effects of food restriction depend on photoperiod...

  17. Water associated zero maze: a novel rat test for long term traumatic re-experiencing

    Ritov, Gilad; Richter-levin, Gal

    2014-01-01

    Often, freezing and startle behaviors in the context of a previously experienced stress are taken as an indication of post-traumatic stress disorder (PTSD)-like symptoms in rats. However, PTSD is characterized by large individual variations of symptoms. In order to take into consideration the complex and long term distinctive variations in effects of trauma exposure additional behavioral measures are required. The current study used a novel behavioral test, the water associated zero maze (WAZ...

  18. Escalated handling of young C57BL/6 mice results in altered Morris water maze performance

    Fridgeirsdottir, Gudrun Andrea; Hillered, Lars; Clausen, Fredrik

    2014-01-01

    Background The handling of experimental animals prior to experimental interventions is often poorly described, even though it may affect the final functional outcome. This study explores how the use of repeated handling of C57BL/6 mice prior to Morris water maze (MWM) tests can affect the performance. Methods and materials The handled animals were subjected to the escalating handling protocol, with the investigator spending 5 min per day per cage for 8 days prior to the MWM test. On the last ...

  19. Comparisons of Online Reading Paradigms: Eye Tracking, Moving-Window, and Maze

    Witzel, Naoko; Witzel, Jeffrey; Forster, Kenneth

    2012-01-01

    This study compares four methodologies used to examine online sentence processing during reading. Specifically, self-paced, non-cumulative, moving-window reading (Just et al. in "J Exp Psychol Gen" 111:228-238, 1982), eye tracking (see e.g., Rayner in "Q J Exp Psychol" 62:1457-1506, 2009), and two versions of the maze task (Forster et al. in…

  20. Memory-impairing effects of local anesthetics in an elevated plus-maze test in mice

    S.L. Blatt

    1998-04-01

    Full Text Available Post-training intracerebroventricular administration of procaine (20 µg/µl and dimethocaine (10 or 20 µg/µl, local anesthetics of the ester class, prolonged the latency (s in the retention test of male and female 3-month-old Swiss albino mice (25-35 g body weight; N = 140 in the elevated plus-maze (mean ± SEM for 10 male mice: control = 41.2 ± 8.1; procaine = 78.5 ± 10.3; 10 µg/µl dimethocaine = 58.7 ± 12.3; 20 µg/µl dimethocaine = 109.6 ± 5.73; for 10 female mice: control = 34.8 ± 5.8; procaine = 55.3 ± 13.4; 10 µg/µl dimethocaine = 59.9 ± 12.3 and 20 µg/µl dimethocaine = 61.3 ± 11.1. However, lidocaine (10 or 20 µg/µl, an amide class type of local anesthetic, failed to influence this parameter. Local anesthetics at the dose range used did not affect the motor coordination of mice exposed to the rota-rod test. These results suggest that procaine and dimethocaine impair some memory process(es in the plus-maze test. These findings are interpreted in terms of non-anesthetic mechanisms of action of these drugs on memory impairment and also confirm the validity of the elevated plus-maze for the evaluation of drugs affecting learning and memory in mice

  1. Effect of single and fractionated x-irradiation on maze learning ability of mice

    Fifty-six-day-old male ddk mice at the starting of the investigation were used as subjects through the experiment for 64 weeks. After 15 days' preliminary training, and 16 times of weekly trial training using complete maze, 15 mice received a single 224 rads of x-rays (S group), another 15 mice received two 112 rads spaced two weeks apart (F group) and another 15 mice were sham-irradiated (Control group). Then those mice were tested on the multiple T-maze with nine-choice points and change of performance was observed in terms of errorchoices by giving one test trial a week. We introduced the concept of ''confusional trials'' as an index for surmising to what extent mice failed to exhibit good maze learning habits. In the results, the F group showed significantly worse performance than the two other groups at early stages, opposite to it the S group exhibited the same, but at late stages after irradiation. The worse performance of F group should be considered to be due to the psychological after-effect to fractionated irradiation and that for S group could be assumed to be due to the acceleration of aging by the irradiation. (auth.)

  2. Optimizing design for the maze exit of a 10-MeV electron irradiation accelerator

    Background: Irradiation accelerator is being used more and more widely, but the optimizing of radiation shielding is always a problem to be solved. Purpose: To make the dose rates of the maze exit lower and the cost to achieve it less, it is of great significance to design a shielding which is cheap and effective. Methods: The radiation dose rates at different maze exits of a 10-MeV industrial electron linear accelerator were compared by formula and Monte Carlo (Fluka) method. A real-time measurement system composed of Mini Digital Data Logging (Mini-DDL) and Gamma detectors was also used. Results: With one comer added to the exit, another scattering would be generated. The dose rate of exit before changing was 3-4 μGy·h-1 while it was 200 nGy·h-1 after that. Conclusion: The radiation dose rate at the exit will be reduced by one order of magnitude because of another scattering generated by the added turn to the maze exit. All of these do not increase any additional cost and conform to the ALARA (as low as reasonably achievable) principle. It provides a good reference for the future design of shielding for industrial electron linear accelerator. (authors)

  3. What is the most sensitive measure of water maze probe test performance?

    Kirill Zaslavsky

    2009-03-01

    Full Text Available The water maze is commonly used to assay spatial cognition, or, more generally, learning and memory in experimental rodent models. In the water maze, mice or rats are trained to navigate to a platform located below the water’s surface. Spatial learning is then typically assessed in a probe test, where the platform is removed from the pool and the mouse or rat is allowed to search for it. Performance in the probe test may then be evaluated using either occupancy-based (percent time in virtual quadrant [Q] or zone [Z] centered on former platform location, error-based (mean proximity to former platform location [P] or counting-based (platform crossings [X] measures. While these measures differ in their popularity, whether they differ in their ability to detect group differences is not known. To address this question we compiled 5 separate databases, containing more than 1600 mouse probe tests. Random selection of individual trials from respective databases then allowed us to simulate experiments with varying sample and effect sizes. Using this Monte Carlo-based method, we found that the P measure consistently outperformed the Q, Z and X measures in its ability to detect group differences. This was the case regardless of sample or effect size, and using both parametric and non-parametric statistical analyses. The relative superiority of P over other commonly used measures suggests that it is the most appropriate measure to employ in both low- and high-throughput water maze screens.

  4. The Hot and the Cold: Radiofrequency Versus Cryoballoon Ablation for Atrial Fibrillation.

    Ang, Richard; Domenichini, Giulia; Finlay, Malcolm C; Schilling, Richard J; Hunter, Ross J

    2015-09-01

    Catheter ablation is superior to antiarrhythmic drugs in maintaining sinus rhythm for patients with atrial fibrillation (AF). Pulmonary vein (PV) isolation is the cornerstone of any AF ablation procedure. Conventionally, this is achieved by performing point by point lesions using radiofrequency (RF) energy. However, this is technically challenging, time consuming and is associated with a number of complications. Long-term durability of PV isolation is also a concern. To address these issues, 'one-shot' energy delivery systems and alternative energy sources have been developed. The cryoballoon system has emerged as the most commonly used alternative to point by point RF technology. In this paper, we compare the technology, biophysics and clinical data of cryoballoon to conventional RF ablation for AF. The safety and efficacy of cryoballoon compared to RF ablation is critically reviewed. We conclude by looking at future applications of this technology. PMID:26266757

  5. Fully Implicit Ablation and Thermal Response Program for Spacecraft Heatshield Analysis

    Chen, Y. K.; Milos, Frank; Rasky, Daniel J. (Technical Monitor)

    1997-01-01

    A fully implicit ablation and thermal response program has been developed for the simulation of one-dimensional transient transport of thermal energy in a multilayer stack of isotropic materials and structure which can ablate from a front surface and decompose in-depth. Equations and numerical procedures for solution are described. Solutions are compared with those of Aerotherm Charring Material Thermal Response and Ablation Program, and with the arcjet data. The code is numerically more stable, and solves much wider range of problems compared with the existing explicit code. Applications of the code for the analysis of aeroshell heatshields of Stardust, Mars 2001, and Mars Microprobe using the advanced Light Weight Ceramic Ablators developed at the NASA Ames Research Center are presented and discussed in detail.

  6. Percutaneous ablation of functioning adenoma in a patient with a single adrenal gland

    Nunes, Thiago Franchi; Szejnfeld, Denis; Xavier, Ana Carolina Wanderley; Goldman, Suzan Menasce

    2013-01-01

    The conventional treatment of functioning adrenal adenomas is laparoscopic resection. Since the 1990s, radiofrequency ablation has been increasingly applied to the treatment of tumours of the liver, lungs and musculoskeletal system. However, the use of radiofrequency ablation to treat adrenal nodules is still an uncommon procedure, particularly in aldosterone-producing adenomas. We report the case of a 35-year-old male patient with resistant hypertension, hypokalaemia and aldosterone-producing adenoma in a single adrenal gland. The patient underwent CT-guided percutaneous radiofrequency ablation. Clinical, laboratory and MRI follow-up data indicated excellent response to treatment. This case report is the first in the literature to describe the use of CT-guided percutaneous radiofrequency ablation in the treatment of a functioning adrenal adenoma in a patient with a single adrenal gland. PMID:23737584

  7. Radiofrequency ablation of lung and liver lesions using CT fluoroscopy

    Full text: Tumour ablation with radiofrequency (RF) energy is a relatively new procedure for the treatment of focal malignant disease. At our institution this is currently being used in the treatment of certain liver and lung lesions with the patients involved being enrolled in clinical trials. The poster describes the technique used at our institution for the placement of the radiofrequency ablation electrode using CT fluoroscopy. Criteria for patient selection are included. Complications from the procedure are described, as well as follow up appearances and results. Our results from the treatment of primary and secondary lesions in the liver correlate well with published literature. Treatment is still not as successful as surgical resection but there is significantly less morbidity. Where this method may be appropriate is when the patient is not a candidate for surgical resection. The treatment of colorectal metastases in the lung shows early promise as a possible second line treatment (as for liver) where the patient is not a candidate for surgery. Preliminary results are soon to be published in conjunction with the Department of Surgery at our institution. RF Electrode placement using CT Fluoroscopy is performed at our institution. While still at its early stages, RF Ablation shows promise as a possible second line treatment (with other adjuvant therapy) for the management of focal malignant disease in the lung and liver. Copyright (2002) Blackwell Science Pty Ltd

  8. Palliative Procedures in Lung Cancer

    Masuda, Emi; Sista, Akhilesh K.; Pua, Bradley B.; Madoff, David C.

    2013-01-01

    Palliative care aims to optimize comfort and function when cure is not possible. Image-guided interventions for palliative treatment of lung cancer is aimed at local control of advanced disease in the affected lung, adjacent mediastinal structures, or distant metastatic sites. These procedures include endovascular therapy for superior vena cava syndrome, bronchial artery embolization for hemoptysis associated with lung cancer, and ablation of osseous metastasis. Pathophysiology, clinical pres...

