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Sample records for ablation results utilizing

  1. Lung ablation: Best practice/results/response assessment/role alongside other ablative therapies.

    Science.gov (United States)

    de Baere, T; Tselikas, L; Gravel, G; Deschamps, F

    2017-08-01

    Today, in addition to surgery, other local therapies are available for patients with small-size non-small-cell lung cancer (NSCLC) and oligometastatic disease from various cancers. Local therapies include stereotactic ablation radiotherapy (SABR) and thermal ablative therapies through percutaneously inserted applicators. Although radiofrequency ablation (RFA) has been explored in series with several hundreds of patients with pulmonary tumours, investigation of the potential of other ablation technologies including microwave ablation, cryoablation, and irreversible electroporation is ongoing. There are no randomised studies available to compare surgery, SABR, and thermal ablation. In small-size lung metastases, RFA seems to produce results very close to surgical series with >90% local control and 5-year overall survival of 50%. In primary lung cancer, the technique is reserved for non-surgical candidates. In future, the low invasiveness of thermal ablative therapies will allow for a combination of ablation and systemic therapies in order to improve the outcomes of ablation alone. Another major advantage of thermal ablation is the possibility to treat several metastases in close proximity to one another and retreatment in the same location in case of failure, which is not possible with SABR. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Radiofrequency ablation for hepatocellular carcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in guiding and assessing early therapeutic response and short-term follow-up results.

    Science.gov (United States)

    Du, Jing; Li, Hong-Li; Zhai, Bo; Chang, Samuel; Li, Feng-Hua

    2015-09-01

    The purpose of this study was to assess the efficacy of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in guiding and assessing early therapeutic response to radiofrequency (RF) ablation for hepatocellular carcinomas (HCCs; up to 3 lesions, each ≤3 cm in diameter) and to report the short-term follow-up results. Between September 2011 and January 2013, 63 patients with 78 HCCs (≤3 cm) underwent conventional US- and CEUS-guided percutaneous RF ablation. CEUS was repeated after 20-30 min to assess therapeutic response, and local efficacy was further confirmed by contrast-enhanced magnetic resonance imaging (MRI) 1 mo after tumor ablation. Patients were followed periodically to look for local tumor or disease progression. Survival probability was estimated with the Kaplan-Meier method. Complete ablation was achieved for 76 (97.4%) of 78 HCCs in one (n = 73) or two (n = 3) sessions. No major complications were observed in any patient. The overall concordance in assessment of therapeutic efficacy of RF ablation between CEUS and MRI was 97.4% (76/78 tumors). The concordance test gave a value of κ = 0.74 (p therapeutic response to RF ablation. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  3. Comparison of ablation stake measurements and Airborne Laser Scanning results

    Science.gov (United States)

    Rieg, Lorenzo; Galos, Stephan; Klug, Christoph; Sailer, Rudolf

    2014-05-01

    Ablation measurements using ablation stakes are a well-established method in glaciology, which sees a lot of use. However, ablation stakes cannot always be installed and read at a sufficient number of points on a glacier or on multiple glaciers, due to limited personnel and financial capacities or because of inaccessible areas due to dangerous zones (crevasses, rock falls, avalanches) or remote terrain. Furthermore, ablation stakes only enable measurements of surface melt, whereas basal or internal melt processes as well as surface change related to glacier dynamics cannot be measured. Multi temporal Airborne laser scanning (ALS) can provide high resolution and very accurate topographic information for the whole glacier area, which allows the calculation of the difference in surface height and therefore - if the density profile is known or can be estimated - the determination of the local mass balance, including processes like basal melt at least to a certain degree. To gain a better understanding of the differences between ablation stake readings and differential ALS data at the stake locations, the results of both methods have been compared in detail. At Langenferner, a glacier in the Italian Eastern Alps, where mass balance measurements have been carried out since 2004, three ALS campaigns have been conducted at the end of the hydrological year in 2005, 2010 and 2013. There are about 30 ablation stakes installed at the glacier, which have been read during or very close to the time of the flight campaigns. The ablation measurements are then compared to the surface differences calculated from ALS data at the locations of the ablation stakes. To take the movement of the stakes due to glacier dyanmics into account, the position of the stakes has been measured with a differential GPS.

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

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, C. M., E-mail: christof.sommer@med.uni-heidelberg.de [University Hospital Heidelberg, INF 110, Department of Diagnostic and Interventional Radiology (Germany); Lemm, G.; Hohenstein, E. [Minimally Invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Clinic for Radiology (Germany); Bellemann, N.; Stampfl, U. [University Hospital Heidelberg, INF 110, Department of Diagnostic and Interventional Radiology (Germany); Goezen, A. S.; Rassweiler, J. [Clinic for Urology, SLK Kliniken Heilbronn GmbH (Germany); Kauczor, H. U.; Radeleff, B. A. [University Hospital Heidelberg, INF 110, Department of Diagnostic and Interventional Radiology (Germany); Pereira, P. L. [Minimally Invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Clinic for Radiology (Germany)

    2013-06-15

    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 m{sup 2} before RF ablation vs. 47.2 {+-} 11.9 ml/min/1.73 m{sup 2} 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.

  5. Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: Utility of contrast-enhanced agent detection imaging

    International Nuclear Information System (INIS)

    Kim, Chan Kyo; Choi, Dongil; Lim, Hyo K.; Kim, Seung Hoon; Lee, Won Jae; Kim, Min Ju; Lee, Ji Yeon; Jeon, Yong Hwan; Lee, Jongmee; Lee, Soon Jin; Lim, Jae Hoon

    2005-01-01

    Purpose: To assess the utility of contrast-enhanced agent detection imaging (ADI) in the assessment of the therapeutic response to percutaneous radiofrequency (RF) ablation in patients with hepatocellular carcinoma (HCC). Materials and methods: Ninety patients with a total of 97 nodular HCCs (mean, 2.1 ± 1.3 cm; range, 1.0-5.0 cm) treated with percutaneous RF ablation under the ultrasound guidance were evaluated with contrast-enhanced ADI after receiving an intravenous bolus injection of a microbubble contrast agent (SH U 508A). We obtained serial contrast-enhanced ADI images during the time period from 15 to 90 s after the initiation of the bolus contrast injection. All of the patients underwent a follow-up four-phase helical CT at 1 month after RF ablation, which was then repeated at 2-4 month intervals during a period of at least 12 months. The results of the contrast-enhanced ADI were compared with those of the follow-up CT in terms of the presence or absence of residual unablated tumor and local tumor progression in the treated lesions. Results: On contrast-enhanced ADI, technical success was obtained in 94 (97%) of the 97 HCCs, while residual unablated tumors were found in three HCCs (3%). Two of the three tumors that were suspicious (was not proven) for incomplete ablation were subjected to additional RF ablation. The remaining one enhancing lesion that was suspicious of a residual tumor on contrast-enhanced ADI was revealed to be reactive hyperemia at the 1-month follow-up CT. Therefore; the diagnostic concordance between the contrast-enhanced ADI and 1-month follow-up CT was 99%. Of the 94 ablated HCCs without residual tumors on both the contrast-enhanced ADI and 1-month follow-up CT after the initial RF ablation, five (5%) had CT findings of local tumor progression at a subsequent follow-up CT. Conclusion: Despite its limitations in predicting local tumor progression in the treated tumors, contrast-enhanced ADI is potentially useful for evaluating the

  6. Forest canopy effects on snow accumulation and ablation: an integrative review of empirical results

    Science.gov (United States)

    Andres Varhola; Nicholas C. Coops; Markus Weiler; R. Dan Moore

    2010-01-01

    The past century has seen significant research comparing snow accumulation and ablation in forested and open sites. In this review we compile and standardize the results of previous empirical studies to generate statistical relations between changes in forest cover and the associated changes in snow accumulation and ablation rate. The analysis drew upon 33 articles...

  7. Ablation of small iron meteoroids-First results

    Czech Academy of Sciences Publication Activity Database

    Čapek, David; Borovička, Jiří

    2017-01-01

    Roč. 143, SI (2017), s. 159-163 ISSN 0032-0633. [Meteoroids 2016. Nordwijk, 06.06.2016-10.06.2016] R&D Projects: GA ČR(CZ) GA16-00761S Institutional support: RVO:67985815 Keywords : ablation * iron * meteor Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics OBOR OECD: Astronomy (including astrophysics,space science) Impact factor: 1.892, year: 2016

  8. Juridical utilization of dosimetric results

    International Nuclear Information System (INIS)

    Hebert, J.

    1976-01-01

    The problems of the legal use of the results of dosimetry, for the solution of an action for instance, are considered first with respect to civil and occasionally administrative third part liability law making a distinction between common law and the special regime of civil liability for nuclear damage, secondly with respect to social security law [fr

  9. Applying DSM evaluation results to utility planning

    Energy Technology Data Exchange (ETDEWEB)

    Baxter, L.W.

    1995-07-01

    This paper describes the results of a study to assess the application of DSM evaluation results to utility forecasting and planning. The paper has three objectives: (1) identify forecasting and planning applications of evaluation studies, (2) identify major obstacles and problems associated with applying evaluation results to forecasting and planning, and (3) suggest approaches to address the major problems. The paper summarizes results from interviews with utilities, regulators, and consultants to determine how the utility industry currently applies evaluation results in forecasting and planning. The paper also includes results from a detailed case study of Sacramento Municipal Utility District (SMUD) and Southern California Edison Company (SCE), two utilities with large DSM programs and active evaluation efforts.

  10. Percutaneous Irreversible Electroporation Lung Ablation: Preliminary Results in a Porcine Model

    International Nuclear Information System (INIS)

    Deodhar, Ajita; Monette, Sébastien; Single, Gordon W.; Hamilton, William C.; Thornton, Raymond H.; Sofocleous, Constantinos T.; Maybody, Majid; Solomon, Stephen B.

    2011-01-01

    Objective: Irreversible electroporation (IRE) uses direct electrical pulses to create permanent “pores” in cell membranes to cause cell death. In contrast to conventional modalities, IRE has a nonthermal mechanism of action. Our objective was to study the histopathological and imaging features of IRE in normal swine lung. Materials and Methods: Eleven female swine were studied for hyperacute (8 h), acute (24 h), subacute (96 h), and chronic (3 week) effects of IRE ablation in lung. Paired unipolar IRE applicators were placed under computed tomography (CT) guidance. Some applicators were deliberately positioned near bronchovascular structures. IRE pulse delivery was synchronized with the cardiac rhythm only when ablation was performed within 2 cm of the heart. Contrast-enhanced CT scan was performed immediately before and after IRE and at 1 and 3 weeks after IRE ablation. Representative tissue was stained with hematoxylin and eosin for histopathology. Results: Twenty-five ablations were created: ten hyperacute, four acute, and three subacute ablations showed alveolar edema and necrosis with necrosis of bronchial, bronchiolar, and vascular epithelium. Bronchovascular architecture was maintained. Chronic ablations showed bronchiolitis obliterans and alveolar interstitial fibrosis. Immediate post-procedure CT images showed linear or patchy density along the applicator tract. At 1 week, there was consolidation that resolved partially or completely by 3 weeks. Pneumothorax requiring chest tube developed in two animals; no significant cardiac arrhythmias were noted. Conclusion: Our preliminary porcine study demonstrates the nonthermal and extracellular matrix sparing mechanism of action of IRE. IRE is a potential alternative to thermal ablative modalities.

  11. Epiphysiodesis Made with Radio Frequency Ablation: First Results from a Pilot Study

    DEFF Research Database (Denmark)

    Shiguetomi Medina, Juan Manuel; Rahbek, Ole; Stødkilde-Jørgensen, Hans

    pigs were used. A control leg was randomly selected and the contralateral treated at two ablation sites (lateral and medial) identified at the proximal tibia growth plate using x-ray. Under general anesthesia, a probe was inserted and the ablation performed. T1, T2 and water content MR images were...... performed right after the procedure and 12 weeks later.The length of both tibiae was measured immediately after the ablation and at the end of the study. Results Both legs were equal at the beginning of the study and there was a leg length difference in average of 3.7mm (SD=0.48) at the end. No damage...... of treatment. These results show that this technique can arrest growth in a safe effective way. However, longer studies must be performed to obtain more evidence of both the safety and effectiveness of the procedure....

  12. Microwave ablation of renal tumors: A narrative review of technical considerations and clinical results.

    Science.gov (United States)

    Cornelis, F H; Marcelin, C; Bernhard, J-C

    2017-04-01

    The purpose of this review was to identify the specific technical considerations to adequately perform microwave ablations (MWA) of renal tumors and analyze the currently available clinical results. Using Medline, a systematic review was performed including articles published between January 2000 and September 2016. English language original articles, reviews and editorials were selected based on their clinical relevance. MWA has several theoretical advantages over radiofrequency ablation in consistently providing higher intratumoral temperatures. MWA is less dependent of electrical conductivities of tissues and the delivered energy is less limited by desiccation of heated tissues. While there are insufficient data, especially because of a lack of studies with mid- to long-term follow-up, to determine the oncologic effectiveness of MWA, this technique appears safe and effective for the ablation of T1 renal tumors. There is evidence for using mid-level settings based on experimental and clinical data. Power set at 50-65W for 5-15min appears adequate in kidney but close clinical and imaging follow-up have to be performed. Renal MWA offers theoretical advantages by comparison with other available techniques to treat renal tumors. However, MWA suffers of less cumulative data compared to radiofrequency ablation or cryoablation. Moreover, microwaves still require further studies to identify the optimal tumor characteristics and device settings leading to predictable ablation. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  13. Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Mizandari, Malkhaz [Tbilisi State Medical University, Department of Radiology (Georgia); Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk; Xi Feng [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Ao Guokun [The 309 Hospital of Chinese PLA, Department of Radiology (China); Kyriakides, Charis [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Dickinson, Robert [Imperial College London, Department of Bioengineering (United Kingdom); Nicholls, Joanna; Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom)

    2013-06-15

    Purpose. Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. Methods. Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. Results. Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14-260) days and median stent patency of 84.5 (range 14-260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14-260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38-210) days. Conclusions. In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies.

  14. Utility of intracardiac echocardiography for catheter ablation of complex cardiac arrhythmias in a medium-volume training center.

    Science.gov (United States)

    Filgueiras-Rama, David; de Torres-Alba, Fernando; Castrejón-Castrejón, Sergio; Estrada, Alejandro; Figueroa, Jorge; Salvador-Montañés, Óscar; López, Teresa; Moreno-Yanguela, Mar; López Sendón, José L; Merino, José L

    2015-04-01

    New electrophysiology tools like intracardiac echocardiography (ICE) might help to minimize and early detect complications during cardiac ablation procedures. The aim of the study was to assess the utility and vascular safety of ICE during catheter ablation of complex cardiac arrhythmias in a medium-volume training center. Prospective, observational study consisted of consecutive patients who underwent catheter-based ablation of complex cardiac arrhythmias. All procedures were performed using three-dimensional electro-anatomical mapping and routine cannulation of right and left femoral veins. The ICE probe was initially positioned at the mid-level of the right atrium and properly moved to monitor different steps of the procedure and identify complications. All procedure-related vascular complications were registered. One hundred two patients (age 61.4 ± 13.1 years, 69 male) underwent 110 ablation procedures. Pulmonary vein isolation was the most common ablation substrate (55.4%). Ventricular tachycardia (17.2%) and left atrial flutter procedures (16.4%) were also common. The use of ICE enabled us to early initiate anticoagulation and to optimize the transseptal puncture. It also provided the capability to early detect life-threatening complications such as tamponade (3.6%), along with important information during the procedure such as exact catheter location, lesion formation, and stability during radiofrequency delivery. Such benefits were not associated with a higher number of vascular complications. The use of ICE during catheter-based ablation of complex cardiac substrates provides technical features that may decrease complications and increase accuracy while applying radiofrequency, especially in training centers where fellows start to perform complex procedures. © 2014, Wiley Periodicals, Inc.

  15. Percutaneous radiofrequency ablation of osteoid osteomas. Technique and results; Perkutane Radiofrequenzablation von Osteoidosteomen. Technik und Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Bruners, P.; Penzkofer, T. [Lehrstuhl fuer Angewandte Medizintechnik, Helmholtz Inst. fuer Biomedizinische Technik, RWTH Aachen (Germany); Guenther, R. W.; Mahnken, A. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum RWTH Aachen (Germany)

    2009-08-15

    Purpose: Osteoid osteoma is a benign primary bone tumor that typically occurs in children and young adults. Besides local pain, which is often worse at night, prompt relief due to medication with acetylsalicylic acid (ASS) is characteristic for this bone lesion. Because long-term medication with ASS does not represent an alternative treatment strategy due to its potentially severe side effects, different minimally invasive image-guided techniques for the therapy of osteoid osteoma have been developed. In this context radiofrequency (RF) ablation in particular has become part of the clinical routine. The technique and results of image-guided RF ablation are compared to alternative treatment strategies. Materials and Methods: Using this technique, an often needle-shaped RF applicator is percutaneously placed into the tumor under image guidance. Then a high-frequency alternating current is applied by the tip of the applicator which leads to ionic motion within the tissue resulting in local heat development and thus in thermal destruction of the surrounding tissue including the tumor. Results: The published primary and secondary success rates of this technique are 87 and 83%, respectively. Surgical resection and open curettage show comparable success rates but are associated with higher complication rates. In addition image-guided RF ablation of osteoid osteomas is associated with low costs. (orig.)

  16. Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Dong; Yoon, Seong Guk; Sung, Gyung Tak [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2012-09-15

    To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs). Percutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy. Technical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases. RFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control.

  17. Utility of Esophageal Temperature Monitoring During Pulmonary Vein Isolation for Atrial Fibrillation Using Duty-Cycled Phased Radiofrequency Ablation

    NARCIS (Netherlands)

    Deneke, Thomas; Bünz, Kathrin; Bastian, Annely; Päsler, Marcus; Anders, Helge; Lehmann, Rainer; Meuser, Wolfgang; de Groot, Joris R.; Horlitz, Marc; Haberkorn, Ron; Mügge, Andreas; Shin, Dong-In

    2011-01-01

    Methods and Results: Ninety consecutive patients undergoing PV-isolation were evaluated. Group A (48 patients) had continuous luminal esophageal temperature (LET) monitoring using a temperature probe with 3 metal electrodes located in the vicinity of the targeted PV ostia. Ablation ceased when LET

  18. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Manenti, Guglielmo; Perretta, Tommaso; Gaspari, Eleonora; Pistolese, Chiara A.; Scarano, Lia; Cossu, Elsa; Simonetti, Giovanni; Masala, Salvatore [University Hospital ' ' Tor Vergata' ' , Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Rome (Italy); Bonanno, Elena [University Hospital ' ' Tor Vergata' ' , Department of Biopathology, Rome (Italy); Buonomo, Oreste C.; Petrella, Giuseppe [University Hospital ' ' Tor Vergata' ' , Department of General Surgery Division, Rome (Italy)

    2011-11-15

    To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy. Fifteen women with a mean age of 73 {+-} 5 years (range 64-82 years) and lesion diameter of 8 {+-} 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation. The iceball size generated by the cryoprobe during the procedure at minus 40 C was 16 x 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe. The percutaneous cryoablation as a ''minimally invasive'' technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices. (orig.)

  19. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

    International Nuclear Information System (INIS)

    Manenti, Guglielmo; Perretta, Tommaso; Gaspari, Eleonora; Pistolese, Chiara A.; Scarano, Lia; Cossu, Elsa; Simonetti, Giovanni; Masala, Salvatore; Bonanno, Elena; Buonomo, Oreste C.; Petrella, Giuseppe

    2011-01-01

    To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy. Fifteen women with a mean age of 73 ± 5 years (range 64-82 years) and lesion diameter of 8 ± 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation. The iceball size generated by the cryoprobe during the procedure at minus 40 C was 16 x 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe. The percutaneous cryoablation as a ''minimally invasive'' technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices. (orig.)

  20. Studies and comparison of currently utilized models for ablation in Electrothermal-chemical guns

    Science.gov (United States)

    Jia, Shenli; Li, Rui; Li, Xingwen

    2009-10-01

    Wall ablation is a key process taking place in the capillary plasma generator in Electrothermal-Chemical (ETC) guns, whose characteristic directly decides the generator's performance. In the present article, this ablation process is theoretically studied. Currently widely used mathematical models designed to describe such process are analyzed and compared, including a recently developed kinetic model which takes into account the unsteady state in plasma-wall transition region by dividing it into two sub-layers, a Knudsen layer and a collision dominated non-equilibrium Hydrodynamic layer, a model based on Langmuir Law, as well as a simplified model widely used in arc-wall interaction process in circuit breakers, which assumes a proportional factor and an ablation enthalpy obtained empirically. Bulk plasma state and parameters are assumed to be consistent while analyzing and comparing each model, in order to take into consideration only the difference caused by model itself. Finally ablation rate is calculated in each method respectively and differences are discussed.

  1. The Results of Ultrasonography-Guided Percutaneous Radiofrequency Ablation in Hyperparathyroid Patients in Whom Surgery Is Not Feasible

    Energy Technology Data Exchange (ETDEWEB)

    Sormaz, Ismail Cem, E-mail: icsormaz@gmail.com [Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery (Turkey); Poyanlı, Arzu, E-mail: arzupoyanli@yahoo.com [Istanbul University, Istanbul Faculty of Medicine, Department of Radiology (Turkey); Açar, Sami, E-mail: acarrsami@gmail.com [Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery (Turkey); İşcan, Ahmet Yalın, E-mail: yaliniscan@gmail.com [Fatih Sultan Mehmet Research and Education Hospital, Department of General Surgery (Turkey); Ozgur, İlker, E-mail: dr.ilkerozgur@gmail.com; Tunca, Fatih, E-mail: drfatihtunca@yahoo.com; Senyürek, Yasemin Giles, E-mail: yasemin.senyurek@gmail.com [Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery (Turkey)

    2017-04-15

    BackgroundThe aim of the study was to evaluate the results of ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) in hyperparathyroid patients who refused surgery or had high surgical risks.Patients and MethodsFive patients with hyperparathyroidism (HPT) underwent US-guided RFA for a single hyperfunctioning parathyroid lesion. Post-ablation serum calcium and parathormone (PTH) assays were performed. All patients underwent imaging studies 6 months after the ablation to visualize the post-ablation change in the size of the treated parathyroid lesions.ResultsAll patients were normocalcemic on the post-ablation 1st day and 6th month. The post-ablation PTH levels were normal in three patients but remained elevated in two patients. The size of the parathyroid lesion was ≥30 mm in the two patients with elevated PTH, whereas the lesion was smaller than 30 mm in those with normal post-ablation PTH values.ConclusionAlthough this is a limited case series, it demonstrates the potential feasibility of RFA for HPT. Benefits were achieved particularly in patients with small parathyroid lesions.

  2. The Results of Ultrasonography-Guided Percutaneous Radiofrequency Ablation in Hyperparathyroid Patients in Whom Surgery Is Not Feasible

    International Nuclear Information System (INIS)

    Sormaz, Ismail Cem; Poyanlı, Arzu; Açar, Sami; İşcan, Ahmet Yalın; Ozgur, İlker; Tunca, Fatih; Senyürek, Yasemin Giles

    2017-01-01

    BackgroundThe aim of the study was to evaluate the results of ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) in hyperparathyroid patients who refused surgery or had high surgical risks.Patients and MethodsFive patients with hyperparathyroidism (HPT) underwent US-guided RFA for a single hyperfunctioning parathyroid lesion. Post-ablation serum calcium and parathormone (PTH) assays were performed. All patients underwent imaging studies 6 months after the ablation to visualize the post-ablation change in the size of the treated parathyroid lesions.ResultsAll patients were normocalcemic on the post-ablation 1st day and 6th month. The post-ablation PTH levels were normal in three patients but remained elevated in two patients. The size of the parathyroid lesion was ≥30 mm in the two patients with elevated PTH, whereas the lesion was smaller than 30 mm in those with normal post-ablation PTH values.ConclusionAlthough this is a limited case series, it demonstrates the potential feasibility of RFA for HPT. Benefits were achieved particularly in patients with small parathyroid lesions.

  3. CT-guided radiofrequency (RF) ablation of osteoid osteoma. Clinical long-term results; CT-gesteuerte Radiofrequenz(RF)-Ablation von Osteoidosteomen. Klinische Langzeitergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Diethard; Clasen, S.; Schaefer, J.F.; Rempp, H.; Koenig, C.W.; Claussen, C.D. [Universitaetsklinikum Tuebingen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Duda, S.; Truebenbach, J. [Juedisches Krankenhaus, Berlin (Germany). Radiologen Praxis; Erdtmann, B. [Radiologie Zentrum Stuttgart, Bad Cannstatt (Germany). Praxis; Pereira, P.L. [SLK-Kliniken, Heilbronn (Germany). Klinik fuer Radiologie, Minimal-Invasive Therapien und Nuklearmedizin

    2011-04-15

    Purpose: To evaluate CT-guided radiofrequency (RF) ablation of osteoid osteoma using internally cooled monopolar RF electrodes for technical success, complications and clinical long-term success. Materials and Methods: Between April 1999 and July 2009, 23 patients were treated under general anesthesia with CT-guided RF ablation using an internally cooled monopolar single RF electrode (Cool-tip, Valleylab, TycoHealthcare, Boulder, USA; active tip: 10 mm). For the removal of the nidus, we used either a manual or an automated drill. The technical success was evaluated by a CT scan (MSCT, Siemens Medical Solutions, Forchheim). The clinical long-term success was investigated by questioning patients prior to discharge, and after 6, 12 and 18 months. After 18 months, patients were interviewed on an annual basis. Results: The technical success rate was 100 %. The nidus was located in n = 19 cases at the lower extremity and in n = 4 cases at the upper extremity. Minor complications were observed for n = 2 patients. The mean hospitalization time was 1.5 d (1-2 d). The mean follow-up was 75.9 months (18-120 months) for n = 23 patients. No local recurrence was observed. One patient had intermediate pain one week after RF ablation without recurrent symptoms. Conclusion: CT-guided RF ablation using an internally cooled monopolar single RF electrode is an effective and safe minimally invasive method for the treatment of osteoid osteoma with excellent clinical long-term success. (orig.)

  4. Utility of intracardiac ultrasound imaging to guide pulmonary vein ablation using laser balloon catheter.

    Science.gov (United States)

    Leite, Luiz; Su, Wilber; Johnson, Susan B; Milton, Mark; Henz, Benhur; Sarabanda, Alvaro; Santos, Simone N; Packer, Douglas L

    2009-12-01

    Pulmonary vein isolation (PVI) with balloon catheter has been used as the endpoint for AF ablation. To determine the usefulness of intracardiac ultrasound (ICUS) to guide PVI using laser balloon catheter. 59 PVs were ablated in 27 dogs. Doppler imaging was used to identify blood flow leaks between PV and balloon. After each energy delivery, the circular mapping catheter was repositioned to check if isolation had been achieved. The leak position was then correlated with the gap position at the pathological study. Multivariate logistic regression analysis was undertaken. 59 PV were ablated. Mean burn time was 279+/-177 sec, mean balloon diameter was 23+/-3 mm, and mean balloon length was 25+/-4 mm. Complete isolation was achieved in 38/59 (64%) cases, and it was significantly more common when there was no leak: [30/38 (79%) versus 8/23 (35%), p<0.001]. This occurred regardless of time of laser application (302+/-223 sec. vs. 266+/-148 sec., p=ns), laser power (3.5 W/cm, 4.5 W/cm, and 5.5 W/cm), balloon diameter (24+/- 3 mm vs. 22+/- 3 mm, p=ns) and length (27+/-4 mm vs. 24+/-4mm, p=ns). The positive predictive value for predicting incomplete isolation was 65% and the negative predictive value was 83%. An identifiable leak between PV and the LBA device seen at the ICUS is predictive of lower PV isolation rates. ICUS may be useful for leak detection to avoid ineffective energy application during circumferential PV ablation. This could also be helpful when other types of energy are used.

  5. Laser ablation of lung metastases: results according to diameter and location

    International Nuclear Information System (INIS)

    Weigel, Christiane; Rosenberg, Christian; Langner, Soenke; Froehlich, Claus-Peter; Hosten, Norbert

    2006-01-01

    Lung tumour ablation with a thin-calibre laser applicator system was evaluated. We quantified feasibility, technical success and complication rates in relation to lesion diameter and location. Forty-two patients with 64 lung tumours were treated (39 patients with metastases and three with primary tumours). Mean follow-up was 7.6 months (range 6 weeks to 39 months). Eighty-six percent of treatments were technically successful in the first session. Pneumothorax was the main complication and occurred in 50% of the first 20 patients and in 35% of the rest. Two patients required a chest tube. Fourteen lesions were central and 50 were peripheral. It took several weeks for the effect of the therapy to become apparent on follow-up CT. Thirty-nine percent of all lesions increased in size immediately after treatment. Gross reduction in size with scar formation was seen in 50% of the lesions and cavitation in 13%. Local tumour control was achieved in 51 lesions. Progression after therapy was seen in 9% of lesions <1.5 cm but in more than 11% of larger lesions. Progression was also more frequent in lesions located in the basal parts of the lung (47%). Sixteen patients died due to systemic progression. Our results suggest that successful laser ablation of lung lesions is possible with a miniaturized applicator. (orig.)

  6. Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Scott M., E-mail: Thompson.scott@mayo.edu [Mayo Clinic, Mayo Graduate School, Mayo Medical School and the Mayo Clinic Medical Scientist Training Program, College of Medicine (United States); Callstrom, Matthew R., E-mail: callstrom.matthew@mayo.edu; McKusick, Michael A., E-mail: mckusick.michael@mayo.edu; Woodrum, David A., E-mail: woodrum.david@mayo.edu [Mayo Clinic, Department of Radiology, College of Medicine (United States)

    2015-10-15

    PurposeThe purpose of this study was to determine the feasibility, safety, and early effectiveness of percutaneous image-guided ablation as second-line treatment for symptomatic soft-tissue vascular anomalies (VA).Materials and MethodsAn IRB-approved retrospective review was undertaken of all patients who underwent percutaneous image-guided ablation as second-line therapy for treatment of symptomatic soft-tissue VA during the period from 1/1/2008 to 5/20/2014. US/CT- or MRI-guided and monitored cryoablation or MRI-guided and monitored laser ablation was performed. Clinical follow-up began at one-month post-ablation.ResultsEight patients with nine torso or lower extremity VA were treated with US/CT (N = 4) or MRI-guided (N = 2) cryoablation or MRI-guided laser ablation (N = 5) for moderate to severe pain (N = 7) or diffuse bleeding secondary to hemangioma–thrombocytopenia syndrome (N = 1). The median maximal diameter was 9.0 cm (6.5–11.1 cm) and 2.5 cm (2.3–5.3 cm) for VA undergoing cryoablation and laser ablation, respectively. Seven VA were ablated in one session, one VA initially treated with MRI-guided cryoablation for severe pain was re-treated with MRI-guided laser ablation due to persistent moderate pain, and one VA was treated in a planned two-stage session due to large VA size. At an average follow-up of 19.8 months (range 2–62 months), 7 of 7 patients with painful VA reported symptomatic pain relief. There was no recurrence of bleeding at five-year post-ablation in the patient with hemangioma–thrombocytopenia syndrome. There were two minor complications and no major complications.ConclusionImage-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA.

  7. Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies

    International Nuclear Information System (INIS)

    Thompson, Scott M.; Callstrom, Matthew R.; McKusick, Michael A.; Woodrum, David A.

    2015-01-01

    PurposeThe purpose of this study was to determine the feasibility, safety, and early effectiveness of percutaneous image-guided ablation as second-line treatment for symptomatic soft-tissue vascular anomalies (VA).Materials and MethodsAn IRB-approved retrospective review was undertaken of all patients who underwent percutaneous image-guided ablation as second-line therapy for treatment of symptomatic soft-tissue VA during the period from 1/1/2008 to 5/20/2014. US/CT- or MRI-guided and monitored cryoablation or MRI-guided and monitored laser ablation was performed. Clinical follow-up began at one-month post-ablation.ResultsEight patients with nine torso or lower extremity VA were treated with US/CT (N = 4) or MRI-guided (N = 2) cryoablation or MRI-guided laser ablation (N = 5) for moderate to severe pain (N = 7) or diffuse bleeding secondary to hemangioma–thrombocytopenia syndrome (N = 1). The median maximal diameter was 9.0 cm (6.5–11.1 cm) and 2.5 cm (2.3–5.3 cm) for VA undergoing cryoablation and laser ablation, respectively. Seven VA were ablated in one session, one VA initially treated with MRI-guided cryoablation for severe pain was re-treated with MRI-guided laser ablation due to persistent moderate pain, and one VA was treated in a planned two-stage session due to large VA size. At an average follow-up of 19.8 months (range 2–62 months), 7 of 7 patients with painful VA reported symptomatic pain relief. There was no recurrence of bleeding at five-year post-ablation in the patient with hemangioma–thrombocytopenia syndrome. There were two minor complications and no major complications.ConclusionImage-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA

  8. Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter

    Directory of Open Access Journals (Sweden)

    Braithwaite SA

    2014-06-01

    Full Text Available Simon A Braithwaite,1 Bruce D Braithwaite2 1University College Hospital Medical School, London, UK; 2Department of Cardiovascular Medicine, University of Nottingham, Nottingham, UK Abstract: The Closure Fast™ Endovenous Radiofrequency Ablation Catheter is the latest version of a minimally invasive system for the treatment of patients with superficial venous disease. The Closure Fast™ catheter heats the vein wall to 120°C, causing denaturation of the collagen of the vein wall and contraction of the vessel such that no blood can flow through it. Nearly one million systems have been sold since the product was launched. Many, if not all, patients can be treated under local anesthesia with the Closure Fast™ catheter. Duplex ultrasound reports occlusion rates for the treated vein of 94%–98% at 1 year and 85%–93% at 3 years. The system produces average postoperative pain scores of less than 2 out of 10 on a visual analog score. In the first postoperative week, 76% of patients do not require analgesia. Some 45% of patients return to normal activity on the first postoperative day. Serious complications appear to be rare following the Closure Fast™ procedure. Transient paresthesia occurs in 0.2% of cases, thrombophlebitis in 1%–10%, and thromboembolic events in up to 1.4%, mainly heat-induced thrombosis. Closure Fast™ adds significant costs to treating superficial venous disease but studies have shown it to be cost-effective when used in an office setting. Keywords: Closure Fast, catheter, Endovenous Radiofrequency Ablation Catheter

  9. Preliminary results of laser ablation of the prostate versus TURP: a randomized study

    Science.gov (United States)

    Shaffer, Brian S.; Costello, Anthony J.

    1993-05-01

    Preliminary results of a randomized study comparing laser ablation of the prostate (LAP) to transurethral resection of the prostate (TURP) for the treatment of symptomatic benign prostatic hyperplasia are reviewed. Forty-five men enrolled in the study had a minimum 6 week followup. Preoperative AUA symptom scores, peak urinary flow rates, and post-void residual urines (PVR) were compared to postoperative values. The TURP group (22 men) did better than its LAP cohort (23 men) with a mean decrease in symptom score of 70% versus 47%, a mean increase in flow rate of 83% versus 53%, and a mean decrease in PVR of 51% versus 28%, respectively, at 12 weeks. LAP patients had less complications associated with impotence and retrograde ejaculation, required urethral catheters for less time, and had shorter hospital stays. With the development of more durable and reflective fibers the difference in efficacy between TURP and LAP should diminish while the benefits of LAP are preserved.

  10. Ablation of the Ferroptosis Inhibitor Glutathione Peroxidase 4 in Neurons Results in Rapid Motor Neuron Degeneration and Paralysis*

    Science.gov (United States)

    Chen, Liuji; Hambright, William Sealy; Na, Ren; Ran, Qitao

    2015-01-01

    Glutathione peroxidase 4 (GPX4), an antioxidant defense enzyme active in repairing oxidative damage to lipids, is a key inhibitor of ferroptosis, a non-apoptotic form of cell death involving lipid reactive oxygen species. Here we show that GPX4 is essential for motor neuron health and survival in vivo. Conditional ablation of Gpx4 in neurons of adult mice resulted in rapid onset and progression of paralysis and death. Pathological inspection revealed that the paralyzed mice had a dramatic degeneration of motor neurons in the spinal cord but had no overt neuron degeneration in the cerebral cortex. Consistent with the role of GPX4 as a ferroptosis inhibitor, spinal motor neuron degeneration induced by Gpx4 ablation exhibited features of ferroptosis, including no caspase-3 activation, no TUNEL staining, activation of ERKs, and elevated spinal inflammation. Supplementation with vitamin E, another inhibitor of ferroptosis, delayed the onset of paralysis and death induced by Gpx4 ablation. Also, lipid peroxidation and mitochondrial dysfunction appeared to be involved in ferroptosis of motor neurons induced by Gpx4 ablation. Taken together, the dramatic motor neuron degeneration and paralysis induced by Gpx4 ablation suggest that ferroptosis inhibition by GPX4 is essential for motor neuron health and survival in vivo. PMID:26400084

  11. Ablation of the Ferroptosis Inhibitor Glutathione Peroxidase 4 in Neurons Results in Rapid Motor Neuron Degeneration and Paralysis.