  9. Radiofrequency ablation of osteoid osteoma: initial experience with a new monopolar ablation device.

    Mahnken, Andreas H; Bruners, Philipp; Delbrück, Heide; Günther, Rolf W

    2011-06-01

    The purpose of this article is to report our initial experience with the "off-label" use of a new monopolar radiofrequency (RF) probe for percutaneous ablation of osteoid osteomas. Seventeen patients (12 male and 5 female, mean age 24.8 [range 9-49]) with osteoid osteoma were treated by computed tomography (CT)-guided RF ablation (RFA). All procedures were performed with the patient under general aesthesia. After localization of the nidus, a 13G hollow drill was introduced into the nidus through a 7F introducer sheath. A monopolar 16.5G RF probe with a 9-mm active tip (Soloist; Boston Scientific, Natick, MA) was inserted through the introducer sheath and connected to the RF generator. Energy application was started at 2 W and subsequently increased every 2 min by 1 W to a maximum of 8 W. The procedure ended if impedance increased by 500 Ω. Mean duration of energy deposition was 14.2±3.3 min. Fourteen of 17 patients (82%) were free of symptoms at 29.9±14.8 (range 4 to 47) months of follow-up. The primary and secondary success rates were 83% and 100%, respectively. In 3 patients, recurrence of pain at 6 (n=1) and 15 (n=2) months after the initial procedure was successfully treated by reablation. There were no complications. Monopolar RFA using the Soloist probe is effective and safe for the treatment of osteoid osteoma. It results in comparable success rates as other monopolar or bipolar RF systems in the treatment of osteoid osteoma. PMID:20490491

  10. The aMAZE LightBench: a web interface to a relational database of cellular processes

    Lemer, C.; Antezana, E; Couche, F; Fays, F; Santolaria, X; Janky, R.; Deville, Yves; Richelle, J; Wodak, SJ

    2004-01-01

    The aMAZE LightBench (http://www.amaze.ulb. ac.be/) is a web interface to the aMAZE relational database, which contains information on gene expression, catalysed chemical reactions, regulatory interactions, protein assembly, as well as metabolic and signal transduction pathways. It allows the user to browse the information in an intuitive way, which also reflects the underlying data model. Moreover links are provided to literature references, and whenever appropriate, to external databases.

  11. Microwave Ablation Compared with Radiofrequency Ablation for Breast Tissue in an Ex Vivo Bovine Udder Model

    Purpose: To compare the effectiveness of microwave (MW) ablation with radiofrequency (RF) ablation for treating breast tissue in a nonperfused ex vivo model of healthy bovine udder tissue. Materials and Methods: MW ablations were performed at power outputs of 25W, 35W, and 45W using a 915-MHz frequency generator and a 2-cm active tip antenna. RF ablations were performed with a bipolar RF system with 2- and 3-cm active tip electrodes. Tissue temperatures were continuously monitored during ablation. Results: The mean short-axis diameters of the coagulation zones were 1.34 ± 0.14, 1.45 ± 0.13, and 1.74 ± 0.11 cm for MW ablation at outputs of 25W, 35W, and 45W. For RF ablation, the corresponding values were 1.16 ± 0.09 and 1.26 ± 0.14 cm with electrodes having 2- and 3-cm active tips, respectively. The mean coagulation volumes were 2.27 ± 0.65, 2.85 ± 0.72, and 4.45 ± 0.47 cm3 for MW ablation at outputs of 25W, 35W, and 45W and 1.18 ± 0.30 and 2.29 ± 0.55 cm3 got RF ablation with 2- and 3-cm electrodes, respectively. MW ablations at 35W and 45W achieved significantly longer short-axis diameters than RF ablations (P < 0.05). The highest tissue temperature was achieved with MW ablation at 45W (P < 0.05). On histological examination, the extent of the ablation zone in MW ablations was less affected by tissue heterogeneity than that in RF ablations. Conclusion: MW ablation appears to be advantageous with respect to the volume of ablation and the shape of the margin of necrosis compared with RF ablation in an ex vivo bovine udder.

  12. Ablation characteristics of special concrete due to an impinging zirconium-dioxide melt jet

    Highlights: • The jet impingement tests were performed for a special concrete of core-catcher. • The ablation rate and depth were measured 1.59 mm/s and 4.33 mm, respectively. • The experimental results were estimated well between the model prediction bounds. • The material ablation was described reasonably by a convective heat transfer model. - Abstract: Jet impingement experiments were performed to investigate the ablation characteristics of special concrete, which has been developed as one of the candidate protecting materials for the EU-APR1400 ex-vessel core catcher. In order to simulate the jet impingement phenomenon owing to the reactor vessel failure during a severe core meltdown accident, the experimental facility was established and the experimental conditions were determined based on parametric studies. The special concrete specimen was manufactured in accordance with the standard procedures, and its microstructures and physicochemical properties were analyzed to verify the requirements for the qualification. An induction melting technique in a cold crucible was employed to generate the zirconium-dioxide melt as a simulant of the corium melt. The special concrete was ablated uniformly over the impact area by jet impingement, and the average ablation depth was measured to be 4.33 mm. The average ablation rate in depth was evaluated as 1.59 mm/s using the temperature measurements of the specimen. As compared with the predictions by the models based on the convective and radiative heat transfer analysis, both the measured ablation rate and depth were estimated appropriately within the bounds of their limits. However, the convective heat transfer model turned out to predict the ablation characteristics of the special concrete more reasonably during the jet impingement even though some water content within the special concrete could lead to a sudden generation of the steam layer through which the material ablation is attenuated substantially by the

  13. Fast and automatic depth control of iterative bone ablation based on optical coherence tomography data

    Fuchs, Alexander; Pengel, Steffen; Bergmeier, Jan; Kahrs, Lüder A.; Ortmaier, Tobias

    2015-07-01

    Laser surgery is an established clinical procedure in dental applications, soft tissue ablation, and ophthalmology. The presented experimental set-up for closed-loop control of laser bone ablation addresses a feedback system and enables safe ablation towards anatomical structures that usually would have high risk of damage. This study is based on combined working volumes of optical coherence tomography (OCT) and Er:YAG cutting laser. High level of automation in fast image data processing and tissue treatment enables reproducible results and shortens the time in the operating room. For registration of the two coordinate systems a cross-like incision is ablated with the Er:YAG laser and segmented with OCT in three distances. The resulting Er:YAG coordinate system is reconstructed. A parameter list defines multiple sets of laser parameters including discrete and specific ablation rates as ablation model. The control algorithm uses this model to plan corrective laser paths for each set of laser parameters and dynamically adapts the distance of the laser focus. With this iterative control cycle consisting of image processing, path planning, ablation, and moistening of tissue the target geometry and desired depth are approximated until no further corrective laser paths can be set. The achieved depth stays within the tolerances of the parameter set with the smallest ablation rate. Specimen trials with fresh porcine bone have been conducted to prove the functionality of the developed concept. Flat bottom surfaces and sharp edges of the outline without visual signs of thermal damage verify the feasibility of automated, OCT controlled laser bone ablation with minimal process time.

  14. Experimental study on ablating goat liver tissue with ultrasound imaging guided percutaneous irreversible electroporation

    Ying LIU

    2011-03-01

    Full Text Available Objective To investigate the proper method of percutaneous irreversible electroporation(IRE to ablate goat liver tissue under ultrasonic guidance,and observe the features of ultrasound imaging and histological changes.Methods The pulse electric fields(PEFs with permanent duration(100 μs,frequency(1Hz,voltage(2000V and pulses(120 pieces were applied to the electrodes,and the electrodes were placed into goats’ liver under ultrasound guidance through the animal skin to the target area.The treated area was observed by real-time ultrasound scanning,and the histopathological changes were assessed by hematoxylin and eosin(HE staining under light microscope at the time of 0h and 24h after IRE ablation.The circumscribed ablated area was compared with that of finite element modeling(FEM calculation method.Results Ultrasound imaging guidance was accurate in focusing on the target area.Imaging captured by the ultrasound after IRE procedure was quite different from that of the normal liver imaging.Complete hepatic cell death with a sharp demarcation between the ablated zone and the non-ablated zone was well visualized 24 hours after the procedure.Necrospy-based measurement demonstrated a high consistence with FEM-anticipated ablation zones.Conclusion With real-time monitoring by ultrasonography and well-controlled ablation of the target tissue,percutaneous IRE can provide a novel and unique ablative method for cancer treatment.The present paper provides a fundamental experimental work for future studies on clinical application of IRE.

  15. Ablation dynamics in laser sclerotomy ab externo

    Brinkmann, Ralf; Droege, Gerit; Mohrenstecher, Dirk; Scheu, M.; Birngruber, Reginald

    1996-01-01

    Laser sclerostomy ab externo with flashlamp excited mid-IR laser systems emitting in the 2-3 micrometer spectral range is in phase II clinical trials. Although acutely high success rates were achieved, the restenosis rate after several months is about 40%. Laser pulses of several hundreds of microseconds, known to induce thermo-mechanical explosive evaporation were used for this procedure. We investigated the ablation dynamics in tissue and the cavitation bubble dynamics in water by means of an Er:YAG laser system to estimate the extent of mechanical damage zones in the sclera and in the anterior chamber, which may contribute to the clinical failure. We found substantial mechanical tissue deformation during the ablation process caused by the cavitation effects. Stress waves up to several bar generated by explosive evaporization were measured. The fast mechanical stretching and collapsing of the scleral tissue induced by cavitation resulted in tissue dissection as could be proved by flash photography and histology. The observed high restenosis might be a result of a subsequent enhanced wound healing process. Early fistula occlusions due to iris adherences, observed in about 20% of the clinical cases may be attributed to intraocular trauma induced by vapor bubble expansion through the anterior chamber after scleral perforation. An automatic feedback system minimizing adverse effects by steering and terminating the laser process during scleral fistulization is demonstrated. Moreover, a new approach in laser sclerostomy ab externo is presented using a cw-IR laser diode system emitting at the 1.94 micrometer mid-IR water absorption peak. This system was used in vitro and showed smaller damage zones compared to the pulsed laser radiation.

  16. Atrial fibrillation radiofrequency ablation: safety using contact force catheter in a low-volume centre

    Diego Vaccari, MD; Daniele Giacopelli, MSc; Eros Rocchetto, MSc; Sabina Vittadello, MD; Roberto Mantovan, MD; Gianfilippo Neri, MD

    2014-08-01

    Full Text Available The tip-to-tissue contact force (CF has been identified as a potential determinant of lesion quality during radiofrequency (RF ablation. The aim of this paper is to report the experience of a single low-volume centre in the atrial fibrillation (AF ablation procedure with an RF catheter capable of measuring this parameter. CF data and their possible implications on patient safety are presented. Thirty-nine consecutive patients suffering of paroxysmal or permanent AF received percutaneous ablation with the novel catheter studied. Procedural characteristics, CF applied and safety events related to the procedure were reported. During RF application the mean CF value was 17 ± 3 g, with a maximum mean value of 37 ± 8 g. CF value never exceeds 62 g and in the 74% of the RF applications ranged between 10 g and 30 g. No complication related to the catheter manipulation or to the energy delivered was observed. This study of a single centre with a low level of experience in AF ablation suggests that the ability to measure CF may provide additional useful information to the operator. It ensures uniform ablations, with little variability in the catheter manipulations, and it avoids excessive contact forces increasing the patient safety.

  17. Characterization of tracked radiofrequency ablation in phantom

    In radiofrequency ablation (RFA), successful therapy requires accurate, image-guided placement of the ablation device in a location selected by a predictive treatment plan. Current planning methods rely on geometric models of ablations that are not sensitive to underlying physical processes in RFA. Implementing plans based on computational models of RFA with image-guided techniques, however, has not been well characterized. To study the use of computational models of RFA in planning needle placement, this work compared ablations performed with an optically tracked RFA device with corresponding models of the ablations. The calibration of the tracked device allowed the positions of distal features of the device, particularly the tips of the needle electrodes, to be determined to within 1.4±0.6 mm of uncertainty. Ablations were then performed using the tracked device in a phantom system based on an agarose-albumin mixture. Images of the sliced phantom obtained from the ablation experiments were then compared with the predictions of a bioheat transfer model of RFA, which used the positional data of the tracked device obtained during ablation. The model was demonstrated to predict 90% of imaged pixels classified as being ablated. The discrepancies between model predictions and observations were analyzed and attributed to needle tracking inaccuracy as well as to uncertainties in model parameters. The results suggest the feasibility of using finite element modeling to plan ablations with predictable outcomes when implemented using tracked RFA

  18. Ablation of tumor and inflammatory tissue with absolute ethanol

    Absolute ethanol was used to ablate tumors, inflammatory lesions, and end-stage nephrosclerotic kidneys in 38 patients. Thirty patients had various types of renal tumors, and 3 had chronic end-stage renal failure with malignant hypertension. One patient had a fibrosarcoma of the right leg and one had a metastatis in the humerus from a renal carcinoma. A large adrenal carcinoma was treated with absolute ethanol in a patient who had liver metastases that were ablated one year after the first procedure. An additional patient had metastatic liver disease from a non-functioning adrenal carcinoma. The remaining patient had an extensive hypervascular inflammatory lesion (tuberculosis and aspergilloma) of the right upper pulmonary lobe. In addition to ethanol, coils were introduced in one patient and Gelfoam in another. The amount of ethanol used ranged from 5 to 50 ml. Twenty-two patients suffered from considerable transient pain during ethanol injection, but sedation was necessary in only 3 of them. Skin necrosis appeared in 2 patients requiring plastic reconstruction in one of them. Two patients died within 5 days of the procedure unrelated to the ablation. Two patients presented upper gastrointestinal bleeding within 2 days of the ethanol injection and one of these died in acute renal failure. One patient suffered from left colonic infarction after left renal tumor ablation, but survived for several months. Absolute ethanol was a useful and efficient sclerosing agent causing extensive tumor destruction and marked reduction of the vascularity in tumor and inflammatory lesions, but caused an 18% complication rate. (orig.)

  19. Laser Ablation Molecular Isotopic Spectrometry

    Russo, Richard E., E-mail: rerusso@lbl.gov [Lawrence Berkeley National Laboratory, University of California, Berkeley, CA 94720 (United States); Applied Spectra, Inc., 46661 Fremont Boulevard, Fremont, CA 94538 (United States); Bol' shakov, Alexander A. [Applied Spectra, Inc., 46661 Fremont Boulevard, Fremont, CA 94538 (United States); Mao Xianglei [Lawrence Berkeley National Laboratory, University of California, Berkeley, CA 94720 (United States); McKay, Christopher P. [NASA-Ames Research Center, Moffett Field, CA 94035 (United States); Perry, Dale L.; Sorkhabi, Osman [Lawrence Berkeley National Laboratory, University of California, Berkeley, CA 94720 (United States)

    2011-02-15

    A new method of performing optical isotopic analysis of condensed samples in ambient air and at ambient pressure has been developed: Laser Ablation Molecular Isotopic Spectrometry (LAMIS). The technique uses radiative transitions from molecular species either directly vaporized from a sample or formed by associative mechanisms of atoms or ions in a laser ablation plume. This method is an advanced modification of a known atomic emission technique called laser-induced breakdown spectroscopy (LIBS). The new method - LAMIS - can determine not only chemical composition but also isotopic ratios of elements in the sample. Isotopic measurements are enabled by significantly larger isotopic shifts found in molecular spectra relative to atomic spectra. Analysis can be performed from a distance and in real time. No sample preparation or pre-treatment is required. Detection of the isotopes of hydrogen, boron, carbon, and oxygen are discussed to illustrate the technique.

  20. Laser Ablation Molecular Isotopic Spectrometry

    Russo, Richard E.; Bol'shakov, Alexander A.; Mao, Xianglei; McKay, Christopher P.; Perry, Dale L.; Sorkhabi, Osman

    2011-02-01

    A new method of performing optical isotopic analysis of condensed samples in ambient air and at ambient pressure has been developed: Laser Ablation Molecular Isotopic Spectrometry (LAMIS). The technique uses radiative transitions from molecular species either directly vaporized from a sample or formed by associative mechanisms of atoms or ions in a laser ablation plume. This method is an advanced modification of a known atomic emission technique called laser-induced breakdown spectroscopy (LIBS). The new method — LAMIS — can determine not only chemical composition but also isotopic ratios of elements in the sample. Isotopic measurements are enabled by significantly larger isotopic shifts found in molecular spectra relative to atomic spectra. Analysis can be performed from a distance and in real time. No sample preparation or pre-treatment is required. Detection of the isotopes of hydrogen, boron, carbon, and oxygen are discussed to illustrate the technique.

  1. Tumor Ablation with Irreversible Electroporation

    Al-Sakere, Bassim; André, Franck,; Bernat, Claire; Connault, Elisabeth; Opolon, Paule; Davalos, Rafael V.; Rubinsky, Boris; Mir, Lluis M.

    2007-01-01

    We report the first successful use of irreversible electroporation for the minimally invasive treatment of aggressive cutaneous tumors implanted in mice. Irreversible electroporation is a newly developed non-thermal tissue ablation technique in which certain short duration electrical fields are used to permanently permeabilize the cell membrane, presumably through the formation of nanoscale defects in the cell membrane. Mathematical models of the electrical and thermal fields that develop dur...

  2. Caries selective ablation: the handpiece

    Hennig, Thomas; Rechmann, Peter; Holtermann, Andreas

    1995-05-01

    Caries selective ablation is fixed to a window of fluences predicted by the ablation thresholds of carious and healthy dentin, respectively. The aim of the study was to develop a dental handpiece which guarantees homogeneous fluence at the irradiated tooth surface. Furthermore the point of treatment should be cooled down without energy losses due to the cooling system. We suggest the direct coupling of the laser radiation into a laminar stream of liquid, which acts in turn as a lengthened beam guide. The impacts of the laser radiation and of the cooling medium fall exactly into the same point. Hot ablation debris is removed out of the crater by the flush of the water jet. Fluences are constant if the handpiece is used in contact mode or at a distance. Normally the surface of a bare fiber working in contact mode is destroyed after a few shots. Coupling the laser radiation into a stream of liquid prevents this destruction. Putting together the benefits of this special handpiece short overall treatment times seem to be possible. High average power can be applied to the tooth without the threat of thermal damage. Furthermore no time consuming cutting of the fiber prolongs the treatment time.

  3. New Procedure for Treatment of Atrial Fibrillation in Patients with Valvular Heart Disease

    Naser Safaie; Nasrollah Maghamipour; Ahmad Reza Jodati; Ata Mahmoodpoor; Leila Dashtaki; Masoud Hakimzadeh

    2010-01-01

    Patients with valvular heart disease suffer from atrial fibrillation for more than 12 months after valve surgery and have a low probability of remaining in sinus rhythm. We performed an intra-operative procedure similar to surgical maze ІІІ procedure for conversion of this arrhythmia to sinus rhythm. We did this study to evaluate the efficacy of this procedure to restore the sinus rhythm in patients with valvular heart disease. 28 patients with valvular heart disease and chronic persistent at...

  4. Transient Ablation Regime in Circuit Breakers

    Alexandre, Martin; Jean-Yves, Trepanier; Marcelo, Reggio; Guo, Xueyan

    2007-12-01

    Nozzle wall ablation caused by high temperature electric arcs is studied in the context of high voltage SF6 circuit breakers. The simplified ablation model used in litterature has been updated to take into account the unsteady state of ablation. Ablation rate and velocity are now calculated by a kinetic model using two layers of transition, between the bulk plasma and the ablating wall. The first layer (Knudsen layer), right by the wall, is a kinetic layer of a few mean-free path of thickness. The second layer is collision dominated and makes the transition between the kinetic layer and the plasma bulk. With this new coupled algorithm, it is now possible to calculate the temperature distribution inside the wall, as well as more accurate ablation rates.

  5. Explosive character of the atheroma plaques ablation

    At the present time, ischemia (heart disease) is a main cause of the death in the world; a promising method for its treatment is the use of the technology of the laser light of raised power for the ablation of the atherosclerosis plaques. In this paper, the thermodynamic processes will be studied at the beginning and during atheroma ablation using Nd-YAG (10-50 w) and Argon (4-10 w) lasers of a theoretical point of view. The spatial distribution of the temperature during the ablation has been modelated by the method of finite volumes. The manifestation of the raised temperature of the tissue at the threshold of the ablation, which describes the explosive nature of the ablation by laser (popcorn effect), is observed and discussed. The results indicate the quantitative differences in the ablation behavior between the two used lasers, which can have important clinical implications particularly in the reduction of thermal damages to surrounding normal tissue. (author)

  6. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day

  7. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    Tewari, Sanjit O., E-mail: tewaris@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Petre, Elena N., E-mail: petree@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Osborne, Joseph, E-mail: osbornej@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Sofocleous, Constantinos T., E-mail: sofoclec@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

    2013-12-15

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

  8. Single-shot and single-spot measurement of laser ablation threshold for carbon nanotubes

    Lednev, Vasily N; Obraztsova, Elena D; Kudryashov, Sergey I; Bunkin, Alexey F

    2013-01-01

    A simple and convenient procedure for single-shot, single-spot ablation threshold measurement has been developed. It is based on the employment of cylindrical lens to obtain elliptical Gaussian laser spot. The ablated spot chords which are parallel to the minor axis were measured across the spot major axis which is proportional to the fluence cross-section thus providing wide range dependence of damaged spot size versus fluence in one spot measurement. For both conventional and new-developed procedures the ablation threshold for typical Nd:YAG laser parameters (1064 nm, 10 ns) has been measured as 50 mJ/cm2 which is one order of magnitude lower than that for a bulk graphite.