    Science.gov (United States)

    Chen, Liuji; Hambright, William Sealy; Na, Ren; Ran, Qitao

    2015-11-20

    Glutathione peroxidase 4 (GPX4), an antioxidant defense enzyme active in repairing oxidative damage to lipids, is a key inhibitor of ferroptosis, a non-apoptotic form of cell death involving lipid reactive oxygen species. Here we show that GPX4 is essential for motor neuron health and survival in vivo. Conditional ablation of Gpx4 in neurons of adult mice resulted in rapid onset and progression of paralysis and death. Pathological inspection revealed that the paralyzed mice had a dramatic degeneration of motor neurons in the spinal cord but had no overt neuron degeneration in the cerebral cortex. Consistent with the role of GPX4 as a ferroptosis inhibitor, spinal motor neuron degeneration induced by Gpx4 ablation exhibited features of ferroptosis, including no caspase-3 activation, no TUNEL staining, activation of ERKs, and elevated spinal inflammation. Supplementation with vitamin E, another inhibitor of ferroptosis, delayed the onset of paralysis and death induced by Gpx4 ablation. Also, lipid peroxidation and mitochondrial dysfunction appeared to be involved in ferroptosis of motor neurons induced by Gpx4 ablation. Taken together, the dramatic motor neuron degeneration and paralysis induced by Gpx4 ablation suggest that ferroptosis inhibition by GPX4 is essential for motor neuron health and survival in vivo. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  12. Epiphysiodesis Made with Radio Frequency Ablation: First Results From a Pilot Study

    DEFF Research Database (Denmark)

    Shiguetomi Medina, Juan Manuel; Gottliebsen, Martin; Rahbek, Ole

    for a reliable and precise procedure which overcomes the complications. Development of a new technique for epiphysiodesis using radiofrequency ablation on an animal model that involves less scarring, less exposure to X-rays, and reduces the risk of injuring the surrounding structures compared to current methods....... 3 non-mature 40 kg pigs were used. A control leg was randomly selected and the contralateral treated at two ablation sites (lateral and medial) identified at the proximal tibia growth plate using x-ray. A probe was inserted and the ablation performed. MR images were performed right after...... the procedure and 12 weeks later. The length of both tibiae was measured. Both legs were equal at the beginning of the study and there was a leg length difference of around 4mm at the end. No damage to the surrounding cartilage structures was found. Epiphysiodesis using radio frequency ablation is an innovative...

  13. Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

    Energy Technology Data Exchange (ETDEWEB)

    Veltri, Andrea; Fazio, Giuseppina De; Malfitana, Valeria; Isolato, Giuseppe; Gandini, Giovanni [University of Turin, Institute of Diagnostic and Interventional Radiology, Turin (Italy); Fontana, Dario; Tizzani, Alessandro [University of Turin, Institute of Urology, Turin (Italy)

    2004-12-01

    Minimally invasive treatment for small renal cell carcinoma (RCC) can be necessary in selected patients and, anyway, is desirable. In situ ablation techniques, including RFA, have been developed. The aim of this study is to evaluate the feasibility, safety and short-term local effectiveness of percutaneous US-guided RFA in a small series, as well as mid-term patient outcome. Thirteen patients with a total of 18 tumors (17 small lesions, 35 mm in size or less, and a larger one, 75 mm in size) underwent 19 RFA sessions. Seven patients had a solitary kidney, and three suffered from VHL disease, too. We treated four lesions in a patient with a bilateral tumor. In another patient, three lesions were ablated. Seventeen tumors were RCC; one was a metastasis from lung cancer. Eight lesions were parenchymal, six exophytic, two parenchymal/exophytic, one parenchymal/central and one central. A monopolar RF system with multitined expandable electrode needles was used. The 35-mm lesion underwent two sessions; the 75-mm lesion was treated with transcatheter arterial embolization before RFA. Tumors with complete loss of contrast enhancement at short-term CT (or MR) were considered successfully treated. Percutaneous US-guided RFA was always feasible without major complications. The success rate after a single treatment in tumors less than 35 mm in size was 88.2% (15/17) and rose to 94.1% (16/17) after the second treatment of the largest lesion. After a mean 14-month follow-up, no successfully treated lesions recurred locally. Only the patient with metastasis from lung cancer died from disease progression in a further location, while all other patients are alive, with renal function still sufficient to avoid dialysis. US guidance allows an easy and safe percutaneous approach for RFA of small non-parahilar RCC. The treatment is locally effective and can be proposed as a minimally invasive therapy for patients with contraindications to surgery or to those expressing an informed

  14. Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

    International Nuclear Information System (INIS)

    Veltri, Andrea; Fazio, Giuseppina De; Malfitana, Valeria; Isolato, Giuseppe; Gandini, Giovanni; Fontana, Dario; Tizzani, Alessandro

    2004-01-01

    Minimally invasive treatment for small renal cell carcinoma (RCC) can be necessary in selected patients and, anyway, is desirable. In situ ablation techniques, including RFA, have been developed. The aim of this study is to evaluate the feasibility, safety and short-term local effectiveness of percutaneous US-guided RFA in a small series, as well as mid-term patient outcome. Thirteen patients with a total of 18 tumors (17 small lesions, 35 mm in size or less, and a larger one, 75 mm in size) underwent 19 RFA sessions. Seven patients had a solitary kidney, and three suffered from VHL disease, too. We treated four lesions in a patient with a bilateral tumor. In another patient, three lesions were ablated. Seventeen tumors were RCC; one was a metastasis from lung cancer. Eight lesions were parenchymal, six exophytic, two parenchymal/exophytic, one parenchymal/central and one central. A monopolar RF system with multitined expandable electrode needles was used. The 35-mm lesion underwent two sessions; the 75-mm lesion was treated with transcatheter arterial embolization before RFA. Tumors with complete loss of contrast enhancement at short-term CT (or MR) were considered successfully treated. Percutaneous US-guided RFA was always feasible without major complications. The success rate after a single treatment in tumors less than 35 mm in size was 88.2% (15/17) and rose to 94.1% (16/17) after the second treatment of the largest lesion. After a mean 14-month follow-up, no successfully treated lesions recurred locally. Only the patient with metastasis from lung cancer died from disease progression in a further location, while all other patients are alive, with renal function still sufficient to avoid dialysis. US guidance allows an easy and safe percutaneous approach for RFA of small non-parahilar RCC. The treatment is locally effective and can be proposed as a minimally invasive therapy for patients with contraindications to surgery or to those expressing an informed

  15. Long-term Results after CT-Guided Percutaneous Ethanol Ablation for the Treatment of Hyperfunctioning Adrenal Disorders

    Directory of Open Access Journals (Sweden)

    Nathan Elie Frenk

    Full Text Available OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. RESULTS: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macronodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. CONCLUSION: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyperfunctioning adrenal disorders and is not without risks.

  16. The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

    Directory of Open Access Journals (Sweden)

    Abdurrahim Çolak

    Full Text Available Abstract Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74 underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90% were in NYHA class III; 34 (85% patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.

  17. Long-term results after CT-guided percutaneous ethanol ablation for the treatment of hyper functioning adrenal disorders

    International Nuclear Information System (INIS)

    Frenk, Nathan Elie; Sebastianes, Fernando; Lerario, Antonio Marcondes; Fragoso, Maria Candida Barisson Villares; Mendonca, Berenice Bilharinho

    2016-01-01

    Objectives: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyper functioning adrenal disorders. Method: We retrospectively evaluated the long-term results of nine patients treated with computed tomography guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macro nodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. Results: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macro nodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. Conclusion: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyper functioning adrenal disorders and is not without risks. (author)

  18. Long-term results after CT-guided percutaneous ethanol ablation for the treatment of hyper functioning adrenal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Frenk, Nathan Elie; Sebastianes, Fernando; Lerario, Antonio Marcondes; Fragoso, Maria Candida Barisson Villares; Mendonca, Berenice Bilharinho [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina; Menezes, Marcos Roberto de, E-mail: menezesmr@gmail.com [Instituto do Cancer do Estado de Sao Paulo, SP (Brazil)

    2016-10-15

    Objectives: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyper functioning adrenal disorders. Method: We retrospectively evaluated the long-term results of nine patients treated with computed tomography guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macro nodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment. Eleven sessions were performed for the nine patients. The patient data were reviewed for the clinical outcome and procedure-related complications over ten years. Results: Patients with aldosterone-producing adenoma had clinical improvement: symptoms recurred in one case 96 months after ethanol ablation, and the other patient was still in remission 110 months later. All patients with pheochromocytoma had clinical improvement but were eventually submitted to surgery for complete remission. No significant clinical improvement was seen in patients with hypercortisolism due to primary macro nodular adrenal hyperplasia or Cushing disease. Major complications were seen in five of the eleven procedures and included cardiovascular instability and myocardial infarction. Minor complications attributed to sedation were seen in two patients. Conclusion: Computed tomography-guided ethanol ablation does not appear to be suitable for the long-term treatment of hyper functioning adrenal disorders and is not without risks. (author)

  19. Atrioventricular nodal ablation in patients with resynchronization therapy and atrial fibrillation - long term results.

    Science.gov (United States)

    Aune, Arleen; Færestrand, Svein; Hoff, Per Ivar; Schuster, Peter

    2017-06-01

    Atrioventricular nodal ablation (AVNA) is recommended for patients (pts) with cardiac resynchronization therapy (CRT) having atrial fibrillation (AF) and incomplete ventricular capture (Class IIa, level B). AVNA reduces mortality and improves the New York Heart Association (NYHA) functional class during intermediate term follow-up. The objectives were to study the long-term outcome regarding quality of life (QoL) and survival of our CRT pts after AVNA. 37 CRT-pts undergoing AVNA due to inadequate biventricular pacing were included in the study. Data were retrospectively obtained from clinical records and through telephone interviews. Twenty pts died during the follow-up period of average 30.6 ± 24 months. After AVNA the ventricular capture improved significantly from 68.4 ± 23% to 98.5 ± 2% (p < 0.001). A significant and sustained improvement of average 0.3 ± 0.5 (p = 0.001) in NYHA functional class was found. Additionally a large percentage of pts discontinued taking rate reducing drugs with potential severe side effects. AVNA in CRT pts was safe and effective. The treatment resulted in a sustained improvement in QoL, including long-term improvement in NYHA functional class.

  20. MR-guided microwave ablation in hepatic tumours: initial results in clinical routine

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Ruediger; Rempp, Hansjoerg; Kessler, David-Emanuel; Weiss, Jakob; Nikolaou, Konstantin; Clasen, Stephan [Eberhard-Karls-University, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Pereira, Philippe L. [SLK-Kliniken Heilbronn GmbH, Department of Radiology, Minimally Invasive Therapies and Nuclear Medicine, Heilbronn (Germany)

    2017-04-15

    Evaluation of the technical success, patient safety and technical effectiveness of magnetic resonance (MR)-guided microwave ablation of hepatic malignancies. Institutional review board approval and informed patient consent were obtained. Fifteen patients (59.8 years ± 9.5) with 18 hepatic malignancies (7 hepatocellular carcinomas, 11 metastases) underwent MR-guided microwave ablation using a 1.5-T MR system. Mean tumour size was 15.4 mm ± 7.7 (7-37 mm). Technical success and ablation zone diameters were assessed by post-ablative MR imaging. Technique effectiveness was assessed after 1 month. Complications were classified according to the Common Terminology Criteria for Adverse Events (CTCAE). Mean follow-up was 5.8 months ± 2.6 (1-10 months). Technical success and technique effectiveness were achieved in all lesions. Lesions were treated using 2.5 ± 1.2 applicator positions. Mean energy and ablation duration per tumour were 37.6 kJ ± 21.7 (9-87 kJ) and 24.7 min ± 11.1 (7-49 min), respectively. Coagulation zone short- and long-axis diameters were 31.5 mm ± 10.5 (16-65 mm) and 52.7 mm ± 15.4 (27-94 mm), respectively. Two CTCAE-2-complications occurred (pneumothorax, pleural effusion). Seven patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed. Microwave ablation is feasible under near real-time MR guidance and provides effective treatment of hepatic malignancies in one session. (orig.)

  1. Catheter ablation of pediatric AV nodal reentrant tachycardia: results in small children.

    Science.gov (United States)

    Krause, Ulrich; Backhoff, David; Klehs, Sophia; Kriebel, Thomas; Paul, Thomas; Schneider, Heike E

    2015-11-01

    AV nodal reentrant tachycardia (AVNRT) is commonly encountered in pediatric patients. Definite treatment can be achieved by catheter ablation. The purpose of the study was to evaluate the efficacy and safety of AVNRT ablation focusing on children with a body weight ≤25 kg. Catheter ablation of AVNRT was attempted in 253 patients. Median age was 12.5 years; median body weight was 48.7 kg. 25 (9.9 %) children had a body weight ≤25 kg. Congenital heart disease was present in 6 patients (2.4 %). Procedural success was achieved in 98 % using radiofrequency, in 100 % using cryoenergy alone, and in 94 % using both energy sources. In patients with a body weight ≤25 kg, success was achieved in 96 %. In patients ≤25 kg, fluoroscopy and procedure duration did not differ from those >25 kg. The rate of major complications was significantly higher in the patients ≤25 kg (12 vs. 2.2 %, p = 0.04). Permanent AV block after RF ablation occurred in 2 patients with congenital heart disease and one infant with a body weight of 8.7 kg. Catheter ablation of AVNRT in children and adolescents was safe and effective. Infants and small children with a body weight ≤25 kg had a higher prevalence of serious complications. This should alert physicians in decision making toward catheter ablation in these patients. In patients with congenital heart disease and different anatomy of the cardiac conduction system, operators must be aware of an increased risk for AV block.

  2. X-ray lasing as a result of an induced instability in an ablative capillary discharge

    NARCIS (Netherlands)

    Ellwi, S. S.; Juschkin, L.; Ferri, S.; Kunze, H. J.; Koshelev, K. N.; E. Louis,

    2001-01-01

    We report lasing of the CVI Balmer-alpha line at 18.22 nm using the new technique of an induced MHD instability in an ablative capillary discharge. A large spike of this line during the second half-cycle of the discharge is observed. The spike is identified as amplified spontaneous emission (ASE),

  3. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results.

    Science.gov (United States)

    D'Onofrio, Mirko; Cardobi, Nicolò; Ruzzenente, Andrea; Conci, Simone; Ciaravino, Valentina; Guglielmi, Alfredo; Mucelli, Roberto Pozzi

    2017-08-31

    To assess the accuracy of unenhanced magnetic resonance imaging (MRI) immediately after the percutaneous ultrasound-guided radiofrequency ablation (RFA) of liver malignancy in predicting treatment efficacy at CT follow-up. Percutaneous ablation was prospectively performed in 23 liver malignancies (20 hepatocarcinomas and 3 metastases). After the procedure in the same day all patients were studied with unenhanced MRI. The best sequence to detect the coagulative necrosis was visually established. Pre-RFA CT and post-RFA MRI were registered with non-rigid transformation algorithm. Manual segmentation of lesions and ablated areas in pre-RFA CT, post-RFA MRI, and follow-up CT were obtained. Sensitivity, specificity, positive predictive value (PPV), negative predicitve value (NPV), and accuracy of MRI in predicting the correct centering and the complete treatment of the lesion were calculated in respect to the 1-month follow-up CT. Fat-saturated T1-weighted (fs T1-w) was the sequence in which the best conspicuity of the ablated area was depicted. Coagulative necrosis was hyperintense in fs T1-w sequence in 17/23 (74%). In respect to follow-up CT, MRI predicted the correct centering of the lesions in 19/20 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%, 75%, 95%, 100%, and 100%, respectively. MRI predicted the complete treatment of the lesions in 17/17 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%. MRI with the single fs T1-w sequence was highly accurate in predicting the treatment efficacy of percutaneous ablation of liver malignancies in comparison to follow-up CT control. Unnecessary CT in case of incomplete treatment can be therefore easily avoided.

  4. Results of patient specific quality assurance for patients undergoing stereotactic ablative radiotherapy for lung lesions

    International Nuclear Information System (INIS)

    Hardcastle, Nicholas; Clements, Natalie; Cramb, Jim; Wanigaratne, Derrick M.; Chesson, Brent; Aarons, Yolanda; Siva, Shankar; Ball, David; Kron, Tomas

    2014-01-01

    Hypofractionated image guided radiotherapy of extracranial targets has become increasingly popular as a treatment modality for inoperable patients with one or more small lesions, often referred to as stereotactic ablative body radiotherapy (SABR). This report details the results of the physical quality assurance (QA) program used for the first 33 lung cancer SABR radiotherapy 3D conformal treatment plans in our centre. SABR involves one or few fractions of high radiation dose delivered in many small fields or arcs with tight margins to mobile targets often delivered through heterogeneous media with non-coplanar beams. We have conducted patient-specific QA similar to the more common intensity modulated radiotherapy QA with particular reference to motion management. Individual patient QA was performed in a Perspex phantom using point dose verification with an ionisation chamber and radiochromic film for verification of the dose distribution both with static and moving detectors to verify motion management strategies. While individual beams could vary by up to 7 %, the total dose in the target was found to be within ±2 % of the prescribed dose for all 33 plans. Film measurements showed qualitative and quantitative agreement between planned and measured isodose line shapes and dimensions. The QA process highlighted the need to account for couch transmission and demonstrated that the ITV construction was appropriate for the treatment technique used. QA is essential for complex radiotherapy deliveries such as SABR. We found individual patient QA helpful in setting up the technique and understanding potential weaknesses in SABR workflow, thus providing confidence in SABR delivery.

  5. Role of [18F]FDG-PET/CT after radiofrequency ablation of liver metastases: preliminary results

    International Nuclear Information System (INIS)

    Travaini, Laura L.; Trifiro, Giuseppe; Paganelli, Giovanni; Ravasi, Laura; Monfardini, Lorenzo; Della Vigna, Paolo; Bonomo, Guido; Orsi, Franco; Chiappa, Antonio; Mallia, Andrew; Ferrari, Mahila

    2008-01-01

    Focal metastasis may be treated with radiofrequency ablation (RFA), a low invasive method yet limited by the lack of direct evidence of radicality of treatment. We, hereby, aimed at assessing the role of positron emission tomography-computed tomography (PET/CT) with fluoride radiolabeled deoxy-glucose ([ 18 F]FDG) in RFA treatment success evaluation and early diagnosis of local relapse of liver metastasis after RFA procedure. RFA was performed in nine patients on 12 liver metastasis, serially imaged through [ 18 F]FDG-PET/CT and multidetector CT (MDCT) at 1, 3, 6, and 9 months after treatment. Eight lesions were also scanned with [ 18 F]FDG-PET/CT at 1 week after treatment. Imaging analyses were performed on 47 [ 18 F]FDG-PET/CT and 51 MDCT. Imaging reading outcomes were compared to each other and to biopsy tissue results when available. In one case, [ 18 F]FDG-PET/CT revealed radiotracer uptake at RFA site a week after procedure. Negative concordant outcome was obtained on eight lesions at 1 month after RFA, on eight cases at 3 months, on four at 6 months, and on two cases at 9 months. Extra-liver (peritoneal) disease was detected in one case by both [ 18 F]FDG-PET/CT and MDCT. In seven cases, [ 18 F]FDG-PET/CT revealed the presence of local recurrence earlier than MDCT. In no cases did MDCT detect local relapse earlier than [ 18 F]FDG-PET/CT. [ 18 F]FDG-PET/CT may detect RFA treatment failure as well as local relapse after RFA earlier than MDCT. (orig.)

  6. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Doros, Attila [Semmelweis University, Radiology Unit, Department of Transplantation and Surgery (Hungary); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom)

    2013-07-11

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  7. Feasibility and potential utility of multicomponent exhaled breath analysis for predicting development of radiation pneumonitis after stereotactic ablative radiotherapy.

    Science.gov (United States)

    Moré, Jayaji M; Eclov, Neville C W; Chung, Melody P; Wynne, Jacob F; Shorter, Joanne H; Nelson, David D; Hanlon, Alexandra L; Burmeister, Robert; Banos, Peter; Maxim, Peter G; Loo, Billy W; Diehn, Maximilian

    2014-07-01

    In this prospective pilot study, we evaluated the feasibility and potential utility of measuring multiple exhaled gases as biomarkers of radiation pneumonitis (RP) in patients receiving stereotactic ablative radiotherapy (SABR) for lung tumors. Breath analysis was performed for 26 patients receiving SABR for lung tumors. Concentrations of exhaled nitric oxide (eNO), carbon monoxide (eCO), nitrous oxide (eN2O), and carbon dioxide (eCO2) were measured before and immediately after each fraction using real-time, infrared laser spectroscopy. RP development (CTCAE grade ≥2) was correlated with baseline gas concentrations, acute changes in gas concentrations after each SABR fraction, and dosimetric parameters. Exhaled breath analysis was successfully completed in 77% of patients. Five of 20 evaluable patients developed RP at a mean of 5.4 months after SABR. Acute changes in eNO and eCO concentrations, defined as percent changes between each pre-fraction and post-fraction measurement, were significantly smaller in RP versus non-RP cases (p = 0.022 and 0.015, respectively). In an exploratory analysis, a combined predictor of baseline eNO greater than 24 parts per billion and acute decrease in eCO less than 5.5% strongly correlated with RP incidence (p =0.0099). Neither eN2O nor eCO2 concentrations were significantly associated with RP development. Although generally higher in patients destined to develop RP, dosimetric parameters were not significantly associated with RP development. The majority of SABR patients in this pilot study were able to complete exhaled breath analysis. Baseline concentrations and acute changes in concentrations of exhaled breath components were associated with RP development after SABR. If our findings are validated, exhaled breath analysis may become a useful approach for noninvasive identification of patients at highest risk for developing RP after SABR.

  8. Evaluation of the Forensic Utility of Scanning Electron Microscopy-Energy Dispersive Spectroscopy and Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry for Printing Ink Examinations.

    Science.gov (United States)

    Corzo, Ruthmara; Subedi, Kiran; Trejos, Tatiana; Almirall, José R

    2016-05-01

    Improvements in printing technology have exacerbated the problem of document counterfeiting, prompting the need for analytical techniques that better characterize inks for forensic analysis and comparisons. In this study, 319 printing inks (toner, inkjet, offset, and Intaglio) were analyzed directly on the paper substrate using scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) and Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry (LA-ICP-MS). As anticipated, the high sensitivity of LA-ICP-MS pairwise comparisons resulted in excellent discrimination (average of ~ 99.6%) between different ink samples from each of the four ink types and almost 100% correct associations between ink samples known to originate from the same source. SEM-EDS analysis also resulted in very good discrimination for different toner and intaglio inks (>97%) and 100% correct association for samples from the same source. SEM-EDS provided complementary information to LA-ICP-MS for certain ink types but showed limited utility for the discrimination of inkjet and offset inks. © 2016 American Academy of Forensic Sciences.

  9. Preventive AF ablation in patients with mitral valve lesion and left atrium enlargement: 3-month follow-up results

    Directory of Open Access Journals (Sweden)

    A. V. Bogachev-Prokophiev

    2017-07-01

    Full Text Available Aim. Persistence or appearance of atrial fibrillation (AF after mitral valve surgery significantly reduces the number of excellent and good results in the long-term period. AF leads to heart failure and pulmonary hypertension and increases the risk of thromboembolic events and stroke. Drug strategies for prevention of new-onset AF in the postoperative period are well developed, while invasive methods are still under development and clinical trials. This study aims to evaluate the safety and efficacy of surgical prevention of atrial fibrillation in patients with left atrium enlargement and mitral valve (MV lesion at 3-month follow-up.Methods. Forty patients operated in our clinic over a period of 2015–2017 were included in the study. All patients had MV lesion and left atrial dilatation greater than 60 mm. All patients had a sinus rhythm at the time of the operation and no documented AF in the history. The mean age of the patients was 48.9±10.1 (23-69 years. All patients had indications for mitral valve surgery and were randomized into two groups. The first group included patients who underwent a concomitant preventive ablation procedure (n = 20. The second group included patients with isolated MV surgery (n = 20. Complications and heart rhythm were evaluated within 3 months after surgery.Results. Patients who underwent preventive ablation within 3 months after the surgery did not differ significantly in the number of complications as compared with the control. In the group of patients with preventive ablation, a higher freedom from AF in comparison with the group of patients with isolated MV surgery was observed: 95 vs. 40%, respectively. Conclusion. Preventive atrial fibrillation ablation in patients with mitral valve lesion and left atrium enlargement is a safe and effective procedure. Preventive ablation reduces the risk of atrial fibrillation by 1.6 times within 3-month follow-up.Received 24 April 2017. Accepted 28 June 2017.Funding: The

  10. Genetic ablation and short-duration inhibition of lipoxygenase results in increased macroautophagy

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Insook; Park, Sujin; Cho, Jin Won [Department of Integrated OMICS for Biomedical Science, WCU Program of Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-749 (Korea, Republic of); Yigitkanli, Kazim; Leyen, Klaus van [Neuroprotection Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 (United States); Roth, Jürgen, E-mail: jurgen.roth@bluewin.ch [Department of Integrated OMICS for Biomedical Science, WCU Program of Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-749 (Korea, Republic of)

    2014-02-15

    12/15-lipoxygenase (12/15-LOX) is involved in organelle homeostasis by degrading mitochondria in maturing red blood cells and by eliminating excess peroxisomes in liver. Furthermore, 12/15-LOX contributes to diseases by exacerbating oxidative stress-related injury, notably in stroke. Nonetheless, it is unclear what the consequences are of abolishing 12/15-LOX activity. Mice in which the alox15 gene has been ablated do not show an obvious phenotype, and LOX enzyme inhibition is not overtly detrimental. We show here that liver histology is also unremarkable. However, electron microscopy demonstrated that 12/15-LOX knockout surprisingly leads to increased macroautophagy in the liver. Not only macroautophagy but also mitophagy and pexophagy were increased in hepatocytes, which otherwise showed unaltered fine structure and organelle morphology. These findings were substantiated by immunofluorescence showing significantly increased number of LC3 puncta and by Western blotting demonstrating a significant increase for LC3-II protein in both liver and brain homogenates of 12/15-LOX knockout mice. Inhibition of 12/15-LOX activity by treatment with four structurally different inhibitors had similar effects in cultured HepG2 hepatoma cells and SH-SY5Y neuroblastoma cells with significantly increased autophagy discernable already after 2 hours. Hence, our study reveals a link between ablation or inhibition of 12/15-LOX and stimulation of macroautophagy. The enhanced macroautophagy may be related to the known tissue-protective effects of LOX ablation or inhibition under various diseased conditions caused by oxidative stress and ischemia. This could provide an important cleaning mechanism of cells and tissues to prevent accumulation of damaged mitochondria and other cellular components. - Highlights: • A relationship between lipoxygenases and autophagy is disclosed. • 12/15-lipoxygenase knockout increases autophagy in mice liver and brain. • Lipoxygenase inhibition boosts

  11. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Tins, Bernhard; Cassar-Pullicino, Victor; McCall, Iain [RJAH Orthopaedic and District Hospital, Department of Radiology, Oswestry (United Kingdom); Cool, Paul [RJAH Orthopaedic and District Hospital, Musculoskeletal Tumour Unit, Oswestry (United Kingdom); Williams, David [Hereford Hospital, Department of Orthopaedics, Hereford (United Kingdom); Mangham, David [RJAH Orthopaedic and District Hospital, Department of Pathology, Oswestry (United Kingdom)

    2006-04-15

    The standard treatment for chondroblastoma is surgery, which can be difficult and disabling due to its apo- or epiphyseal location. Radiofrequency (RF) ablation potentially offers a minimally invasive alternative. The often large size of chondroblastomas can make treatment with plain electrode systems difficult or impossible. This article describes the preliminary experience of RF treatment of chondroblastomas with a multi-tined expandable RF electrode system. Four cases of CT guided RF treatment are described. The tumour was successfully treated in all cases. In two cases, complications occurred; infraction of a subarticular chondroblastoma in one case and cartilage and bone damage in the unaffected compartment of a knee joint in the other. Radiofrequency treatment near a joint surface threatens the integrity of cartilage and therefore long-term joint function. In weight-bearing areas, the lack of bone replacement in successfully treated lesions contributes to the risk of mechanical failure. Multi-tined expandable electrode systems allow the treatment of large chondroblastomas. In weight-bearing joints and lesions near to the articular cartilage, there is a risk of cartilage damage and mechanical weakening of the bone. In lesions without these caveats, RF ablation appears promising. The potential risks and benefits need to be evaluated for each case individually. (orig.)

  12. Radiofrequency ablation in the treatment of osteoid osteoma: results and complications

    Energy Technology Data Exchange (ETDEWEB)

    Earhart, Jeffrey [Case Western Reserve University, Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH (United States); Wellman, David [Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY (United States); Donaldson, James [Feinberg School of Medicine at Northwestern University, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Chesterton, Julie [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); King, Erik [Northwestern University Feinberg School of Medicine, Department of Orthopaedic Surgery, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Janicki, Joseph A. [Northwestern University Feinberg School of Medicine, Department of Orthopaedic Surgery, Children' s Hospital of Chicago, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Orthopaedic Surgery, Chicago, IL (United States)

    2013-07-15

    Percutaneous radiofrequency ablation (RFA) for treatment of osteoid osteoma is effective and avoids the potential complications of open surgical resection. This study evaluates the efficacy of RFA at a single tertiary-care pediatric hospital and highlights an important complication. The medical records of 21 cases of RFA in 21 children between 2004 and 2010 were reviewed retrospectively for demographic data, lesion site, access point and technique for ablation, clinical outcome and complications. Clinical follow-up was available for 17/21 children (81%) at an average of 17.0 months (range 0.5-86.1 months). No persistence or recurrence of pre-procedural pain was noted. Two children (9.5%) had a complication, including a burn to the local skin and muscle requiring local wound care, and a late subtrochanteric femur fracture treated successfully with open reduction internal fixation. RFA is a safe and effective alternative to surgical resection of the osteoid osteoma nidus. When accessing the proximal femur, the risk of late post-procedural fracture must be considered and discussed with the family. An understanding of biomechanical principles in the proximal femur might provide an effective strategy for limiting this risk. (orig.)

  13. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results

    International Nuclear Information System (INIS)

    Tins, Bernhard; Cassar-Pullicino, Victor; McCall, Iain; Cool, Paul; Williams, David; Mangham, David

    2006-01-01

    The standard treatment for chondroblastoma is surgery, which can be difficult and disabling due to its apo- or epiphyseal location. Radiofrequency (RF) ablation potentially offers a minimally invasive alternative. The often large size of chondroblastomas can make treatment with plain electrode systems difficult or impossible. This article describes the preliminary experience of RF treatment of chondroblastomas with a multi-tined expandable RF electrode system. Four cases of CT guided RF treatment are described. The tumour was successfully treated in all cases. In two cases, complications occurred; infraction of a subarticular chondroblastoma in one case and cartilage and bone damage in the unaffected compartment of a knee joint in the other. Radiofrequency treatment near a joint surface threatens the integrity of cartilage and therefore long-term joint function. In weight-bearing areas, the lack of bone replacement in successfully treated lesions contributes to the risk of mechanical failure. Multi-tined expandable electrode systems allow the treatment of large chondroblastomas. In weight-bearing joints and lesions near to the articular cartilage, there is a risk of cartilage damage and mechanical weakening of the bone. In lesions without these caveats, RF ablation appears promising. The potential risks and benefits need to be evaluated for each case individually. (orig.)

  14. Image-guided multipolar radiofrequency ablation of liver tumours: initial clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Terraz, Sylvain; Constantin, Christophe; Becker, Christoph D. [Geneva University Hospital, Department of Radiology, Geneva 14 (Switzerland); Majno, Pietro Edoardo; Mentha, Gilles [Geneva University Hospital, Department of Surgery, Geneva 14 (Switzerland); Spahr, Laurent [Geneva University Hospital, Department of Gastroenterology, Geneva 14 (Switzerland)

    2007-09-15

    The local effectiveness and clinical usefulness of multipolar radiofrequency (RF) ablation of liver tumours was evaluated. Sixty-eight image-guided RF sessions were performed using a multipolar device with bipolar electrodes in 53 patients. There were 45 hepatocellular carcinomas (HCC) and 42 metastases with a diameter {<=}3 cm (n = 55), 3.1-5 cm (n = 29) and >5 cm (n = 3); 26 nodules were within 5 mm from large vessels. Local effectiveness and complications were evaluated after RF procedures. Mean follow-up was 17 {+-} 10 months. Recurrence and survival rates were analysed by the Kaplan-Meier method. The primary and secondary technical effectiveness rate was 82% and 95%, respectively. The major and minor complication rate was 2.9%, respectively. The local tumour progression at 1- and 2-years was 5% and 9% for HCC nodules and 17% and 31% for metastases, respectively; four of 26 nodules (15%) close to vessels showed local progression. The survival at 1 year and 2 years was 97% and 90% for HCC and 84% and 68% for metastases, respectively. Multipolar RF technique creates ablation zones of adequate size and tailored shape and is effective to treat most liver tumours, including those close to major hepatic vessels. (orig.)

  15. Long-Term Results after Treatment of Very Low-, Low-, and High-Risk Thyroid Cancers in a Combined Setting of Thyroidectomy and Radio Ablation Therapy in Euthyroidism

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2013-01-01

    Full Text Available Introduction. Differentiated thyroid cancer treatment usually consists of thyroidectomy and radio ablation in hypothyroidism 4-6 weeks after surgery. Replacing hypothyroidism by recombinant human thyroid stimulating hormone can facilitate radio ablation in euthyroidism within one week after surgery. The outcome of this approach was investigated. Methods. This is a prospective randomized trial to compare thyroidectomy and radio ablation within a few days after preconditioning with recombinant human thyroid stimulating hormone versus thyroidectomy and radio ablation separated by four weeks of L-T4 withdrawal. Tumors were graded into very low-, low- , or high-risk tumors. Recurrence-free survival was confirmed at follow-up controls by neck ultrasound and serum thyroglobulin. Suspected tumor recurrence was treated by additional radio ablation or surgery. Quality-of-life questionnaires with additional evaluation of job performance and sick-leave time were used in all patients. Results. Radio ablation in euthyroidism in quick succession after thyroidectomy did not lead to higher tumor recurrence rates of differentiated thyroid cancers in any risk category and was significantly advantageous with respect to quality-of-life (P<0.001, sick-leave time (P<0.001, and job performance (P=0.002. Conclusion. Recombinant human thyroid stimulating hormone can be used safely and with good efficacy to allow radio ablation under sustained euthyroidism within one week after thyroidectomy.

  16. A novel, flat, electronically-steered phased array transducer for tissue ablation: preliminary results

    International Nuclear Information System (INIS)

    Ellens, Nicholas P K; Lucht, Benjamin B C; Gunaseelan, Samuel T; Hudson, John M; Hynynen, Kullervo H

    2015-01-01

    Flat, λ/2-spaced phased arrays for therapeutic ultrasound were examined in silico and in vitro. All arrays were made by combining modules made of 64 square elements with 1.5 mm inter-element spacing along both major axes. The arrays were designed to accommodate integrated, co-aligned diagnostic transducers for targeting and monitoring. Six arrays of 1024 elements (16 modules) and four arrays of 6144 elements (96 modules) were modelled and compared according to metrics such as peak pressure amplitude, focal size, ability to be electronically-steered far off-axis and grating lobe amplitude. Two 1024 element prototypes were built and measured in vitro, producing over 100 W of acoustic power. In both cases, the simulation model of the pressure amplitude field was in good agreement with values measured by hydrophone. Using one of the arrays, it was shown that the peak pressure amplitude dropped by only 24% and 25% of the on-axis peak pressure amplitude when steered to the edge of the array (40 mm) at depths of 30 mm and 50 mm. For the 6144 element arrays studied in in silico only, similarly high steerability was found: even when steered 100 mm off-axis, the pressure amplitude decrease at the focus was less than 20%, while the maximum pressure grating lobe was only 20%. Thermal simulations indicate that the modules produce more than enough acoustic power to perform rapid ablations at physiologically relevant depths and steering angles. Arrays such as proposed and tested in this study have enormous potential: their high electronic steerability suggests that they will be able to perform ablations of large volumes without the need for any mechanical translation. (paper)

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

    Science.gov (United States)

    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

    2016-05-01

    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. 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 (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. ClinicalTrials.gov NCT01767558. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

  18. Utility of esophageal temperature monitoring during pulmonary vein isolation for atrial fibrillation using duty-cycled phased radiofrequency ablation.

    Science.gov (United States)

    Deneke, Thomas; Bünz, Kathrin; Bastian, Annely; Päsler, Marcus; Anders, Helge; Lehmann, Rainer; Meuser, Wolfgang; de Groot, Joris R; Horlitz, Marc; Haberkorn, Ron; Mügge, Andreas; Shin, Dong-In

    2011-03-01

    A novel ablation system has been introduced for rapid treatment of atrial fibrillation (AF). This system delivers duty-cycled phased radiofrequency (RF) energy via an over-the-wire catheter (PVAC® , Medtronic) to achieve pulmonary vein (PV) isolation. Lower power and depth control suggests that collateral damage might be minimized. However, no studies have investigated the potential for thermal effect and damage to the esophagus. Ninety consecutive patients undergoing PV-isolation were evaluated. Group A (48 patients) had continuous luminal esophageal temperature (LET) monitoring using a temperature probe with 3 metal electrodes located in the vicinity of the targeted PV ostia. Ablation ceased when LET exceeded 40 °C. Only patients with LET ≥ 39 °C underwent endoscopic evaluation to assess esophageal damage. Group B (42 patients) excluded LET monitoring but all patients underwent endoscopy. In Group A, 27 (56%) patients showed LET ≥ 39 °C (mean LET 40.5 °C). Endoscopy revealed esophageal alterations in 5 (8%) (3 erythema and 2 intramural bleeding). One hundred eighty-nine out of 190 (99.5%) targeted PVs were successfully isolated, with 1 PV unsuccessful due to high LET. In Group B all 165 targeted PVs (100%) were successfully isolated. Endoscopy in Group 2 revealed no esophageal alterations. Using a duty-cycled, phased RF ablation system is safe and effective to isolate PVs. No Eso alteration was documented after ablation when LET was not monitored. This suggests that the LET probe may contribute to the thermal effect. Whether the documented increments in LET are due to direct tissue heating or possible interaction between the LET probe requires further investigation. © 2010 Wiley Periodicals, Inc.

  19. Long-term results of percutaneous resection and interstitial laser ablation of osteoid osteomas

    Energy Technology Data Exchange (ETDEWEB)

    Roqueplan, Francois; Hamze, Bassam; Bousson, Valerie; Zouari, Leila; Younan, Tonine; Parlier-Cuau, Caroline; Laredo, Jean-Denis [Hopital Lariboisiere, Service de Radiologie Osteo-articulaire, Paris, Cedex 10 (France); Porcher, Raphael [Hopital Saint Louis, Departement de Biostatistiques et Informatique Medicale, Paris, Cedex 10 (France)

    2010-01-15

    To evaluate the efficiency and complication rate of two percutaneous treatments of osteoid osteomas, percutaneous trephine resection (PR) and interstitial laser ablation (ILA). Ethical review board was obtained for the retrospective study. One hundred and 26 patients were treated by PR (n=26) or ILA (n=100) under CT, with a median follow-up of 113 months for the PR group and 47 months for the ILA group. In the group treated by PR, the clinical success rate was 96% at 6-month and 95% at 24-month follow-up, with 12% (3/26) transient complications (one meralgia, two skin burns). One patient experienced immediate failure, and none had delayed failure. In the group treated by ILA, the clinical success rate was 96% at 6-month and 94% at 24-month follow-up, with 4% (4/100) transient complications (one common fibular nerve contusion, one hematoma, one infection and one tendinitis). Four ILA procedures were repeated, one because of initial failure and three because of recurrence (at 6.5, 15 and 32 months). Two were successful and two failed again. Failure was more frequent (p=0.0094) in patients less than 18 years old, and in lesions with a nidus size of 12 mm or larger (p=0.0022). (orig.)

  20. A study of economic utility resulting from CERN

    International Nuclear Information System (INIS)

    Schmied, H.

    1975-01-01

    The study attempts to quantify the technical and economic benefit to the manufacturing industries involved in CERN contracts, in relation to the expenditures on CERN by its Member States. Interviews were carried out in some 130 European firms, who supplied data on estimates of increased sales and decreased costs due to CERN contracts. This 'economic utility' totals 1,665 million Swiss francs (up to the year 1978), compared with a sales value to CERN of 394 MSF. Utility/sales ratios range from 0.9 to 7.3 for application fields of cables, magnets, cooling systems, vacuum equipment, electronics, and steels; they are as high as 17.3 for computers and 31.6 for precision mechanics. Some 80 per cent of the total reported utility results from sales to markets outside high-energy and nuclear physics, for example, railways, ship-building, refrigeration, power generation and power distribution. For the 877 MSF spent by CERN in European industry from its over-all budget of 3,500 MSF during 1955 to 1973, the total utility is estimated to be nearly 5,000 MSF. The method and procedure of analysis and quantification are discussed in detail and some specific cases are presented as examples. (author)

  1. A study of economic utility resulting from CERN contracts

    International Nuclear Information System (INIS)

    Schmied, H.

    1975-01-01

    The study attempts to quantify the technical and economic benefit to the manufacturing industries involved in CERN contracts, in relation to the expenditures on CERN by its Member States. Interviews were carried out in some 130 European firms, who supplied data on estimates of increased sales and decreased costs due to CERN contracts. This 'economic utility' totals 1,665 million Swiss francs (up to the year 1978), compared with a sales value to CERN of 394 MSF. Utility/sales ratios range from 0.9 to 7.3 for application fields of cables, magnets, cooling systems, vacuum equipment, electronics, and steels; they are as high as 17.3 for computers and 31.6 for precision mechanics. Some 80 per cent of the total reported utility results from sales to markets outside high-energy and nuclear physics, for example, railways, ship-building, refrigeration, power generation and power distribution. For the 877 MSF spent by CERN in European industry from its over-all budget of 3,500 MSF during 1955 to 1973, the total utility is estimated to be nearly 5,000 MSF. The method and procedure of analysis and quantification are discussed in detail and some specific cases are presented as examples. (author) [fr

  2. Conditional ablation of the prorenin receptor in nephron progenitor cells results in developmental programming of hypertension.

    Science.gov (United States)

    Song, Renfang; Kidd, Laura; Janssen, Adam; Yosypiv, Ihor V

    2018-04-01

    Nephron induction during kidney development is driven by reciprocal interactions between progenitor cells (NPCs) of the cap mesenchyme (CM) and the ureteric bud (UB). The prorenin receptor (PRR) is a receptor for renin and prorenin, and an accessory subunit of the vacuolar proton pump V-ATPase. Previously, we demonstrated that conditional ablation of the PRR in Six2 + NPCs in mice (Six2 PRR -/- ) causes early neonatal death. Here, we identified genes that are regulated by PRR in Six2 + NPCs FACS-isolated from Six2 PRR -/- and control kidneys on embryonic day E15.5 using whole-genome expression analysis. Seven genes with expression in CM cells previously shown to direct kidney development, including Notch1, β-catenin, Lef1, Lhx1, Jag1, and p53, were downregulated. The functional groups within the downregulated gene set included genes involved in embryonic and cellular development, renal regeneration, cellular assembly and organization, cell morphology, death and survival. Double-transgenic Six2 PRR -/- /BatGal + mice, a reporter strain for β-catenin transcriptional activity, showed decreased β-catenin activity in the UB in vivo. Reduced PRR gene dosage in heterozygous Six2 PRR +/- mice was associated with decreased glomerular number, segmental thickening of the glomerular basement membrane with focal podocyte foot process effacement, development of hypertension and increased soluble PRR (sPRR) levels in the urine at 2 months of age. Together, these data demonstrate that NPC PRR performs essential functions during nephrogenesis via control of hierarchy of genes that regulate critical cellular processes. Both reduced nephron endowment and augmented urine sPRR likely contribute to programming of hypertension in Six2 PRR +/- mice. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  3. Percutaneous peripheral rotational ablation using the Rotablator: immediate and mid term results. Single center experience concerning 146 lesions treated.

    Science.gov (United States)

    Henry, M; Amor, M; Ethevenot, G; Henry, I

    1993-09-01

    In order to assess the role of percutaneous peripheral rotational ablation using Rotablator (PPRA), 95 symptomatic patients (58 M, 37 F, m. age: 77 +/- 1 y) (r: 50-90 y) having 146 peripheral vascular lesions (PVL) were treated by PPRA. 59% were below the knee and 41% above. The runoff status (n of distal leg art. involved) was as follows: 3:52 pts, 2:23 pts, 1:14 pts, 0:6 pts. The femoral lesions were significantly longer than those at other sites (5.27 +/- 0.43 vs 2.97 +/- 0.3 cm) (p Pop) than in distal leg lesions (10/86.). RESULTS. After PPRA alone (99 PVL) the stenosis % decreased from 81 +/- 0.75 to 18 +/- 1.1. The residual stenosis was greater at femoral (26 +/- 2.3%) than at distal leg level (16 +/- 1.2%) (p or = 4 mths, 74 pts representing 115 treated PVL underwent an angiography control (2 deaths, 2 lost for follow-up). 87 lesions (76%) showed no restenosis and 28 lesions (34%) showed restenosis of 83 +/- 2.4% (r: 50-100%). The restenosis rate was higher in femoral (12/21: 36%) than in distal (15/58: 21%) or popliteal arteries (1/8: 12%). Restenosis was more frequent for PVL > or = 7 cm (67% vs 16%) (p or = 6.7 cm would be a limitation for PPRA. CONCLUSIONS. In our experience Percutaneous Peripheral Rotational Ablation has taken a pre-eminent position in the treatment of distal leg arteries. Our results lead us to broaden its indications to complex vascular lesions. The possibility of runoff treatment should allow an improvement in the long-term patency of PTA and bypass grafts.

  4. Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

    International Nuclear Information System (INIS)

    Bhatia, Shivank S.; Spector, Seth; Echenique, Ana; Froud, Tatiana; Suthar, Rekha; Lawson, Ivy; Dalal, Ravi; Dinh, Vy; Yrizarry, Jose; Narayanan, Govindarajan

    2015-01-01

    PurposeThe purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.Materials and MethodsFrom January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.ResultsOne patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.ConclusionThese data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis

  5. Is Antibiotic Prophylaxis for Percutaneous Radiofrequency Ablation (RFA) of Primary Liver Tumors Necessary? Results From a Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Bhatia, Shivank S., E-mail: sbhatia1@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Spector, Seth, E-mail: sspector@med.miami.edu [University of Miami, Department of Surgery, VA Hospital (Veterans Affairs Medical Center) (United States); Echenique, Ana, E-mail: aechenique@med.miami.edu; Froud, Tatiana, E-mail: tfroud@med.miami.edu; Suthar, Rekha, E-mail: rsuthar@med.miami.edu; Lawson, Ivy, E-mail: i.lawson1@med.miami.edu; Dalal, Ravi, E-mail: rdalal@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States); Dinh, Vy, E-mail: vdinh@med.miami.edu [VA Hospital (Veterans Affairs Medical Center), Department of Medicine (United States); Yrizarry, Jose, E-mail: jyrizarr@med.miami.edu; Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami, Vascular/Interventional Radiology, Department of Radiology, Miller School of Medicine (United States)

    2015-08-15

    PurposeThe purpose of this study was to evaluate need for antibiotic prophylaxis for radiofrequency ablation (RFA) of liver tumors in patients with no significant co-existing risk factors for infection.Materials and MethodsFrom January 2004 to September 2013, 83 patients underwent 123 percutaneous RFA procedures for total of 152 hepatocellular carcinoma (HCC) lesions. None of the patients had pre-existing biliary enteric anastomosis (BEA) or any biliary tract abnormality predisposing to ascending biliary infection or uncontrolled diabetes mellitus. No pre- or post-procedure antibiotic prophylaxis was provided for 121 procedures. Data for potential risk factors were reviewed retrospectively and analyzed for the frequency of infectious complications, including abscess formation.ResultsOne patient (1/121 (0.8 %) RFA sessions) developed a large segment 5 liver abscess/infected biloma communicating with the gallbladder 7 weeks after the procedure, successfully treated over 10 weeks with IV and PO antibiotic therapy and percutaneous catheter drainage. This patient did not receive any antibiotics prior to RFA. During the procedure, there was inadvertent placement of RFA probe tines into the gallbladder. No other infectious complications were documented.ConclusionThese data suggest that the routine use of prophylactic antibiotics for liver RFA is not necessary in majority of the patients undergoing liver ablation for HCC and could be limited to patients with high-risk factors such as the presence of BEA or other biliary abnormalities, uncontrolled diabetes mellitus, and large centrally located tumors in close proximity to central bile ducts. Larger randomized studies are needed to confirm this hypothesis.

  6. Economic utility resulting from CERN contracts (second study)

    International Nuclear Information System (INIS)

    Bianchi-Streit, M.; Blackburne, N.; Budde, R.; Reitz, H.; Sagnell, B.; Schorr, B.; Schmied, H.

    1985-01-01

    The study attempts to quantify the economic benefit to high technology manufacturing industries involved in CERN contracts, in relation to their sales to CERN. It covers the period 1973-87 and complements an earlier study made in 1973-75 (see CERN Report 75-5). Interviews were carried out in 160 European firms, who supplied estimates of increased sales and cost savings due to CERN contracts. This 'economy utility' totals 3107 million Swiss francs (up to the year 1987), compared to sales to CERN amounting to 748 million Swiss francs in 1982 prices. It is estimated that, by 1987, CERN's high technology purchases made in 1973-82 will have generated Economic Utility amounting to about 60% of the overall cost of the Organization during the same period. In 1982, about 75% of the increased turnover due to CERN resulted from sales to markets outside high energy particle physics, for example, railways, shipbuilding, refrigeration, power generation and distribution, and health care. The quantification model used is discussed in detail and some specific cases are presented as examples. The industrial managers interviewed during both studies have confirmed that the forecasts made ten years ago were, on average, accurate. (orig.)

  7. Economic utility resulting from CERN contracts (second study)

    International Nuclear Information System (INIS)

    Bianchi-Streit, M.; Blackburne, N.; Budde, R.; Reitz, H.; Sagnell, B.; Schorr, B.; Schmied, H.

    1984-01-01

    The study attempts to quantify the economic benefit to high technology manufacturing industries involved in CERN contracts, in relation to their sales to CERN. It covers the period 1973-87 and complements an earlier study made in 1973-75 (see CERN Report 75-5). Interviews were carried out in 160 European firms, who supplied estimates of increased sales and cost savings due to CERN contracts. This ''economic utility'' totals 3107 million Swiss francs (up to the year 1987), compared to sales to CERN amounting to 748 million Swiss francs in 1982 prices. It is estimated that, by 1987, CERN's high technology purchases made in 1973-82 will have generated Economic Utility amounting to about 60% of the overall cost of the Organization during the same period. In 1982, about 75% of the increased turnover due to CERN resulted from sales to markets outside high energy particle physics, for example, railways, shipbuilding, refrigeration, power generation and distribution, and health care. The quantification model used is discussed in detail and some specific cases are presented as examples. The industrial managers interviewed during both studies have confirmed that the forecasts made ten years ago were, on average, accurate. (orig.)

  8. Determination of Physical Properties of Carbon Materials by Results of Ablative Experiments Con-ducted in the Jets of Gas Dynamic Units

    Directory of Open Access Journals (Sweden)

    V. V. Gorsky

    2015-01-01

    Full Text Available The process of hypersonic vehicles’ movement in the dense layers of the atmosphere is accompanied by the considerable combustion of heat shield, which effects on the aerodynamic, mass-inertial and centering characteristics of the product.For correct calculation of model's movement parameters it is necessary:* Using the theoretical and computation methods for determining ablative characteristics of heat-protective materials;* Taking into account all the basic physical and chemical processes, involved in their ablation, using the above mentioned methods;* Testing these techniques in the wide range of experimental data. This physic-mathematical model of carbon materials (CM aerothermochemical destruction is based on using the following:* Arrhenius equations to calculate carbon kinetic oxidation;* Langmuir-Knudsen formula to calculate the velocity of non-equilibrium carbon’s sublimation;* Carbon erosion law represented as a unique dependence of this process velocity on the gas pressure on the wall.Mathematical description of all major processes included in this formulation of the problem, contains a number of "free" parameters that can be determined only on the basis of comparison of theoretical and experimental data according to total ablation characteristics of these materials.This comparison was performed in the article applicable to the tests conditions of modern CM in the stream of electric arc plant and in combustion products of liquid-propellant rocket engines.As the result, the data of kinetic of carbon oxidation by atomic oxygen at sublimation mode of material ablation were obtained for the first time. Carbon erosion law under high pressure was established for the first time.The new approach to processing of ablation experiments is enunciated. Using this approach allows to turn this experiments for CM from comparative tests into the tests to determine ablation properties of thermal protection. Moreover, it enables us also to use the

  9. Hazard report. Incorrect measurement of uterine cavity while using Hologic NovaSure endometrial ablation system can result in patient injury.

    Science.gov (United States)

    2009-09-01

    If the uterine cavity is improperly or inaccurately measured during use of the Hologic NovaSure endometrial ablation system, it could result in thermal or perforation injuries. This article describes some of these injuries and offers guidance on reducing their likelihood.

  10. ClariVein® - Early results from a large single-centre series of mechanochemical endovenous ablation for varicose veins.

    Science.gov (United States)

    Tang, T Y; Kam, J W; Gaunt, M E

    2017-02-01

    Objectives This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. Methods A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment. Postoperative complications were recorded along with patient satisfaction. Results All 393 procedures were completed successfully under local anaesthetic. Complete occlusion of the treated vein was initially achieved in all the patients, but at eight weeks' follow-up, there was only partial obliteration in 13/393 (3.3%) veins. These were all successfully treated with ultrasound-guided foam sclerotherapy. Procedures were well tolerated with a mean pain score of 0.8 (0-10). No significant complications were reported. Conclusions ClariVein® can be used to ablate long and short saphenous varicose veins on a walk-in-walk-out basis. Bilateral procedures can be successfully performed, and these are well tolerated as can multiple veins in the same leg. Early results are promising but further evaluation and longer term follow-up are required.

  11. Rayleigh-Taylor instability and resulting failure modes of ablatively imploded inertial fusion targets

    International Nuclear Information System (INIS)

    Montierth, L.; Morse, R.

    1984-01-01

    This chapter discusses small amplitude growth of the outside surface instability and modes of failure resulting from nonlinear development of the inside surface instability. It is demonstrated that pellets with initial pellet aspect ratio, A /SUB p/ >5 may have difficulty with Rayleigh-Taylor instability and that shells with A /SUB p/ greater than or equal to10 will probably demand stringent smoothness specification in order not to experience failure in the final implosion. The linear amplification of the outside surface instability can easily exceed 10 3 for A /SUB p/ and resulting A values in the range of programmatic interest. Amplifications of this order, starting from attainable surface finishes, can then penetrate to the inside shell surface, producing perturbations there which approach the nonlinear development amplitude and at the start of the final deceleration. It is shown that such inside surface perturbations can be amplified to large amplitude by the inside instability and cause failure through reduction of the maximum fuel temperature achieved. Insight into the scaling of failure mechanisms is offered

  12. Left atrial appendage thrombus with resulting stroke post-RF ablation for atrial fibrillation in a patient on dabigatran.

    LENUS (Irish Health Repository)

    Lobo, R

    2015-11-01

    Dabigatran etexilate is licensed for use in prevention of deep venous thromboembolism and in prevention of stroke and systemic embolism in nonvalvular atrial fibrillation (AF). It has also been used in patients for other indications as a substitute for warfarin therapy because it requires no monitoring; one group being patients undergoing radiofrequency (RF), ablation for AF, although there have been no consensus guidelines with regards to dosage and timing of dose. We report the case of a patient with documentary evidence of left atrial appendage (LAA) thrombus formation and neurological sequelae post-RF ablation despite being on dabigatran. This case highlights the concern that periprocedural dabigatran may not provide adequate protection from development of LAA thrombus and that a standardised protocol will need to be developed and undergo large multicentre trials before dabigatran can be safely used for patients undergoing RF-ablation.

  13. Randomised Comparison of Costs and Cost-Effectiveness of Cryostripping and Endovenous Laser Ablation for Varicose Veins : 2-Year Results

    NARCIS (Netherlands)

    Disselhoff, B. C. V. M.; Buskens, E.; Kelder, J. C.; Kinderen, D. J. der; Moll, F. L.

    Background: Although endovenous laser ablation for varicose veins is replacing surgical stripping, proper economic evaluation with adequate follow-up in a randomised clinical trial is important for considered policy decisions regarding the implementation of new techniques. Methods: Data from a

  14. Pace-capture-guided ablation after contact-force-guided pulmonary vein isolation: results of the randomized controlled DRAGON trial.

    Science.gov (United States)

    Masuda, Masaharu; Fujita, Masashi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Sunaga, Akihiro; Tsujimura, Takuya; Matsuda, Yasuhiro; Ohashi, Takuya; Uematsu, Masaaki

    2017-11-17

    Before the discovery of contact-force guidance, eliminating pacing capture along the pulmonary vein (PV) isolation line had been reported to improve PV isolation durability and rhythm outcomes. DRAGON (UMIN-CTR, UMIN000015332) aimed to elucidate the efficacy of pace-capture-guided ablation following contact-force-guided PV isolation ablation in paroxysmal atrial fibrillation (AF) patients. A total of 156 paroxysmal AF patients with AF-trigger ectopies from any of the four PVs induced by isoproterenol were randomly assigned to undergo pace-capture-guided ablation along a contact-force-guided isolation line around AF-trigger PVs (PC group, n = 76) or contact-force-guided PV isolation ablation alone (control group, n = 80). Follow-up of at least 1 year commenced with serial 24 h Holter and symptom-triggered ambulatory monitoring. There was no significant difference in acute PV reconnection rates during a 20 min waiting period after the last ablation or adenosine infusion testing between the PC and the control groups (per patient, 21% vs. 27%, P = 0.27; per AF-trigger PV, 5.9% vs. 7.3%, P = 0.70; and per non-AF-trigger PV, 7.1% vs. 7.4%, P = 0.92). Atrial tachyarrhythmia-free survival rates off antiarrhythmic drugs after the initial session were comparable at 19.3 ± 6.2 months between the two groups (82% vs. 80%, P = 0.80). Among 22 patients who required a second ablation procedure, there was no difference between the PC and the control groups in the PV reconnection rates at both previously AF-trigger (29% vs. 43%, P = 0.70) and non-AF-trigger PVs (18% vs. 19%, P = 0.88). Pace-capture-guided ablation performed after contact-force-guided PV isolation demonstrated no improvement in PV isolation durability or rhythm outcome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  15. Results of topography-guided laser in situ keratomileusis custom ablation treatment with a refractive excimer laser.

    Science.gov (United States)

    Stulting, R Doyle; Fant, Barbara S; Bond, William; Chotiner, Ben; Durrie, Daniel; Gordon, Michael; Milauskas, Albert; Moore, Charles; Slade, Stephen; Randleman, J. Bradley; Stonecipher, Karl

    2016-01-01

    To evaluate the safety and effectiveness of topography-guided custom ablation treatment (T-CAT) to correct myopia and myopic astigmatism with laser in situ keratomileusis (LASIK). Nine clinical sites in the USA. Prospective observational nonrandomized unmasked study. The study comprised patients aged 18 to 65 years old with myopia or myopic astigmatism with a manifest refraction spherical equivalent (MRSE) up to -9.0 diopters (D) and astigmatism of 6.0 D or less. Patients with previous refractive surgery or abnormal topography were excluded. Corneal topographies were obtained using the Allegro Topolyzer, and laser treatment was delivered with the Allegretto Wave Eye-Q excimer laser system. Visual outcomes were evaluated postoperatively at 1 day, 1 week, and 1, 3, 6, 9, and 12 months. The clinical trial enrolled 212 patients (249 eyes). The T-CAT procedure significantly reduced the MRSE and cylinder, with stability of outcomes evident from 3 to 12 months after surgery. Compared with the preoperative corrected distance visual acuity (CDVA), the postoperative uncorrected distance visual acuity (UDVA) improved by 1 line or more in 30% of eyes and the postoperative UDVA was at least as good as the preoperative CDVA in 90% of eyes. Most visual symptoms improved after T-CAT. There were no significant treatment-related adverse events or loss of vision. The T-CAT procedure performed with the diagnostic device and the refractive excimer laser system safely and effectively achieved predictable refractive outcomes and reduced visual symptoms with stable results through 12 months. Dr. Stulting is a paid consultant to Alcon Laboratories, Inc., and was a medical monitor for the U.S. Food and Drug Administration (FDA) clinical trial. Dr. Fant is president of Clinical Research Consultants, Inc. (CRC), the clinical and regulatory consulting group that sponsored the FDA clinical trial. Dr. Fant and CRC were supported by Alcon Laboratories, Inc. Copyright © 2016 ASCRS and ESCRS

  16. MHD facilities. Experimental results and prospects for utilization

    International Nuclear Information System (INIS)

    Kirillin, V.A.; Shejndlin, A.E.

    1978-01-01

    The main progress and prospects of investigation into the MHD-method of energy conversion are presented. The utilization of power plant units with MHD generators will permit to increase the heat power plant efficiency up to 50-60% and lead to fuel economy by 20-35%. An MHD power plant (MHDPP) is a two-staged facility, in which an MHD generator and an ordinary steam turbine plant operate. It is shown that it is advisable to construct big power plant units with a unit power of the 1000 MW order and more. The utilization of MHDPP significantly decreases the environmental contamination in comparison with power stations. An MHDPP is characterized by a great manoeuvrability: the load can change from the rated plant power to 20%. MHD facilities of the open cycle, operating on the basis of combustion products of the fossil organic fuels in combination with an ordinary steam-power cycle are the most advisable to the inductrial introduction at present. Since 1964 the U-02 facility (the whole resource fo work is 20000 hrs) has been exploited in the Soviet Union. The pilot-industrial power station has been working since 1971, and its MHD generator continuously worked in 1975 with the rated load from 2 to 19 MW during more than 250 hrs. The conclusion is made that the MHD power station peculiarities permit to consider them as one of the most advisable types of power plants for the European part of the Soviet union in particular

  17. Percutaneous treatment of liver tumors with an adapted probe for cooled-tip, impedance-controlled radio-frequency ablation under open-magnet MR guidance: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, Alexis D.; Terraz, Sylvain; Roggan, Andre; Terrier, Francois; Majno, Pietro; Mentha, Gilles; Roth, Arnaud; Becker, Christoph D. [Department of Diagnostic and Interventional Radiology, University Hospital, 24 rue Micheli-du-Crest, 1211, Geneva (Switzerland)

    2003-05-01

    Percutaneous radio-frequency (RF) ablation of liver tumors is usually performed under guidance of real-time US, but some tumor nodules in some patients cannot be adequately visualized with this technique. We report our preliminary results with an MR-compatible, internally perfused 17-G RF probe adapted to a standard RF generator for impedance-controlled RF ablation under MR guidance. Following initial testing of the probe for MR compatibility, artifacts and macroscopic effects on an ex vivo pig liver, four patients with eight neoplastic liver nodules (five metastatic and three primary), which could not be properly targeted by US, were treated with the cooled-tip technique under MRI guidance in an open 0.23-T magnet. Metallic artifacts produced by the probe were useful for accurate placement and did not interfere with MRI monitoring at the end of the procedure. Based on imaging findings, the immediate result of RF was considered adequate in all instances. Local recurrence occurred in one instance after 6 months, requiring repeat treatment. No adverse effects were noted. Initial experience suggests that the probe we used allows to perform impedance-controlled cooled-tip RF ablation of liver tumors under open-magnet MR guidance. (orig.)

  18. Feasibility Study on MR-Guided High-Intensity Focused Ultrasound Ablation of Sciatic Nerve in a Swine Model: Preliminary Results

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, Elena A., E-mail: kayee@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Medical Physics (United States); Gutta, Narendra Babu, E-mail: gnbabu.aiims@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Monette, Sebastien, E-mail: monettes@mskcc.org [The Rockefeller University, Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (United States); Gulati, Amitabh, E-mail: gulatia@mskcc.org; Loh, Jeffrey, E-mail: jeffreyloh@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Anesthesiology-Critical Care (United States); Srimathveeravalli, Govindarajan, E-mail: srimaths@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Ezell, Paula C., E-mail: paula.ezell@intusurg.com [The Rockefeller University, Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College (United States); Erinjeri, Joseph P., E-mail: erinjerj@mskcc.org; Solomon, Stephen B., E-mail: solomons@mskcc.org; Maybody, Majid, E-mail: maybodym@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States)

    2015-08-15

    IntroductionSpastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system.MethodsThe HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T MRI scanner. Acute lesions were confirmed using T1-weighted contrast-enhanced (CE) MRI and histopathology using hematoxylin and eosin staining. The animals were euthanized immediately following post-ablation imaging.ResultsReddening and mild thickening of the nerve and pallor of the adjacent muscle were seen in all animals. The HIFU-treated sections of the nerves displayed nuclear pyknosis of Schwann cells, vascular hyperemia, perineural edema, hyalinization of the collagenous stroma of the nerve, myelin sheet swelling, and loss of axons. Ablations were visible on CE MRI. Non-perfused volume of the lesions (5.8–64.6 cc) linearly correlated with estimated lethal thermal dose volume (4.7–34.2 cc). Skin burn adjacent to the largest ablated zone was observed in the first animal. Bilateral treatment time ranged from 55 to 138 min, and preparation time required 2 h on average.ConclusionThe acute pilot study in swine demonstrated the feasibility of a noninvasive neurolysis of the sciatic nerve using a clinical MRgHIFU system. Results revealed that acute HIFU nerve lesions were detectable on CE MRI, gross pathology, and histology.

  19. Cyst Ablation Using a Mixture of N-Butyl Cyanoacrylate and Iodized Oil in Patients with Autosomal Dominant Polycystic Kidney Disease: the Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, See Hyung; Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2009-08-15

    We wanted to assess the long-term results of cyst ablation with using N-butyl cyanoacrylate (NBCA) and iodized oil in patients with autosomal dominant polycystic kidney disease (ADPKD) and symptomatic cysts. Cyst ablation using a mixture of NBCA and iodized oil was performed in 99 cysts from 21 patients who had such symptoms as abdominal distension and pain. The collapse or reaccumulation of the ablated cysts after the procedure was assessed during the follow-up period of 36 to 90 months. The treatment effects, including symptom relief, and the clinical data such as the blood pressure and serum creatinine levels were also assessed, together with the complications. The procedure was technically successful in all 99 cysts from the 21 patients. Any procedure-related significant complications were not detected. Seventy-seven of 99 cysts (78%) were successfully collapsed on the follow-up CT. Twenty-two cysts showed reaccumulation during long-term follow-up period. The clinical symptoms were relieved in 17 of the 21 patients (76%). Four of 12 patients (33%) with hypertension and two of six patients (33%) with azotemia were improved. End stage renal disease (ESRD) occurred in six of the 21 patients (28%) during the follow-up period. The mean age of ESRD in our patients was 57 years. The mean time interval for the development of ESRD was 19 months. Ablation using a mixture of NBCA and iodized oil may be an effective, safe method for obtaining symptom relief in patients with ADPKD.

  20. Delocalized Photomechanical Effects of UV ns Laser Ablation on Polymer Substrates Captured by Optical Holography Workstation: An Overview on Experimental Result

    Directory of Open Access Journals (Sweden)

    Vivi Tornari

    2014-01-01

    Full Text Available A brief overview of results from an experimental investigation performed on polymer materials to examine delocalized photomechanical effects generated due to UV laser ablation is provided. Delocalized structural modifications were observed in PMMA, PS by means of optical holographic interferometry. The integrity of samples was examined before and after irradiation in 193 and 248 nm (15 ns above and below ablation threshold, F = 0.1–1.0 J/cm2. A value of structural continuity was initially determined for each sample by generation of a reference holographic image before irradiation. Microscopic discontinuities were intentionally induced to act as preexistent defects. Sequential holographic recording monitored the growth of morphological alterations according to the number of pulses in the neighbor as well as far from the preexistent discontinuities. The imposed alterations are visually observable at the whole extent of the irradiated sample in distances far off the ablation spot as local cracks and voids. The induced flaws cannot be classified as transient or instantly generated. Fracture follows a long-term emergence and deterioration pattern. Extensively fluctuated long-term effects were also observed in laser-assisted varnish removal of multilayered technical samples simulating Byzantine icons with decrease of effect duration and fluctuation being according to increase in sample homogeneity.

  1. Utilizing non-ablative fractional photothermolysis prior to ALA-photodynamic therapy in the treatment of acne vulgaris: a case series.

    Science.gov (United States)

    Qureshi, Sarah; Lin, Jennifer Y

    2017-04-01

    Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an emerging modality in the treatment of acne. While ablative fractional lasers have been used to enhance drug delivery into the epidermis, recent evidence suggests that non-ablative fractional photothermolysis may also improve uptake of ALA. We explored the use of non-ablative 1550 nm laser as a safe alternative in the delivery of ALA prior to red-light PDT for refractory inflammatory and cystic acne. Subjects referred for treatment of acne refractory to several topical and oral regimens, including isotretinoin, were pre-treated with non-ablative fractional photothermolysis (NAFP). This was followed by 20 % ALA application with an incubation time of 1-3 h and then exposure to 50-100 J/cm 2 red light. Follow-up was at 1, 3, and 6 months. In all three cases, patients demonstrated marked reduction in inflammatory lesions. Two subjects had remission of acne after a single combination treatment. Non-ablative fractional laser applied immediately prior to PDT may be used in the treatment of acne with minimal side effects and fewer sessions needed than PDT alone. This may be due to enhanced delivery of ALA from pre-treating the skin with non-ablative fractional photothermolysis.

  2. Utilization of aging program results in plant inspections

    International Nuclear Information System (INIS)

    Gunther, W.; Fullwood, R.

    1988-01-01

    Research conducted under the auspices of the US Nuclear Regulatory Commission Nuclear Plant Aging Research (NPAR) Program has resulted in a large data base of component and system operating experience. This data base has been used to determine equipment aging susceptibility and the potential for equipment aging to impact plant safety and reliability. Methods of detecting and mitigating component and system aging have also been identified. This paper discusses how the NPAR results could be used to focus inspection activities on age-sensitive components and systems and on the specific modes and mechanisms of age degradation. These activities range from the regular inspections conducted by resident inspectors to extensive special inspections such as the Safety System Functional Inspection typically conducted by a team of inspectors. 5 refs., 3 figs., 1 tab

  3. Utilization of aging program results in plant inspections

    International Nuclear Information System (INIS)

    Gunther, W.; Fullwood, R.

    1989-01-01

    Research conducted under the auspices of the US Nuclear Regulatory Commission Nuclear Plant Aging Research (NPAR) Program has resulted in a large data base of component and system operating experience. This data base has been used to determine equipment aging susceptibility and the potential for equipment aging to impact plant safety and reliability. Methods of detecting and mitigating component and system aging have also been identified. This paper discusses how the NPAR results could be used to focus inspection activities on age-sensitive components and systems and on the specific modes and mechanisms of age degradation. These activities range from the regular inspections conducted by resident inspectors to extensive special inspections such as the Safety System Functional Inspection typically conducted by a team of inspectors. 5 refs., 3 figs., 1 tab

  4. TEWI Analysis: Its Utility, Its Shortcomings, and Its Results

    International Nuclear Information System (INIS)

    Baxter, V.D.; Fischer, S.K.; Sand, J.R.