  9. Ablation and carbon deposition induced by UV laser irradiation of polyimide: Application to the metallization of VIAs in high density printed circuit boards

    Polyimides are known to exhibit large ablation rates upon irradiation with excimer laser due to their high absorbance in the UV and low fluorescence yield. We have studied different regimes of laser ablation according to the fluence and studied the structures resulting from carbon products deposition. For fluences larger than the polyimide ablation threshold, but lower than the carbon one, the development of one structure is the dominant process, whereas large ablation rates lead to polyimide etching above the carbon ablation threshold. The deposition of a carbon layer on the walls of ablated slits has in particular been investigated using an original experimental technique. Optical microscopy and MEB have shown that this carbon layer covered the main height of the ablated holes whereas a threshold (bare polyimide) for carbon condensation was evidenced at the bottom of the ablated hole. Raman spectroscopy and conductivity measurements have shown that the carbon phase is mainly graphitic. A dependence of the carbon condensation threshold on the slit width has been evidenced and discussed in relation with the angle of ejection of ablation debris. A procedure has been developed to render the bare polyimide of the threshold region conductive. At last the conductive properties of the walls of the ablated holes have been exploited to perform an electrolytic metallization. Implications for the production of interconnection vertical interconnections (VIAs) in high density printed circuits are addressed

  10. Role of Cardiac Imaging (CT/MR Before and After RF Catheter Ablation in Patients with Atrial Fibrillation

    Aravindan Kolandaivelu, MD

    2012-08-01

    Full Text Available Pre-procedure X-ray computed tomography (CT and magnetic resonance imaging (MRI angiography are commonly used to delineate the complex and variable relationship of the left atrium, pulmonary veins, and surrounding structures. 3D CT and MR angiography are routinely incorporated into electroanatomic mapping systems to guide ablation lesion placement in the context of patient specific anatomy. Post-procedure CT and MRI have also proven useful for evaluating complications such as pulmonary vein stenosis. In the future, these imaging modalities may be used to visualize more detailed tissue characteristics such as atrial fibrosis and ablation lesions. This could improve selection of patients for different treatment strategies and perhaps guide more effective ablation. This review will discuss current and emerging applications of CT and MRI before and after radiofrequency catheter ablation of atrial fibrillation.

  11. Radiofrequency Ablation of Hepatic Cysts : Case Report

    Radiofrequency ablation has been frequently performed on intra-hepatic solid tumor, namely, hepatocellular carcinoma, metastatic tumor and cholangio carcinoma, for take the cure. But, the reports of radiofrequency ablation for intrahepatic simple cysts are few. In vitro experiment of animal and in vivo treatment for intrahepatic cysts of human had been reported in rare cases. We report 4 cases of radiofrequency ablation for symptomatic intrahepatic cysts

  12. Computer-aided hepatic tumour ablation

    Voirin, D; Amavizca, M; Leroy, A; Letoublon, C; Troccaz, J; Voirin, David; Payan, Yohan; Amavizca, Miriam; Leroy, Antoine; Letoublon, Christian; Troccaz, Jocelyne

    2001-01-01

    Surgical resection of hepatic tumours is not always possible. Alternative techniques consist in locally using chemical or physical agents to destroy the tumour and this may be performed percutaneously. It requires a precise localisation of the tumour placement during ablation. Computer-assisted surgery tools may be used in conjunction to these new ablation techniques to improve the therapeutic efficiency whilst benefiting from minimal invasiveness. This communication introduces the principles of a system for computer-assisted hepatic tumour ablation.

  13. 2-Methyl-6-(phenylethynyl pyridine (MPEP reverses maze learning and PSD-95 deficits in Fmr1 knock-out mice.

    Cary Samuel Kogan

    2014-03-01

    Full Text Available Fragile X syndrome (FXS is caused by the lack of expression of the fragile X mental retardation protein (FMRP, which results in intellectual disability and other debilitating symptoms including impairment of visual-spatial functioning. FXS is the only single-gene disorder that is highly co-morbid with autism spectrum disorder and can therefore provide insight into its pathophysiology. Lack of FMRP results in altered group I metabotropic glutamate receptor (mGluR signalling, which is a target for putative treatments. The Hebb-Williams (H-W mazes are a set of increasingly complex spatial navigation problems that depend on intact hippocampal and thus mGluR-5 functioning. In the present investigation, we examined whether an antagonist of mGluR-5 would reverse previously described behavioural deficits in Fmr1 KO mice. Mice were trained on a subset of the H-W mazes and then treated with either 20 mg/kg of an mGluR-5 antagonist, 2-Methyl-6-(phenylethynyl pyridine (MPEP; n = 11 or an equivalent dose of saline (n = 11 prior to running test mazes. Latency and errors were dependent variables recorded during the test phase. Immediately after completing each test, marble-burying behavior was assessed which confirmed that the drug treatment was pharmacologically active during maze learning. Although latency was not statistically different between the groups, MPEP treated Fmr1 KO mice made significantly fewer errors on mazes deemed more difficult suggesting a reversal of the behavioural deficit. MPEP treated mice were also less perseverative and impulsive when navigating mazes. Furthermore, MPEP treatment reversed PSD-95 protein deficits in Fmr1 KO treated mice, whereas levels of a control protein (β-tubulin remained unchanged. These data further validate MPEP as a potentially beneficial treatment for FXS. Our findings also suggest that adapted H-W mazes may be a useful tool to document alterations in behavioural functioning following pharmacological

  14. Long-term efficacy of surgical ablation of atrial fibrillation in a low-volume centre

    Zyśko, Dorota; Bielicki, Grzegorz; Obremska, Marta; Goździk, Anna; Kustrzycki, Wojciech

    2015-01-01

    Surgical ablation is a recommended procedure for patients with atrial fibrillation (AF) undergoing a cardiac surgery operation. However, the procedure is associated with significant risk of late recurrence of AF. The aim of the study was to assess the long-term efficacy of the procedure with respect to the comorbidities. The study group consisted of 22 patients: 9 women and 13 men, who underwent surgical AF ablation in the 2008-2013 period. The patients were interviewed by telephone and were asked to send their recently performed 12-lead electrocardiography (ECG). The semi-structured interview consisted of 25 items regarding the history of AF, concomitant comorbidities, lifelong syncopal history, smoking, family history of premature cardiovascular diseases, and current medical treatment. Furthermore, the Epworth test was performed to measure the daytime sleepiness, which in turn is related to the presence of obstructive sleep apnoea. On the basis of the obtained data, the CHADS2, and Epworth scale scores were calculated for each patient. As a result of the study six patients (27%) had sinus rhythm or paced dual chamber rhythm, and 16 patients had atrial fibrillation. The multivariate analysis revealed that Epworth scale scoring > 9, CHADS2 score > 0, and persistent type of AF were related to poor outcome of surgical ablation procedure. In conclusion, patients with AF treated with surgical ablation have similar prognosis of sinus rhythm maintenance to those treated with radiofrequency ablation. Moreover, the same predisposing factors play a significant role in AF recurrence both in surgical patients and in patients treated with radiofrequency ablation. PMID:26855645

  15. Aromatic Thermosetting Copolyesters for Ablative TPS Project

    National Aeronautics and Space Administration — Better performing ablative thermal protection systems than currently available are needed to satisfy requirements of the most severe crew exploration vehicles, such...

  16. Plasma-mediated ablation of biofilm contamination

    Guo, Zhixiong; Wang, Xiaoliang; Huang, Huan

    2010-12-01

    Ultra-short pulsed laser removal of thin biofilm contamination on different substrates has been conducted via the use of plasma-mediated ablation. The biofilms were formed using sheep whole blood. The ablation was generated using a 1.2 ps ultra-short pulsed laser with wavelength centered at 1552 nm. The blood contamination was transformed into plasma and collected with a vacuum system. The single line ablation features have been measured. The ablation thresholds of blood contamination and bare substrates were determined. It is found that the ablation threshold of the blood contamination is lower than those of the beneath substrates including the glass slide, PDMS, and human dermal tissues. The ablation effects of different laser parameters (pulse overlap rate and pulse energy) were studied and ablation efficiency was measured. Proper ablation parameters were found to efficiently remove contamination with maximum efficiency and without damage to the substrate surface for the current laser system. Complete removal of blood contaminant from the glass substrate surface and freeze-dried dermis tissue surface was demonstrated by the USP laser ablation with repeated area scanning. No obvious thermal damage was found in the decontaminated glass and tissue samples.

  17. Femtosecond laser ablation of polymethyl-methacrylate with high focusing control

    The interest of laser ablation of transparent polymers with short pulses relies on the possibility of ablating the material with little thermal damage and high spatial resolution. This enables microscopic design features needed for microfluidic devices and micromachining. Laser ablation of polymethyl-methacrylate (PMMA) surface with an Yb:KYW laser beam was carried out in air environment at room temperature. The laser had a wavelength of 1027 nm and the pulse duration was 450 fs. An open aperture z-scan procedure was used as a method to determine with high precision and control the best focusing conditions of the laser beam on the surface of the samples For this, the transmitted energy was measured with a photodiode detector placed beyond the sample. This was possible due to the high transparency of PMMA to the laser wavelength. Ablation craters produced on the PMMA surface at different laser pulse energies after the z-scan focusing process were characterized by means of optical and scanning electron microscopies. The fluence threshold found for ablation of PMMA is 3.2 J/cm2. Well-defined craters, with diameters as small as 200 nm, can be obtained with pulse energies near the ablation threshold.

  18. Ultrasound-guided percutaneous radiofrequency ablation of liver tumors: How we do it safety and completely

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Hong, Jun Hyung; Lim, Hyo Soon; Seon, Hyun Ju; Hur, Young Hoe; Park, Chang Hwan; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2015-12-15

    Ultrasound-guided percutaneous radiofrequency (RF) ablation has become one of the most promising local cancer therapies for both resectable and nonresectable hepatic tumors. Although RF ablation is a safe and effective technique for the treatment of liver tumors, the outcome of treatment can be closely related to the location and shape of the tumors. There may be difficulties with RF ablation of tumors that are adjacent to large vessels or extrahepatic heat-vulnerable organs and tumors in the caudate lobe, possibly resulting in major complications or treatment failure. Thus, a number of strategies have been developed to overcome these challenges, which include artificial ascites, needle track ablation, fusion imaging guidance, parallel targeting, bypass targeting, etc. Operators need to use the right strategy in the right situation to avoid the possibility of complications and incomplete thermal tissue destruction; with the right strategy, RF ablation can be performed successfully, even for hepatic tumors in high-risk locations. This article offers technical strategies that can be used to effectively perform RF ablation as well as to minimize possible complications related to the procedure with representative cases and schematic illustrations.

  19. Echocardiography-guided Radiofrequency Catheter Ablation of Atrioventricular Node and VVI Pacemaker Implantation

    T Guo

    2014-05-01

    Full Text Available Objective: This study is to evaluate the feasibility and safety of intracardiac radiofrequency catheter ablation (RFCA of the atrioventricular node (AVN and pacemaker implantation using transthoracic echocardiography. Methods: Eleven patients – six males and five females (mean age 66 years – with persistent or permanent atrial fibrillation/atrial flutter received RFCA of AVN and VVI pacemaker implantation (paces and senses the ventricle and is inhibited if it senses ventricular activity. Under transthoracic echocardiography, the electrode catheters were positioned intracardiac, and target ablation was performed, with the permanent pacemaking catheter in the left subclavian vein and the ablation catheter in the right femoral vein. The multi-view imaging and dynamic observation applied during the stable AV dissociation were successful. Results: Atrioventricular node ablation and permanent pacemaker implantation in 11 patients were completed successfully without X-ray exposure. The operation success rate was 100%. All patients recovered well within the follow-up period. Conclusions: Radiofrequency catheter ablation of AVN and VVI pacemaker implantation under transthoracic echocardiography guidance is a safe, easy and feasible approach. This procedure could be an important supplemental measure to catheter ablation of arrhythmia under routine X-ray fluoroscopy.

  20. Behavioral profiles displayed by rats in an elevated asymmetric plus-maze: effects of diazepam

    Ruarte M.B.

    1999-01-01

    Full Text Available When rats are exposed to unknown environments where novelty and fear-inducing characteristics are present (conflictive environments, some specific behaviors are induced and exploration is apparently modulated by fear. In our laboratory, a new type of plus-maze was designed as a model of conflictive exploration. The maze is composed of four arms with different geometrical characteristics, differing from each other by the presence or absence of walls. The degree of asymmetry was as follows: NW, no wall arm; SW, a single high wall present; HL, a low and a high wall present, and HH, two high walls present. The four arms were arranged at 90o angles and the apparatus was called the elevated asymmetric plus-maze (APM. The purpose of the present study was to assess the behavioral profile of rats exposed for a single time to the APM with or without treatment with benzodiazepine. Increasing doses of diazepam were injected intraperitoneally in several groups of male, 90-day-old Holtzman rats. Distilled water was injected in control animals. Thirty minutes after treatment all rats were exposed singly to a 5-min test in the APM. Diazepam induced a biphasic modification of exploration in the NW and SW arms. The increase in the exploration score was evident at low doses of diazepam (0.25-1.0 mg/kg body weight and the decrease in exploration was found with the higher doses of diazepam (2.0-3.0 mg/kg body weight. Non-exploratory behaviors (permanency were not affected by benzodiazepine treatment. In the HL arm, exploration was not modified but permanency was increased in a dose-dependent manner. In the HH arm, exploration and permanency were not affected. Results are compatible with the idea that exploration-processing mechanisms in conflictive environments are modulated by fear-processing mechanisms of the brain.

  1. Behavioral profiles displayed by rats in an elevated asymmetric plus-maze: effects of diazepam.

    Ruarte, M B; Alvarez, E O

    1999-01-01

    When rats are exposed to unknown environments where novelty and fear-inducing characteristics are present (conflictive environments), some specific behaviors are induced and exploration is apparently modulated by fear. In our laboratory, a new type of plus-maze was designed as a model of conflictive exploration. The maze is composed of four arms with different geometrical characteristics, differing from each other by the presence or absence of walls. The degree of asymmetry was as follows: NW, no wall arm; SW, a single high wall present; HL, a low and a high wall present, and HH, two high walls present. The four arms were arranged at 90 degrees angles and the apparatus was called the elevated asymmetric plus-maze (APM). The purpose of the present study was to assess the behavioral profile of rats exposed for a single time to the APM with or without treatment with benzodiazepine. Increasing doses of diazepam were injected intraperitoneally in several groups of male, 90-day-old Holtzman rats. Distilled water was injected in control animals. Thirty minutes after treatment all rats were exposed singly to a 5-min test in the APM. Diazepam induced a biphasic modification of exploration in the NW and SW arms. The increase in the exploration score was evident at low doses of diazepam (0.25-1.0 mg/kg body weight) and the decrease in exploration was found with the higher doses of diazepam (2.0-3.0 mg/kg body weight). Non-exploratory behaviors (permanency) were not affected by benzodiazepine treatment. In the HL arm, exploration was not modified but permanency was increased in a dose-dependent manner. In the HH arm, exploration and permanency were not affected. Results are compatible with the idea that exploration-processing mechanisms in conflictive environments are modulated by fear-processing mechanisms of the brain. PMID:10347776

  2. A role for puberty in water maze performance in male and female rats.

    Willing, Jari; Drzewiecki, Carly M; Cuenod, Bethany A; Cortes, Laura R; Juraska, Janice M

    2016-08-01

    Adolescence is characterized by neuroanatomical changes that coincide with increased cognitive performance. This developmental period is particularly important for the medial prefrontal cortex (mPFC), which mediates higher-order cognitive functioning. The authors' laboratory has shown that puberty is associated with sex-specific changes in neuron number and the dendritic tree in the rat mPFC, but the effects of pubertal onset on cognitive performance remain relatively unexplored. Here, we use a water maze task to assess spatial memory for the location of an escape platform, followed by a test of reversal learning, when the platform is moved to an alternate quadrant in the maze. For both males and females, 2 groups of prepubertal animals were tested (postnatal day [P]30 and P33 for females, P40 and P43 for males), along with 1 group of newly (2 days) postpubertal animals and 1 group of young adults (P60). There were no group differences in learning the initial location of the platform or when the platform location changed, although grouping pre- and postpubertal ages did result in significantly better performance in postpubertal animals. In addition after the platform location changed, individual prepubertal males and females spent a significantly greater percentage of time in the quadrant of the maze where the platform was formerly located than the postpubertal animals. This collectively implies that pubertal onset in both males and females coincides with improved performance on a reversal task, which may be linked with the neuroanatomical changes occurring in the mPFC during this time. (PsycINFO Database Record PMID:27054406

  3. Terminology and Reporting Criteria for Radiofrequency Ablation of Tumors in the Scientific Literature: Systematic Review of Compliance with Reporting Standards

    Kang, Tae Wook; Rhim, Hyunchul; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Lim, Hyo Keun

    2014-01-01

    Objective To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Materials and Methods Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure ...

  4. Nigella sativa Oil Enhances the Spatial Working Memory Performance of Rats on a Radial Arm Maze

    Mohamad Khairul Azali Sahak; Abdul Majid Mohamed; Noor Hashida Hashim; Durriyyah Sharifah Hasan Adli

    2013-01-01

    Nigella sativa, an established historical and religion-based remedy for a wide range of health problems, is a herbal medicine known to have antioxidant and neuroprotective effects. This present study investigated the effect of Nigella sativa oil (NSO) administration on the spatial memory performance (SMP) of male adult rats using eight-arm radial arm maze (RAM). Twelve Sprague Dawley rats (7–9 weeks old) were force-fed daily with 6.0  μ L/100 g body weight of Nigella sativa oil (NSO group; n ...

  5. Estradiol to aged female or male mice improves learning in inhibitory avoidance and water maze tasks

    Frye, Cheryl A.; Rhodes, Madeline E; Dudek, Bruce

    2005-01-01

    Although 17β-Estradiol (E2) improves cognitive performance of aged female mice, its mnemonic effects when administered post-training to aged male mice have not been examined. E2 (10 µg, SC) or oil vehicle was administered to intact, 24-month-old female or male congenic (primarily C57BL/6 background) mice immediately after training in the inhibitory avoidance or water maze tasks. Following behavioral testing, effects of 1 or 24 h of E2 exposure on hippocampal levels of E2 and brain-derived neu...

  6. Two Learning Approaches to Maze Exploration: Case Study with E-puck Mobile Robots

    Neruda, Roman; Slušný, Stanislav; Vidnerová, Petra

    Hong Kong: Newswood Limited, 2008, s. 655-660. (Lecture Notes in Engineering and Computer Science). ISBN 978-988-98671-0-2. [WCECS 2008. World Congress on Engineering and Computer Science. San Francisco (US), 22.10.2008-24.10.2008] R&D Projects: GA MŠk(CZ) 1M0567 Institutional research plan: CEZ:AV0Z10300504 Keywords : evolutionary robotics * reinforcement learning * maze exploration Subject RIV: IN - Informatics, Computer Science http://www.iaeng.org/publication/WCECS2008/WCECS2008_pp655-660.pdf

  7. Optimization of Catheter Ablation of Atrial Fibrillation: Insights Gained from Clinically-Derived Computer Models

    Jichao Zhao

    2015-05-01

    Full Text Available Atrial fibrillation (AF is the most common heart rhythm disturbance, and its treatment is an increasing economic burden on the health care system. Despite recent intense clinical, experimental and basic research activity, the treatment of AF with current antiarrhythmic drugs and catheter/surgical therapies remains limited. Radiofrequency catheter ablation (RFCA is widely used to treat patients with AF. Current clinical ablation strategies are largely based on atrial anatomy and/or substrate detected using different approaches, and they vary from one clinical center to another. The nature of clinical ablation leads to ambiguity regarding the optimal patient personalization of the therapy partly due to the fact that each empirical configuration of ablation lines made in a patient is irreversible during one ablation procedure. To investigate optimized ablation lesion line sets, in silico experimentation is an ideal solution. 3D computer models give us a unique advantage to plan and assess the effectiveness of different ablation strategies before and during RFCA. Reliability of in silico assessment is ensured by inclusion of accurate 3D atrial geometry, realistic fiber orientation, accurate fibrosis distribution and cellular kinetics; however, most of this detailed information in the current computer models is extrapolated from animal models and not from the human heart. The predictive power of computer models will increase as they are validated with human experimental and clinical data. To make the most from a computer model, one needs to develop 3D computer models based on the same functionally and structurally mapped intact human atria with high spatial resolution. The purpose of this review paper is to summarize recent developments in clinically-derived computer models and the clinical insights they provide for catheter ablation.

  8. Micropatterned polysaccharide surfaces via laser ablation for cell guidance

    Barbucci, Rolando; Lamponi, Stefania; Pasqui, Daniela; Rossi, Antonella; Weber, Elisabetta

    2003-03-03

    Micropatterned materials were obtained by a controlled laser ablation of a photoimmobilised homogeneous layer of hyaluronic acid (Hyal) and its sulphated derivative (HyalS). The photoimmobilisation was performed by coating the polysaccharide, adequately functionalised with a photoreactive group, on aminosilanised glass substrate and immobilising it on the surface under UV light. Hyal or HyalS photoimmobilised samples were then subjected to laser ablation with wavelengths in the UV regions in order to drill the pattern. Four different patterns with stripes of 100, 50, 25 and 10 {mu}m were generated. A chemical characterisation by attenuated total reflection/Fourier transform infrared (ATR/FT-IR) and time of flight-secondary ions mass spectrometry (TOF-SIMS) confirmed the success of the laser ablation procedure and the presence of alternating stripes of polysaccharide and native glass. The exact dimensions of the stripes were determined by atomic force microscopy. The analysis of cell behaviour in terms of adhesion, proliferation and movement using mouse fibroblasts (3T3 line) and bovine aortic endothelial cells (BAEC) was also performed.

  9. Epicardial Ventricular Tachycardia Ablation: Clinical Practice and Recent Developments

    Michalis Efremidis MD

    2011-08-01

    Full Text Available Mapping and radiofrequency (RF catheter ablation of ventricular tachycardia (VT is a demanding procedure, with variable success rates (1. The presence of deep subendocardial or epicardial re-entry circuits is regarded as one of the reasons of failure of endocardial ablation, and these circuits have been acknowledged in ischemic and non-ischemic dilated cardiomyopathy (CMP, other types of CMP and especially in arrhythmogenic right ventricular cardiomyopathy (ARVC.The significance of epicardial VT circuits was brought to light in Chagas’ disease, which characteristically results in epicardial involvement in approximately 70% of patients (2. A recent study found one third of VTs to be epicardial in origin among patients with nonischemic CMP, about double the incidence among those with ischemic heart disease(3. Mapping and ablation of these epicardial circuits is quite exigent. Although coronary veins can be used to perform epicardial mapping, the manipulation of the catheter is strictly limited to the anatomical distribution of these vessels. Thus, the subxiphoid percutaneous approach to the pericardial space is the only technique that allows extensive, unhampered mapping of the epicardial surface of both ventricles.