    1999-01-01

    The past decade has been a challenging time for the refrigeration and air conditioning industry worldwide. Provisions of the Montreal Protocol and its amendments require the phaseout of chlorofluorocarbon (CFC) and hydrochlorofluorocarbon (HCFC) compounds that have been used extensively as insulating foam blowing agents and refrigerants in refrigeration systems, heat pumps, and air conditioners. In response, hydrofluorocarbon (HFC) compounds were proposed, developed, and are starting to be used as the primary alternatives to CFCs and HCFCs. However, in 1997 under the Kyoto Protocol, industrialized nations have agreed to roll back emissions of HCFCs, carbon dioxide (CO*), and four other greenhouse gases which threaten to cause excessive global warming. The US. Department of Energy and the Alternative Fluorocarbon Environmental Acceptability Study (AFEAS) jointly sponsored research projects to identify the major applications of CFCs, HCFCs, and HFCs and to examine the impacts of these compounds and the energy use of applications employing these compounds on global warming. The five major uses of fluorocarbons based on sales were automobile air conditioning, supermarket refrigeration, unitary heat pumps and air conditioning, chillers for cooling large office buildings, and household refrigeration. Almost all of the refrigerants used in these applications are global warming gases, and if the refrigerant leaks out of the system during operation, is lost during maintenance or is not recovered when the system is scraped, it contributes to global warming. But, it is also true that the energy consumed by refrigeration and air conditioning systems, in the form of electricity or the direct combustion of fossil fuel, results in the release of CO*, the primary cause of atmospheric global warming

  5. Determination of major, minor and trace elements in rock samples by laser ablation inductively coupled plasma mass spectrometry: Progress in the utilization of borate glasses as targets

    International Nuclear Information System (INIS)

    Leite, Tacito Dantas F.; Escalfoni, Rainerio; Fonseca, Teresa Cristina O. da; Miekeley, Norbert

    2011-01-01

    The present work is a continuation of a research study performed at our laboratory aiming at the multielement analysis of rock samples (basalts and shale) by inductively coupled plasma mass spectrometry in combination with laser ablation using borate glasses as analytical targets. Argon, nitrogen-argon mixtures and helium were evaluated as cell gases, the latter confirming its better performance. Different operational parameters of the laser, such as gas flow, energy, focus, scanning speed and sampling frequency were optimized. External calibration was made with standards prepared by fusion of geological reference materials (basalts 688 and BCR-2, obsidian SRM 278, and shale SGR-1) of different mass fractions in the meta-tetra borate matrix. Coefficients of determination (R 2 ) were > 0.99 for 30 elements from o total of 40 determined. Method validation was then performed using additional certified reference materials (BHVO-2, BIR-1, SCo-1) produced as borate targets in a similar way. Accuracies were better than 10% for most of the elements studied and analytical precisions, calculated from the residual standard deviations of calibration curves were, typically, between 6% and 10%. Additionally, the semiquantitative TotalQuant (registered) technique was applied, which gave, within the expected uncertainty for this calibration technique, concordant results when compared to the quantitative external calibration procedure. Both methods were then used for the analysis of marine shale samples, which are of great geological interest in petroleum prospecting.

  6. Three-dimension finite-element analyses of multiple electrodes bipolar RF global endometrial ablation

    Science.gov (United States)

    Hu, Tao; Panhao, Tang; Xiao, Jiahua

    2015-03-01

    Radio-frequency ablation (RFA) is a minimally invasive surgical procedure to thermally ablate the targeted diseased tissue. There have been many finite-element method (FEM) studies of cardiac and hepatic RFA, but hardly find any FEM study on endometrial ablation for abnormal uterine bleeding. In this paper, a FEM model was generated to analyze the temperature distribution of bipolar RF global endometrial ablation with three pairs of bipolar electrodes placed at the perimeter of the uterine cavity. COMSOL was utilized to calculate the RF electric fields and temperature fields by numerically solving the bioheat equation in the triangle uterine cavity range. The 55°C isothermal surfaces show the shape of the ablation dimensions (depth and width), which reasonably matched the experimental results.

  7. [Comparison of operative and oncologic results between partial nephrectomy and radiofrequency ablation for treatment of renal tumors in patients older than 75].

    Science.gov (United States)

    Cholley, I; Correas, J M; Masson-Lecomte, A; Sanchez, S; Champy, C; Le Guilchet, T; Ariane, M; Hurel, S; Audenet, F; Thiounn, N; Fontaine, E; Mejean, A; Timsit, M O

    2018-01-01

    Elderly patients represent a growing part of our society for who treatment strategy for localized renal tumors has to be chosen knowing iatrogen effects and renal function morbidity. The aim was to analyze oncological and functional results of nephron sparing surgery (PN) versus radiofrequency ablation (RFA). All patients aged more than 75 treated by partial nephrectomy or radiofrequency ablation between 2007 and 2014 in our centre were included. Patient and tumors data were compared and these criteria were analyzed: survival (overall and without recurrence) and loss of renal function (pre- and postoperative MDRD). In total, 100 patients were included (26 partial nephrectomies, group 1 and 74 radiofrequency ablation, group 2) with a 32-months medium follow-up. Medium age and tumor size were significantly different (respectively, 78 versus 81 years old, P=0.001, 38mm versus 29mm, P=0.003). Perioperative results showed no differences in complications. Transfusion rate and duration of hospital stay were significantly higher in the PN group. Median overall survival were 45 vs. 27 months (P=0.23) for PN and RFA and median recurrence-free survival were 28 vs. 10 months (P=0.34). On a multivariate analysis, operative technique (PN or RFA) were not significantly linked to survival (HR 2.37 [95% CI: 0.66-8.5]), P=0.19. Loss of renal function were 1.5±14mL/min/1.73m 2 for PN and 3±14mL/min/1.73m 2 for RFA (P=0.69). Our study showed better perioperative results for RFA than for PN, without significant different survival. Loss of renal function were little and similar. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Power Laser Ablation Symposia

    CERN Document Server

    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...

  9. Renal cell carcinoma in patients with a solitary kidney after nephrectomy treated with radiofrequency ablation: Mid term results

    International Nuclear Information System (INIS)

    Hoffmann, Ralf-Thorsten; Jakobs, Tobias F.; Kubisch, Constanze H.; Trumm, Christoph; Weber, Christof; Siebels, Michael; Helmberger, Thomas K.; Reiser, Maximilian F.

    2010-01-01

    This retrospective study aimed to evaluate the feasibility and effectiveness of radiofrequency ablation (RFA) in patients with solitary kidney for the treatment of renal cell carcinoma (RCC). Within 2 years 10 patients (seven males, three females; age 65 ± 8 years) were treated. All patients had a history of nephrectomy of the contralateral kidney. The indications for RFA were inoperability or high probability of complete renal failure after surgical enucleation of the tumor. 13 tumors with a size between 1.9 and 4.2 cm (average 2.7 cm) were treated. In patients with a tumor diameter larger than 2.5 cm a transarterial embolization was performed prior to RFA to reduce heat sink effect and risk of bleeding. Therapeutical success was defined as a lack of contrast enhancement in follow up examinations and shrinking of the treated area. Furthermore all patients' renal function was monitored. RFA of renal tumors under CT-fluoroscopy was feasible in all patients. Within the follow up (3 and 24 months) no tumor recurrence or major complication was detected. One patient developed another RCC and was successfully treated with a second RF-ablation. None of the patients developed renal failure with the need of hemodialysis. In one of the patients a hemorrhage into the surrounding tissue was noticed, which stopped spontaneously. RFA is a valuable and effective therapeutical option in patients with solitary kidney suffering from inoperable renal cell carcinoma. The complication rate is small and an excellent tumor control can be achieved without deterioration of the renal function.

  10. Sex differences in health status and rehabilitation outcomes in patients with atrial fibrillation treated with ablation: Results from the CopenHeartRFA trial.

    Science.gov (United States)

    Wagner, Mette Kirstine; Zwisler, Ann-Dorthe Olsen; Risom, Signe Stelling; Svendsen, Jesper Hastrup; Christensen, Anne Vinggaard; Berg, Selina Kikkenborg

    2018-02-01

    Increased physical capacity after comprehensive rehabilitation in patients with atrial fibrillation (AF) undergoing ablation has been found in the CopenHeartRFA trial. The purpose of this study was to investigate: (a) sex differences in health status, psychological distress and quality of life, (b) sex differences in rehabilitation outcomes and (c) predictors of effect of rehabilitation. We conducted an exploratory analysis of data from the randomized CopenHeartRFA trial, where patients treated with ablation were randomized with 1:1 to comprehensive rehabilitation consisting of a physical exercise program and psycho-educational consultations versus usual care. Sex disparities in health status were tested using Chi-square and t-tests. Included were: 151 men (median age 59.25 years) and 59 women (median age 62.5 years). At hospital discharge, women reported lower physical health status compared with men. Among women, significant differences were found in the 6-min walk test [rehabilitation: 496.8 meters (SD 98.5) versus 559.3meters (SD 55.5) and usual care: 521.9 meters (SD 97.8) versus 530.9 meters (SD 102.2), p = 0.01] and exercise time [rehabilitation: 387.6 s (SD 126.0) versus 463.2 s (SD 121.8) and usual care: 353.4 s (SD 145.2) versus 355.8 s (SD 154.8), p differences were found in mental health outcomes among men and in quality of life scores among women. Patients with a European Heart Rhythm Association (EHRA) score I-II had a positive effect of rehabilitation. The results suggest that sex differences exist in self-reported health after rehabilitation in patients ablated for AF. Patients with an I-II EHRA score seem more likely to gain from the rehabilitation programme compared with those with a III-IV score.

  11. Assessment of safety and efficacy of Morrow septal myectomy and alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: the results of a pilot randomized trial

    Directory of Open Access Journals (Sweden)

    Р. А. Найденов

    2016-11-01

    Full Text Available Aim. The aim of this randomized study was to evaluate the safety and efficacy of septal myectomy (SM and alcohol septal ablation (ASA in patients with an obstructive form of hypertrophic cardiomyopathy.Methods. The study included 76 patients eligible for ASA and Morrow myectomy. The patients were divided into two equal groups: one for ASA (n = 38, the other for SM.The primary endpoint (combined was to assess the safety, which included 30-day complications after surgery (mortality, bleeding, tamponade, stroke, development of VT / VF and the frequency of pacemaker/ICD implantation.Secondary endpoints focused on the evaluation of pressure gradient (efficiency, repeated operations, clinical and functional indicators, volume and mass of the ablation zone and dissected infarction. Control observation period was 12 months.Results. By the end of control observations, it was found out that SM is a safer technique as compared to ASA, the complication rate was 13 % and 47 % respectively (log-rank test p = 0.0021; Cox: HR 11.4 95% CI [1.52 -11.1] p = 0.005. No significant differences in early (30 days postoperative complications were found (log-rank test p = 0.24; Cox: HR 2.52, 95% CI [0.48-12.9] p = 0.27. Rhythm disturbances requiring pacemaker implantation / ICD (log-rank test p = 0.0029; Cox: HR 95% CI 4.92 [1.06-22.74] p = 0.042 were the most common complication. In both groups, there was a significant reduction of the LVOT gradient, p <0.01. However, the residual gradient in the ASA group was significantly higher than that in the SM group, p <0.01. Clinical data of both groups were comparable in the long term. A significant correlation was observed between the dissected infarction volume and the degree of reduction in the LVOT gradient of the SM group, p = 0.01. No significant dependency of the ablation zone volume on the degree of reduction in the LVOT gradient was observed, p = 0.7.Conclusion. Septal myectomy is a safe treatment for hypertrophic

  12. Thermistor guided radiofrequency ablation of atrial insertion sites in patients with accessory pathways.

    Science.gov (United States)

    Tracy, C M; Moore, H J; Solomon, A J; Rodak, D J; Fletcher, R D

    1995-11-01

    Radiofrequency ablation has gained acceptance in the treatment of patients with symptomatic Wolff-Parkinson-White syndrome. The purpose of this study was to characterize the relation between temperature and other electroconductive parameters in patients undergoing atrial insertion accessory pathway ablation utilizing a thermistor equipped catheter. The mean temperature and power at sites of atrial insertion ablation are lower than has been previously associated with creation of radiofrequency lesions in the ventricle. While high cavitary blood flow in the atrium may result in cooling, the thinner atrial tissue may require less energy to achieve adequate heating than ventricular myocardium.

  13. Relationship between LIBS Ablation and Pit Volume for Geologic Samples: Applications for in situ Absolute Geochronology

    Science.gov (United States)

    Devismes, D.; Cohen, Barbara A.

    2014-01-01

    , variable vacuum pressure), and c) the ablation is made with hundreds of successive laser pulses. In this work, we aim to understand the effects that occur on LIBS spectra when a homogeneous rock or a mineral is ablated under high vacuum. Understanding these effects is important to define best practices for LIBS measurements and may lead to improved measurement (or possibly prediction) of the ablated volume. We will describe our laboratory approach and first results, and discuss its utility for situ absolute geochronology campaigns.

  14. Laboratory Simulations of Micrometeoroid Ablation

    Science.gov (United States)

    Thomas, Evan Williamson

    Each day, several tons of meteoric material enters Earth's atmosphere, the majority of which consist of small dust particles (micrometeoroids) that completely ablate at high altitudes. The dust input has been suggested to play a role in a variety of phenomena including: layers of metal atoms and ions, nucleation of noctilucent clouds, effects on stratospheric aerosols and ozone chemistry, and the fertilization of the ocean with bio-available iron. Furthermore, a correct understanding of the dust input to the Earth provides constraints on inner solar system dust models. Various methods are used to measure the dust input to the Earth including satellite detectors, radar, lidar, rocket-borne detectors, ice core and deep-sea sediment analysis. However, the best way to interpret each of these measurements is uncertain, which leads to large uncertainties in the total dust input. To better understand the ablation process, and thereby reduce uncertainties in micrometeoroid ablation measurements, a facility has been developed to simulate the ablation of micrometeoroids in laboratory conditions. An electrostatic dust accelerator is used to accelerate iron particles to relevant meteoric velocities (10-70 km/s). The particles are then introduced into a chamber pressurized with a target gas, and they partially or completely ablate over a short distance. An array of diagnostics then measure, with timing and spatial resolution, the charge and light that is generated in the ablation process. In this thesis, we present results from the newly developed ablation facility. The ionization coefficient, an important parameter for interpreting meteor radar measurements, is measured for various target gases. Furthermore, experimental ablation measurements are compared to predictions from commonly used ablation models. In light of these measurements, implications to the broader context of meteor ablation are discussed.

  15. Matrix metalloproteinase-2 ablation in dystrophin-deficient mdx muscles reduces angiogenesis resulting in impaired growth of regenerated muscle fibers.

    Science.gov (United States)

    Miyazaki, Daigo; Nakamura, Akinori; Fukushima, Kazuhiro; Yoshida, Kunihiro; Takeda, Shin'ichi; Ikeda, Shu-ichi

    2011-05-01

    Matrix metalloproteases (MMPs) are a family of endopeptidases classified into subgroups based on substrate preference in normal physiological processes such as embryonic development and tissue remodeling, as well as in various disease processes via degradation of extracellular matrix components. Among the MMPs, MMP-9 and MMP-2 have been reported to be up-regulated in skeletal muscles in the lethal X-linked muscle disorder Duchenne muscular dystrophy (DMD), which is caused by loss of dystrophin. A recent study showed that deletion of the MMP9 gene in mdx, a mouse model for DMD, improved skeletal muscle pathology and function; however, the role of MMP-2 in the dystrophin-deficient muscle is not well known. In this study, we aimed at verifying the role of MMP-2 in the dystrophin-deficient muscle by using mdx mice with genetic ablation of MMP-2 (mdx/MMP-2(-/-)). We found impairment of regenerated muscle fiber growth with reduction of angiogenesis in mdx/MMP-2(-/-) mice at 3 months of age. Expression of vascular endothelial growth factor-A (VEGF-A), an important angiogenesis-related factor, decreased in mdx/MMP-2(-/-) mice at 3 months of age. MMP-2 had not a critical role in the degradation of dystrophin-glycoprotein complex (DGC) components such as β-dystroglycan and β-sarcoglycan in the regeneration process of the dystrophic muscle. Accordingly, MMP-2 may be essential for growth of regenerated muscle fibers through VEGF-associated angiogenesis in the dystrophin-deficient skeletal muscle.

  16. Formation and characterization of nanoparticles via laser ablation in solution

    Science.gov (United States)

    Golightly, Justin Samuel

    isopropyl alcohol. Ablation in n-hexane also showed diffraction patterns correlating with carbides, and water showed oxygen incorporation. These results showed the ability to utilize the solvent in tailoring nanoparticles to achieve desired properties. Zirconium and nickel were ablated with the Nd:YAG at 532 nm. These studies utilized a stainless steel chamber designed and built to improve control over the experimental variables. The nickel study showcased the new chamber's ability for reproducibility in a size dependence study based upon laser fluence. The results of ablation with the Nd:YAG were compared to femtosecond ablation experiments performed with a titanium:sapphire femtosecond laser system. The Ti:sapphire femtosecond laser operated at 10 Hz, produced femtosecond pulses centered at ˜795 nm. The pulse duration was varied from 100 fs to 390 fs, the nanoparticles created from each condition were characterized, and the results are presented in chapters 5 and 6. Aluminum nanoparticles were made using both nanosecond and femtosecond laser ablation techniques. Aluminum nanoparticles have a great deal of potential for use as fuel additives as well as in paints and coatings. The nanosecond ablation process rendered large nanoparticles (over 200 nm) and the results are briefly shown in Appendix A. The femtosecond system produced a much smaller distribution of nanoparticles, with nanoparticles remaining in suspension for over a month's time, as evidenced by their unique UV-Vis absorbance. These nanoparticles were produced in isopropyl alcohol, and were stabilized by the solvent, as TEM analysis showed nanoparticles with very little oxygen incorporation. The solvent is bound to the nanoparticles as a result of the formation process and as a result forms a protective coating, which prevents further oxidation over time. The remarkable stability of these aluminum nanoparticles is a testament of employing the high energy scheme of the laser ablation process in a manner to

  17. Fractional ablative erbium YAG laser

    DEFF Research Database (Denmark)

    Taudorf, Elisabeth H; Haak, Christina S; Erlendsson, Andrés M

    2014-01-01

    BACKGROUND AND OBJECTIVES: Treatment of a variety of skin disorders with ablative fractional lasers (AFXL) is driving the development of portable AFXLs. This study measures micropore dimensions produced by a small 2,940 nm AFXL using a variety of stacked pulses, and determines a model correlating...... energies of 2.3-12.8 mJ/microbeam and total energy levels of 4.6-640 mJ/microchannel. Histological endpoints were ablation depth (AD), coagulation zone (CZ) and ablation width (AW). Data were logarithmically transformed if required prior to linear regression analyses. Results for histological endpoints...

  18. Abnormal P-53 suppressor gene expression predicts for a poorer outcome in patients with locally advanced adenocarcinoma of the prostate treated by external beam radiation therapy with or without pre-radiation androgen ablation: results based on RTOG study 86-10

    International Nuclear Information System (INIS)

    Lawton, Colleen A.; Grignon, David; Caplan, Richard; Sarkar, Fazlul; Forman, Jeffrey; Mesic, John; Fu, Karen K.; Abrams, Ross

    1995-01-01

    Purpose/Objective: The purpose of this study is to establish the effect of the abnormal expression of the P-53 suppressor gene on the results of locally advanced adenocarcinoma of the prostate treated with radiation therapy with or without pre-radiation therapy androgen ablation. Materials and Methods: Patients evaluated were part of a RTOG phase III multi-institutional trial. This trial assessed the value of pre-radiation therapy androgen ablation on patients with locally advanced disease (bulky stage B and stage C). Of the 471 patients registered, pre-treatment pathological material was available for 129 patients. P-53 status was determined immunohistochemically utilizing a commercially available antibody (D07). Clinical endpoints evaluated were overall survival and development of metastases. Results: Twenty-three of the 129 patients had abnormal expression of the P-53 suppressor gene. Presence of this abnormal expression significantly correlated with lower overall survival (p=0.03) and the development of distant metastases (p=0.03). Abnormal expression of the P-53 gene was an independent prognostic indicator when evaluated against clinical stage and Gleason score. Conclusion: This data from patients entered on a phase III multi-institutional, randomized clinical trial shows that abnormal P-53 suppressor gene expression as determined immunohistochemically is an independent predictor of poorer survival and the development of distant metastases in patients with locally advanced adenocarcinoma of the prostate treated with radiation therapy with or without pre-radiation therapy androgen ablation

  19. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial.

    Science.gov (United States)

    Walfridsson, H; Walfridsson, U; Nielsen, J Cosedis; Johannessen, A; Raatikainen, P; Janzon, M; Levin, L A; Aronsson, M; Hindricks, G; Kongstad, O; Pehrson, S; Englund, A; Hartikainen, J; Mortensen, L S; Hansen, P S

    2015-02-01

    The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF. In this substudy, we evaluated the effect of these treatment modalities on the Health-Related Quality of Life (HRQoL) and symptom burden of patients at 12 and 24 months. During the study period, 294 patients were enrolled in the MANTRA-PAF trial and randomized to receive AAD (N = 148) or RFA (N = 146). Two generic questionnaires were used to assess the HRQoL [Short Form-36 (SF-36) and EuroQol-five dimensions (EQ-5D)], and the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) was used to evaluate the symptoms appearing during the trial. All comparisons were made on an intention-to-treat basis. Both randomization groups showed significant improvements in assessments with both SF-36 and EQ-5D, at 24 months. Patients randomized to RFA showed significantly greater improvement in four physically related scales of the SF-36. The three most frequently reported symptoms were breathlessness during activity, pronounced tiredness, and worry/anxiety. In both groups, there was a significant reduction in ASTA symptom index and in the severity of seven of the eight symptoms over time. Both AAD and RFA as first-line treatment resulted in substantial improvement of HRQoL and symptom burden in patients with PAF. Patients randomized to RFA showed greater improvement in physical scales (SF-36) and the EQ-visual analogue scale. URL http://www.clinicaltrials.gov. Unique identifier: NCT00133211. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  20. Percutaneous radiofrequency ablation with transarterial embolization is useful for treatment of stage 1 renal cell carcinoma with surgical risk. Results at 2-year mean follow up

    International Nuclear Information System (INIS)

    Arima, Kiminobu; Yamakado, Kouichirou; Kinbara, Hiroyuki; Nakatsuka, Atsuhiro; Takeda, Kan; Sugimura, Yoshiki

    2007-01-01

    Despite laparoscopic partial nephrectomy and laparoscopic cryotherapy being performed lately, an even less invasive treatment would be desirable in high-risk patients. Under local anesthesia with intravenous (i.v.) sedation, we were able to perform percutaneous radiofrequency ablation (RFA) combined with renal arterial embolization for unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC). We evaluated the feasibility, safety and therapeutic effects of this technique after a 2-year mean follow up. Thirty-one patients who were not candidates for surgery underwent RFA for 36 stage 1 RCC. Twenty-eight tumors were percutaneously ablated 6 days after the tumor vessels were embolized. Dynamic contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) were performed to evaluate treatment at completion. Tumor enhancement was eliminated after two RFA sessions in all tumors. Thirty tumors remained free of enhancement during a mean follow-up period of 24.3 months. There were no major complications related to the procedures though one instance of pyonephrosis, two of subcapsular hematomas, one of retroperitoneal hemorrhage and one of nausea were seen after RFA. Two patients died of other diseases (id est (i.e.) colon cancer and cerebral bleeding) 20 and 26 months after RFA treatment. One patient had a local recurrence of tumor and underwent re-RFA. The recurrence rate of RCC after successful RFA was 2.8%. There was no recurrence in patients who had tumors of less than 4 cm after RFA at a mean follow-up period of 24.3 months. Local control was achieved in 100% of T1NoMo tumors including the recurrence case that underwent re-RFA. The result of the present study at 2-year mean follow up showed percutaneous RFA was a feasible, safe and promising therapy for the treatment of unresectable stage 1 RCC, especially those smaller than 4 cm. (author)

  1. The cost-effectiveness of radiofrequency ablation for Barrett's esophagus with low-grade dysplasia: results from a randomized controlled trial (SURF trial).

    Science.gov (United States)

    Phoa, K Nadine; Rosmolen, Wilda D; Weusten, Bas L A M; Bisschops, Raf; Schoon, Erik J; Das, Shefali; Ragunath, Krish; Fullarton, G; DiPietro, Massimiliano; Ravi, Narayanasamy; Tijssen, Jan G P; Dijkgraaf, Marcel G W; Bergman, Jacques J G H M

    2017-07-01

    The Surveillance versus Radiofrequency Ablation (SURF) trial randomized 136 patients with Barrett's esophagus (BE) containing low-grade dysplasia (LGD), to receive radiofrequency ablation (ablation, n = 68) or endoscopic surveillance (control, n = 68). Ablation reduced the risk of neoplastic progression to high-grade dysplasia and esophageal adenocarcinoma (EAC) by 25% over 3 years (1.5% for ablation vs 26.5% for control). We performed a cost-effectiveness analysis from a provider perspective alongside this trial. Patients were followed for 3 years to quantify their use of health care services, including therapeutic and surveillance endoscopies, treatment of adverse events, and medication. Costs for treatment of progression were analyzed separately. Incremental cost-effectiveness ratios (ICER) were calculated by dividing the difference in costs (excluding and including the downstream costs for treatment of progression) by the difference in prevented events of progression. Bootstrap analysis (1000 samples) was used to construct 95% confidence intervals (CIs). Patients who underwent ablation generated mean costs of U.S.$13,503 during the trial versus $2236 for controls (difference $11,267; 95% CI, $9996-$12,378), with an ICER per prevented event of progression of $45,066. Including the costs for treatment of progression, ablation patients generated mean costs of $13,523 versus $4,930 for controls (difference $8593; 95% CI, $6881-$10,153) with an ICER of $34,373. Based on the various ICER estimates derived from the bootstrap analysis, one can be reasonably certain (>75%) that ablation is efficient at a willingness to pay of $51,664 per prevented event of progression or $40,915 including downstream costs of progression. Ablation for patients with confirmed BE-LGD is more effective and more expensive than endoscopic surveillance in reducing the risk of progression to high-grade dysplasia/EAC. The increase in costs of ablation can be justified to avoid a serious event

  2. Percutaneous thermal ablation of renal neoplasms

    International Nuclear Information System (INIS)

    Tacke, J.; Mahnken, A.H.; Guenther, R.W.

    2005-01-01

    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

  3. Catch 22: a case of incessant ventricular tachycardia post-left ventricular assist device resulting in right ventricular failure, left ventricular cavity obliteration and failure of endocardial ventricular tachycardia ablation.

    Science.gov (United States)

    Thosani, Amit J; Bailey, Stephen H; Raina, Amresh

    2017-06-01

    Ventricular tachycardia (VT) in the setting of left ventricular assist device (LVAD) therapy has been well described. We present a case of incessant ventricular tachycardia resulting in severe right ventricular (RV) failure and subsequent left ventricular (LV) cavity obliteration, which in turn diminished the feasibility of initial attempt at VT ablation.

  4. Targeted ablation of nesprin 1 and nesprin 2 from murine myocardium results in cardiomyopathy, altered nuclear morphology and inhibition of the biomechanical gene response.

    Directory of Open Access Journals (Sweden)

    Indroneal Banerjee

    2014-02-01

    Full Text Available Recent interest has focused on the importance of the nucleus and associated nucleoskeleton in regulating changes in cardiac gene expression in response to biomechanical load. Mutations in genes encoding proteins of the inner nuclear membrane and nucleoskeleton, which cause cardiomyopathy, also disrupt expression of a biomechanically responsive gene program. Furthermore, mutations in the outer nuclear membrane protein Nesprin 1 and 2 have been implicated in cardiomyopathy. Here, we identify for the first time a role for the outer nuclear membrane proteins, Nesprin 1 and Nesprin 2, in regulating gene expression in response to biomechanical load. Ablation of both Nesprin 1 and 2 in cardiomyocytes, but neither alone, resulted in early onset cardiomyopathy. Mutant cardiomyocytes exhibited altered nuclear positioning, shape, and chromatin positioning. Loss of Nesprin 1 or 2, or both, led to impairment of gene expression changes in response to biomechanical stimuli. These data suggest a model whereby biomechanical signals are communicated from proteins of the outer nuclear membrane, to the inner nuclear membrane and nucleoskeleton, to result in changes in gene expression required for adaptation of the cardiomyocyte to changes in biomechanical load, and give insights into etiologies underlying cardiomyopathy consequent to mutations in Nesprin 1 and 2.

  5. UTILIZATION OF EVALUATION RESULTS IN LEGAL POLICY-MAKING AND ADMINISTRATION

    Directory of Open Access Journals (Sweden)

    Hellmut Wollmann

    2017-01-01

    Full Text Available The article is devoted to the analysis of evaluation method and its impact on legal policy development in governance, including in the area of law enforcement.The author outlines the importance of question whether, when and how the evaluation results of public policies, programs and measures has been utilized (or not utilized in policy making and policy implementation.In the pursuit of this guiding question the article will come in five steps.First, major variants of evaluation will be briefly presented particularly with an eye on their respective “utilization potential”.Second, different concepts will be sketched that have been forwarded to capture the utilization of social science generated knowledge by political, administrative and social actors. The author outlines a detailed description of types of evaluations: a retrospective, prelimi-nary, ongoing, interactive, – as well as existing concepts of application of its results.Third, looking at Germany, Switzerland and the European Union as “cases in point” perti-ent research findings will be discussed. The article also subjected to a detailed analysis of the experience of Germany, Switzerland and the European Union in the field of utilization of evaluation results.Fourth, a summary and conclusion will be given.Fifth, some remarks on pertinent research needs will be made.The author comes to the conclusion that that the rate of the utilization of evaluation-generated knowledge has so far turned out be, by and large, scarce. The author says that re-garding the politically crucial decisions the political rationality and its underlying political will of the decision-makers prevail while concerning less important decisions evaluation-generated evidence does show some effect and, hence, a dose of scientific rationality comes to the fore.There is also a need for further research on the subject of how should (and should not use assessment results when making legal and political decisions.

  6. Long-term Survival Following Ablation of Colorectal Liver Metastases

    DEFF Research Database (Denmark)

    Andersen, Iben Rahbek; Mortensen, Frank Viborg; Kirkegård, Jakob

    2018-01-01

    Introduction: Ablation of colorectal liver metastases (CRLM) in highly selected patients is an option with curative potential. Patient selection and the ablative technique have continued to improve over the years. This study assessed the trends in long-term survival after ablation of CRLM. Methods...... divided into three subgroups according to time of ablation (2000-2004; 2005-2009, and 2010-2014). Survival was defined as the time from the first ablation procedure until death, censoring or end of the follow-up period (December 31, 2015). Results: 741 CRLM ablations were performed in 444 patients...

  7. Genetic ablation of AQP2 in the mouse connecting tubules results in a mild urinary concentrating defect

    DEFF Research Database (Denmark)

    Kortenoeven, Marleen; Pedersen, Nis Borbye; Miller, Lance

    Body water balance is regulated in the kidney via the vasopressin (AVP) regulated water channel aquaporin-2 (AQP2) expressed in the connecting tubule (CNT) and the collecting duct (CD). Although crucial for the urinary concentrating mechanism, the relative role of AQP2 in the CNT and CD...... are not fully understood. To study the role of AQP2 in the CNT we generated a mouse model with a CNT-specific knock-out of AQP2. Confocal immunofluorescence microscopy of kidney sections demonstrated an absence of AQP2 immunolabeling in the CNT of the knock-out animals. 24 hour urine output was significantly...... in cortical kidney fractions with no compensatory changes in the AVP-regulated transporters NKCC2, AQP3 and AQP4. In conclusion, we have demonstrated that deletion of AQP2 from the CNT results in a mild urinary concentrating defect, without diminished maximal urinary concentrating ability. Our studies suggest...

  8. Diabetes and quality of life: Comparing results from utility instruments and Diabetes-39.

    Science.gov (United States)

    Chen, Gang; Iezzi, Angelo; McKie, John; Khan, Munir A; Richardson, Jeff

    2015-08-01

    To compare the Diabetes-39 (D-39) with six multi-attribute utility (MAU) instruments (15D, AQoL-8D, EQ-5D, HUI3, QWB, and SF-6D), and to develop mapping algorithms which could be used to transform the D-39 scores into the MAU scores. Self-reported diabetes sufferers (N=924) and members of the healthy public (N=1760), aged 18 years and over, were recruited from 6 countries (Australia 18%, USA 18%, UK 17%, Canada 16%, Norway 16%, and Germany 15%). Apart from the QWB which was distributed normally, non-parametric rank tests were used to compare subgroup utilities and D-39 scores. Mapping algorithms were estimated using ordinary least squares (OLS) and generalised linear models (GLM). MAU instruments discriminated between diabetes patients and the healthy public; however, utilities varied between instruments. The 15D, SF-6D, AQoL-8D had the strongest correlations with the D-39. Except for the HUI3, there were significant differences by gender. Mapping algorithms based on the OLS estimator consistently gave better goodness-of-fit results. The mean absolute error (MAE) values ranged from 0.061 to 0.147, the root mean square error (RMSE) values 0.083 to 0.198, and the R-square statistics 0.428 and 0.610. Based on MAE and RMSE values the preferred mapping is D-39 into 15D. R-square statistics and the range of predicted utilities indicate the preferred mapping is D-39 into AQoL-8D. Utilities estimated from different MAU instruments differ significantly and the outcome of a study could depend upon the instrument used. The algorithms reported in this paper enable D-39 data to be mapped into utilities predicted from any of six instruments. This provides choice for those conducting cost-utility analyses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Decreasing unnecessary utilization in acute bronchiolitis care: results from the value in inpatient pediatrics network.

    Science.gov (United States)

    Ralston, Shawn; Garber, Matthew; Narang, Steve; Shen, Mark; Pate, Brian; Pope, John; Lossius, Michele; Croland, Trina; Bennett, Jeff; Jewell, Jennifer; Krugman, Scott; Robbins, Elizabeth; Nazif, Joanne; Liewehr, Sheila; Miller, Ansley; Marks, Michelle; Pappas, Rita; Pardue, Jeanann; Quinonez, Ricardo; Fine, Bryan R; Ryan, Michael

    2013-01-01

    Acute viral bronchiolitis is the most common diagnosis resulting in hospital admission in pediatrics. Utilization of non-evidence-based therapies and testing remains common despite a large volume of evidence to guide quality improvement efforts. Our objective was to reduce utilization of unnecessary therapies in the inpatient care of bronchiolitis across a diverse network of clinical sites. We formed a voluntary quality improvement collaborative of pediatric hospitalists for the purpose of benchmarking the use of bronchodilators, steroids, chest radiography, chest physiotherapy, and viral testing in bronchiolitis using hospital administrative data. We shared resources within the network, including protocols, scores, order sets, and key bibliographies, and established group norms for decreasing utilization. Aggregate data on 11,568 hospitalizations for bronchiolitis from 17 centers was analyzed for this report. The network was organized in 2008. By 2010, we saw a 46% reduction in overall volume of bronchodilators used, a 3.4 dose per patient absolute decrease in utilization (95% confidence interval [CI] 1.4-5.8). Overall exposure to any dose of bronchodilator decreased by 12 percentage points as well (95% CI 5%-25%). There was also a statistically significant decline in chest physiotherapy usage, but not for steroids, chest radiography, or viral testing. Benchmarking within a voluntary pediatric hospitalist collaborative facilitated decreased utilization of bronchodilators and chest physiotherapy in bronchiolitis. Copyright © 2012 Society of Hospital Medicine.

  10. Results of Cryoenergy and Radiofrequency-Based Catheter Ablation for Treating Ventricular Arrhythmias Arising From the Papillary Muscles of the Left Ventricle, Guided by Intracardiac Echocardiography and Image Integration.

    Science.gov (United States)

    Rivera, Santiago; Ricapito, Maria de la Paz; Tomas, Leandro; Parodi, Josefina; Bardera Molina, Guillermo; Banega, Rodrigo; Bueti, Pablo; Orosco, Agustin; Reinoso, Marcelo; Caro, Milagros; Belardi, Diego; Albina, Gaston; Giniger, Alberto; Scazzuso, Fernando

    2016-04-01

    Catheter radiofrequency ablation of ventricular arrhythmias (VAs) arising from the left ventricle's papillary muscles has been associated with inconsistent results. The use of cryoenergy versus radiofrequency has not been compared yet. This study compares outcomes and complications of catheter ablation of VA from the papillary muscles of the left ventricle with either cryoenergy or radiofrequency. Twenty-one patients (40±12 years old; 47% males; median ejection fraction 59±7.3%) with drug refractory premature ventricular contractions or ventricular tachycardia underwent catheter cryoablation or radiofrequency ablation. VAs were localized using 3-dimensional mapping, multidetector computed tomography, and intracardiac echocardiography, with arrhythmia foci being mapped at either the anterolateral papillary muscle or posteromedial papillary muscles of the left ventricle. Focal ablation was performed using an 8-mm cryoablation catheter or a 4-mm open-irrigated radiofrequency catheter, via transmitral approach. Acute success rate was 100% for cryoenergy (n=12) and 78% for radiofrequency (n=9; P=0.08). Catheter stability was achieved in all patients (100%) treated with cryoenergy, and only in 2 (25%) patients treated with radiofrequency (P=0.001). Incidence of multiple VA morphologies was observed in 7 patients treated with radiofrequency (77.7%), whereas none was observed in those treated with cryoenergy (P=0.001). VA recurrence at 6 months follow-up was 0% for cryoablation and 44% for radiofrequency (P=0.03). Cryoablation was associated with higher success rates and lower recurrence rates than radiofrequency catheter ablation, better catheter stability, and lesser incidence of polymorphic arrhythmias. © 2016 American Heart Association, Inc.