  10. Contact force assessment in catheter ablation of atrial fibrillatio

    Josef Kautzner; Petr Peichl

    2014-04-01

    Full Text Available The efficacy of catheter ablation of atrial fibrillation (AF remains limited. Increase of success would require more durable lesions without increased risk of steam pop and cardiac perforation. Recently, novel technologies have been developed to estimate real-time catheter-tissue contact force (CF. This paper reviews three available tools for assessment of CF and data on experimental or clinical experience. Experimental data with open-irrigated catheter showed that lesion size was greater with applications of lower power (like 30 W and greater CF (e.g. 30 to 40 g than vice versa. Impedance drop in the first 5 seconds was significantly correlated to catheter CF. Perforation was achieved more rapidly with the ablation catheter in a sheath despite the same CF because the sheath prevents catheter buckling. Clinical experience confirmed poor relationship between CF and either unipolar amplitude, bipolar amplitude, or impedance. Within the left atrium, the most common high CF site was found at the anterior/rightward LA roof, directly beneath the ascending aorta (confirmed by merging the CT image and map. Importantly, several studies showed that the use of CF leads to shorter procedure with less fluoroscopy time and less RF applications. CF assessment was also found to be associated with higher proportion of durable lesions. Finally, pilot studies showed that CF measurement could be associated with better clinical efficacy AF ablation.

  11. Role of Optical Coherence Tomography on Corneal Surface Laser Ablation

    Bruna V. Ventura

    2012-01-01

    Full Text Available This paper focuses on reviewing the roles of optical coherence tomography (OCT on corneal surface laser ablation procedures. OCT is an optical imaging modality that uses low-coherence interferometry to provide noninvasive cross-sectional imaging of tissue microstructure in vivo. There are two types of OCTs, each with transverse and axial spatial resolutions of a few micrometers: the time-domain and the fourier-domain OCTs. Both have been increasingly used by refractive surgeons and have specific advantages. Which of the current imaging instruments is a better choice depends on the specific application. In laser in situ keratomileusis (LASIK and in excimer laser phototherapeutic keratectomy (PTK, OCT can be used to assess corneal characteristics and guide treatment decisions. OCT accurately measures central corneal thickness, evaluates the regularity of LASIK flaps, and quantifies flap and residual stromal bed thickness. When evaluating the ablation depth accuracy by subtracting preoperative from postoperative measurements, OCT pachymetry correlates well with laser ablation settings. In addition, OCT can be used to provide precise information on the morphology and depth of corneal pathologic abnormalities, such as corneal degenerations, dystrophies, and opacities, correlating with histopathologic findings.

  12. Complications of atrial fibrillation ablation: when prevention is better than cure

    Sorgente, A.; Chierchia, G.B.; Asmundis, C. de; Sarkozy, A.; Capulzini, L.; Brugada, P.

    2011-01-01

    As atrial fibrillation ablation is becoming increasingly popular in many cardiac electrophysiological laboratories around the world, preventing, avoiding, or treating procedure-related complications is of utmost importance. In our review of the literature regarding this issue, we addressed in detail

  13. Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

    Veselka, Josef; Jensen, Morten Kvistholm; Liebregts, Max;

    2016-01-01

    AIMS: The first cases of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) were published two decades ago. Although the outcomes of single-centre and national ASA registries have been published, the long-term survival and clinical outcome of the procedure are still...

  14. Transcoronary ablation of septal hypertrophy compared with surgery in the treatment of hypertrophic obstructive cardiomyopathy

    姜腾勇; 吴学思; 吕强; 孟旭; 贾长琪; 张银

    2004-01-01

    @@ Transcoronary ablation of septal hypertrophy (TASH)can lead to sustained improvement in both hemodynamics and symptoms in patients with hypertrophic obstructive cardiomyopathy ( HOCM ) . 1-4 However, there have been few reports about its efficacy and safety compared with traditional surgical procedures. This study sought to compare TASH with surgery in the treatment of HOCM.

  15. Percutaneous ultrasound-guided radiofrequency ablation for kidney tumors in patients with surgical risk

    The aim of this study was to describe our experience with percutaneous ultrasound-guided radiofrequency ablation of kidney tumors. From July 2002 to August 2005, 45 radiofrequency ablations (RFA) in 42 selected patients with kidney tumor were performed. The patients had either contraindications to surgery procedures or had a solitary kidney. The average tumor size was 37.5 mm (range, 18-59 mm) with the mean age of 68 years (range, 28-83 years). RFA were performed based on radiographic findings. Needle biopsy was made only twice. Monopolar Cool-tip Tyco or bipolar Celon Olympus radiofrequency devices were used. The procedure was performed under conscious sedation with local anesthesia. Treatment efficacy was assessed by computed tomography and by Doppler ultrasound. The absence of contrast enhancement on computed tomography was considered to be a successful treatment. The average follow up was 14 months (range, 3-36 months). In 42 tumors (93%), total absence of contrast enhancement was obtained after the initial RFA and in three tumors (7%) after the second ablation session. There were no complications following 41 procedures, including all ablations in small (<35 mm) renal masses. In four procedures, minor complications were observed. All patients are alive. There has been no need for chronic hemodialysis and, until now, we have not observed any local recurrences with the exception of one metastasis to an ipsilateral adrenal gland. RFA of kidney tumors is a promising alternative treatment which could be considered for patients who are not suitable for surgery. (author)

  16. Increase in Volume of Ablation Zones during Follow-up Is Highly Suggestive of Ablation Site Recurrence in Colorectal Liver Metastases Treated with Radiofrequency Ablation

    Kele, Petra G.; de Jong, Koert P.; van der Jagt, Eric J.

    2012-01-01

    Purpose: To test the hypothesis that volume changes of ablation zones (AZs) on successive computed tomography (CT) scans could predict ablation site recurrences (ASRs) in patients with colorectal liver metastases treated by radiofrequency (RF) ablation. Materials and Methods: RF ablation was perform

  17. Therapeutic efficacy of percutaneous radiofrequency ablation versus microwave ablation for hepatocellular carcinoma.

    Lei Zhang

    Full Text Available The aim of this study was to investigate the therapeutic efficacy of percutaneous radiofrequency (RF ablation versus microwave (MW ablation for hepatocellular carcinoma (HCC measuring ≤ 5 cm in greatest diameter. From January 2006 to December 2006, 78 patients had undergone RF ablation whereas 77 had undergone MW ablation. Complete ablation (CA, local tumour progression (LTP and distant recurrence (DR were compared. The overall survival curves were calculated with the Kaplan-Meier technique and compared with the log-rank test. The CA rate was 83.4% (78/93 for RF ablation and 86.7%(91/105 for MW ablation. The LTP rate was 11.8% (11/93 for RF ablation and 10.5% (11/105 for MW ablation. DR was found in 51 (65.4% in the RF ablation and 62 (80.5% in the MW ablation. There was no significant difference in the 1-, 3-, and 5-year overall survival rates (P = 0.780 and the 1-, 3-, and 5-year disease-free survival rates (P = 0.123 between RF and MW ablation. At subgroup analyses, for patients with tumors ≤ 3.0 cm, there was no significant difference in the 1-, 3-, and 5-year overall survival rates (P = 0.067 and the corresponding disease-free survival rates(P = 0.849. For patients with tumor diameters of 3.1-5.0 cm, the 1-, 3-, and 5-year overall survival rates were 87.1%, 61.3%, and 40.1% for RF ablation and 85.4%, 36.6%, and 22% for MW ablation, with no significant difference (P = 0.068. The corresponding disease-free survival rates were 74.2%, 54.8%, and 45.2% for the RF ablation group and 53.3%, 26.8%, and 17.1% for the MW ablation group. The disease-free survival curve for the RF ablation group was significantly better than that for the MW ablation group (P = 0.018. RF ablation and MW ablation are both effective methods in treating hepatocellular carcinomas, with no significant differences in CA, LTP, DR, and overall survival.

  18. Laser ablation studies of solid aerosols on the Baltic coast

    Robert Jaworski

    2004-09-01

    Full Text Available A Berner cascade impactor was used for the separation of solid urban aerosols in two localities of the Baltic coastal macro-region - Słupsk and Hel - in different seasons and weathers. Ten ranges of aerodynamic diameters between 0.009 and 8.11 µm were used. The elementary composition for each diameter was obtained in a complex procedure consisting of laser ablation of deposits, then their successive ionization in an inductively coupled plasma generator, and finally, mass selection in a quadrupole spectrometer. Despite its complexity, the chemical element analysis method proved to be versatile, allowing the identification air pollution from natural and industrial sources, and road traffic.

  19. Modeling Of Laser Ablation And Fragmentation Of Human Calculi

    Gitomer, Steven J.; Jones, Roger D.; Howsare, Charles

    1989-09-01

    The large-scale radiation-hydrodynamics computer code LASNEX, has been used to model experimental results in the laser ablation and fragmentation of renal and biliary calculi. Recent experiments have demonstrated laser ablation and fragmentation of human calculi in vitro and in vivo. In the interaction, laser light incident upon the calculus is of sufficient intensity to produce a plasma (a hot ionized gas). The physical picture which emerges is as follows. The plasma couples to acoustic and shear waves which then propagate through the dense stone material, causing spall and fracture by reflection from material discontinuities or boundaries. Experiments have thus far yielded data on the interaction against which models can be tested. Data on the following have been published: (1) light emission, (2) absorption and emission spectra, (3) fragmentation efficiency, (4) cavitation bubble dynamics and (5) mass removal. We have performed one dimensional simulations of the laser-matter interaction to elucidate the im-portant physical mechanisms. We find that good quantitative fits between simulation and experiment are obtained for visible light emission, electron temperature, electron density, plasma pressure and cavitation bubble growth. With regard to mass removal, experiment and simulation are consistent with each other and give an excellent estimate of the ablation threshold. The modeling indicates that a very small ablation layer at the surface of the calulus is responsible for significant mass loss by fragmentation within the bulk of the calculus. With such quantitative fits in hand, we believe this type of modeling can now be applied to the study of other procedures involving plasma formation of interest to the medical community.

  20. Modeling of laser ablation and fragmentation of human calculi

    Gitomer, S.; Jones, R.D.; Howsare, C.

    1989-01-01

    The large-scale radiation-hydrodynamics computer code LASNEX, has been used to model experimental results in the laser ablation and fragmentation of renal and biliary calculi. Recent experiments have demonstrated laser ablation and fragmentation of human calculi in vitro and in vivo. In the interaction, laser light incident upon the calculus is of sufficient intensity to produce a plasma (a hot ionized gas). The physical picture which emerges is as follows. The plasma couples to acoustic and shear waves which then propagate through the dense stone material, causing spall and fracture by reflection from material discontinuities or boundaries. Experiments have thus far yielded data on the interaction against which models can be tested. Data on the following have been published: (1) light emission, (2) absorption and emission spectra, (3) fragmentation efficiency, (4) cavitation bubble dynamics and (5) mass removal. We have performed one dimensional simulations of the laser-matter interaction to elucidate the important physical mechanisms. We find that good quantitative fits between simulation and experiment are obtained for visible light emission, electron temperature, electron density, plasma pressure and cavitation bubble growth. With regard to mass removal, experiment and simulation are consistent with each other and give an excellent estimate of the ablation threshold. The modeling indicates that a very small ablation layer at the surface of the calculus is responsible for significant mass loss by fragmentation within the bulk of the calculus. With such quantitative fits in hand, we believe this type of modeling can now be applied to the study of other procedures involving plasma formation of interest to the medical community. 25 refs., 7 figs.

  1. Treatment of osteoid osteoma using CT-guided radiofrequency ablation versus MR-guided laser ablation: A cost comparison

    Objective: To compare the costs of CT-guided radiofrequency ablation (RFA) and MR-guided laser ablation (LA) for minimally invasive percutaneous treatment of osteoid osteoma. Materials and methods: Between November 2005 and October 2011, 20 patients (14 males, 6 females, mean age 20.3 ± 9.1 years) underwent CT-guided RFA and 24 patients (18 males, 6 females; mean age, 23.8 ± 13.8 years) MR-guided LA (open 1.0 Tesla, Panorama HFO, Philips, Best, Netherlands) for osteoid osteoma diagnosed on the basis of clinical presentation and imaging findings. Prorated costs of equipment use (purchase, depreciation, and maintenance), staff costs, and expenditure for disposables were identified for CT-guided RFA and MR-guided LA procedures. Results: The average total costs per patient were EUR 1762 for CT-guided RFA and EUR 1417 for MR-guided LA. These were (RFA/LA) EUR 92/260 for equipment use, EUR 149/208 for staff, and EUR 870/300 for disposables. Conclusion: MR-guided LA is less expensive than CT-guided RFA for minimally invasive percutaneous ablation of osteoid osteoma. The higher costs of RFA are primarily due to the higher price of the disposable RFA probes.

  2. Reprint of "Value of water mazes for assessing spatial and egocentric learning and memory in rodent basic research and regulatory studies".

    Vorhees, Charles V; Williams, Michael T

    2015-01-01

    Maneuvering safely through the environment is central to survival of all animals. The ability to do this depends on learning and remembering locations. This capacity is encoded in the brain by two systems: one using cues outside the organism (distal cues), allocentric navigation, and one using self-movement, internal cues and sometimes proximal cues, egocentric navigation. Allocentric navigation involves the hippocampus, entorhinal cortex, and surrounding structures (e.g., subiculum); in humans this system encodes declarative memory (allocentric, semantic, and episodic, i.e., memory for people, places, things, and events). This form of memory is assessed in laboratory animals by many methods, but predominantly the Morris water maze (MWM). Egocentric navigation involves the dorsal striatum and connected structures; in humans this system encodes routes and integrated paths and when over-learned becomes implicit or procedural memory. Several allocentric methods for rodents are reviewed and compared with the MWM with particular focus on the Cincinnati water maze (CWM). MWM advantages include minimal training, no food deprivation, ease of testing, reliable learning, insensitivity to differences in body weight and appetite, absence of non-performers, control methods for performance effects, repeated testing capability and other factors that make this test well-suited for regulatory studies. MWM limitations are also reviewed. Evidence-based MWM design and testing methods are presented. On balance, the MWM is arguably the preferred test for assessing learning and memory in basic research and regulatory studies and the CWM is recommended if two tests can be accommodated so that both allocentric (MWM) and egocentric (CWM) learning and memory can be effectively and efficiently assessed. PMID:26071087

  3. Heading which way? Y-maze chemical assays: not all crustaceans are alike

    Kenning, Matthes; Lehmann, Philipp; Lindström, Magnus; Harzsch, Steffen

    2015-09-01

    In a world full of chemicals, many crustaceans rely on elaborate olfactory systems to guide behaviors related to finding food or to assess the presence of conspecifics and predators. We analyzed the responses of the isopod Saduria entomon to a range of stimuli by which the animal is likely to encounter in its natural habitat using a Y-maze bioassay. In order to document the efficiency of the experimental design, the same bioassay was used to test the behavior of the crayfish Procambarus fallax whose ability to track odors is well documented. The crayfish performed well in the Y-maze and were able to locate the source of a food-related odor with high fidelity. The isopod S. entomon reacted indifferently or with aversion to most of the stimuli applied. In 1800 trials, only four out of 15 different stimuli yielded statistically significant results, and only one odorant was found to be significantly attractive. The findings raise several questions whether the stimuli presented and/or the experimental setup used represents an ecologically relevant situation for S. entomon. In each instance, our experiments illustrate that established methods cannot be readily transferred from one species to another.

  4. Vertical T-maze choice assay for arthropod response to odorants.

    Stelinski, Lukasz; Tiwari, Siddharth

    2013-01-01

    Given the economic importance of insects and arachnids as pests of agricultural crops, urban environments or as vectors of plant and human diseases, various technologies are being developed as control tools. A subset of these tools focuses on modifying the behavior of arthropods by attraction or repulsion. Therefore, arthropods are often the focus of behavioral investigations. Various tools have been developed to measure arthropod behavior, including wind tunnels, flight mills, servospheres, and various types of olfactometers. The purpose of these tools is to measure insect or arachnid response to visual or more often olfactory cues. The vertical T-maze olfactometer described here measures choices performed by insects in response to attractants or repellents. It is a high throughput assay device that takes advantage of the positive phototaxis (attraction to light) and negative geotaxis (tendency to walk or fly upward) exhibited by many arthropods. The olfactometer consists of a 30 cm glass tube that is divided in half with a Teflon strip forming a T-maze. Each half serves as an arm of the olfactometer enabling the test subjects to make a choice between two potential odor fields in assays involving attractants. In assays involving repellents, lack of normal response to known attractants can also be measured as a third variable. PMID:23439130

  5. Influence of magnetic field on zebrafish activity and orientation in a plus maze.

    Osipova, Elena A; Pavlova, Vera V; Nepomnyashchikh, Valentin A; Krylov, Viacheslav V

    2016-01-01

    We describe an impact of the geomagnetic field (GMF) and its modification on zebrafish's orientation and locomotor activity in a plus maze with four arms oriented to the north, east, south and west. Zebrafish's directional preferences were bimodal in GMF: they visited two arms oriented in opposed directions (east-west) most frequently. This bimodal preference remained stable for same individuals across experiments divided by several days. When the horizontal GMF component was turned 90° clockwise, the preference accordingly shifted by 90° to arms oriented to the north and south. Other modifications of GMF (reversal of both vertical and horizontal GMF components; reversal of vertical component only; and reversal of horizontal component only) did not exert any discernible effect on the orientation of zebrafish. The 90° turn of horizontal component also resulted in a significant increase of fish's locomotor activity in comparison with the natural GMF. This increase became even more pronounced when the horizontal component was repeatedly turned by 90° and back with 1min interval between turns. Our results show that GMF and its variations should be taken into account when interpreting zebrafish's directional preferences and locomotor activity in mazes and other experimental devices. PMID:26589739

  6. Water Associated Zero Maze: A novel rat test for long term traumatic re-experiencing

    Gilad eRitov

    2014-01-01

    Full Text Available Often, freezing and startle behaviors in the context of a previously experienced stress are taken as an indication of posttraumatic stress disorder (PTSD-like symptoms in rats. However, PTSD is characterized by large individual variations of symptoms. In order to take into consideration the complex and long term distinctive variations in effects of trauma exposure additional behavioral measures are required.The current study used a novel behavioral test, the Water Associated Zero Maze (WAZM. This test was planned to enable a formation of an association between the context of the maze and an underwater trauma or swim stress in order to examine the impact of exposure to the context which immediately precedes a stressful or a traumatic experience on rat's complex behavior. Rats were exposed to the WAZM and immediately after to an underwater trauma or short swim. One month later rats were re-exposed to the context of the WAZM while their behavior was video recorded. Furthermore, c-Fos expression in the amygdala was measured 90 min after this exposure.The results of the current study indicate that the WAZM can be used to discern behavioral changes measured a long time after the actual traumatic or stressful events. Furthermore, the behavioral changes detected were accompanied by changes of c-Fos expression in the amygdala of exposed rats. We suggest that the WAZM can be used to model traumatic memories re-experiencing in rodent models of human stress-related pathologies such as PTSD.

  7. Cognitive enrichment for bottlenose dolphins (Tursiops truncatus): evaluation of a novel underwater maze device.

    Clark, Fay E; Davies, Samuel L; Madigan, Andrew W; Warner, Abby J; Kuczaj, Stan A

    2013-01-01

    Cognitive enrichment is gaining popularity as a tool to enhance captive animal well-being, but research on captive cetaceans is lacking. Dolphin cognition has been studied intensively since the 1950s, and several hundred bottlenose dolphins are housed in major zoos and aquaria worldwide, but most dolphin enrichment consists of simple floating objects. The aim of this study was to investigate whether a novel, underwater maze device (UMD) was cognitively enriching for one group of male and one group of female dolphins at Six Flags Discovery Kingdom, CA. The dolphin's task was to navigate a rubber ball through a maze of pipes, towards an exit pipe. We also tested a modification where an edible gelatine ball fell into the pool once the UMD was solved. The UMD was provided to each group between 8 and 11 times over a 4-week period. Male dolphins used the UMD without prior training, whereas females did not use the UMD at all. Two male dolphins solved the UMD 17 times, using a variety of problem-solving strategies. The UMD had no significant effect on circular (repetitive) swimming patterns, but males spent significantly more time underwater when the UMD was present. Males used the UMD significantly more when it contained the rubber ball, but the gelatine ball stimulated social play. The UMD is a safe and practical device for captive dolphins. It now requires further testing on other dolphins, particularly females, to in order to examine whether the sex differences we observed are a general phenomenon. PMID:24018985

  8. Laparoscopic Radiofrequency Thermal Ablation for Uterine Adenomyosis

    Scarperi, Stefano; Pontrelli, Giovanni; Campana, Colette; Steinkasserer, Martin; Ercoli, Alfredo; Minelli, Luca; Bergamini, Valentino; Ceccaroni, Marcello

    2015-01-01

    Background and Objectives: Symptomatic uterine adenomyosis, unresponsive to medical therapy, is a challenging condition for patients who desire to preserve their uterus. This study was an evaluation of the feasibility and efficacy of laparoscopic radiofrequency thermal ablation of symptomatic nodular uterine adenomyosis. Methods: Fifteen women with symptomatic nodular adenomyosis, who had no plans for pregnancy but declined hysterectomy, underwent radiofrequency thermal ablation. Ultrasonogra...

  9. Time-stepping for laser ablation

    Harihar Khanal; David Autrique; Vasilios Alexiades

    2013-01-01

    Nanosecond laser ablation is a popular technique, applied in many areas of science and technology such as medicine, archaeology, chemistry, environmental and materials sciences. We outline a computational model for radiative and collisional processes occurring during ns-laser ablation, and compare the performance of various low and high order time-stepping algorithms.

  10. PULSED LASER ABLATION OF CEMENT AND CONCRETE

    Laser ablation was investigated as a means of removing radioactive contaminants from the surface and near-surface regions of concrete from nuclear facilities. We present the results of ablation tests on cement and concrete samples using a pulsed Nd:YAG laser with fiber optic beam...