  11. Utility bill comprehension in the commercial and industrialsector: results of field research

    Energy Technology Data Exchange (ETDEWEB)

    Payne, Christopher T.

    2000-06-02

    This paper presents the results of interviews conducted with 44 business people in 10 states to examine the use of the utility bill as an information mechanism for providing businesses with the relationship between energy consumption and cost. Our results indicate that there are significant barriers to the use of the utility bill as an information tool for energy consumers. Furthermore, we found significant variations among respondents in the information desired from the bill, and differences in decision-making criteria for investments aimed at reducing energy consumption and for those aimed at other forms of waste minimization. These results call into question the applicability of standard market theories in the purchase of energy by most businesses.

  12. Quality of Life Following Stereotactic Ablative Radiation Therapy Versus Surgery for Early-Stage Lung Cancer : Results From the ROSEL Randomized Controlled Trial and a Systematic Review

    NARCIS (Netherlands)

    Louie, A V; Chen, H.; Van Werkhoven, E; Smit, E.; Palma, D A; Paul, M A; Warner, A; Widder, J; Groen, H. J. M.; van Den Borne, B; De Jaeger, K; Rodrigues, G; Slotman, B J; Senan, S

    2016-01-01

    Purpose/Objective(s) One of the purported advantages of stereotactic ablative radiation therapy (SABR) as an alternative treatment option to surgery for early-stage non-small cell lung cancer (ES-NSCLC) is health-related quality of life (HRQOL). The objectives of this study are 1) to assess HRQOL

  13. Electrical and thermal effects of esophageal temperature probes on radiofrequency catheter ablation of atrial fibrillation: results from a computational modeling study.

    Science.gov (United States)

    Pérez, Juan J; D'Avila, Andre; Aryana, Arash; Berjano, Enrique

    2015-05-01

    Luminal esophageal temperature (LET) monitoring is commonly employed during catheter ablation of atrial fibrillation (AF) to detect high esophageal temperatures during radiofrequency (RF) delivery along the posterior wall of the left atrium. However, it has been recently suggested that in some cases the esophageal probe itself may serve as an RF "antenna" and promote esophageal thermal injury. The aim of this study was to assess the electrical and thermal interferences induced by different types of commercially available esophageal temperature probes (ETPs) on RF ablation. In this study, we developed a computational model to assess the electrical and thermal effects of 3 different types of ETPs: a standard single-sensor and 2 multisensor probes (1 with and 1 without metallic surfaces). LET monitoring invariably underestimated the maximum temperature reached in the esophageal wall. RF energy cessation guided by LET monitoring using an ETP yielded lower esophageal wall temperatures. Also, the phenomenon of thermal latency was observed, particularly in the setting of LET monitoring. Most importantly, while only the ETP with a metallic surface produced minimal electrical alterations, the magnitude of this interference did not appear to be clinically significant. Temperature rises in both the esophageal wall and the ETP seem to be primarily produced by thermal conduction, and not caused by electrical and/or thermal interactions between the ablation catheter and the ETP, itself. As such, the proposed notion of the "antenna effect" producing satellite esophageal lesions during AF ablation was not evident in this study. © 2015 Wiley Periodicals, Inc.

  14. Laser ablation of paint in nuclear industry

    International Nuclear Information System (INIS)

    Brygo, Francois; Semerok, Alexandre; Weulersse, Jean-Marc; Thro, Pierre-Yves; Oltra, Roland; Decobert, Guy

    2006-01-01

    Nuclear dismantling faces the challenge of paint removal on large surfaces of painted walls. The conventional methods for paint stripping on concrete walls are mainly based on mechanical grinder and lead to an important volume of aerosols and wastes. Laser ablation has been evaluated as a promising method for paint removal with a number of advantages. The method reduces considerably the waste volume as the removal of paint is selective. The ablated matter can be collected by aerosol aspiration/filtration. The automation of the process can provide a higher capacity of paint removal. Laser ablation of paint was under our extensive studies. Laser ablation with different nanosecond repetition rate lasers was comparatively studied to understand the ablation mechanisms, and to obtain the highest efficiency of paint removal. The investigations were made with three Q-Switched Nd:YAG lasers (λ = 532 nm and λ = 1.064 μm). The different pulse durations (5 ns and 100 ns) demonstrated the different ablation regimes. Ablation with long pulses (100 ns) provided the best removal efficiency while the short ones (5 ns) decreased the ablation threshold fluence. It was demonstrated that the pulse repetition rate increasing in the 20 Hz - 10 kHz range induced heat accumulation in the paint. It resulted in ablation efficiency increase with a large decrease in the ablation threshold fluence. Laser ablation in the 0 - 10 J / cm 2 fluence range was investigated. Various paints were under investigation to obtain the maximum efficiency of paint removal for each specific experimental case. The ejected matter recording with a high speed imaging system allows to analyse the laser-matter interaction. (authors)

  15. Microwave Tissue Ablation: Biophysics, Technology and Applications

    Science.gov (United States)

    2010-01-01

    Microwave ablation is an emerging treatment option for many cancers, cardiac arrhythmias and other medical conditions. During treatment, microwaves are applied directly to tissues to produce rapid temperature elevations sufficient to produce immediate coagulative necrosis. The engineering design criteria for each application differ, with individual consideration for factors such as desired ablation zone size, treatment duration, and procedural invasiveness. Recent technological developments in applicator cooling, power control and system optimization for specific applications promise to increase the utilization of microwave ablation in the future. This article will review the basic biophysics of microwave tissue heating, provide an overview of the design and operation of current equipment, and outline areas for future research for microwave ablation. PMID:21175404

  16. Laser ablation in analytical chemistry - A review

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Quantification and controllability study of minimally invasive exothermic chemo-ablation therapy for tumor ablation.

    Science.gov (United States)

    Liu, Ran; Huang, Yu; Liu, Jing

    2009-01-01

    The recently proposed exothermic chemical reaction based tumor hyperthermia method presented a new way of realizing truly minimally invasive treatment for tumor. This method utilizes heat generated from the reaction between acid and alkali solutions to allow for tumor ablation. Successful clinical implementation of this method requires a clearer understanding and quantification of the ablation area such that a more controllable operation can be made. A number of in-vitro and in-vivo experiments are designed to examine the features of thermal chemo-ablation therapy which include micro and macro characteristics of ablated tissue and temperature change during the ablation process. A Quantitative study on the relationship between velocity and ablation volume as well as a Graphical User Interface in Matlab for computerized ablation area analysis are also presented in this article. We present in here two instrument designs for thermal chemo-ablation and have completed the prototype design for the injection pump which has been tested and successfully applied in ex-vivo and vivo experiments.

  18. Valuation of transfusion-free living in MDS: results of health utility interviews with patients

    Directory of Open Access Journals (Sweden)

    Lübbert Michael

    2009-09-01

    Full Text Available Abstract Background This study measured how myelodysplastic syndrome (MDS patients value transfusion independence (TI, reduced transfusions (RT and transfusion-dependence (TD using health utility assessment methodology. Methods 47 MDS patients were interviewed, US (n = 8, France (n = 9, Germany (n = 9 and the UK (n = 21, to elicit the utility value of TI, RT and TD. Health states were developed based on literature; patient forum discussions; and were validated by a hematologist. Face-to-face interviews used the feeling thermometer Visual Analogue Scale (VAS and the Time Trade-Off (TTO method to value the health states on a 0 (dead to 1 (perfect health scale. Socio-demographic, clinical, and quality-of-life (EQ-5D characteristics were surveyed to describe the patient sample. Results and Discussion The mean age was 67 years (range: 29-83; 45% male, 70% retired; 40% had secondary/high school education, or higher (32%, and 79% lived with family, a partner or spouse, or friends. The mean time from MDS diagnosis was 5 years (range:1-23. Most patients (87% received previous transfusions and 49% had received a transfusion in the last 3 months. Mean EQ-5D index score was 0.78; patients reported at least some problem with mobility (45%, usual activities (40%, pain/discomfort (47%, and anxiety/depression (34%. Few patients had difficulty understanding the VAS (n = 3 and TTO (n = 4 exercises. Utility scores for TI were higher than for RT (0.84 vs. 0.77; p Conclusion Patients value TI, suggesting an important role for new treatments aiming to achieve greater TI in MDS. These results can be used in preference-based health economic evaluation of new MDS treatments, such as in future cost-utility studies.

  19. Femtosecond laser ablation of dentin

    Science.gov (United States)

    Alves, S.; Oliveira, V.; Vilar, R.

    2012-06-01

    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.

  20. Femtosecond laser ablation of dentin

    International Nuclear Information System (INIS)

    Alves, S; Vilar, R; Oliveira, V

    2012-01-01

    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)

  1. Ablation of typical atrial flutter using a non-fluoroscopic catheter tracking system vs. conventional fluoroscopy--results from a prospective randomized study.

    Science.gov (United States)

    Schoene, Katharina; Rolf, Sascha; Schloma, Denis; John, Silke; Arya, Arash; Dinov, Borislav; Richter, Sergio; Bollmann, Andreas; Hindricks, Gerhard; Sommer, Philipp

    2015-07-01

    Reduction of radiation exposure using a sensor-based non-fluoroscopic catheter tracking (NFCT) system (MediGuide™, St Jude Medical, Inc.) was recently demonstrated by retrospective comparisons. We aimed to prospectively compare the effects of using NFCT vs. standard fluoroscopy on procedural parameters in patients undergoing radiofrequency ablation of typical atrial flutter. We prospectively randomized 40 patients undergoing cavotricuspid isthmus ablation for typical atrial flutter to either NFCT (n = 20) or conventional fluoroscopy (CONV, n = 20). Procedural parameters such as fluoroscopy time, radiation dose, and procedure duration, as well as periprocedural complications were compared. There were no statistically significant differences in baseline characteristics between the two groups. Bidirectional isthmus block was achieved in all patients. Fluoroscopy time was significantly reduced in the NFCT group {0.3 [inter-quartile range (IQR) 0.2; 0.48] min} when compared with CONV [5.7 (IQR 4.2; 11.5) min] (P fluoroscopy in patients undergoing radiofrequency ablation of typical atrial flutter, NFCT significantly reduced both radiation dose and fluoroscopy time with no effects on procedural duration. These findings support the incorporation of NFCT in routine clinical use. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  2. Pulmonary ablation: a primer.

    Science.gov (United States)

    Roberton, Benjamin J; Liu, David; Power, Mark; Wan, John M C; Stuart, Sam; Klass, Darren; Yee, John

    2014-05-01

    Percutaneous image-guided thermal ablation is safe and efficacious in achieving local control and improving outcome in the treatment of both early stage non-small-cell lung cancer and pulmonary metastatic disease, in which surgical treatment is precluded by comorbidity, poor cardiorespiratory reserve, or unfavorable disease distribution. Radiofrequency ablation is the most established technology, but new thermal ablation technologies such as microwave ablation and cryoablation may offer some advantages. The use of advanced techniques, such as induced pneumothorax and the popsicle stick technique, or combining thermal ablation with radiotherapy, widens the treatment options available to the multidisciplinary team. The intent of this article is to provide the reader with a practical knowledge base of pulmonary ablation by concentrating on indications, techniques, and follow-up. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  3. Synergistic Combination of Electrolysis and Electroporation for Tissue Ablation.

    Science.gov (United States)

    Stehling, Michael K; Guenther, Enric; Mikus, Paul; Klein, Nina; Rubinsky, Liel; Rubinsky, Boris

    2016-01-01

    Electrolysis, electrochemotherapy with reversible electroporation, nanosecond pulsed electric fields and irreversible electroporation are valuable non-thermal electricity based tissue ablation technologies. This paper reports results from the first large animal study of a new non-thermal tissue ablation technology that employs "Synergistic electrolysis and electroporation" (SEE). The goal of this pre-clinical study is to expand on earlier studies with small animals and use the pig liver to establish SEE treatment parameters of clinical utility. We examined two SEE methods. One of the methods employs multiple electrochemotherapy-type reversible electroporation magnitude pulses, designed in such a way that the charge delivered during the electroporation pulses generates the electrolytic products. The second SEE method combines the delivery of a small number of electrochemotherapy magnitude electroporation pulses with a low voltage electrolysis generating DC current in three different ways. We show that both methods can produce lesion with dimensions of clinical utility, without the need to inject drugs as in electrochemotherapy, faster than with conventional electrolysis and with lower electric fields than irreversible electroporation and nanosecond pulsed ablation.

  4. Near-field mapping by laser ablation of PMMA coatings

    DEFF Research Database (Denmark)

    Fiutowski, J.; Maibohm, C.; Kostiucenko, O.

    2011-01-01

    enhancements on and around the gold nanostructures. At the positions of the enhancements, the ablation threshold of the polymer coating is significantly lowered creating subdiffractional topographic modifications on the surface which are quantified via scanning electron microscopy and atomic force microscopy......The optical near-field of lithography-defined gold nanostructures, arranged into regular arrays on a gold film, is characterized via ablation of a polymer coating by laser illumination. The method utilizes femto-second laser pulses from a laser scanning microscope which induces electrical field....... The obtained experimental results for different polymer coating thicknesses and nanostructure geometries are in good agreement with theoretical calculations of the near field distribution for corresponding enhancement mechanisms. The developed method and its tunable experimental parameters show...

  5. Results of a prospective phase 2 clinical trial of induction gemcitabine/capecitabine followed by stereotactic ablative radiation therapy in borderline resectable or locally advanced pancreatic adenocarcinoma.

    Science.gov (United States)

    Quan, Kimmen; Sutera, Philip; Xu, Karen; Bernard, Mark E; Burton, Steven A; Wegner, Rodney E; Zeh, Herbert; Bahary, Nathan; Stoller, Ronald; Heron, Dwight E

    Stereotactic ablative radiation therapy's (SABR's) great conformity and short duration has become an attractive treatment modality. We report a phase 2 clinical trial to evaluate efficacy and safety of induction chemotherapy (ICT) followed by SABR in patient with borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). Patients with biopsy-proven BR or LA PDAC were treated with four 21-day cycles of intravenous gemcitabine and oral capecitabine. Patients were restaged within 4 weeks after ICT by computed tomography and treated by 3-fraction SABR if no metastasis or progressive disease was identified. Patients were restaged 4 weeks following SABR to determine resectability. Tumor response was assessed with carbohydrate antigen 19-9. Thirty-five patients (19 BR/16 LA) were enrolled. The median age was 71.8 years (range, 50.6-81.1). ICT was completed in 91.4% (n = 32) of patients. All patients who completed ICT completed SABR. Of those 32 patients, 34.3% (n = 12: 10 BR, 2 LA) underwent pancreaticoduodenectomy and 11 of 12 (91.7%) received R0 resection. Median overall survival was 18.8, 28.3, and 14.3 months for the entire cohort, BR, and LA, respectively. The 2-year local progression-free survival (LPFS) was 44.9%, 40%, and 52% for the entire cohort, BR, and LA, respectively. For BR patients, multivariate analysis showed surgery was associated with better overall survival and LPFS. One-year LPFS for patients with surgery was 80% and 44% without surgery. Within the 15.4-month follow-up, no grade 3+ toxicity from SABR was observed. No significant quality of life change was observed before and after ICT, SABR, or surgery for BR or LA patients. This is the first prospective phase 2 study to investigate the feasibility and efficacy of a 12-week gemcitabine/capecitabine ICT followed by SABR for BR or LA PDAC. The results suggest excellent tolerability, high R0 resection rates, and acceptable posttreatment complications. Copyright © 2017

  6. 7-year follow-up after stereotactic ablative radiotherapy for patients with stage I non-small cell lung cancer: Results of a phase 2 clinical trial.

    Science.gov (United States)

    Sun, Bing; Brooks, Eric D; Komaki, Ritsuko U; Liao, Zhongxing; Jeter, Melenda D; McAleer, Mary F; Allen, Pamela K; Balter, Peter A; Welsh, James D; O'Reilly, Michael S; Gomez, Daniel; Hahn, Stephen M; Roth, Jack A; Mehran, Reza J; Heymach, John V; Chang, Joe Y

    2017-08-15

    The authors evaluated the efficacy, patterns of failure, and toxicity of stereotactic ablative radiotherapy (SABR) for patients with medically inoperable, clinical stage I non-small cell lung cancer (NSCLC) in a prospective clinical trial with 7 years of follow-up. Clinical staging was performed according to the seventh edition of the American Joint Committee on Cancer TNM staging system. Eligible patients with histologically confirmed NSCLC of clinical stage I as determined using positron emission tomography staging were treated with SABR (50 grays in 4 fractions). The primary endpoint was progression-free survival. Patients were followed with computed tomography and/or positron emission tomography/computed tomography every 3 months for the first 2 years, every 6 months for the next 3 years, and then annually thereafter. A total of 65 patients were eligible for analysis. The median age of the patients was 71 years, and the median follow-up was 7.2 years. A total of 18 patients (27.7%) developed disease recurrence at a median of 14.5 months (range, 4.3-71.5 months) after SABR. Estimated incidences of local, regional, and distant disease recurrence using competing risk analysis were 8.1%, 10.9%, and 11.0%, respectively, at 5 years and 8.1%, 13.6%, and 13.8%, respectively, at 7 years. A second primary lung carcinoma developed in 12 patients (18.5%) at a median of 35 months (range, 5-67 months) after SABR. Estimated 5-year and 7-year progression-free survival rates were 49.5% and 38.2%, respectively; the corresponding overall survival rates were 55.7% and 47.5%, respectively. Three patients (4.6%) experienced grade 3 treatment-related adverse events. No patients developed grade 4 or 5 adverse events (toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 3.0]). With long-term follow-up, the results of the current prospective study demonstrated outstanding local control and low toxicity after SABR in

  7. Aluminum X-ray mass-ablation rate measurements

    Directory of Open Access Journals (Sweden)

    J.L. Kline

    2017-01-01

    Full Text Available Measurements of the mass ablation rate of aluminum (Al have been completed at the Omega Laser Facility. These measurements show that the mass-ablation rate of Al is higher than plastic (CH, comparable to high density carbon (HDC, and lower than beryllium. The mass-ablation rate is consistent with predictions using a 1D Lagrangian code, Helios. The results suggest Al capsules have a reasonable ablation pressure even with a higher albedo than beryllium or carbon ablators and further investigation into the viability of Al capsules for ignition should be pursued.

  8. Laser ablation comparison by picosecond pulses train and nanosecond pulse

    Science.gov (United States)

    Lednev, V. N.; Filippov, M. N.; Bunkin, A. F.; Pershin, S. M.

    2015-12-01

    A comparison of laser ablation by a train of picosecond pulses and nanosecond pulses revealed a difference in laser craters, ablation thresholds, plasma sizes and spectral line intensities. Laser ablation with a train of picosecond pulses resulted in improved crater quality while ablated mass decreased up to 30%. A reduction in laser plasma dimensions for picosecond train ablation was observed while the intensity of atomic/ionic lines in the plasma spectra was greater by a factor of 2-4 indicating an improved excitation and atomization in the plasma.

  9. Laser ablation principles and applications

    CERN Document Server

    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.

  10. Processing condition influence on the characteristics of gold nanoparticles produced by pulsed laser ablation in liquids

    International Nuclear Information System (INIS)

    Nikov, R.G.; Nikolov, A.S.; Nedyalkov, N.N.; Atanasov, P.A.; Alexandrov, M.T.; Karashanova, D.B.

    2013-01-01

    A study is presented of Au nanoparticles (NPs) created by nanosecond pulsed laser ablation of a solid target in double distilled water. The influence was examined of the laser wavelength on the size, shape and optical properties of the resulting NPs. Three different wavelengths: the fundamental (λ = 1064 nm), second (λ SHG = 532) and third (λ THG = 355) harmonic of a Nd:YAG laser at the same fluence were utilized to produce various colloids. Ablation at the wavelength of 532 nm was investigated in more detail to reveal the influence of self-absorption by the already created NPs on their characteristics. The colloid produced was irradiated by λ irrad = 532 nm (laser energy 40 mJ) at different times up to 25 min after the end of ablation. The initial structure of welded NPs forming wires was modified. Transmission electron microscopy and optical transmission measurements were used to evaluate the shape and size distribution of the NPs.

  11. Long-term results of CT-guided percutaneous radiofrequency ablation of inoperable patients with stage Ia non-small cell lung cancer: A retrospective cohort study.

    Science.gov (United States)

    Huang, Bing-Yang; Li, Xin-Min; Song, Xiao-Yong; Zhou, Jun-Jun; Shao, Zhuang; Yu, Zhi-Qi; Lin, Yi; Guo, Xin-Yu; Liu, Da-Jiang; Li, Lu

    2018-03-16

    This study was performed to retrospectively evaluate the 10-year overall survival (OS), progression-free survival (PFS), and local control rates of patients with inoperable stage Ia non-small cell lung cancer (NSCLC) who underwent computed tomography (CT)-guided radiofrequency ablation (RFA) in a single center. Fifty patients with inoperable NSCLC underwent RFA between 2004 and 2016. Thoracic surgeons evaluated the patients and performed RFA under CT guidance. Follow-up CT and positron emission tomography/CT scans were obtained. Local control rates and recurrence patterns were analyzed. Seventy-three lesions in 50 patients (M:F = 22:28; median age: 73 years; range: 52-82 years) were treated with CT-guided RFA. The mean lesion size was 2.2 cm (range: 1-3 cm). No procedure-related deaths occurred. Low-grade fever was the most common post-ablation complication, with an incidence rate of 36%. The 1-, 2-, 3-, 5-, and 10-year OS rates of patients with Ia NSCLC were 96.0%, 86.5%, 67.1%, 36.3%, and 1%, respectively, and the 1-, 2-, 3-, and 5-year PFS rates were 94.0%, 77.5%, 43.5%, and 10.8%, respectively. The most common pattern of recurrence was local, and 15 patients with recurrence were treated with repeat RFA. Tumor size Ia NSCLC. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Ablation mass features in multi-pulses femtosecond laser ablate molybdenum target

    Science.gov (United States)

    Zhao, Dongye; Gierse, Niels; Wegner, Julian; Pretzler, Georg; Oelmann, Jannis; Brezinsek, Sebastijan; Liang, Yunfeng; Neubauer, Olaf; Rasinski, Marcin; Linsmeier, Christian; Ding, Hongbin

    2018-03-01

    In this study, the ablation mass features related to reflectivity of bulk Molybdenum (Mo) were investigated by a Ti: Sa 6 fs laser pulse at central wavelength 790 nm. The ablated mass removal was determined using Confocal Microscopy (CM) technique. The surface reflectivity was calibrated and measured by a Lambda 950 spectrophotometer as well as a CCD camera during laser ablation. The ablation mass loss per pulse increase with the increasing of laser shots, meanwhile the surface reflectivity decrease. The multi-pulses (100 shots) ablation threshold of Mo was determined to be 0.15 J/cm2. The incubation coefficient was estimated as 0.835. The reflectivity change of the Mo target surface following multi-pulses laser ablation were studied as a function of laser ablation shots at various laser fluences from 1.07 J/cm2 to 36.23 J/cm2. The results of measured reflectivity indicate that surface reflectivity of Mo target has a significant decline in the first 3-laser pulses at the various fluences. These results are important for developing a quantitative analysis model for laser induced ablation and laser induced breakdown spectroscopy for the first wall diagnosis of EAST tokamak.

  13. Treatment utilization and barriers to treatment: Results of a survey of dependent methamphetamine users

    Directory of Open Access Journals (Sweden)

    Lee Nicole K

    2011-02-01

    Full Text Available Abstract Background Australia has one of the highest rates of methamphetamine use in the world; however, treatment access for methamphetamine is comparatively low. This descriptive study aimed to identify patterns of treatment utilization and perceived barriers to accessing treatment among dependent methamphetamine users in the hope that such information will enable services to more appropriately respond to this group. Methods One hundred and twenty-six methamphetamine users who had a current or past history of methamphetamine dependence were interviewed about their experiences of, and perceived barriers to, treatment. Results Treatment utilization among methamphetamine users was reportedly low. One of the main reasons cited for not accessing treatment was that methamphetamine users did not perceive their drug use to be a problem (despite apparent levels of dependence. Self-detoxification with the use of other licit and illicit drugs was high among this group. Participants identified a lack of confidence in the ability of treatment services to address methamphetamine dependence and the 'opiate-centric' nature of treatment services as significant blocks to treatment entry. Suggestions for improvement by participants included operating specialist services for methamphetamine users, placing an emphasis on responsiveness and routinely involving case management services for this group. Discussion and Conclusions To improve service delivery, treatment services should reorient their services to better address the needs of methamphetamine users by making small changes such as specific opening times for methamphetamine users or using a dedicated space for methamphetamine treatment. Alternative options such as online treatments and specialist methamphetamine clinics should be considered for methamphetamine users.

  14. Utilization of supportive care by survivors of colorectal cancer : Results from the PROFILES registry

    NARCIS (Netherlands)

    Holla, Jasmijn F M; van de Poll-Franse, L.V.; Huijgens, Peter C; Mols, F.; Dekker, Joost

    2016-01-01

    PURPOSE: In an equitable healthcare system, healthcare utilization should be predominantly explained by patient-perceived need and clinical need factors. This study aims to analyze whether predisposing, enabling, and need factors are associated with the utilization of supportive care (i.e., dietary

  15. Laser systems for ablative fractional resurfacing

    DEFF Research Database (Denmark)

    Paasch, Uwe; Haedersdal, Merete

    2011-01-01

    Ablative fractional resurfacing (AFR) creates microscopic vertical ablated channels that are surrounded by a thin layer of coagulated tissue, constituting the microscopic treatment zones (MTZs). AFR induces epidermal and dermal remodeling, which raises new possibilities for the treatment...... of a variety of skin conditions, primarily chronically photodamaged skin, but also acne and burn scars. In addition, it is anticipated that AFR can be utilized in the laser-assisted delivery of topical drugs. Clinical efficacy coupled with minimal downtime has driven the development of various fractional...

  16. Interest of Electrostimulation of Peripheral Motor Nerves during Percutaneous Thermal Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Garnon, Julien, E-mail: juliengarnon@gmail.com; Ramamurthy, Nitin, E-mail: nitin_ramamurthy@hotmail.com; Buy, Xavier, E-mail: xbuy@ymail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [University Hospital of Strasbourg (France)

    2013-12-15

    Purpose: We present our experience of utilizing peripheral nerve electrostimulation as a complementary monitoring technique during percutaneous thermal ablation procedures; and we highlight its utility and feasibility in the prevention of iatrogenic neurologic thermal injury. Methods: Peripheral motor nerve electrostimulation was performed in 12 patients undergoing percutaneous image-guided thermal ablations of spinal/pelvic lesions in close proximity to the spinal cord and nerve roots. Electrostimulation was used in addition to existing insulation (active warming/cooling with hydrodissection, passive insulation with CO{sub 2} insufflation) and temperature monitoring (thermocouples) techniques. Impending neurologic deficit was defined as a visual reduction of muscle response or need for a stronger electric current to evoke muscle contraction, compared with baseline. Results: Significant reduction of the muscle response to electrostimulation was observed in three patients during the ablation, necessitating temporary interruption, followed by injection of warm/cool saline. This resulted in complete recovery of the muscle response in two cases, while for the third patient the response did not improve and the procedure was terminated. No patient experienced postoperative motor deficit. Conclusion: Peripheral motor nerve electrostimulation is a simple, easily accessible technique allowing early detection of impending neurologic injury during percutaneous image-guided thermal ablation. It complements existing monitoring techniques and provides a functional assessment along the whole length of the nerve.

  17. Interest of Electrostimulation of Peripheral Motor Nerves during Percutaneous Thermal Ablation

    International Nuclear Information System (INIS)

    Tsoumakidou, Georgia; Garnon, Julien; Ramamurthy, Nitin; Buy, Xavier; Gangi, Afshin

    2013-01-01

    Purpose: We present our experience of utilizing peripheral nerve electrostimulation as a complementary monitoring technique during percutaneous thermal ablation procedures; and we highlight its utility and feasibility in the prevention of iatrogenic neurologic thermal injury. Methods: Peripheral motor nerve electrostimulation was performed in 12 patients undergoing percutaneous image-guided thermal ablations of spinal/pelvic lesions in close proximity to the spinal cord and nerve roots. Electrostimulation was used in addition to existing insulation (active warming/cooling with hydrodissection, passive insulation with CO 2 insufflation) and temperature monitoring (thermocouples) techniques. Impending neurologic deficit was defined as a visual reduction of muscle response or need for a stronger electric current to evoke muscle contraction, compared with baseline. Results: Significant reduction of the muscle response to electrostimulation was observed in three patients during the ablation, necessitating temporary interruption, followed by injection of warm/cool saline. This resulted in complete recovery of the muscle response in two cases, while for the third patient the response did not improve and the procedure was terminated. No patient experienced postoperative motor deficit. Conclusion: Peripheral motor nerve electrostimulation is a simple, easily accessible technique allowing early detection of impending neurologic injury during percutaneous image-guided thermal ablation. It complements existing monitoring techniques and provides a functional assessment along the whole length of the nerve

  18. Radiofrequency ablation in dermatology

    Directory of Open Access Journals (Sweden)

    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.

  19. ROLE OF RADIOFREQUENCY ABLATION IN ADENOMA SEBACEUM

    Directory of Open Access Journals (Sweden)

    Ch. Madh

    2016-03-01

    Full Text Available Adenoma sebaceum, pathognomonic of tuberous sclerosis, are tiny angiofibromas which commonly occur over central part of face. Recurrence after treatment is common and hence a need for inexpensive, safe and efficient treatment is required. Radiofrequency ablation is a safe and an economical procedure and has been known to cause less scarring with good aesthetic results compared to other ablative methods such as electrocautery.

  20. Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling

    Directory of Open Access Journals (Sweden)

    Marcello Lucchese

    2017-06-01

    Full Text Available Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years and a long-term (lifetime horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs. Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis.

  1. Utilization of Morning Report by Acute Care Surgery Teams: Results from a Qualitative Study

    Science.gov (United States)

    Pringle, Patricia L.; Collins, Courtney; Santry, Heena P.

    2013-01-01

    Background The rigor of hand-offs is increasingly scrutinized in the era of shift-based patient care. Acute Care Surgery (ACS) embraced such a model of care; however, little is known about hand-offs in ACS programs. Methods We conducted 18 open-ended interviews with ACS leaders representing diverse geographic and practice settings. Two independent reviewers analyzed interviews using an inductive approach to elucidate themes regarding use of morning report (NVivo qualitative analysis software). Results 12/18 respondents reported a morning report but only 6/12 included attending-to-attending hand-offs. 1/12 incentivized attendings to participate, 2/12 included nursing staff, and 2/12 included physician extenders. Cited benefits of morning report were safe and effective information exchange (2/12), quality improvement (2/12), multidisciplinary discussion (1/12), and resident education (2/12). 3/12 respondents cited time commitment as the main limitation of morning report. Conclusions Morning report is under-utilized among ACS programs; however, if implemented strategically, it may improve patient care and resident education. PMID:24157348

  2. NASA Technology Utilization House technical support package Summary of results and house description

    Science.gov (United States)

    1979-01-01

    The Technology Utilization House (Tech House) was designed and constructed to demonstrate to the building industry and the public the benefits of aerospace technology and other new technology that are presently available or will be in very near future. Use of solar energy, conservation of energy and of water, safety, and security were incorporated in the design of the house. The terms to be incorporated into the house and to assist in the design of the house were evaluated. An architectural engineering team was employed to investigate energy conservation ideas, determine cost effectiveness of new materials and systems, and prepare specifications and drawings for the house. The Tech House was constructed during the spring of 1976. All the systems were monitored to insure proper operation, and data were collected during a one year occupancy. Results obtained during the family live-in period, comments on the acceptance of the various energy-saving systems by the family, and suggestions for improvement of the systems are presented.

  3. Aid in the detection of myocardial perfusion abnormality utilizing SPECT atlas and images registration: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Padua, Rodrigo Donizete Santana de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia]. E-mail: rodrigo_dsp@hcrp.fmrp.usp.br; Oliveira, Lucas Ferrari de [Universidade Federal de Pelotas (UFPel), RS (Brazil). Inst. de Fisica e Matematica. Dept. de Tecnologia da Informacao; Marques, Paulo Mazzoncini de Azevedo [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Groote, Jean-Jacques Georges Soares de [Instituto de Ensino Superior COC, Ribeirao Preto, SP (Brazil). Lab. of Artifical Intelligence and Applications; Castro, Adelson Antonio de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina; Ana, Lauro Wichert [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Simoes, Marcus Vinicius [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina. Divisao de Cardiologia

    2008-11-15

    To develop an atlas of myocardial perfusion scintigraphy and evaluating its applicability in computer-aided detection of myocardial perfusion defects in patients with ischemic heart disease. The atlas was created with rest-stress myocardial perfusion scintigraphic images of 20 patients of both genders with low probability of coronary artery disease and considered as normal by two experienced observers. Techniques of image registration and mathematical operations on images were utilized for obtaining template images depicting mean myocardial uptake and standard deviation for each gender and physiological condition. Myocardial perfusion scintigraphy images of one male and one female patient were aligned with the corresponding atlas template image, and voxels with myocardial uptake rates two standard deviations below the mean voxel value of the respective region in the atlas template image were highlighted on the tomographic sections and confirmed as perfusion defects by both observe. The present study demonstrated the creation of an atlas of myocardial perfusion scintigraphy with promising results of this tool as an aid in the detection of myocardial perfusion defects. However, further prospective validation with a more representative sample is recommended. (author)

  4. Results of a utilization-focused evaluation of a Right To Play program for Indigenous youth.

    Science.gov (United States)

    Arellano, Alexandra; Halsall, Tanya; Forneris, Tanya; Gaudet, Cindy

    2018-02-01

    This paper presents an evaluation of the Promoting Life Skills for Aboriginal Youth (PLAY) program that is operated by Right to Play (RTP). The focus of the program is to help youth develop a variety of life skills and become leaders within their communities. Piloted in 2010 with 2 communities, the program is now implemented in 88 communities in Ontario, Manitoba, British Columbia, and Alberta. This study applies a utilization-focused evaluation to examine staff perceptions related to program implementation. Data were collected using semi-structured interviews and a thematic analysis was performed. Themes emerged related to: 1) Integrating program flexibility to help facilitate community ownership, 2) Building capacity through skills training for Community Mentors (CMs), 3) Having a motivated staff and organizational learning, 4) Balancing the integration of culture and 5) Challenges related to adapting to multiple stakeholders and program pace. Findings are discussed in relation to relevant literature and recommendations for program improvements are provided. We also describe program improvements that were made as a result of applying the findings. This research contributes to the expanding literature related to programming for youth and evaluation practice within Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Ultrafast laser ablation in liquids for nanomaterials and applications.

    Science.gov (United States)

    Rao, S Venugopal; Podagatlapalli, G Krishna; Hamad, Syed

    2014-02-01

    We present an inclusive overview of the ultrafast ablation technique performed in liquids. Being a comparatively new method, we bring out the recent progress achieved, present the challenges ahead, and outline the future prospects for this technique. The review is conveniently divided into five parts: (a) a succinct preamble to the technique of ultrafast ablation in liquids (ULAL) is provided. A brief introduction to the conventional ns ablation is also presented for the sake of completeness (b) fundamental physical processes involved in this technique are elaborated (c) specific advantages of the technique compared to other physical and chemical methodologies are enumerated (d) applications of this technique in photonics; biomedical and explosives detection [using surface-enhanced Raman scattering (SERS)] is updated (e) future prospects describing the potential of this technique for creating unique nanoparticles (NPs) and nanostructures (NSs) for niche applications. We also discuss some of the recently reported significant results achieved in a variety of materials, especially metals, using this technique. Furthermore, we present some of our own experimental data obtained from ULAL of Ag, Cu, and Zn in a variety of liquids such as acetone, water, acetonitrile etc. The generated NPs (colloidal solutions) and NSs (on substrates) have been successfully utilized for nonlinear optical, SERS, and biomedical applications.

  6. Numerical Modeling of Ablation Heat Transfer

    Science.gov (United States)

    Ewing, Mark E.; Laker, Travis S.; Walker, David T.

    2013-01-01

    A unique numerical method has been developed for solving one-dimensional ablation heat transfer problems. This paper provides a comprehensive description of the method, along with detailed derivations of the governing equations. This methodology supports solutions for traditional ablation modeling including such effects as heat transfer, material decomposition, pyrolysis gas permeation and heat exchange, and thermochemical surface erosion. The numerical scheme utilizes a control-volume approach with a variable grid to account for surface movement. This method directly supports implementation of nontraditional models such as material swelling and mechanical erosion, extending capabilities for modeling complex ablation phenomena. Verifications of the numerical implementation are provided using analytical solutions, code comparisons, and the method of manufactured solutions. These verifications are used to demonstrate solution accuracy and proper error convergence rates. A simple demonstration of a mechanical erosion (spallation) model is also provided to illustrate the unique capabilities of the method.