  11. Testing and evaluation of light ablation decontamination

    This report details the testing and evaluation of light ablation decontamination. It details WINCO contracted research and application of light ablation efforts by Ames Laboratory. Tests were conducted with SIMCON (simulated contamination) coupons and REALCON (actual radioactive metal coupons) under controlled conditions to compare cleaning effectiveness, speed and application to plant process type equipment

  12. RADIOFREQUENCY ABLATION OF IDIOPATHIC RIGHT VENTRICULAR TACHYCARDIA

    华伟; JituVohra

    1998-01-01

    This paper presents our experieaee with radioreqencey ablation (RFA) for idiopathic ventricular tschycardia (VT) arising from right ventricle in 12 patients(pts). The age range d patients was 21~50, with a mean of 38. 5 years. Ten out of 12 were females, 1 patient had eandia failure due to almost incessant VT while the rest had normal left ventricular function.Twelve pts had VT arising from the fight ventricle; of those, 9 were from the outflow truct, 2 from the RV apex, and l from the RV inflow. In all tats the diagnostic study and therapeutic RFA were combined in a single procedure, pacemapping and local aetlvition time were used to guide the site of RFA in Ors with VT arising froth the tight ventricle.RFA was successful in 11 of the 12 pts ( 91%). Ntmaher of RF applications were 1~27, mean 9. 6; fluoroscopy time were 4~75, mean 26. 9 minutes. RFA for idiopathic RV has a high success rate. This mode of treament should be considered as a nonphartaaeologieal curative treatment for symptomatic pts.

  13. Radiofrequency ablation for renal tumors. Our experience

    The objective of this study was to report our results of percutaneous radiofrequency ablation (RFA) for renal tumors and to assess predictors of therapeutic efficacy. Forty patients (median age 73 years) with renal tumors were treated with RFA under local or epidural anesthesia. All of them had high surgical risk or refused radical surgery. Tumors were punctured percutaneously using the Radionics Cool-tip RF System under computed tomography or ultrasonographic guidance. Median tumor diameter was 24 mm. After RFA, contrast-enhanced computed tomography or magnetic resonance imaging was performed within 1 month. Complete response (CR) was defined as no enhancement inside the tumor. Factors related to the outcome and to renal function were assessed. Median follow up was 16 months. CR was observed in 34 cases (85.0%). A significant difference in CR rate was observed between tumors ≤30 mm and those >30 mm. Outcomes tended to be better for tumors in the mid to lower kidney, and those away from the renal hilum. Recurrence was observed in one case (2.9%), but a CR was obtained again by additional RFA. Out of a total of 77 RFA procedures, complications occurred in only three cases (3.9%), and conservative treatment was possible in all cases. Serum creatinine levels 3 months after RFA did not differ from those before RFA. Percutaneous RFA is a safe and effective treatment for small renal tumors in patients with high surgical risk or who refuse radical surgery. (author)

  14. High Heat Flux Block Ablator-in-Honeycomb Heat Shield Using Ablator/Aerogel-Filled Foam Project

    National Aeronautics and Space Administration — Ultramet and ARA Ablatives Laboratory previously developed and demonstrated advanced foam-reinforced carbon/phenolic ablators that offer substantially increased...

  15. Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors

    IntroductionThe imaging features of unresectable hepatic malignancies in patients who underwent radiofrequency ablation (RFA) in combination with lyso-thermosensitive liposomal doxorubicin (LTLD) were determined.Materials and MethodsA phase I dose escalation study combining RFA with LTLD was performed with peri- and post- procedural CT and MRI. Imaging features were analyzed and measured in terms of ablative zone size and surrounding penumbra size. The dynamic imaging appearance was described qualitatively immediately following the procedure and at 1-month follow-up. The control group receiving liver RFA without LTLD was compared to the study group in terms of imaging features and post-ablative zone size dynamics at follow-up.ResultsPost-treatment scans of hepatic lesions treated with RFA and LTLD have distinctive imaging characteristics when compared to those treated with RFA alone. The addition of LTLD resulted in a regular or smooth enhancing rim on T1W MRI which often correlated with increased attenuation on CT. The LTLD-treated ablation zones were stable or enlarged at follow-up four weeks later in 69 % of study subjects as opposed to conventional RFA where the ablation zone underwent involution compared to imaging acquired immediately after the procedure.ConclusionThe imaging features following RFA with LTLD were different from those after standard RFA and can mimic residual or recurrent tumor. Knowledge of the subtle findings between the two groups can help avoid misinterpretation and proper identification of treatment failure in this setting. Increased size of the LTLD-treated ablation zone after RFA suggests the ongoing drug-induced biological effects

  16. Real-time tumor ablation simulation based on the dynamic mode decomposition method

    Bourantas, George C.

    2014-05-01

    Purpose: The dynamic mode decomposition (DMD) method is used to provide a reliable forecasting of tumor ablation treatment simulation in real time, which is quite needed in medical practice. To achieve this, an extended Pennes bioheat model must be employed, taking into account both the water evaporation phenomenon and the tissue damage during tumor ablation. Methods: A meshless point collocation solver is used for the numerical solution of the governing equations. The results obtained are used by the DMD method for forecasting the numerical solution faster than the meshless solver. The procedure is first validated against analytical and numerical predictions for simple problems. The DMD method is then applied to three-dimensional simulations that involve modeling of tumor ablation and account for metabolic heat generation, blood perfusion, and heat ablation using realistic values for the various parameters. Results: The present method offers very fast numerical solution to bioheat transfer, which is of clinical significance in medical practice. It also sidesteps the mathematical treatment of boundaries between tumor and healthy tissue, which is usually a tedious procedure with some inevitable degree of approximation. The DMD method provides excellent predictions of the temperature profile in tumors and in the healthy parts of the tissue, for linear and nonlinear thermal properties of the tissue. Conclusions: The low computational cost renders the use of DMD suitable forin situ real time tumor ablation simulations without sacrificing accuracy. In such a way, the tumor ablation treatment planning is feasible using just a personal computer thanks to the simplicity of the numerical procedure used. The geometrical data can be provided directly by medical image modalities used in everyday practice. © 2014 American Association of Physicists in Medicine.

  17. Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors

    Hong, Cheng William, E-mail: williamhongcheng@gmail.com; Chow, Lucy, E-mail: lucychow282@gmail.com [National Institutes of Health, Center for Interventional Oncology, Clinical Center (United States); Turkbey, Evrim B., E-mail: evrimbengi@yahoo.com [National Institutes of Health, Radiology and Imaging Sciences, Clinical Center (United States); Lencioni, Riccardo, E-mail: riccardo.lencioni@med.unipi.it [Pisa University Hospital, Division of Diagnostic Imaging and Intervention, Department of Hepatology and Liver Transplantation (Italy); Libutti, Steven K., E-mail: slibutti@montefiore.org [Albert Einstein College of Medicine, Montefiore-Einstein Center for Cancer Care, Department of Surgery (United States); Wood, Bradford J., E-mail: bwood@nih.gov [National Institutes of Health, Center for Interventional Oncology, Clinical Center (United States)

    2016-03-15

    IntroductionThe imaging features of unresectable hepatic malignancies in patients who underwent radiofrequency ablation (RFA) in combination with lyso-thermosensitive liposomal doxorubicin (LTLD) were determined.Materials and MethodsA phase I dose escalation study combining RFA with LTLD was performed with peri- and post- procedural CT and MRI. Imaging features were analyzed and measured in terms of ablative zone size and surrounding penumbra size. The dynamic imaging appearance was described qualitatively immediately following the procedure and at 1-month follow-up. The control group receiving liver RFA without LTLD was compared to the study group in terms of imaging features and post-ablative zone size dynamics at follow-up.ResultsPost-treatment scans of hepatic lesions treated with RFA and LTLD have distinctive imaging characteristics when compared to those treated with RFA alone. The addition of LTLD resulted in a regular or smooth enhancing rim on T1W MRI which often correlated with increased attenuation on CT. The LTLD-treated ablation zones were stable or enlarged at follow-up four weeks later in 69 % of study subjects as opposed to conventional RFA where the ablation zone underwent involution compared to imaging acquired immediately after the procedure.ConclusionThe imaging features following RFA with LTLD were different from those after standard RFA and can mimic residual or recurrent tumor. Knowledge of the subtle findings between the two groups can help avoid misinterpretation and proper identification of treatment failure in this setting. Increased size of the LTLD-treated ablation zone after RFA suggests the ongoing drug-induced biological effects.

  18. Percutaneous radiofrequency ablation of hepatocellular carcinoma: analysis of 80 patients treated with two consecutive sessions

    Rhim, Hyunchul; Kim, Young-sun; Choi, Dongil; Lim, Hyo K.; Park, KoWoon [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea)

    2008-07-15

    This study investigated the reasons for some patients requiring two consecutive sessions of percutaneous radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). We reviewed our database of 1,179 patients (1,624 treatments) with HCCs treated by percutaneous ultrasound (US)-guided RF ablation over 6 years. We retrospectively evaluated 80 patients who required a second session after the first session. The medical records and follow-up CTs were studied. We assessed the reasons for the second session and the patient outcomes. A second session was required in 80 (4.8%) out of 1,642 treatments of percutaneous RF ablation for HCC. The reason for the second session included technical failure related to the patient or the procedure (n=26), technical failure due to residual (n=40), newly detected (n=11) or missed (n=3) tumors found at the immediate follow-up CT. All patients were retreated with a second RFA session the next day. Seventy-five (93%) of 80 patients achieved complete ablation after the second session. The remaining five patients were treated by TACE (n=1), additional RFA (as second treatment at next admission) (n=3), or were lost to follow-up (n=1). After 1 month follow-up, 72 patients (96%) showed complete ablation after the second session. The interventional oncologist should understand the technical reasons for a patient requiring a second session of RF ablation when providing treatment for HCCs and perform careful pre-procedural planning to minimize the need for multi-session procedures. (orig.)

  19. Percutaneous radiofrequency ablation of hepatocellular carcinoma: analysis of 80 patients treated with two consecutive sessions

    This study investigated the reasons for some patients requiring two consecutive sessions of percutaneous radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). We reviewed our database of 1,179 patients (1,624 treatments) with HCCs treated by percutaneous ultrasound (US)-guided RF ablation over 6 years. We retrospectively evaluated 80 patients who required a second session after the first session. The medical records and follow-up CTs were studied. We assessed the reasons for the second session and the patient outcomes. A second session was required in 80 (4.8%) out of 1,642 treatments of percutaneous RF ablation for HCC. The reason for the second session included technical failure related to the patient or the procedure (n=26), technical failure due to residual (n=40), newly detected (n=11) or missed (n=3) tumors found at the immediate follow-up CT. All patients were retreated with a second RFA session the next day. Seventy-five (93%) of 80 patients achieved complete ablation after the second session. The remaining five patients were treated by TACE (n=1), additional RFA (as second treatment at next admission) (n=3), or were lost to follow-up (n=1). After 1 month follow-up, 72 patients (96%) showed complete ablation after the second session. The interventional oncologist should understand the technical reasons for a patient requiring a second session of RF ablation when providing treatment for HCCs and perform careful pre-procedural planning to minimize the need for multi-session procedures. (orig.)

  20. New Technologies in Atrial Fibrillation Ablation

    John Rickard, MD, MPH; Saman Nazarian MD, PhD

    2014-08-01

    Full Text Available Atrial fibrillation (AF is a major public health issue worldwide the incidence of which is likely to continue to rise. With the birth of pulmonary vein isolation(PVI, cardiac ablation has emerged as key strategy for the treatment of AF. PVI using traditional point by point radiofrequency ablation is time consuming and technically challenging. Refining patient selection for PVI also remains an important goal. New ablative strategies using catheter-based balloon technologies, such as cryothermy and laser-based systems, may simplify PVI. In addition, new MRI-based techniques offer the hope of refining patient selection prior to ablation. Lastly, FIRM mapping represents an entirely new approach to AF ablation via the targeting of mechanisms that perpetuate AF rather than simply targeting triggers alone.