  7. Advances in Imaging for Atrial Fibrillation Ablation

    International Nuclear Information System (INIS)

    D'Silva, A.; Wright, M.; Wright, M.

    2011-01-01

    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

  8. Diffusion-weighted magnetic resonance imaging using different b-value combinations for the evaluation of treatment results after volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Ikink, Marlijne E.; Voogt, Marianne J.; Bosch, Maurice A.A.J. van den; Nijenhuis, Robbert J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Keserci, Bilgin [Samsung Medical Center, High-intensity Focused Ultrasound (HIFU) Center, Seoul (Korea, Republic of); Philips Healthcare, Advanced Science and Development, Seoul (Korea, Republic of); Kim, Young-sun [Samsung Medical Center, High-intensity Focused Ultrasound (HIFU) Center, Seoul (Korea, Republic of); Samsung Medical Center, Sunkyunkwan University, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Vincken, Koen L.; Bartels, Lambertus W. [University Medical Center Utrecht, Department of Radiology and Image Sciences Institute, Utrecht (Netherlands)

    2014-09-15

    To assess the value of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) mapping using different b-value combinations for treatment evaluation after magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) of uterine fibroids. Fifty-six patients with 67 uterine fibroids were treated with volumetric MR-HIFU. Pre-treatment and post-treatment images were obtained using contrast-enhanced T1-weighted MRI (CE-T1WI) and DWI using b = 0, 200, 400, 600, 800 s/mm{sup 2}. ADC maps were generated using subsets of b-values to investigate the effects of tissue ablation on water diffusion and perfusion in fibroids treated with MR-HIFU. Four combinations of b-values were used: (1) all b-values; (2) b = 0, 200 s/mm{sup 2}; (3) b = 400, 600, 800 s/mm{sup 2}; and (4) b = 0, 800 s/mm{sup 2}. Using the lowest b-values (0 and 200 s/mm{sup 2}), the mean ADC value in the ablated tissue reduced significantly (p < 0.001) compared with baseline. Calculating the ADC value with the highest b-values (400, 600, 800 s/mm{sup 2}), the ADC increased significantly (p < 0.001) post-treatment. ADC maps calculated with the lowest b-values resulted in the best visual agreement of non-perfused fibroid tissue detected on CE images. Other b-value combinations and normal myometrium showed no difference in ADC after MR-HIFU treatment. A decrease in contrast agent uptake within the ablated region on CE-T1WI was correlated to a significantly decreased ADC when b = 0 and 200 s/mm{sup 2} were used. (orig.)

  9. Recurrence of Esophageal Intestinal Metaplasia After Endoscopic Mucosal Resection and Radiofrequency Ablation of Barrett’s Esophagus: Results From a US Multicenter Consortium Recurrence of Barrett’s Esophagus after EMR and RFA

    Science.gov (United States)

    Gupta, Milli; Iyer, Prasad G.; Lutzke, Lori; Gorospe, Emmanuel C.; Abrams, Julian A.; Falk, Gary W.; Ginsberg, Gregory G.; Rustgi, Anil K.; Lightdale, Charles J.; Wang, Timothy C.; Fudman, David I.; Poneros, John M.; Wang, Kenneth K.

    2013-01-01

    BACKGROUND & AIMS Radiofrequency ablation (RFA) is an established treatment for dysplastic Barrett’s esophagus (BE). Although short-term endpoints of ablation have been ascertained, there have been concerns about recurrence of intestinal metaplasia (IM) after ablation. We aimed to estimate the incidence and identify factors that predicted the recurrence of IM after successful RFA. METHODS We analyzed data from 592 patients with BE treated with RFA from 2003 through 2011 at 3 tertiary referral centers. Complete remission of intestinal metaplasia (CRIM) was defined as eradication of IM (in esophageal and gastro esophageal junction biopsies), documented by 2 consecutive endoscopies. Recurrence was defined as presence of IM or dysplasia after CRIM in surveillance biopsies. Two experienced gastrointestinal pathologists confirmed pathology findings. RESULTS Based on histology analysis, before RFA, 71% of patients had high-grade dysplasia or esophageal adenocarcinoma, 15% had low-grade dysplasia, and 14% had non-dysplastic BE. Of patients treated, 448 (76%) were assessed following RFA. 55% of patients underwent endoscopic mucosal resection before RFA. The median time to CRIM was 22 months, with 56% of patients in CRIM by 24 months. Increasing age and length of BE segment were associated with a longer times to CRIM. Twenty-four months after CRIM, the incidence of recurrence was 33%; 22% of all recurrences observed were dysplastic BE. There were no demographic or endoscopic factors associated with recurrence. Complications developed in 6.5% of subjects treated with RFA; strictures were the most common complication. CONCLUSION Of patients with BE treated by RFA, 56% are in complete remission after 24 months. However, 33% of these patients have disease recurrence within the next 2 years. Most recurrences were non-dysplastic and endoscopically manageable, but continued surveillance after RFA is essential. PMID:23499759

  10. Safety and effect on ablation size of hydrochloric acid-perfused radiofrequency ablation in animal livers.

    Science.gov (United States)

    Zhang, Tian-Qi; Huang, Sen-Miao; Gu, Yang-Kui; Gao, Fei; Huang, Zhi-Mei; Jiang, Xiong-Ying; Liu, Ding-Xin; Huang, Jin-Hua

    2018-02-26

    Our objective was to determine the safety and ablation size of hydrochloric acid-perfused radiofrequency ablation (HCl-RFA) in liver tissues, prospectively using in vivo rabbit and ex vivo porcine liver models. The livers in 30 rabbits were treated in vivo with perfusions of normal saline (controls) and HCl concentrations of 5%, 10%, 15%, and 20%, during RFA at 103 °C and 30 W for 3 min. For each experimental setting, six ablations were created. Safety was assessed by comparing baseline weight and selected laboratory values with those at 2, 7, and 14 days' post-ablation, and by histopathological analysis. The livers in 25 pigs were treated ex vivo with the same five perfusions during RFA at 103 °C, at both 30 W and 60 W, for 30 min. Ablation diameters and volumes were measured by two examiners. Rabbit weights and selected laboratory values did not differ significantly from baseline to 7 and 14 days' post-ablation, liver tissues outside the ablation zones were normal histologically, and adjacent organs showed no macroscopic damage. The mean ablation volumes in the porcine livers treated with HCl-RFA were all larger than those treated with normal saline perfusion during RFA (NS-RFA), at both 30 W and 60 W (p < 0.001). The largest ablation volume and transverse diameter were observed in the porcine livers during 10% HCl-RFA at 60 W, measuring 179.22 (SD = 24.79) cm 3 and 6.84 (SD = 0.36) cm, respectively. Based on our experiments, HCl-RFA in the liver appears to be as safe as NS-RFA while also resulting in larger ablation zones.

  11. Thermal Ablation of Lung Tumors: Focus on Microwave Ablation.

    Science.gov (United States)

    Vogl, Thomas J; Nour-Eldin, Nour-Eldin A; Albrecht, Moritz Hans; Kaltenbach, Benjamin; Hohenforst-Schmidt, Wolfgang; Lin, Han; Panahi, Bita; Eichler, Kathrin; Gruber-Rouh, Tatjana; Roman, Andrei

    2017-09-01

    Background  Image-guided thermal ablation can be used for the treatment of medically inoperable primary and metastatic lung cancer. These techniques are based on the heating up or freezing (cryoablation) of a volume of tissue around a percutaneous applicator that induces necrosis of the tumor. Method  The English-language literature concerning thermal ablation of the lung was reviewed. Radiofrequency ablation (RFA) is the most widely performed and investigated of these techniques. Microwave ablation (MWA) represents a relatively new alternative that shares the same indications and is conducted in a very similar fashion as RFA. It has been experimentally and clinically shown that MWA produces larger, more spherical ablation zones over shorter periods of time compared to RFA. Seven different MWA systems are available in Europe and the USA with significant differences in the size and shape of the produced ablation zones. Results  The types of complications caused by MWA and their rates of occurrence are very similar to those caused by RFA. The local progression rates after MWA of lung malignancies vary between 0 % and 34 % and are similar to those in the RFA literature. Conclusion  Despite technical improvements, the current generation of MWA systems has comparable clinical outcomes to those of RFA. Key Points   · MWA is a safe technique that should be considered one of the treatment options for medically inoperable lung tumors. · As thermal ablations of lung tumors are becoming more frequent, radiologists should be acquainted with the post-ablation imaging characteristics. · Although MWA has some theoretical advantages over RFA, the clinical outcomes are similar. Citation Format · Vogl TJ, Nour-Eldin NA, Albrecht MH et al. Thermal Ablation of Lung Tumors: Focus on Microwave Ablation. Fortschr Röntgenstr 2017; 189: 828 - 843. © Georg Thieme Verlag KG Stuttgart · New York.

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    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 perfor......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.......61 in vitro). We conclude that during temperature controlled radiofrequency ablation lesion size differs for septal and apical left ventricular applications. Differences in convective cooling might play an important role in this respect. This is supported by our in vitro experiments, where increased...

  13. Temperature Controlled Radiofrequency Ablation

    Directory of Open Access Journals (Sweden)

    Olaf J. Eick

    2002-07-01

    Full Text Available Since its introduction in 1987, radiofrequency (RF ablation has developed to become the treatment of choice for symptoms caused by atrio ventricular (AV reentrant tachycardia, isthmus related atrial flutter, AV-nodal reentrant tachycardia and to some extent also for certain types of ventricular tachycardias. The introduction of new cardiac activation mapping systems has further contributed to the successful and safe application of RF ablation for various tachyarrhythmias.

  14. Transcatheter ablation of cardiac tissue: advantages and disadvantages of different ablative techniques.

    Science.gov (United States)

    Shenasa, M; Willems, S; Chen, X; Fromer, M; Borggrefe, M

    1992-06-01

    Transcatheter ablation techniques are emerging as an alternative therapeutical tool in the management of cardiac arrhythmias. Catheter ablation was initially introduced as the last resort to ablate the atrioventricular nodal conduction in patients with atrial fibrillation and uncontrolled ventricular response and in patients with drug refractory ventricular tachycardias. Direct current energy was used as the sole source of energy, but because of potential significant complications and early and late mortality, presumably mostly due to ventricular tachyarrhythmias, other sources of energy were sought. Radiofrequency current which does not produce barotrauma and does not require general anesthesia rapidly replaced direct current ablation in many centers. Early results with radiofrequency current ablation of the atrioventricular node and accessory atrioventricular pathways are very encouraging. The results of radiofrequency as well as direct current ablation for atrial flutter, atrial tachycardia and ventricular tachycardia, where the components of reentry circuit are less defined, are not as favorable as those of AV junctional tachycardias. However, improvement of catheter and generatory technology and better understanding of the mechanisms of ventricular tachycardias and characteristics of the target site will enhance the results of catheter ablation in ventricular tachcardias. The procedures are still considered investigational, and mostly done by very experienced groups at tertiary referral hospitals with surgical teams available in case of serious complications. Larger patient populations and longer follow-up periods are required before these techniques expand to community hospitals and to patients with minimal symptoms or asymptomatic individuals as a prophylaxis therapy.

  15. Implications and considerations of thermal effects when applying irreversible electroporation tissue ablation therapy.

    Science.gov (United States)

    Davalos, Rafael V; Bhonsle, Suyashree; Neal, Robert E

    2015-07-01

    Irreversible electroporation (IRE) describes a cellular response to electric field exposure, resulting in the formation of nanoscale defects that can lead to cell death. While this behavior occurs independently of thermally-induced processes, therapeutic ablation of targeted tissues with IRE uses a series of brief electric pulses, whose parameters result in secondary Joule heating of the tissue. Where contemporary clinical pulse protocols use aggressive energy regimes, additional evidence is supplementing original studies that assert care must be taken in clinical ablation protocols to ensure the cumulative thermal effects do not induce damage that will alter outcomes for therapies using the IRE non-thermal cell death process for tissue ablation. In this letter, we seek to clarify the nomenclature regarding IRE as a non-thermal ablation technique, as well as identify existing literature that uses experimental, clinical, and numerical results to discretely address and evaluate the thermal considerations relevant when applying IRE in clinical scenarios, including several approaches for reducing these effects. Existing evidence in the literature describes cell response to electric fields, suggesting cell death from IRE is a unique process, independent from traditional thermal damage. Numerical simulations, as well as preclinical and clinical findings demonstrate the ability to deliver therapeutic IRE ablation without occurrence of morbidity associated with thermal therapies. Clinical IRE therapy generates thermal effects, which may moderate the non-thermal aspects of IRE ablation. Appropriate protocol development, utilization, and pulse delivery devices may be implemented to restrain these effects and maintain IRE as the vastly predominant tissue death modality, reducing therapy-mitigating thermal damage. Clinical applications of IRE should consider thermal effects and employ protocols to ensure safe and effective therapy delivery. © 2015 The Authors. The Prostate

  16. Research on the maximum utilization of PSR (Periodic Safety Review) results

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Myung; Lee, Jae Kyung; Ahn, Jin Chul; Kim, G. U.; Ryu, Y. S.; Lee, G. B.; Park, D. H. [Chungju Univ., Cheongju (Korea, Republic of)

    2002-03-15

    This is the final report of 'research on the maximum utilization of PSR results' focused on linkage strategy of PSR with continued operation over design life of operating NPP. Study was mace mainly on the analysis of current status of continued operation over plant design life in foreign countries, analysis of domestic PSR implementation status and establishment of basic strategy for linking PSR with continued operation. The results of the study performed so far can be summarized as below, the recent worldwide trend of promoting efficiency of NPP operation is focused on life extension of the plants rather than building of new. Considering the fact that some developed countries have already implemented the plant life extension and not a few countries at least have invested a good amount of fund for R and D of plant life management, we can not disregard the owner's request for review of life extension application without any reasonable description. As a result of investigation and analysis for the current status of continued operation over plant design life in foreign countries, it is concluded that most countries tend to link PSR with continued operation over plant design life and the extended operation has already been implemented in some developed countries. From the point, it turned out to be more desirable to couple those two systems for continued operation over plant design life of Korean NPP. A less than 7 years left until the end of design life for the oldest NPP Kori unit 1, it is strongly recommended to establish institutional frame including a legal basis and regulatory guidelines for continued operation over plant design life before long. For the prioritization methods of corrective actions in consideration of safety significance of shortcomings picked up from PSR, some related systems are reviewed including IAEA guidelines, PSR implementation experience of UK and US prioritization system for GSI (Generic Safety Issue). Basic principles are

  17. Percutaneous ablation of pancreatic cancer

    Science.gov (United States)

    D’Onofrio, Mirko; Ciaravino, Valentina; De Robertis, Riccardo; Barbi, Emilio; Salvia, Roberto; Girelli, Roberto; Paiella, Salvatore; Gasparini, Camilla; Cardobi, Nicolò; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma is a highly aggressive tumor with an overall 5-year survival rate of less than 5%. Prognosis and treatment depend on whether the tumor is resectable or not, which mostly depends on how quickly the diagnosis is made. Chemotherapy and radiotherapy can be both used in cases of non-resectable pancreatic cancer. In cases of pancreatic neoplasm that is locally advanced, non-resectable, but non-metastatic, it is possible to apply percutaneous treatments that are able to induce tumor cytoreduction. The aim of this article will be to describe the multiple currently available treatment techniques (radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation), their results, and their possible complications, with the aid of a literature review. PMID:27956791

  18. Photothermal ablation with the excimer laser sheath technique for embedded inferior vena cava filter removal: initial results from a prospective study.

    Science.gov (United States)

    Kuo, William T; Odegaard, Justin I; Louie, John D; Sze, Daniel Y; Unver, Kamil; Kothary, Nishita; Rosenberg, Jarrett K; Hovsepian, David M; Hwang, Gloria L; Hofmann, Lawrence V

    2011-06-01

    To evaluate the safety and effectiveness of the excimer laser sheath technique for removing embedded inferior vena cava (IVC) filters. Over 12 months, 25 consecutive patients undergoing attempted IVC filter retrieval with a laser-assisted sheath technique were prospectively enrolled into an institutional review board-approved study registry. There were 10 men and 15 women (mean age 50 years, range 20-76 years); 18 (72%) of 25 patients were referred from an outside hospital. Indications for retrieval included symptomatic filter-related acute caval thrombosis (with or without acute pulmonary embolism), chronic IVC occlusion, and bowel penetration. Retrieval was also performed to remove risks from prolonged implantation and potentially to eliminate need for lifelong anticoagulation. After failure of standard methods, controlled photothermal ablation of filter-adherent tissue with a Spectranetics laser sheath and CVX-300 laser system was performed. All patients were evaluated with cavography, and specimens were sent for histologic analysis. Laser-assisted retrieval was successful in 24 (96%) of 25 patients as follows: 11 Günther Tulip (mean 375 days, range 127-882 days), 4 Celect (mean 387 days, range 332-440 days), 2 Option (mean 215 days, range 100-330 days), 4 OPTEASE (mean 387 days, range 71-749 days; 1 failed 188 days), 2 TRAPEASE (mean 871 days, range 187-1,555 days), and 2 Greenfield (mean 12.8 years, range 7.2-18.3 years). There was one (4%) major complication (acute thrombus, treated with thrombolysis), three (12%) minor complications (small extravasation, self-limited), and one adverse event (coagulopathic retroperitoneal hemorrhage) at follow-up (mean 126 days, range 13-302 days). Photothermal ablation of filter-adherent tissue was histologically confirmed in 23 (92%) of 25 patients. The laser-assisted sheath technique appears to be a safe and effective tool for retrieving embedded IVC filters, including permanent types, with implantation ranging from

  19. Endovenous laser ablation with and without high ligation compared to high ligation and stripping for treatment of great saphenous varicose veins: Results of a multicentre randomised controlled trial with up to 6 years follow-up.

    Science.gov (United States)

    Flessenkämper, I; Hartmann, M; Hartmann, K; Stenger, D; Roll, S

    2016-02-01

    High ligation and stripping was compared to endovenous laser ablation for the therapy of great saphenous vein varicosity. Long-term efficacy was assessed in terms of avoidance of inguinal reflux and mechanisms of recurrence were investigated. Multicentre, randomised, three-arm, parallel trial. A total of 449 patients were randomised into three different treatment groups: high ligation and stripping group (n = 159), endovenous laser ablation group (n = 142; 980 nm, 30 W continuous mode, bare fibre) or a combination of laser ablation with high ligation (endovenous laser ablation group/ high ligation group, n = 148). Patients were examined clinically and by duplex ultrasound once a year.The primary end point of this study is inguinal reflux at the saphenofemoral junction after 2 years. This paper presents secondary data on sonographically determined inguinal reflux and clinical recurrences in the treated area after up to 6 years of follow-up. Median time to follow-up was 4.0 years; the mean time follow-up 3.6 years. Follow-up rates were: 2 years 74%, 3 years 47%, 4 years 39%, 5 years 36% and 6 years 31%. Most reflux into the great saphenous vein appeared in the endovenous laser ablation group (after 6 years: high ligation/stripping versus endovenous laser ablation p = 0.0102; high ligation/endovenous laser ablation vs. endovenous laser ablation p < 0.0002). Furthermore, more refluxive side branches were also observed in the endovenous laser ablation group (after 6 years high ligation/stripping vs. endovenous laser ablation p = 0.0569; high ligation/endovenous laser ablation vs. endovenous laser ablation p = 0.0111). In terms of clinical recurrence during the 6 years post therapy, no significant differences between the three treatment groups were observed (p values from log-rank test: high ligation/stripping vs. endovenous laser ablation p = 0.5479; high ligation/stripping vs. high ligation/endovenous laser ablation p = 0

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  1. Different methods to define utility functions yield similar results but engage different neural processes

    Directory of Open Access Journals (Sweden)

    Marcus Heldmann

    2009-10-01

    Full Text Available Although the concept of utility is fundamental to many economic theories, up to now a generally accepted method determining a subject’s utility function is not available. We investigated two methods that are used in economic sciences for describing utility functions by using response-locked event-related potentials in order to assess their neural underpinnings. For defining the certainty equivalent (CE, we used a lottery game with probabilities to win p=0.5, for identifying the subjects’ utility functions directly a standard bisection task was applied. Although the lottery tasks’ payoffs were only hypothetical, a pronounced negativity was observed resembling the error related negativity (ERN previously described in action monitoring research, but this occurred only for choices far away from the indifference point between money and lottery. By contrast, the bisection task failed to evoke an ERN irrespective of the responses’ correctness. Based on these findings we are reasoning that only decisions made in the lottery task achieved a level of subjective relevance that activates cognitive-emotional monitoring. In terms of economic sciences, our findings support the view that the bisection method is unaffected by any kind of probability valuation or other parameters related to risk and in combination with the lottery task can, therefore, be used to differentiate between payoff and probability valuation.

  2. Temporal changes in patient characteristics and prior pharmacotherapy in patients undergoing radiofrequency ablation of atrial fibrillation

    DEFF Research Database (Denmark)

    Karasoy, Deniz; Gislason, Gunnar Hilmar; Hansen, Jim

    2013-01-01

    Trends in patient selection and pharmacotherapy before radiofrequency ablation (RFA) of atrial fibrillation are not well studied. We examined temporal trends in RFA utilization on a nationwide scale in Denmark.......Trends in patient selection and pharmacotherapy before radiofrequency ablation (RFA) of atrial fibrillation are not well studied. We examined temporal trends in RFA utilization on a nationwide scale in Denmark....

  3. Design of Ablation Test Device for Brick Coating of Gun

    Science.gov (United States)

    shirui, YAO; yongcai, CHEN; fei, WANG; jianxin, ZHAO

    2018-03-01

    As a result of the live ammunition test conditions, the barrel resistance of the barrel coating has high cost, time consuming, low efficiency and high test site requirements. This article designed a simple, convenient and efficient test device. Through the internal trajectory calculation by Matlab, the ablation environment produced by the ablation test device has achieved the expected effect, which is consistent with the working condition of the tube in the launching state, which can better reflect the ablation of the coating.

  4. Hard tissue ablation with a spray-assisted mid-IR laser

    International Nuclear Information System (INIS)

    Kang, H W; Rizoiu, I; Welch, A J

    2007-01-01

    The objective of this study was to understand the dominant mechanism(s) for dental enamel ablation with the application of water spray. A free-running Er,Cr:YSGG (yttrium, scandium, gallium, garnet) laser was used to ablate human enamel tissue at various radiant exposures. During dental ablation, distilled water was sprayed on the sample surface, and these results were compared to ablation without a spray (dry ablation). In order to identify dominant ablation mechanisms, transient acoustic waves were compared to ablation thresholds and the volume of material removed. The ablation profile and depth were measured using optical coherence tomography (OCT). Irregular surface modification, charring and peripheral cracks were associated with dry ablation, whereas craters for spray samples were relatively clean without thermal damage. In spite of a 60% higher ablation threshold for spray associated irradiations owing to water absorption, acoustic peak pressures were six times higher and ablation volume was up to a factor of 2 larger compared to dry ablation. The enhanced pressure and ablation performance of the spray-assisted process was the result of rapid water vaporization, material ejection with recoil stress, interstitial water explosion and possibly liquid-jet formation. With water cooling and abrasive/disruptive mechanical effects, the spray ablation can be a safe and efficient modality for dental treatment

  5. Ovulation synchrony after follicle ablation in mares.

    Science.gov (United States)

    Bergfelt, D R; Adams, G P

    2000-01-01

    Two experiments were performed to determine the efficacy of ultrasound-guided transvaginal follicle ablation for synchronizing ovarian function in mares. The experiments were initiated at random stages of the oestrous cycle in control (nonablated) and follicle-ablated mares. On day 0, all follicles > or =10 mm in diameter were punctured, aspirated and curettaged in ablated mares, and, on day 4, two doses of PGF2alpha were administered with a 12 h interval between the doses to both ablated and nonablated (control) mares. In Expt 1, hCG was administered to the ablated mares on the first or second day after the largest follicle was > or =30 mm in diameter. In Expt 2, hCG was administered to ablated mares 6 days after PGF2alpha administration, at which time the largest follicle was expected to be > or =30 mm in diameter. FSH concentrations increased initially and decreased subsequently in the ablated mares, and the ablation-induced wave (first detection of a follicle > or =10 mm in diameter) was observed 1.9 days after ablation and was synchronous (1-3 days) in 90% of mares. In both Expts 1 and 2, the uniformity of follicular wave emergence among follicle-ablated mares resulted in significantly better synchrony of ovulation after PGF2alpha administration compared with that of control mares. The variation in the interval from PGF2alpha administration to ovulation in ablated mares was reduced further by hCG administration. In the ablation + hCG groups, ovulation synchrony occurred 6-10 days after PGF2alpha administration in Expt 1 (13/16, 81%) and 7-8 days after PGF2alpha administration in Expt 2 (7/8, 88%). The extended period of ovulation in Expt 1 compared with that of Expt 2 (5 versus 2 days) was inherent in the experimental design, as hCG was not administered in Expt 1 until the largest follicle reached > or =30 mm in diameter, whereas in Expt 2 the experimental design was modified such that hCG was administered 6 days after PGF2alpha administration. As a result, in

  6. Modeling CO2 Laser Ablative Impulse with Polymers

    International Nuclear Information System (INIS)

    Sinko, John E.; Phipps, Claude R.; Sasoh, Akihiro

    2010-01-01

    Laser ablation vaporization models have usually ignored the spatial dependence of the laser beam. Here, we consider effects from modeling using a Gaussian beam for both photochemical and photothermal conditions. The modeling results are compared to experimental and literature data for CO 2 laser ablation of the polymer polyoxymethylene under vacuum, and discussed in terms of the ablated mass areal density and momentum coupling coefficient. Extending the scope of discussion, laser ablative impulse generation research has lacked a cohesive strategy for linking the vaporization and plasma regimes. Existing models, mostly formulated for ultraviolet laser systems or metal targets, appear to be inappropriate or impractical for applications requiring CO 2 laser ablation of polymers. A recently proposed method for linking the vaporization and plasma regimes for analytical modeling is addressed here along with the implications of its use. Key control parameters are considered, along with the major propulsion parameters needed for laser ablation propulsion modeling.

  7. Microwave Ablation of Porcine Kidneys in vivo: Effect of two Different Ablation Modes (“Temperature Control” and “Power Control”) on Procedural Outcome

    International Nuclear Information System (INIS)

    Sommer, C. M.; Arnegger, F.; Koch, V.; Pap, B.; Holzschuh, M.; Bellemann, N.; Gehrig, T.; Senft, J.; Nickel, F.; Mogler, C.; Zelzer, S.; Meinzer, H. P.; Stampfl, U.; Kauczor, H. U.; Radeleff, B. A.

    2012-01-01

    Purpose: This study was designed to analyze the effect of two different ablation modes (“temperature control” and “power control”) of a microwave system on procedural outcome in porcine kidneys in vivo. Methods: A commercially available microwave system (Avecure Microwave Generator; MedWaves, San Diego, CA) was used. The system offers the possibility to ablate with two different ablation modes: temperature control and power control. Thirty-two microwave ablations were performed in 16 kidneys of 8 pigs. In each animal, one kidney was ablated twice by applying temperature control (ablation duration set point at 60 s, ablation temperature set point at 96°C, automatic power set point; group I). The other kidney was ablated twice by applying power control (ablation duration set point at 60 s, ablation temperature set point at 96°C, ablation power set point at 24 W; group II). Procedural outcome was analyzed: (1) technical success (e.g., system failures, duration of the ablation cycle), and (2) ablation geometry (e.g., long axis diameter, short axis diameter, and circularity). Results: System failures occurred in 0% in group I and 13% in group II. Duration of the ablation cycle was 60 ± 0 s in group I and 102 ± 21 s in group II. Long axis diameter was 20.3 ± 4.6 mm in group I and 19.8 ± 3.5 mm in group II (not significant (NS)). Short axis diameter was 10.3 ± 2 mm in group I and 10.5 ± 2.4 mm in group II (NS). Circularity was 0.5 ± 0.1 in group I and 0.5 ± 0.1 in group II (NS). Conclusions: Microwave ablations performed with temperature control showed fewer system failures and were finished faster. Both ablation modes demonstrated no significant differences with respect to ablation geometry.

  8. Utility Test Results of a 2-Megawatt, 10-Second Reserve-Power System

    Energy Technology Data Exchange (ETDEWEB)

    BALL,GREG J.; NORRIS,BENJAMIN L.

    1999-10-01

    This report documents the 1996 evaluation by Pacific Gas and Electric Company of an advanced reserve-power system capable of supporting 2 MW of load for 10 seconds. The system, developed under a DOE Cooperative Agreement with AC Battery Corporation of East Troy, Wisconsin, contains battery storage that enables industrial facilities to ''ride through'' momentary outages. The evaluation consisted of tests of system performance using a wide variety of load types and operating conditions. The tests, which included simulated utility outages and voltage sags, demonstrated that the system could provide continuous power during utility outages and other disturbances and that it was compatible with a variety of load types found at industrial customer sites.

  9. [Utilization of the health care system due to somatoform complaints -- results of a representative survey].

    Science.gov (United States)

    Hessel, Aike; Geyer, Michael; Hinz, Andreas; Brahler, Elmar

    2005-01-01

    Utilization of the health care system is not determined by the presence of an organic illness, but by a multitude of interacting factors. This applies particularly to somatoform complaints and disorders, in the context of which the health care system is used very intensively and inadequately in relation to the disorder. The present paper summarizes the frequency of somatoform complaints in the general population and health care utilization due to these complaints. On the basis of a survey carried out in 2002 for a representative population of 2089 persons (aged 14 to 92 years), the prevalence of somatoform complaints during a period of 2 years was determined. In this survey, physical complaints were defined as being somatoform when they seriously affected the person's well-being but exhibited a disparity between objective diagnostic findings and subjective experience. The psychosocial aspects were also determined. When somatoform complaints were identified, the specific utilization of the healthcare system for them was investigated. Somatoform complaints are very frequent in Germany: 8.3% of the population claim to suffer from clinically relevant somatoform disorders that fully meet the criteria mentioned above. The health care system is used heavily for these complaints. Within the last two years, each test person suffering from somatoform disorders consulted a physician a mean 18 times and was incapable of working for a mean of 20 days. 16% of these persons were hospitalized, 9 % received treatment at a health resort, 9 % retired, etc. The considerable utilization of health care services is an essential element of somatoform pathology and has immense medico-political relevance. The most important prerequisite for handling the 'commitment to health care system' symptom is thorough training of all physicians in the basics of somato-psycho-social medicine. This will be an important measure for cost reduction in the health care system.

  10. Isotope analysis of micro metal particles by adopting laser-ablation mass spectrometry

    International Nuclear Information System (INIS)

    Song, Kyu Seok; Ha, Young Kyung; Han, Sun Ho; Park, Yong Joon; Kim, Won Ho

    2005-01-01

    The isotope analysis of microparticles in environmental samples as well as laboratory samples is an important task. A special concern is necessary in particle analysis of swipe samples. Micro particles are normally analyzed either by dissolving particles in the solvents and adopting conventional analytical methods or direct analysis method such as a laser-ablation ICP mass spectrometry (LA-ICP-MS), SIMS, and SNMS (sputtered neutral mass spectrometry). But the LA-ICPMS uses large amount of samples because normally laser beam is tightly focused on the target particle for the complete ablation. The SIMS and SNMS utilize ion beams for the generation of sample ions from the particle. But the number of ions generated by an ion beam is less than 5% of the total generated particles in SIMS. The SNMS is also an excellent analytical technique for particle analysis, however, ion beam and frequency tunable laser system are required for the analysis. Recently a direct analysis of elements as well as isotopes by using laser-ablation is recognized one of the most efficient detection technology for particle samples. The laser-ablation mass spectrometry requires only one laser source without frequency tuneability with no sample pretreatment. Therefore this technique is one of the simplest analysis techniques for solid samples as well as particles. In this study as a part of the development of the new isotope analysis techniques for particles samples, a direct laser-ablation is adopted with mass spectrometry. Zinc and gadolinium were chosen as target samples, since these elements have isotopes with minor abundance (0.62% for Zn, and 0.2% for Gd). The preliminary result indicates that isotopes of these two elements are analyzed within 10% of natural abundance with good mass resolution by using direct laser-ablation mass spectrometry

  11. Effects of mitomycin-C on tear film, corneal biomechanics, and surface irregularity in mild to moderate myopic surface ablation: preliminary results.

    Science.gov (United States)

    Mohammadi, Seyed-Farzad; Ashrafi, Elham; Norouzi, Nima; Abdolahinia, Tahereh; Mir-AbouTalebi, Mohsen; Jabbarvand, Mahmoud

    2014-06-01

    To assess the effect of mitomycin-C (MMC) on the tear film, corneal biomechanics, and surface irregularity in surface ablation (photorefractive keratectomy [PRK]) for low to moderate myopia. Refractive Surgery Unit, Farabi Eye Hospital, Tehran, Iran. Double-masked randomized clinical trial. In patients with spherical equivalent myopia of -0.75 to -3.87 diopters (D) and astigmatism up to -1.75 D, the first eye was randomly assigned to the application of MMC 0.02% or a balanced salt solution for 15 seconds. The fellow eye received the alternate in a masked fashion after excimer photoablation. The study enrolled 60 patients. In fellow eyes, the changes in the tear-film index were comparable 1 month and 6 months postoperatively. There was no significant difference in changes in total higher-order aberrations, spherical aberration, coma, or Q values (Pentacam HR) between fellow eyes at 1 month and 6 months. There was a trend toward a higher asymmetry index at 1 month; however, a statistically significant drop was observed at 6 months in the MMC group (P<.01). It was hypothesized that stromal remodeling was delayed, but better, in MMC-treated eyes. No haze was recorded at 6 months in either group. Use of MMC in PRK did not appear to contribute significantly to surface irregularity, transient tear-film dysfunction, or biomechanical weakening of the cornea compared with PRK without MMC. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. CT-guided percutaneous radiofrequency ablation in osteoid osteoma. Re-assessments of results with optimized technique and possible pain patterns in mid-term follow-up

    International Nuclear Information System (INIS)

    Omlor, G.; Merle, C.; Lehner, B.; Ewerbeck, V.; Rehnitz, C.; Weber, M.A.; Ludwig, K.

    2012-01-01

    To re-assess radiofrequency ablation (RFA) of osteoid osteoma (OO) with an optimized technique and to evaluate patterns of post-interventional pain important for the detection of recurrence. 44 consecutive patients with OO treated with precise inclusion criteria by RFA were examined retrospectively. RFA was performed with an optimized technique. Technical success (TS), primary and secondary clinical success (PCS/SCS) and minor and major complications (MIC/MAC) were evaluated. Pain patterns defined as 'osteoid osteoma-specific pain' (OOSP) and 'unspecific pain' (UP), 'limitations in daily activity' (LDA) and 'patient satisfaction' (PS) were evaluated using a numeric rating scale (0 - 10; 0 = no pain, 0 = no limitation, 10 = fully satisfied). The pain intensity before and after RFA was compared. The mean follow-up time was 35 months (n = 40, range 2 - 60 months). TS was 100 % (n = 44), PCS 98 % (n = 44), and SCS 100 % (n = 40). MIC and MAC were 0 % (n = 44). OOSP was 0 after RFA in all 44 patients. UP was 0 in 24 of 40 patients (60 %), 1 in 11 patients (28 %) for up to 7 days and 1 - 4 in 5 patients (13 %) for 30 - 180 days. LDA was 0 in 39 of 40 patients (98 %), and 1 in 1 patient. PS was 10 in all patients. The pain after RFA was significantly less than before RFA (p < 0.0001). Using an optimized technique primary clinical success rates in the high nineties have to be expected. Unspecific pain of low intensity is not unusual after RFA and has to be distinguished from pain caused by recurrent disease. (orig.)

  13. CT-guided percutaneous radiofrequency ablation in osteoid osteoma. Re-assessments of results with optimized technique and possible pain patterns in mid-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Omlor, G.; Merle, C.; Lehner, B.; Ewerbeck, V. [Universitaetsklinik Heidelberg (Germany). Orthopaedische Universitaetsklinik; Rehnitz, C.; Weber, M.A. [Universitaetsklinik Heidelberg (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Ludwig, K. [Klinikum Herford (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie

    2012-04-15

    To re-assess radiofrequency ablation (RFA) of osteoid osteoma (OO) with an optimized technique and to evaluate patterns of post-interventional pain important for the detection of recurrence. 44 consecutive patients with OO treated with precise inclusion criteria by RFA were examined retrospectively. RFA was performed with an optimized technique. Technical success (TS), primary and secondary clinical success (PCS/SCS) and minor and major complications (MIC/MAC) were evaluated. Pain patterns defined as 'osteoid osteoma-specific pain' (OOSP) and 'unspecific pain' (UP), 'limitations in daily activity' (LDA) and 'patient satisfaction' (PS) were evaluated using a numeric rating scale (0 - 10; 0 = no pain, 0 = no limitation, 10 = fully satisfied). The pain intensity before and after RFA was compared. The mean follow-up time was 35 months (n = 40, range 2 - 60 months). TS was 100 % (n = 44), PCS 98 % (n = 44), and SCS 100 % (n = 40). MIC and MAC were 0 % (n = 44). OOSP was 0 after RFA in all 44 patients. UP was 0 in 24 of 40 patients (60 %), 1 in 11 patients (28 %) for up to 7 days and 1 - 4 in 5 patients (13 %) for 30 - 180 days. LDA was 0 in 39 of 40 patients (98 %), and 1 in 1 patient. PS was 10 in all patients. The pain after RFA was significantly less than before RFA (p < 0.0001). Using an optimized technique primary clinical success rates in the high nineties have to be expected. Unspecific pain of low intensity is not unusual after RFA and has to be distinguished from pain caused by recurrent disease. (orig.)

  14. Understanding how patients use visualization during ablation of atrial fibrillation in reducing their experience of pain, anxiety, consumption of pain medication and procedure length: Integrating quantitative and qualitative results.

    Science.gov (United States)

    Nørgaard, Marianne W; Pedersen, Preben U; Bjerrum, Merete

    2018-02-01

    Patients who undergo radiofrequency ablation of atrial fibrillation with a light conscious sedation often feel pain during the procedure which can be difficult to relieve with pharmacological pain treatment alone. In a quasi-experimental study, it was found that visualization together with usual pain medication reduced the amount of analgesics used. In addition, patients spontaneously expressed pain significantly fewer times outside the scheduled measurements. No difference was found in the perception of pain intensity or anxiety and procedure length in the study. In a subsequent qualitative study with patients from the intervention group in the quantitative study, patients reported visualization as a positive experience which helped them manage pain and anxiety by supporting their individual strategies and without inconvenience. To examine patients' experiences with the effect of visualization during ablation of atrial fibrillation and its association with pain intensity, anxiety, pain medication and procedure length. A mixed-method study with explanatory sequential design including a quasi-experimental study with a control and an intervention group and a qualitative interview study with semi-structured interviews. The results from the two studies in the mixed method study have been integrated by merging and constructing follow-up joint displays. Three themes were identified from the integration of the results from the quantitative and qualitative studies when analyzing and interpreting the results: "Zero pain is not always the goal"; "Not a real procedure time reduction but a sense of time shrinkage" and "Importance of the nurse's presence, visualization or not". Visualization can help patients to manage procedural pain when going through ablation of atrial fibrillation but the effect of an intervention such as visualization cannot be measured by pain intensity because the effect of visualization helps patients to cope with the pain and not to reduce the

  15. Thermal Ablation of Colorectal Lung Metastases: Retrospective Comparison Among Laser-Induced Thermotherapy, Radiofrequency Ablation, and Microwave Ablation.

    Science.gov (United States)

    Vogl, Thomas J; Eckert, Romina; Naguib, Nagy N N; Beeres, Martin; Gruber-Rouh, Tatjana; Nour-Eldin, Nour-Eldin A

    2016-12-01

    for those receiving RFA, and 32.8 months for those who underwent MWA. The overall survival rate at 1, 2, and 4 years was 95.2%, 47.6%, and 23.8%, respectively, for patients treated with LITT; 76.9%, 50.8%, and 8.0%, respectively, for patients treated with RFA; and 82.7%, 67.5%, and 16.6%, respectively, for patients treated with MWA. The log-rank test revealed no statistically significant difference among LITT, RFA, and MWA. The progression-free survival rate at 1, 2, 3, and 4 years was 96.8%, 52.7%, 24.0%, and 19.1%, respectively, for patients who underwent LITT; 77.3%, 50.2%, 30.8%, and 16.4%, respectively, for patients who underwent RFA; and 54.6%, 29.1%, 10.0%, and 1.0%, respectively, for patients who underwent MWA, with no statistically significant difference noted among the three ablation methods. LITT, RFA, and MWA can be used as therapeutic options for lung metastases resulting from colorectal cancer. Statistically significant differences in local tumor control revealed a potential advantage in using MWA. No differences in time to tumor progression or survival rates were detected when the three different ablation methods were compared.

  16. Sexual orientation and substance abuse treatment utilization in the United States: results from a national survey.

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T; Hughes, Tonda L; Boyd, Carol J

    2013-01-01

    This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, and behavior) in a large national sample of adults in the United States. Prevalence estimates were based on data collected from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults 20 years and older, and represented a population that was 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. An estimated 2% of the target population self-identified as lesbian, gay or bisexual; 4% reported same-sex sexual behavior, and 6% reported same-sex sexual attraction. Sexual minorities, especially women, had a greater likelihood of lifetime substance use disorders and earlier age of drinking onset. The majority of respondents with substance use disorders were untreated and lifetime substance abuse treatment utilization differed based on sexual orientation. Sexual minorities were found to have more extensive family histories of substance abuse problems. The findings indicate the underutilization of substance abuse treatment among all adults, and highlight some important factors to consider when working with sexual minorities. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Sexual Orientation and Substance Abuse Treatment Utilization in the United States: Results from a National Survey

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T.; Hughes, Tonda L.; Boyd, Carol J.

    2012-01-01

    This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, behavior) in a large national sample of adults in the United States. Prevalence estimates were based on data collected from the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults aged 20 years and older: 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. Approximately 2% of the sample self-identified as lesbian, gay or bisexual; 4% reported same-sex sexual behavior, and 6% reported same-sex sexual attraction. Sexual minorities, especially women, had a greater likelihood of lifetime substance use disorders and earlier age of drinking onset. The majority of respondents with substance use disorders were untreated and lifetime substance abuse treatment utilization differed based on sexual orientation. Sexual minorities were found to have more extensive family history of substance abuse problems. The findings indicate the underutilization of substance abuse treatment among all adults, and highlight some important factors to consider when working with sexual minorities. PMID:22444421

  18. Successful management of atrio-esophageal fistula after cardiac radiofrequency catheter ablation.

    Science.gov (United States)

    Shim, Hun Bo; Kim, Chilsung; Kim, Hong-Kwan; Sung, Kiick

    2013-04-01

    An increase in cardiac radiofrequency catheter ablation for treating refractory atrial fibrillation has resulted in an increased prevalence of complications. Among numerous complications of radiofrequency catheter ablation, atrio-esophageal fistula, although rare, is known to have fatal results. We report a case of successful management of an atrio-esophageal fistula as a complication of cardiac radiofrequency catheter ablation.

  19. Percutaneous tumor ablation in medical radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Mack, M.G. [University Hospital Frankfurt Univ. (Germany). Inst. for Diagnostic and Interventional Radiology; Helmberger, T.K. [Klinikum Bogenhausen, Academic Teaching Hospital of the Technical Univ. Munich (Germany). Dept. for Diagnostic and Interventional Radiology and Nuclear Medicine; Reiser, M.F. (eds.) [University Hospitals - Grosshadern and Innenstadt Munich Univ. (Germany). Dept. of Clinical Radiology

    2008-07-01

    Thermal ablation has become an integral part of oncology, especially in the field of interventional oncology. This very comprehensive book encompasses the different technologies employed in thermal ablation, its indications and the results achieved in various clinical conditions. The first part of the book clearly explains the basics of thermal ablative techniques such as laser-induced thermotherapy, radiofrequency ablation, microwave ablation, cryotherapy, and localized tumor therapy. The latest developments in the application of minimally invasive therapies in localized neoplastic disease are demonstrated. In the main part of the book, techniques of guiding the applicators to the target structures by use of different imaging tools such as ultrasound, computed tomography and magnetic resonance imaging are discussed. The results are presented for a variety of clinical indications, including liver and lung tumors and metastases and some rather rare conditions involving the kidney, the head and neck, the prostate, and soft tissue structures. A large number of acknowledged experts have contributed to the book, which benefits from a lucid structure and excellent images. (orig.)

  20. Percutaneous tumor ablation in medical radiology

    International Nuclear Information System (INIS)

    Vogl, T.J.; Mack, M.G.; Helmberger, T.K.; Reiser, M.F.

    2008-01-01

    Thermal ablation has become an integral part of oncology, especially in the field of interventional oncology. This very comprehensive book encompasses the different technologies employed in thermal ablation, its indications and the results achieved in various clinical conditions. The first part of the book clearly explains the basics of thermal ablative techniques such as laser-induced thermotherapy, radiofrequency ablation, microwave ablation, cryotherapy, and localized tumor therapy. The latest developments in the application of minimally invasive therapies in localized neoplastic disease are demonstrated. In the main part of the book, techniques of guiding the applicators to the target structures by use of different imaging tools such as ultrasound, computed tomography and magnetic resonance imaging are discussed. The results are presented for a variety of clinical indications, including liver and lung tumors and metastases and some rather rare conditions involving the kidney, the head and neck, the prostate, and soft tissue structures. A large number of acknowledged experts have contributed to the book, which benefits from a lucid structure and excellent images. (orig.)

  1. Is Cryoballoon Ablation Preferable to Radiofrequency Ablation for Treatment of Atrial Fibrillation by Pulmonary Vein Isolation? A Meta-Analysis

    Science.gov (United States)

    Xu, Junxia; Huang, Yingqun; Cai, Hongbin; Qi, Yue; Jia, Nan; Shen, Weifeng; Lin, Jinxiu; Peng, Feng; Niu, Wenquan

    2014-01-01

    Objective Currently radiofrequency and cryoballoon ablations are the two standard ablation systems used for catheter ablation of atrial fibrillation; however, there is no universal consensus on which ablation is the optimal choice. We therefore sought to undertake a meta-analysis with special emphases on comparing the efficacy and safety between cryoballoon and radiofrequency ablations by synthesizing published clinical trials. Methods and Results Articles were identified by searching the MEDLINE and EMBASE databases before September 2013, by reviewing the bibliographies of eligible reports, and by consulting with experts in this field. Data were extracted independently and in duplicate. There were respectively 469 and 635 patients referred for cryoballoon and radiofrequency ablations from 14 qualified clinical trials. Overall analyses indicated that cryoballoon ablation significantly reduced fluoroscopic time and total procedure time by a weighted mean of 14.13 (95% confidence interval [95% CI]: 2.82 to 25.45; P = 0.014) minutes and 29.65 (95% CI: 8.54 to 50.77; P = 0.006) minutes compared with radiofrequency ablation, respectively, whereas ablation time in cryoballoon ablation was nonsignificantly elongated by a weighted mean of 11.66 (95% CI: −10.71 to 34.04; P = 0.307) minutes. Patients referred for cryoballoon ablation had a high yet nonsignificant success rate of catheter ablation compared with cryoballoon ablation (odds ratio; 95% CI; P: 1.34; 0.53 to 3.36; 0.538), and cryoballoon ablation was also found to be associated with the relatively low risk of having recurrent atrial fibrillation (0.75; 0.3 to 1.88; 0.538) and major complications (0.46; 0.11 to 1.83; 0.269). There was strong evidence of heterogeneity and low probability of publication bias. Conclusion Our findings demonstrate greater improvement in fluoroscopic time and total procedure duration for atrial fibrillation patients referred for cryoballoon ablation than those for

  2. Comparison of the Three NIF Ablators

    Energy Technology Data Exchange (ETDEWEB)

    Kritcher, A. L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Clark, D. S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Haan, S. W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Yi, S. A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Zylstra, A. B. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Ralph, J. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Weber, C. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-11-01

    Indirect drive implosion experiments on NIF have now been performed using three different ablator materials: glow discharge polymer (GDP) or CH, high density carbon (HDC, which we also refer to as diamond), and sputtered beryllium (Be). It has been appreciated for some time that each of these materials has specific advantages and disadvantages as an ICF ablator.[1-4] In light of experiments conducted on NIF in the last few years, how do these ablators compare? Given current understanding, is any ablator more or less likely to reach ignition on NIF? Has the understanding of their respective strengths and weaknesses changed since NIF experiments began? How are those strengths and weaknesses highlighted by implosion designs currently being tested or planned for testing soon? This document aims to address these questions by combining modern simulation results with a survey of the current experimental data base. More particularly, this document is meant to fulfill an L2 Milestone for FY17 to “Document our understanding of the relative advantages and disadvantages of CH, HDC, and Be designs.” Note that this document does not aim to recommend a down-selection of the current three ablator choices. It is intended only to gather and document the current understanding of the differences between these ablators and thereby inform the choices made in planning future implosion experiments. This document has two themes: (i) We report on a reanalysis project in which post-shot simulations were done on a common basis for layered shots using each ablator. This included data from keyholes, 2D ConA, and so forth, from each campaign, leading up to the layered shots. (“Keyholes” are shots dedicated to measuring the shock timing in a NIF target, as described in Ref. 5. “2DConAs” are backlit implosions in which the symmetry of the implosion is measured between about half and full convergence, as described in Ref. 6.) This set of common-basis postshot simulations is compared to

  3. Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling.

    Science.gov (United States)

    Lucchese, Marcello; Borisenko, Oleg; Mantovani, Lorenzo Giovanni; Cortesi, Paolo Angelo; Cesana, Giancarlo; Adam, Daniel; Burdukova, Elisabeth; Lukyanov, Vasily; Di Lorenzo, Nicola

    2017-01-01

    To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  4. Catheter Ablation for Long-Standing Persistent Atrial Fibrillation.

    Science.gov (United States)

    Romero, Jorge; Gianni, Carola; Di Biase, Luigi; Natale, Andrea

    2015-01-01

    Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide and represents a major burden to health care systems. Atrial fibrillation is associated with a 4- to 5-fold increased risk of thromboembolic stroke. The pulmonary veins have been identified as major sources of atrial triggers for AF. This is particularly true in patients with paroxysmal AF but not always the case for those with long-standing persistent AF (LSPAF), in which other locations for ectopic beats have been well recognized. Structures with foci triggering AF include the coronary sinus, the left atrial appendage (LAA), the superior vena cava, the crista terminalis, and the ligament of Marshall. More than 30 studies reporting results on radiofrequency ablation of LSPAF have been published to date. Most of these are observational studies with very different methodologies using different strategies. As a result, there has been remarkable variation in short- and long-term success, which suggests that the optimal ablation technique for LSPAF is still to be elucidated. In this review we discuss the different approaches to LSPAF catheter ablation, starting with pulmonary vein isolation (PVI) through ablation lines in different left atrial locations, the role of complex fractionated atrial electrograms, focal impulses and rotor modulation, autonomic modulation (ganglionated plexi), alcohol ablation, and the future of epicardial mapping and ablation for this arrhythmia. A stepwise ablation approach requires several key ablation techniques, such as meticulous PVI, linear ablation at the roof and mitral isthmus, electrogram-targeted ablation with particular attention to triggers in the coronary sinus and LAA, and discretionary right atrial ablation (superior vena cava, intercaval, or cavotricuspid isthmus lines).

  5. Effect of Particle Concentration on Ablation Behavior of Carbon/Carbon Composites

    Directory of Open Access Journals (Sweden)

    ZHA Bai-lin

    2016-07-01

    Full Text Available A self-designed oxygen-kerosene ablation system was employed to study the ablation mechanism and performance of the carbon-carbon composites. Particle concentrations of the gas-solid two-phase ablation flow were 0, 1.37%, 2.22%, and 2.64% respectively. The microstructure of post-test samples was analysed through the scanning electron microscope (SEM, and the ablation rate was calculated. The influence principle of particle concentrations on the ablation rate of the carbon-carbon composites was studied, and the mechanism of ablation was analysed. Experiment results show that with no particles involved the mass ablation rate is 0.159g/s and the linear ablation rate is 0.175mm/s, while with particles introduced, the minimum mass ablation rate and linear ablation rate are 0.432g/s and 0.843mm/s respectively, with the increase of particle concentrations, the ablation rate becomes accelerated. Particle erosion makes the ablation of sample seriously intensified, and the ablation gradient of radial fiber on erosion surface is increased with the increase of particle concentrations as well.

  6. Gallbladder ablation by radiologic intervention

    International Nuclear Information System (INIS)

    Becker, C.D.; Quenville, N.F.; Burhenne, H.J.

    1988-01-01

    Thirty pigs underwent cystic duct occlusion by means of transcatheter endoluminal bipolar radiofrequency electrocoagulation under fluoroscopic guidance. Twenty animals subsequently underwent gallbladder ablation with alcohol and sotradecol; ten animals served as controls. Serial histologic blocking of the common bile duct, cystic duct, and gallbladder in all animals revealed no adverse effects of the sclerosants on the bile ducts or the structures adjacent to the gallbladder. The combination of 95% alcohol plus 3% sotradecol resulted in necrosis of the gallbladder mucosa within 2 weeks (two of two animals) and complete eradication of the mucosa and fibrotic obliteration of the gallbladder lumen within 8 weeks (six of eight animals)

  7. Past-Year Treatment Utilization Among Individuals Meeting DSM-5 PTSD Criteria: Results From a Nationally Representative Sample.

    Science.gov (United States)

    Hale, Andrew C; Sripada, Rebecca K; Bohnert, Kipling M

    2018-03-01

    Little is known regarding treatment utilization among individuals meeting DSM-5 criteria for posttraumatic stress disorder (PTSD). Data were analyzed from the third wave of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample using DSM-5 criteria. Factors related to increased odds of PTSD treatment utilization for individuals meeting lifetime criteria included some college education versus less than a high school degree (odds ratio [OR]=3.17), having health insurance versus no insurance (OR=2.86), having a comorbid phobia disorder versus not having a phobia disorder (OR=1.36), and greater PTSD symptom count (OR=1.11). Older age (OR=.40), identifying as black or Asian versus white non-Hispanic (OR=.70 and OR=.28, respectively), and greater social functioning (OR=.98) were associated with decreased odds of PTSD treatment utilization. Results highlight factors that may be useful in identifying population subgroups with PTSD that are at risk for underutilization of services.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Xu, H.-X.; Xie, X.-Y.; Lu, M.-D.; 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

  10. Study of Laser Ablation Efficiency for an Acrylic-Based Photopolymerizing Composition

    Science.gov (United States)

    Loktionov, E. Yu.

    2014-05-01

    Results are presented from study of the effi ciency (ablated mass per unit energy, mechanical recoil momentum per unit energy) of laser ablation for a light-curable polymer. A substantial difference is seen between the thresholds and indicated criteria for laser ablation effi ciency in the liquid and cured phases. The highest energy effi ciency for laser ablation (~22.6 %) is achieved when the initially liquid polymer is exposed to radiation with the wavelength optimal for photopolymerization (365 ± 15 nm).

  11. Ablation behaviors of carbon reinforced polymer composites by laser of different operation modes

    Science.gov (United States)

    Wu, Chen-Wu; Wu, Xian-Qian; Huang, Chen-Guang

    2015-10-01

    Laser ablation mechanism of Carbon Fiber Reinforced Polymer (CFRP) composite is of critical meaning for the laser machining process. The ablation behaviors are investigated on the CFRP laminates subject to continuous wave, long duration pulsed wave and short duration pulsed wave lasers. Distinctive ablation phenomena have been observed and the effects of laser operation modes are discussed. The typical temperature patterns resulted from laser irradiation are computed by finite element analysis and thereby the different ablation mechanisms are interpreted.

  12. Soft x-ray driven ablation and its positive use for a new efficient acceleration

    International Nuclear Information System (INIS)

    Yabe, Takashi; Kiyokawa, Shuji; Mochizuki, Takayasu; Sakabe, Shuji; Yamanaka, Chiyoe

    1983-01-01

    The ablation process driven by soft X-ray is investigated by one-dimensional hydrodynamic code coupled with LTE, average ion model and multi-group radiation package. The following two major results are obtained: (1) the ablation pressure and mass ablation rate scalings, and (2) a new acceleration scheme which positively uses the unique property of soft X-ray transport. (author)

  13. Ablação histeroscópica do endométrio: resultados após seguimento clínico de 5 anos Results of hysteroscopic endometrial ablation after five-year follow-up

    Directory of Open Access Journals (Sweden)

    Winny Hirome Takahashi

    2012-02-01

    avaliar os fatores que poderão futuramente influenciar na indicação do procedimento em casos selecionados.PURPOSE: To evaluate the clinical outcomes after a minimum period of 5 years of follow-up of patients with abnormal uterine bleeding of benign etiology who underwent endometrial ablation, analyzing the success rate of treatment defined as patient satisfaction and improvement in uterine abnormal bleeding, as well as late complications and factors associated with recurrence of symptoms. METHODS: A cross-sectional survey was conducted after a minimum period of 5 years after surgery in patients who underwent the procedure between 1999 and 2004. We analyzed the following data: age at the time of surgery, immediate and late complications and associated factors. Logistic regression with Odds Ratio (OR calculation was performed to evaluate possible associations between the success rate of surgery and the analyzed variables. RESULTS: A total of 114 patients underwent endometrial ablation between March 1999 and April 2004. The median follow-up was 82 months. The logistic regression model allowed the correct prediction of the success of endometrial ablation in 80.6% of cases. Age was directly related to the success of the procedure (OR=1.2; p=0.003 and previous tubal ligation showed a negative association with the success of endometrial ablation (OR=0.3; p=0.049. Among the patients with treatment failure, 21 (72.4% underwent hysterectomy. In one of the hysterectomy cases, hydro/hematosalpinx was confirmed by the anatomopathological exam, characterizing the postablation-tubal sterilization syndrome. CONCLUSION: Endometrial ablation has proven to be a worthwhile treatment option, maintaining high rates of patient satisfaction, even over long-term follow-up. The age at endometrial ablation influenced the therapeutic success. Further studies are needed to evaluate the factors that may influence the future indication for the procedure in selected cases.

  14. Computational modeling of ultra-short-pulse ablation of enamel

    Energy Technology Data Exchange (ETDEWEB)

    London, R.A.; Bailey, D.S.; Young, D.A. [and others

    1996-02-29

    A computational model for the ablation of tooth enamel by ultra-short laser pulses is presented. The role of simulations using this model in designing and understanding laser drilling systems is discussed. Pulses of duration 300 sec and intensity greater than 10{sup 12} W/cm{sup 2} are considered. Laser absorption proceeds via multi-photon initiated plasma mechanism. The hydrodynamic response is calculated with a finite difference method, using an equation of state constructed from thermodynamic functions including electronic, ion motion, and chemical binding terms. Results for the ablation efficiency are presented. An analytic model describing the ablation threshold and ablation depth is presented. Thermal coupling to the remaining tissue and long-time thermal conduction are calculated. Simulation results are compared to experimental measurements of the ablation efficiency. Desired improvements in the model are presented.

  15. Radiofrequency Ablation for Treatment of Symptomatic Uterine Fibroids

    Directory of Open Access Journals (Sweden)

    Siân Jones

    2012-01-01

    Full Text Available The use of thermal energy-based systems to treat uterine fibroids has resulted in a plethora of devices that are less invasive and potentially as effective in reducing symptoms as traditional options such as myomectomy. Most thermal ablation devices involve hyperthermia (heating of tissue, which entails the conversion of an external electromagnetic or ultrasound waves into intracellular mechanical energy, generating heat. What has emerged from two decades of peer-reviewed research is the concept that hyperthermic fibroid ablation, regardless of the thermal energy source, can create large areas of necrosis within fibroids resulting in reductions in fibroid volume, associated symptoms and the need for reintervention. When a greater percentage of a fibroid's volume is ablated, symptomatic relief is more pronounced, quality of life increases, and it is more likely that such improvements will be durable. We review radiofrequency ablation (RFA, one modality of hyperthermic fibroid ablation.

  16. Image-Guided Spinal Ablation: A Review

    International Nuclear Information System (INIS)

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

    2016-01-01

    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.

  17. Image-Guided Spinal Ablation: A Review

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Garnon, Julien, E-mail: julien.garnon@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: roberto-luigi.cazzato@chru-strasbourg.fr; Edalat, Faramarz, E-mail: faramarz.edalat@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital (France)

    2016-09-15

    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.

  18. Utilization of Geographic Information Systems for 1999 Election Results Mapping in Yogyakarta Special Province

    Directory of Open Access Journals (Sweden)

    Endang Saraswati

    2004-01-01

    Full Text Available Up to present data and information relating to result of general eletion, 1999 still in tabuler for especially in form of figures. Data presentation in form of tables has disadvantage such as not attractive as well as not so effective for communication. Data presentation which is able to adapt the demand is presented in form in map. The aims of this research are 1 to depict data of general election result, in 1999 in form on digital map; 2 to identify factors which influence the result of vote, using map analysis technique of resulted map. The methodology of the research is to use secondary data, mean while the methods for its mapping to apply point symbol, line, and area which appropriated with data characteristics and expected visual perception of the data. The data then is elaborated with aid of Geographic Information System (GIS, to produce map of vote result in general election 1999. To identify what factors that influence voice between map of vote result and map  of population amount, according to education, occupation, and religion. The result of the research show that Partai Demokrasi Indonesia Perjuangan got highest voices, that is 33,73% followed by Partai Amanat Nasional 15,87%, Partai Golongan Karya 13,78%, Partai Kebangkitan Bangsa 13,43%, Partai Persatuan Pembangunan 4,95% and the rest 18,20% for 43 other parties. The voice gathering to occupation and their religion. The voice which are gathered by Partai Demokrasi Indonesia Perjuangan ome from middle to lower group of society which are nasionalist interest, either live in urban area or in rural area. Participant of Partai Amanat Nasional come from modern moslem group and member of Muhammadiyah, result in the voice of Partai Amanat Nasional is high in urban area. The voice which is gathered by Golongan Karya for urban area come from group of birocrate consists of official/ military/ pension, meanwhile form rural area come farmers who enjoy product result of new era regime

  19. Research Project Control System (RPCS); research results utilization data as of 06/30/81. Status summary report

    International Nuclear Information System (INIS)

    1981-09-01

    The report on 'Research Results Utilization' provides status and control information concerning the utilization of research results in the regulatory policies and practices of the NRC. Research Information Letters (RILs) are prepared by RES to transmit research results to NRC user offices upon completion of a substantial, coherent and reasonably complete body of experimental and/or analytical research work. Section 3.0 of this report lists the RILs issued to date, together with an identification of the research program manager and the research program element which generated the RIL. The potential applicability of each RIL to the regulatory process is also identified, and comments from the cognizant RES and user office staff are summarized which relate to the expected impact of the reported RILs on the regulatory process

  20. Radiofrequency ablation of the supra-orbital nerve in the treatment algorithm of hemicrania continua.

    Science.gov (United States)

    Weyker, Paul; Webb, Christopher; Mathew, Leena

    2012-01-01

    Hemicrania continua (HC) is an uncommon primary headache disorder in which the diagnosis centers on unilaterality and its absolute responsiveness to indomethacin. We describe 3 patients with a long standing history of headache diagnosed as hemicrania continua. There was profound response to indomethacin which was limited by side effects. In one patient the therapy with indomethacin was limited secondary to co-morbidities. Initial diagnostic blockade provided significant relief of symptoms based on which radio-frequency ablation of the supraorbital nerve was performed with substantial improvement in symptoms. Traditionally, hemicrania continua has been managed exclusively with oral analgesics and is defined by its singular response to indomethacin. Radio-frequency ablation (RFA) has been reported in the literature for multiple indications. This case series is unique in that it describes 3 patients diagnosed with hemicrania continua with pain referred in the supraorbital nerve distribution, who underwent radiofrequency ablation of the supraorbital nerve with resultant resolution of headaches. Traditionally, hemicrania continua has been managed exclusively with oral analgesics and is defined by its singular response to indomethacin. This report is unique in that it describes three patients diagnosed with hemicrania continua with pain referred in the supraorbital nerve distribution who underwent radiofrequency ablation of the supraorbital nerve with resultant resolution of headaches. After the RFA medical management was minimal to none in both patients. Though the utility and cost efficacy of RFA of peripheral nerves needs to be confirmed in well-designed trials we present these cases as an example of how this minimally invasive technique can safely provide analgesia in a difficult to treat cephalgia. Moreover if precise anatomical localization of the headache is possible then diagnostic blockade of the appropriate peripheral nerve may be performed followed by

  1. Ultrafast laser ablation for targeted atherosclerotic plaque removal

    Science.gov (United States)

    Lanvin, Thomas; Conkey, Donald B.; Descloux, Laurent; Frobert, Aurelien; Valentin, Jeremy; Goy, Jean-Jacques; Cook, Stéphane; Giraud, Marie-Noelle; Psaltis, Demetri

    2015-07-01

    Coronary artery disease, the main cause of heart disease, develops as immune cells and lipids accumulate into plaques within the coronary arterial wall. As a plaque grows, the tissue layer (fibrous cap) separating it from the blood flow becomes thinner and increasingly susceptible to rupturing and causing a potentially lethal thrombosis. The stabilization and/or treatment of atherosclerotic plaque is required to prevent rupturing and remains an unsolved medical problem. Here we show for the first time targeted, subsurface ablation of atherosclerotic plaque using ultrafast laser pulses. Excised atherosclerotic mouse aortas were ablated with ultrafast near-infrared (NIR) laser pulses. The physical damage was characterized with histological sections of the ablated atherosclerotic arteries from six different mice. The ultrafast ablation system was integrated with optical coherence tomography (OCT) imaging for plaque-specific targeting and monitoring of the resulting ablation volume. We find that ultrafast ablation of plaque just below the surface is possible without causing damage to the fibrous cap, which indicates the potential use of ultrafast ablation for subsurface atherosclerotic plaque removal. We further demonstrate ex vivo subsurface ablation of a plaque volume through a catheter device with the high-energy ultrafast pulse delivered via hollow-core photonic crystal fiber.

  2. Laser ablation with applied magnetic field for electric propulsion

    Science.gov (United States)

    Batishcheva, Alla; Batishchev, Oleg; Cambier, Jean-Luc

    2012-10-01

    Using ultrafast lasers with tera-watt-level power allows efficient ablation and ionization of solid-density materials [1], creating dense and hot (˜100eV) plasma. We propose ablating small droplets in the magnetic nozzle configurations similar to mini-helicon plasma source [2]. Such approach may improve the momentum coupling compared to ablation of solid surfaces and facilitate plasma detachment. Results of 2D modeling of solid wire ablation in the applied magnetic field are presented and discussed. [4pt] [1] O. Batishchev et al, Ultrafast Laser Ablation for Space Propulsion, AIAA technical paper 2008-5294, -16p, 44th JPC, Hartford, 2008.[0pt] [2] O. Batishchev and J.L. Cambier, Experimental Study of the Mini-Helicon Thruster, Air Force Research Laboratory Report, AFRL-RZ-ED-TR-2009-0020, 2009.

  3. Utilization of paleoclimate results to validate projections of a future greenhouse warming

    International Nuclear Information System (INIS)

    Crowley, T.J.

    1991-01-01

    Paleoclimate data provide a rich source of information for testing projections of future greenhouse trends. This paper summarizes the present state-of-the-art as to assessments of two important climate problems. (1) Validation of climate models - The same climate models that have been used to make greenhouse forecasts have also been used for paleoclimate simulations. Comparisons of model results and observations indicate some impressive successes but also some cases where there are significant divergences between models and observations. However, special conditions associated with the impressive successes could lead to a false confidence in the models; disagreements are a topic of greater concern. It remains to be determined whether the disagreements are due to model limitations or uncertainties in geologic data. (2) Role of CO 2 as a significant climate feedback: Paleoclimate studies indicate that the climate system is generally more sensitive than our ability to model it. Addition or subtraction of CO 2 leads to a closer agreement between models and observations. In this respect paleoclimate results in general support the conclusion that CO 2 is an important climate feedback, with the magnitude of the feedback approximately comparable to the sensitivity of present climate models. If the CO 2 projections are correct, comparison of the future warming with past warm periods indicate that there may be no geologic analogs for a future warming; the future greenhouse climate may represent a unique climate realization in earth history. 55 refs.; 5 figs

  4. Utilization of paleoclimate results to validate projections of a future greenhouse warming

    International Nuclear Information System (INIS)

    Crowley, T.J.

    1990-01-01

    Paleoclimate data provide a rich source of information for testing projections of future greenhouse trends. This paper summarizes the present state-of-the-art as to assessments of two important climate problems. (1) Validation of climate models - The same climate models that have been used to make greenhouse forecasts have also been used for paleoclimate simulations. Comparisons of model results and observations indicate some impressive successes but also some cases where there are significant divergences between models and observations. However, special conditions associated with the impressive successes could lead to a false confidence in the models; disagreements are a topic of greater concern. It remains to be determined whether the disagreements are due to model limitations or uncertainties in geologic data. (2) Role of CO 2 as a significant climate feedback: Paleoclimate studies indicate that the climate system is generally more sensitive than our ability to model it. Addition or subtraction of CO 2 leads to a closer agreement between models and observations. In this respect paleoclimate results in general support the conclusion that CO 2 is an important climate feedback, with the magnitude of the feedback approximately comparable to the sensitivity of present climate models. If the CO 2 projections are correct, comparison of the future warming with past warm periods indicate that there may be no geologic analogs for a future warming; the future greenhouse climate may represent a unique climate realization in earth history

  5. Impacts of Workplace Health Promotion and Wellness Programs on Health Care Utilization and Costs: Results From an Academic Workplace.

    Science.gov (United States)

    Dement, John M; Epling, Carol; Joyner, Julie; Cavanaugh, Kyle

    2015-11-01

    This study evaluated the impacts of a long-standing workplace health promotion (HP) program on health care utilization and costs and estimated return on investment (ROI). Analyses used a retrospective, observational cohort design based on 7 years (2005 to 2011) of health claims and HP program participation data for 3829 HP participants and 6617 controls. Inverse propensity score-weighted mixed-model regression methods were used to balance employee demographics and comorbidities by study arm. Mean monthly health care costs were $35 less for HP participants compared with controls, and results were robust based on sensitivity analyses. ROI was estimated to be $2.53 for every dollar spent on the HP program. Results support a positive impact of HP program participation with regard to reduced health care utilization and costs and a positive ROI.

  6. Preparation of Silicon Rubber/2,2'-(3-methyl-4-dihydro-1,3,2-benzoxazinePropane Ablative-resistant Composites and Its Ablative Structure

    Directory of Open Access Journals (Sweden)

    DONG Yimin

    2017-10-01

    Full Text Available Benzoxazine resin is a new generation of anti-ablation resin with high char yield and high-temperature oxidation resistance. Using high temperature vulcanized silicon rubber as ablation resistance matrix and 2,2'-(3-methyl-4-dihydro-1,3,2-benzoxazinepropane as anti-ablation resin, silicon rubber/polybenzoxazine anti-ablation composite was prepared by blending method. The mechanical properties were tested,and the ablation structure and the composition of the composite were investigated by DSC,SEM,FT-IR and Raman.Experimental results show that the polybenzoxazine resin can improve the ablation resistance property of silicone rubber composite. The composite has good ablation resistance and mechanical property when the addition of polybenzoxazine resin reaches 20 phr. After ablated by oxygen acetylene flame,the ablation layer is divided into three obvious layers as surface ceramic layer,pyrolysis carbonization layer and base layer. The surface ceramic layer formed in the progress of ablation plays a positive role in the ablation property of the composite material.

  7. Maxillary single-tooth replacement utilizing a novel ceramic restorative system: results to 30 months.

    Science.gov (United States)

    Ormianer, Zeev; Schiroli, Guido

    2006-01-01

    This study reports on the first longitudinal results of an alumina (70%)-zirconia (30%) ceramic restorative system for implant-supported, single-tooth replacement in the anterior maxillary jaw. Eighteen patients (9 men, 9 women, mean age = 42.4 years) were treated with 22 implants placed into 19 extraction sockets and 3 residual ridges. Eight implants were immediately loaded with nonoccluding provisional prostheses. All implants were definitively loaded with fully occluding ceramic restorations after osseointegration and soft tissue maturation. Patients were monitored from 7 to 30 months (mean = 18.1 months) after loading. All implants osseointegrated and were successfully restored. One case of abutment screw loosening occurred because of patient parafunction (bruxing), and another patient reported chewing pain attributed to malocclusion. Both problems were successfully resolved without further incidence. Within the context of this study, single-tooth replacement in the anterior maxillary jaw was successfully achieved with alumina-zirconia ceramic single-tooth restorations with up to 30 months of clinical function.

  8. [Utilization of medical and psychosocial services by mentally ill homeless persons. Results of an epidemiological study].

    Science.gov (United States)

    Meller, I; Fichter, M; Quadflieg, N; Koniarczyk, M; Greifenhagen, A; Wolz, J

    2000-07-01

    The aim of this study was to ascertain to what extent homeless, mentally ill subjects in Munich take advantage of available psychosocial services. To obtain a representative picture of the situation, the first step was to ascertain how many people in Munich are actually homeless. The next step was to ascertain what proportion of them are in need of psychotherapy. Using the standardized Diagnostic Interview Schedule (DIS), 146 men and 32 women were interviewed. The results according to the DSM-III demonstrated high lifelong and 6-month prevalence of psychic disturbances. Medical and social services were often enjoyed, but mostly over a short period of time in particularly critical situations. Continued treatment rarely followed. Women were treated more often than men. Elements such as age and level of education hardly influenced patients' seeking help. Despite a high prevalence of addictive disease, alcohol and drug clinics were rarely consulted. The increase in the number of diagnoses was paralleled by an increase in the number of patients seeking help. Most treatments involved schizophrenia and anxiety. By means of logistic regression models, predictors of the extent to which these services were used were analysed. We conclude that new clinical models are needed and that the aversion to the present care system is too great. Continued treatment occurs only rarely.

  9. Multi-voxel MR spectroscopic imaging of the brain: utility in clinical setting-initial results

    International Nuclear Information System (INIS)

    Parmar, Hemant; Lim, Tchoyoson C.C.; Yin Hong; Chua, Violet; Khin, Lay-Wai; Raidy, Tom; Hui, Francis

    2005-01-01

    Background and purpose: Compared to single voxel methods, MR spectroscopic imaging (MRSI) of the brain provides metabolic information with improved anatomical coverage and spectral resolution, but may be difficult to perform in the clinical setting. We evaluate the factors influencing spectral quality in MRSI using a semi-automated method, focussing on lipid contamination, and phase correction errors related to magnetic field inhomogeneity. Methods: We retrospectively analysed MRSI studies planned by radiologists and radiographers. Two-dimensional MRSI studies using point-resolved spectroscopy (PRESS) localisation, at long echo time (135 or 144 ms) were acquired on a 1.5 T scanner. Studies that contained lipid contamination and abnormally inverted spectra were reviewed and the latter correlated with anatomic location at the base of skull, and with the area of the region of interest (ROI) studied. Results: Of 128 consecutive MRSI studies, six showed abnormal inverted spectra, of which four were acquired at the base of skull. Multivariate logistic regression analysis showed that study location at the base of skull, but not larger ROI, was a significant predictor for the risk of being affected by inverted spectra (RR for base of skull: 11.76, 95% CI: 1.86-74.18, P = 0.009. RR for area of ROI: 3.68, 95% CI: 0.57-23.67, P = 0.170). Seven studies showed lipid contamination; all were in close proximity to the overlying scalp. Conclusion: Using a semi-automated acquisition and post-processing method, MRSI can be successfully applied in the clinical setting. However, care should be taken to avoid regions of high magnetic field inhomogeneity at the base of skull, and lipid contamination in voxels prescribed near the scalp

  10. Utilization of dashboard technology in academic radiology departments: results of a national survey.

    Science.gov (United States)

    Mansoori, Bahar; Novak, Ronald D; Sivit, Carlos J; Ros, Pablo R

    2013-04-01

    The aim of this study was to identify the most widely used financial, productivity, and accessibility metrics used by academic radiology departments (ARDs) in a dashboard format via a national survey. The results provide a guide to the selection of preferred or commonly used indicators to facilitate dashboard implementation and use. The study met the criteria for an exemption from institutional review board approval. A cross-sectional survey was conducted using a survey approved by the Society of Chairs of Academic Radiology Departments and sent to its members. The survey was designed to evaluate the adoption, access, and composition of dashboard technology in ARDs, particularly those related to measures of productivity and financial performance. The overall response rate was 42% (56 of 131 members). Sixty-two percent of responding ARDs currently use some form of dashboard technology, but 50% have used this technology for ≤2 years. Sixty-five percent of all ARDs use their dashboard information on a monthly basis. The two dashboard financial indicators most frequently used by ARDs are revenue and actual expenses. Similarly, the two productivity indicators used most widely are total examination volume and examination volume per modality. The two most important access indicators used are report turnaround time and backlog per unit time. Currently, fewer than two-thirds of the responding ARDs use dashboard technology, and one-half have used the technology for ≤2 years. Although some fiscal and productivity indices are more frequently used, there are a diverse number of factors used to measure productivity, finance, access, and other operational parameters in ARD dashboards. Thus, the information provided by each institutional dashboard may be significantly different from that in other ARDs. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Sphere-Enhanced Microwave Ablation (sMWA) Versus Bland Microwave Ablation (bMWA): Technical Parameters, Specific CT 3D Rendering and Histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Gockner, T. L., E-mail: theresa.gockner@med.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Zelzer, S., E-mail: s.zelzer@dkfz-heidelberg.de [German Cancer Research Center (dkfz), Medical and Biological Informatics (Germany); Mokry, T., E-mail: theresa.mokry@med.uni-heidelberg.de; Gnutzmann, D., E-mail: daniel.gnutzmann@med.uni-heidelberg.de; Bellemann, N., E-mail: nadine.bellemann@med.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Mogler, C., E-mail: carolin.mogler@med.uni-heidelberg.de [University Hospital Heidelberg, Department of General Pathology (Germany); Beierfuß, A., E-mail: anja.beierfuss@ethianum.de; Köllensperger, E., E-mail: eva.koellensperger@ethianum.de; Germann, G., E-mail: guenter.germann@ethianum.de [Ethianum Heidelberg, Clinic for Plastic Reconstructive Surgery and Aesthetic Surgery (Germany); Radeleff, B. A., E-mail: boris.radeleff@med.uni-heidelberg.de; Stampfl, U., E-mail: ulrike.stampfl@med.uni-heidelberg.de; Kauczor, H. U., E-mail: hu.kauczor@med.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Pereira, P. L., E-mail: philippe.pereira@slk-kliniken.de [SLK Kliniken Heilbronn GmbH, Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine (Germany); Sommer, C. M., E-mail: christof.sommer@med.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany)

    2015-04-15

    PurposeThis study was designed to compare technical parameters during ablation as well as CT 3D rendering and histopathology of the ablation zone between sphere-enhanced microwave ablation (sMWA) and bland microwave ablation (bMWA).MethodsIn six sheep-livers, 18 microwave ablations were performed with identical system presets (power output: 80 W, ablation time: 120 s). In three sheep, transarterial embolisation (TAE) was performed immediately before microwave ablation using spheres (diameter: 40 ± 10 μm) (sMWA). In the other three sheep, microwave ablation was performed without spheres embolisation (bMWA). Contrast-enhanced CT, sacrifice, and liver harvest followed immediately after microwave ablation. Study goals included technical parameters during ablation (resulting power output, ablation time), geometry of the ablation zone applying specific CT 3D rendering with a software prototype (short axis of the ablation zone, volume of the largest aligned ablation sphere within the ablation zone), and histopathology (hematoxylin-eosin, Masson Goldner and TUNEL).ResultsResulting power output/ablation times were 78.7 ± 1.0 W/120 ± 0.0 s for bMWA and 78.4 ± 1.0 W/120 ± 0.0 s for sMWA (n.s., respectively). Short axis/volume were 23.7 ± 3.7 mm/7.0 ± 2.4 cm{sup 3} for bMWA and 29.1 ± 3.4 mm/11.5 ± 3.9 cm{sup 3} for sMWA (P < 0.01, respectively). Histopathology confirmed the signs of coagulation necrosis as well as early and irreversible cell death for bMWA and sMWA. For sMWA, spheres were detected within, at the rim, and outside of the ablation zone without conspicuous features.ConclusionsSpecific CT 3D rendering identifies a larger ablation zone for sMWA compared with bMWA. The histopathological signs and the detectable amount of cell death are comparable for both groups. When comparing sMWA with bMWA, TAE has no effect on the technical parameters during ablation.

  12. Comparison of plastic, high-density carbon, and beryllium as NIF ablators

    Science.gov (United States)

    Kritcher, Andrea

    2017-10-01

    An effort is underway to compare the three principal ablators for National Ignition Facility (NIF) implosions: plastic (CH), High Density Carbon (HDC), and beryllium (Be). This presentation will summarize the comparison and discuss in more detail the issues pertaining to hohlraum performance and symmetry. Several aspects of the hohlraum design are affected by the ablator properties, as the ablator constrains the first shock and determines the overall pulse length. HDC targets can utilize shorter pulse lengths due to the thinner, higher density shell, and should be less susceptible to late time wall motion. However, HDC requires a larger picket energy to ensure adequate melt, leading to increased late time wall movement. Be is intermediate to CH and HDC in both these regards, and has more ablated material in the hohlraum. These tradeoffs as well as other design choices for currently fielded campaigns are assessed in this work. To assess consistently the radiation drive and symmetry, integrated postshot simulations of the hohlraum and capsule were done for each design using the same methodology. The simulation results are compared to experimental data. Using this post-shot model, we make a projection of the relative plausible performance that can be achieved, while maintaining adequate symmetry, using the full NIF laser, i.e. 1.8 MJ/500 TW Full NIF Equivalent (FNE). The hydrodynamic stability of the different ablators is also an important consideration and will be presented for the current platforms and projection to FNE. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  13. Testing of Advanced Conformal Ablative TPS

    Science.gov (United States)

    Gasch, Matthew; Agrawal, Parul; Beck, Robin

    2013-01-01

    In support of the CA250 project, this paper details the results of a test campaign that was conducted at the Ames Arcjet Facility, wherein several novel low density thermal protection (TPS) materials were evaluated in an entry like environment. The motivation for these tests was to investigate whether novel conformal ablative TPS materials can perform under high heat flux and shear environment as a viable alternative to rigid ablators like PICA or Avcoat for missions like MSL and beyond. A conformable TPS over a rigid aeroshell has the potential to solve a number of challenges faced by traditional rigid TPS materials (such as tiled Phenolic Impregnated Carbon Ablator (PICA) system on MSL, and honeycomb-based Avcoat on the Orion Multi Purpose Crew Vehicle (MPCV)). The compliant (high strain to failure) nature of the conformable ablative materials will allow better integration of the TPS with the underlying aeroshell structure and enable monolithic-like configuration and larger segments to be used in fabrication.A novel SPRITE1 architecture, developed by the researchers at NASA Ames was used for arcjet testing. This small probe like configuration with 450 spherecone, enabled us to test the materials in a combination of high heat flux, pressure and shear environment. The heat flux near the nose were in the range of 500-1000 W/sq cm whereas in the flank section of the test article the magnitudes were about 50 of the nose, 250-500W/sq cm range. There were two candidate conformable materials under consideration for this test series. Both test materials are low density (0.28 g/cu cm) similar to Phenolic Impregnated Carbon Ablator (PICA) or Silicone Impregnated Refractory Ceramic Ablator (SIRCA) and are comprised of: A flexible carbon substrate (Carbon felt) infiltrated with an ablative resin system: phenolic (Conformal-PICA) or silicone (Conformal-SICA). The test demonstrated a successful performance of both the conformable ablators for heat flux conditions between 50

  14. Field enhancement induced laser ablation

    DEFF Research Database (Denmark)

    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....... The accompanying field enhancement substantially lowers the ablation threshold of the polymer film and thus creates local ablation spots and corresponding topographic modifications of the polymer film. Such modifications are quantified straightforwardly via scanning electron and atomic force microscopy. Thickness...

  15. Photonic Doppler velocimetry of laser-ablated ultrathin metals.

    Science.gov (United States)

    Valenzuela, A R; Rodriguez, G; Clarke, S A; Thomas, K A

    2007-01-01

    Obtaining velocity information from the interaction of a laser pulse on a metal layer provides insight into the rapid dynamics of material removal and plasma plume physics during ablation. A traditional approach involves using a velocity interferometer system for any reflector (VISAR) on a reflective metal surface. However, when the target is a thin metal layer, the cohesion of the surface is quickly lost resulting in a large spread of particle velocities that cannot be easily resolved by VISAR. This is due to material ejection"confusing" the VISAR measurement surface, effectively washing out the spatial fringe visibility in the VISAR interferometer. A new heterodyne-based optical velocimeter method is the photonic Doppler velocimeter (PDV). Because PDV tracks motion in a frequency encoded temporal electro-optical signal, velocity information is preserved and allows for multiple velocity components to be recorded simultaneously. The challenge lies in extracting PDV velocity information at short (nanosecond) laser ablation time scales with rapidly varying heterodyne beats by using electronic, optical, and analytical techniques to recover the velocity information from a fleeting signal. Here we show how we have been able to obtain velocity information on the nanosecond time scale and are able to compare it to hydrodynamic simulations. Also, we examine refinements to our PDV system by increasing the bandwidth, utilizing different probes, and sampling different analysis techniques.

  16. Dental hard tissue ablation using mid-infrared tunable nanosecond pulsed Cr:CdSe laser.

    Science.gov (United States)

    Lin, Taichen; Aoki, Akira; Saito, Norihito; Yumoto, Masaki; Nakajima, Sadahiro; Nagasaka, Keigo; Ichinose, Shizuko; Mizutani, Koji; Wada, Satoshi; Izumi, Yuichi

    2016-12-01

    Mid-infrared erbium: yttrium-aluminum-garnet (Er:YAG) and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers (2.94- and 2.78-μm, respectively) are utilized for effective dental hard tissue treatment because of their high absorption in water, hydroxide ion, or both. Recently, a mid-infrared tunable, nanosecond pulsed, all-solid-state chromium-doped: cadmium-selenide (Cr:CdSe) laser system was developed, which enables laser oscillation in the broad spectral range around 2.9 μm. The purpose of this study was to evaluate the ablation of dental hard tissue by the nanosecond pulsed Cr:CdSe laser at a wavelength range of 2.76-3.00 μm. Enamel, dentin, and cementum tissue were irradiated at a spot or line at a fluence of 0-11.20 J/cm 2 /pulse (energy output: 0-2.00 mJ/pulse) with a repetition rate of 10 Hz and beam diameter of ∼150 μm on the target (pulse width ∼250 ns). After irradiation, morphological changes, ablation threshold, depth, and efficiency, and thickness of the structurally and thermally affected layer of irradiated surfaces were analyzed using stereomicroscopy, scanning electron microscopy (SEM), and light microscopy of non-decalcified histological sections. The nanosecond pulsed irradiation without water spray effectively ablated dental hard tissue with no visible thermal damage such as carbonization. The SEM analysis revealed characteristic micro-irregularities without major melting and cracks in the lased tissue. The ablation threshold of dentin was the lowest at 2.76 μm and the highest at 3.00 μm. The histological analysis revealed minimal thermal and structural changes ∼20 μm wide on the irradiated dentin surfaces with no significant differences between wavelengths. The efficiency of dentin ablation gradually increased from 3.00 to 2.76 μm, at which point the highest ablation efficiency was observed. The nanosecond pulsed Cr:CdSe laser demonstrated an effective ablation ability of hard dental tissues

  17. Temporal trends in atrial fibrillation recurrence rates after ablation between 2005 and 2014

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Gislason, Gunnar Hilmar; Hansen, Jim

    2018-01-01

    the recurrence rate of AF following ablation has improved during last decade. Methods and results: Through Danish nationwide registers, all patients with first-time AF ablation, between 2005 and 2014 in Denmark were identified. Recurrent AF after ablation was identified with 1 year follow-up. A total of 5425...... of recurrent AF following first-time ablation has almost halved from 2006 to 2014. Hypertension, female sex, cardioversion 1 year prior to ablation, and AF duration for more than 2 years all increased the associated risk of recurrent AF....

  18. A case study in technology utilization: Industrial products and practices. [summary of benefits to national economy resulting from space programs

    Science.gov (United States)

    1973-01-01

    In pursuit of such missions as Apollo, the National Aeronautics and Space Administration has called into being unique equipment that obviously has little direct application beyond the achievement of mission objectives. Yet, to assume that further direct application of space program hardware is somehow a measure of the industrial benefits accruing to the nation is to misunderstand how the creation of new technology affects modern industrial capability. This document presents a profile of the significant ways in which technological developments in response to aerospace mission requirements have been coupled into industrial practice, with the result being that improved products and processes are now being utilized to benefit the nation.

  19. Results from the second Galaxy Serpent web-based table top exercise utilizing the concept of nuclear forensics libraries

    International Nuclear Information System (INIS)

    Borgardt, James; Canaday, Jodi; Chamberlain, David

    2017-01-01

    Galaxy Serpent is a unique, virtual, web-based international tabletop series of exercises designed to mature the concept of National Nuclear Forensics Libraries (NNFLs). Teams participating in the second version of the exercise were provided synthetic sealed radioactive source data used to compile a model NNFL which then served as a comparative instrument in hypothetical scenarios involving sources out of regulatory control, allowing teams to successfully down-select and determine whether investigated sources were consistent with holdings in their model library. The methodologies utilized and aggregate results of the exercise will be presented, along with challenges encountered and benefits realized. (author)

  20. Transmitted fresh water flow rate of reverse osmosis desalination system utilizing the static pressure head. Formulation of numerical results and comparison with experimental results

    Energy Technology Data Exchange (ETDEWEB)

    Miyatake, Osamu; Tagawa, Kotaro; Noda, Hidehiko [Kyushu University, Fukuoka (Japan)

    1999-08-01

    Based on the authors' previous numerical results of a reverse osmosis desalination system for seawater or brackish water utilizing the static pressure head of seawater in a deep-sea region or brackish water in a vertical pit, a dimensionless expression is formulated to predict the transmitted fresh water flow rate from the geometry and the submerged depth of the device, the pure water permeability and the solute permeability of membrane, and the physical properties properties of seawater or brackish water. The derived expression is compared with experimental results obtained by field experiments carried out in the Sea of Japan and the East China with fair agreement and thus confirmed the applicability and usefulness of the expression. (author)

  1. Combining Electrolysis and Electroporation for Tissue Ablation.

    Science.gov (United States)

    Phillips, Mary; Rubinsky, Liel; Meir, Arie; Raju, Narayan; Rubinsky, Boris

    2015-08-01

    Electrolytic ablation is a method that operates by delivering low magnitude direct current to the target region over long periods of time, generating electrolytic products that destroy cells. This study was designed to explore the hypothesis stating that electrolytic ablation can be made more effective when the electrolysis-producing electric charges are delivered using electric pulses with field strength typical in reversible electroporation protocols. (For brevity we will refer to tissue ablation protocols that combine electroporation and electrolysis as E(2).) The mechanistic explanation of this hypothesis is related to the idea that products of electrolysis generated by E(2) protocols can gain access to the interior of the cell through the electroporation permeabilized cell membrane and therefore cause more effective cell death than from the exterior of an intact cell. The goal of this study is to provide a first-order examination of this hypothesis by comparing the charge dosage required to cause a comparable level of damage to a rat liver, in vivo, when using either conventional electrolysis or E(2) approaches. Our results show that E(2) protocols produce tissue damage that is consistent with electrolytic ablation. Furthermore, E(2) protocols cause damage comparable to that produced by conventional electrolytic protocols while delivering orders of magnitude less charge to the target tissue over much shorter periods of time. © The Author(s) 2014.

  2. Monitoring Atrial Fibrillation After Catheter Ablation.

    Science.gov (United States)

    Forleo, Giovanni B; Casella, Michela; Russo, Antonio Dello; Moltrasio, Massimo; Fassini, Gaetano; Tesauro, Manfredi; Tondo, Claudio

    2014-01-01

    Although catheter ablation is an effective treatment for recurrent atrial fibrillation (AF), there is no consensus on the definition of success or follow-up strategies. Symptoms are the major motivation for undergoing catheter ablation in patients with AF, however it is well known that reliance on perception of AF by patients after AF ablation results in an underestimation of recurrence of the arrhythmia. Because symptoms of AF occurrence may be misleading, a reliable assessment of rhythm outcome is essential for the definition of success in both clinical care and research trials. Continuous rhythm monitoring over long periods of time is superior to intermittent recording using external monitors to detect the presence of AF episodes and to quantify the AF burden. Today, new devices implanted subcutaneously using a minimally invasive technique have been developed for continuous AF monitoring. Implantable devices keep detailed information about arrhythmia recurrences and might allow identification of very brief episodes of AF, the significance of which is still uncertain. In particular, it is not known whether there is any critical value of daily AF burden that has a prognostic significance. This issue remains an area of active discussion, debate and investigation. Further investigation is required to determine if continuous AF monitoring with implantable devices is effective in reducing stroke risk and facilitating maintenance of sinus rhythm after AF ablation.

  3. Radiofrequency ablation of osteoid osteoma

    NARCIS (Netherlands)

    Vanderschueren, Geert Maria Joris Michael

    2009-01-01

    The main purpose of this thesis was to evaluate the effectiveness and safety of CT-guided radiofrequency ablation for the treatment of spinal and non-spinal osteoid osteomas. Furthermore, the technical requirements needed for safe radiofrequency ablation and the clinical outcome after radiofrequency

  4. Results of fractional ablative facial skin resurfacing with the erbium:yttrium-aluminium-garnet laser 1 week and 2 months after one single treatment in 30 patients.

    Science.gov (United States)

    Trelles, Mario A; Mordon, Serge; Velez, Mariano; Urdiales, Fernando; Levy, Jean Luc

    2009-03-01

    The erbium:yttrium-aluminium-garnet (Er:YAG) laser has recently been used in the fractional resurfacing of photo-aged skin. Our study evaluated the results after one single session of fractional resurfacing with Er:YAG. Thirty women participated in the study, with an average age of 46 years, skin types from II to IV, and wrinkle grades I to III. The 2,940 nm Er:YAG system used (Pixel, Alma Laser, Israel) had variable pulse durations (1 ms to 2 ms) and energy densities (800 mJ/cm(2) to 1,400 mJ/cm(2)) which, together with the number of passes (four to eight), were selected as a function of wrinkle severity. All patients received only one treatment. Postoperative side effects were evaluated. The number of wrinkles was documented with clinical photography and was scored. Histological assessment was carried out on two patients before and 2 months after treatment. All patients completed the study. Of the patients, 93% reported good or very good improvement of the degree of their wrinkles, with a satisfaction index of 83%. Pain was not a problem during treatment, and there were no side effects except for in one phototype IV patient, who had hyperpigmentation. Histology 2 months after the single treatment demonstrated younger morphology of both the epidermis and dermis, with improvement of the pretreatment typical elastotic appearance. At the parameters used in our study, only one treatment session of Er:YAG laser could achieve effective skin rejuvenation, with effects recognized in both the dermis and, more importantly, the epidermis. This regimen offers an interesting alternative to the conventional approach of multi-session fractional resurfacing.

  5. Customized ablation using an all-solid-state deep-UV laser

    Science.gov (United States)

    Korn, G.; Lenzner, M.; Kittelmann, O.; Zatonski, R.; Kirsch, M.; Kuklin, Y.

    2003-07-01

    We show first deep UV ablation results achieved with our new all solid state laser system. The system parameters allow high repetition rate ablation with a small spot diameter of about 0.250mm and a fluence of 350 mJ/cm2 at a wavelength of 210 nm using sequential frequency conversion of a diode pumped laser source. The single shot and multishot ablation rates as well as the ablation profiles have been defined using MicroProf (Fries Research and Technology GmbH, Germany). By means of computer controlled scanning we produce smooth ablation profiles corresponding to a correction of myopia, hyperopia or astigmatism. Due to the small spot size and high repetition rate of the laser we are able to generate in short time intervals complicated ablation profiles described by higher order polynomial functions which are required for the needs of customized corneal ablation.

  6. Ablative Material Testing at Lewis Rocket Lab

    Science.gov (United States)

    1997-01-01

    The increasing demand for a low-cost, reliable way to launch commercial payloads to low- Earth orbit has led to the need for inexpensive, expendable propulsion systems for new launch vehicles. This, in turn, has renewed interest in less complex, uncooled rocket engines that have combustion chambers and exhaust nozzles fabricated from ablative materials. A number of aerospace propulsion system manufacturers have utilized NASA Lewis Research Center's test facilities with a high degree of success to evaluate candidate materials for application to new propulsion devices.

  7. Laser systems for ablative fractional resurfacing

    DEFF Research Database (Denmark)

    Paasch, Uwe; Haedersdal, Merete

    2011-01-01

    ablative laser systems. Fractionated CO(2) (10,600-nm), erbium yttrium aluminum garnet, 2940-nm and yttrium scandium gallium garnet, 2790-nm lasers are available. In this article, we present an overview of AFR technology, devices and histopathology, and we summarize the current clinical possibilities...... of a variety of skin conditions, primarily chronically photodamaged skin, but also acne and burn scars. In addition, it is anticipated that AFR can be utilized in the laser-assisted delivery of topical drugs. Clinical efficacy coupled with minimal downtime has driven the development of various fractional...

  8. Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

    Science.gov (United States)

    Dunn, Richard A; Tan, Andrew K G

    2011-01-01

    As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. © 2011 Wiley Periodicals, Inc.

  9. High-Speed, Integrated Ablation Cell and Dual Concentric Injector Plasma Torch for Laser Ablation-Inductively Coupled Plasma Mass Spectrometry.

    Science.gov (United States)

    Douglas, David N; Managh, Amy J; Reid, Helen J; Sharp, Barry L

    2015-11-17

    In recent years, laser ablation-inductively coupled plasma mass spectrometry (LA-ICPMS) has gained increasing importance for biological analysis, where ultratrace imaging at micrometer resolution is required. However, while undoubtedly a valuable research tool, the washout times and sensitivity of current technology have restricted its routine and clinical application. Long periods between sampling points are required to maintain adequate spatial resolution. Additionally, temporal signal dispersion reduces the signal-to-noise ratio, which is a particular concern when analyzing discrete samples, such as individual particles or cells. This paper describes a novel, two-volume laser ablation cell and integrated ICP torch designed to minimize aerosol dispersion for fast, efficient sample transport. The holistic design utilizes a short, continuous diameter fused silica conduit, which extends from the point of ablation, through the ICP torch, and into the base of the plasma. This arrangement removes the requirement for a dispersive component for argon addition, and helps to keep the sample on axis with the ICP cone orifice. Hence, deposition of sample on the cones is theoretically reduced with a resulting improvement in the absolute sensitivity (counts per unit mole). The system described here achieved washouts of 1.5, 3.2, and 4.9 ms for NIST 612 glass, at full width half, 10%, and 1% maximum, respectively, with an 8-14-fold improvement in absolute sensitivity, compared to a single volume ablation cell. To illustrate the benefits of this performance, the system was applied to a contemporary bioanalytical challenge, specifically the analysis of individual biological cells, demonstrating similar improvements in performance.

  10. Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins.

    Science.gov (United States)

    Moon, K H; Dharmarajah, B; Bootun, R; Lim, C S; Lane, Tra; Moore, H M; Sritharan, K; Davies, A H

    2017-07-01

    Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups ( p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.

  11. Noninvasive Assessment of Tissue Heating During Cardiac Radiofrequency Ablation Using MRI Thermography

    Science.gov (United States)

    Kolandaivelu, Aravindan; Zviman, Menekhem M.; Castro, Valeria; Lardo, Albert C.; Berger, Ronald D.; Halperin, Henry R.

    2010-01-01

    Background Failure to achieve properly localized, permanent tissue destruction is a common cause of arrhythmia recurrence after cardiac ablation. Current methods of assessing lesion size and location during cardiac radiofrequency ablation are unreliable or not suited for repeated assessment during the procedure. MRI thermography could be used to delineate permanent ablation lesions because tissue heating above 50°C is the cause of permanent tissue destruction during radiofrequency ablation. However, image artifacts caused by cardiac motion, the ablation electrode, and radiofrequency ablation currently pose a challenge to MRI thermography in the heart. In the current study, we sought to demonstrate the feasibility of MRI thermography during cardiac ablation. Methods and Results An MRI-compatible electrophysiology catheter and filtered radiofrequency ablation system was used to perform ablation in the left ventricle of 6 mongrel dogs in a 1.5-T MRI system. Fast gradient-echo imaging was performed before and during radiofrequency ablation, and thermography images were derived from the preheating and postheating images. Lesion extent by thermography was within 20% of the gross pathology lesion. Conclusions MR thermography appears to be a promising technique for monitoring lesion formation and may allow for more accurate placement and titration of ablation, possibly reducing arrhythmia recurrences. PMID:20657028

  12. Radiofrequency Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC).

    Science.gov (United States)

    Romero, Jorge; Grushko, Michael; Briceño, David F; Natale, Andrea; Di Biase, Luigi

    2017-09-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heritable form of cardiomyopathy, typically with autosomal dominant transmission, shown to be a defect in the cardiac desmosomes, with distinct regional and histopathological features. Clinically, this can ultimately result in bi-ventricular failure and/or malignant ventricular tachycardia (VT) via reentrant circuits created by patchy scar formation. We sought to review the current treatment for ventricular arrhythmias in the setting of ARVC, with particular attention to radiofrequency (RF) ablation and its varied techniques, along with potential therapies in the ablation spectrum. There is underwhelming data on the effectiveness of medical therapy for ARVC-related VT, including beta-blockers and antiarrhythmic medication. Primary and secondary prophylactic implantable-cardioverter defibrillator (ICD) implantation in higher-risk patients is recommended. More recently, RF ablation has been used for ARVC-related VT. Endocardial VT ablation in this setting can produce acute success, though recurrence rate is quite high, which may be explained by the more epicardial and patchy nature of the disease. Combined endocardial-epicardial ablation has since been shown to be feasible, safe, and with significantly better acute and long-term success, particularly when combined with scar dechanneling or homogenization of the scar. However, recurrence rates are not insignificant, and ablation does not eliminate the need for ICD placement. Medical therapy for ARVC-related VT is suboptimal. RF ablation techniques including endocardial and epicardial approaches appear to have the highest success rates for ARVC-related VT. Catheter ablation of VT in ARVC patients should be considered a potentially effective strategy for eliminating frequent VT episodes and ICD shocks rather than a curative therapeutic approach, until long-term efficacy has been consistently documented. Research into the optimal mapping and ablation techniques

  13. Meta-analysis of bipolar radiofrequency endometrial ablation versus thermal balloon endometrial ablation for the treatment of heavy menstrual bleeding.

    Science.gov (United States)

    Zhai, Yan; Zhang, Zihan; Wang, Wei; Zheng, Tingping; Zhang, Huili

    2018-01-01

    Heavy menstrual bleeding is a common problem that can severely affect quality of life. To compare bipolar radiofrequency endometrial ablation and thermal balloon ablation for heavy menstrual bleeding in terms of efficacy and health-related quality of life (HRQoL). Online registries were systematically searched using relevant terms without language restriction from inception to November 24, 2016. Randomized control trials or cohort studies of women with heavy menstrual bleeding comparing the efficacy of two treatments were eligible. Data were extracted. Results were expressed as risk ratios (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs). Six studies involving 901 patients were included. Amenorrhea rate at 12 months was significantly higher after bipolar radiofrequency endometrial ablation than after thermal balloon ablation (RR 2.73, 95% CI 2.00-3.73). However, no difference at 12 months was noted for dysmenorrhea (RR 1.04, 95% CI 0.68-1.58) or treatment failure (RR 0.78, 95% CI 0.38-1.60). The only significant difference for HRQoL outcomes was for change in SAQ pleasure score (12 months: WMD -3.51, 95% CI -5.42 to -1.60). Bipolar radiofrequency endometrial ablation and thermal balloon ablation reduce menstrual loss and improve quality of life. However, bipolar radiofrequency endometrial ablation is more effective in terms of amenorrhea rate and SAQ pleasure. © 2017 International Federation of Gynecology and Obstetrics.

  14. A study of particle generation during laser ablation with applications

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Chunyi [Univ. of California, Berkeley, CA (United States)

    2005-01-01

    A study has been made of the generation of particles during laser ablation and has included size distribution measurements and observation of the formation processes. The particle size distribution with respect to different laser parameters was obtained in-line using a differential mobility analyzer (DMA) and a particle counter. The experimental results show that the particle size varies with laser energy, laser pulsewidth, ambient gas flow rate and sample properties. The results serve as a basis for controlling the size of nanoparticles generated by laser ablation. Laser shadowgraph imaging was used to study mass ejection processes and mechanisms. At higher laser irradiance, some particles were ejected in the liquid and even in the solid phase. Time-resolved images show the propagation of the shockwaves: external shockwaves propagate outward and decelerate, and internal shockwaves reflect back and forth between the gas contact surface and the sample surface. The internal shockwave is proposed to cause the ejection of liquid particles when the internal shockwave strikes the liquid molten layer. A simulation based on vapor plume expansion was carried out and provides satisfactory agreement with experimental results. Different material properties result in different particle ejection behavior:particle ejection for most materials including metals result in a conically shaped envelope for the ejected material while ejection for silicon resembles a liquid jet. The difference in density change when the materials melt was proposed to be an important factor in the different ejection behavior. The characteristics of particles generated by laser ablation have a strong influence on the chemical analysis of the irradiated sample. Large particles are more difficult to completely vaporize and ionize, and induced preferential vaporization causes fractionation (i.e. a detected chemical composition that differs from the sample material). Large particles also result in spikes in

  15. Multielectrode phased radiofrequency ablation compared with point-by-point ablation for pulmonary vein isolation – outcomes in 539 patients

    Directory of Open Access Journals (Sweden)

    Spitzer SG

    2014-01-01

    Full Text Available Stefan G Spitzer,1 Laszlo Karolyi,1 Thomas Weinmann,1 Frank Scharfe,1 Carola Rämmler,1 Tobias Otto,1 Friedrich Jung,2 Clemens T Kadalie11Praxisklinik Herz und Gefäße, Akademische Lehrpraxisklinik der TU Dresden, Dresden, Germany; 2Saarland University, Homburg, Saar, GermanyPurpose: To provide data on acute and long-term outcomes from pulmonary vein isolation with the pulmonary vein ablation catheter (PVAC in patients with paroxysmal or persistent atrial fibrillation (AF.Methods: This was a single-center, retrospective, nonrandomized, case control study. Patients with documented symptomatic paroxysmal or persistent AF were treated with PVAC or with point-by-point radiofrequency ablation guided by the NavX™ mapping system. All follow-up visits were conducted in our center at 1 month, 3 months, and 6 months, and then at 6-month intervals. Electrocardiography and 24-hour Holter monitoring were performed at each follow-up visit. The endpoints included procedure times, acute and 24-month outcomes, and complications.Results: Of the 539 patients that were enrolled consecutively, 388 were ablated using PVAC and 151 using radiofrequency ablation. More patients with paroxysmal AF were treated with PVAC than with radiofrequency ablation. Acute success rates were >99% with both methods. Procedure duration and fluoroscopy times were significantly (P<0.001 shorter with PVAC than with point-by-point ablation. Rates of freedom from AF at all follow-up times available (up to 24 months were significantly higher after PVAC ablation than with radiofrequency ablation (64.2% versus 48.2% at 24 months. With both ablation strategies, the rates of freedom from AF were higher in patients with paroxysmal AF than for persistent AF. Two posterior cerebral infarcts occurred in the PVAC group within 2 days of the procedure. No phrenic nerve injuries and no esophageal injuries were recorded. Data on embolic lesions were not collected.Conclusion: PVAC ablation achieved

  16. Transferability of results of cost utility analyses for biologicals in inflammatory conditions for Central and Eastern European countries.

    Science.gov (United States)

    Gulácsi, László; Rencz, Fanni; Péntek, Márta; Brodszky, Valentin; Lopert, Ruth; Hevér, Noémi V; Baji, Petra

    2014-05-01

    Several Central and Eastern European (CEE) countries require cost-utility analyses (CUAs) to support reimbursement formulary listing. However, CUAs informed by local evidence are often unavailable, and the cost-effectiveness of the several currently reimbursed biologicals is unclear. To estimate the cost-effectiveness as multiples of per capita GDP/quality adjusted life years (QALY) of four biologicals (infliximab, etanercept, adalimumab, golimumab) currently reimbursed in six CEE countries in six inflammatory rheumatoid and bowel disease conditions. Systematic literature review of published cost-utility analyses in the selected conditions, using the United Kingdom (UK) as reference country and with study selection criteria set to optimize the transfer of results to the CEEs. Prices in each CEE country were pro-rated against UK prices using purchasing power parity (PPP)-adjusted per capita GDP, and local GDP per capita/QALY ratios estimated. Central and Eastern European countries list prices were 144-333% higher than pro rata prices. Out of 85 CUAs identified by previous systematic literature reviews, 15 were selected as a convenience sample for estimating the cost-effectiveness of biologicals in the CEE countries in terms of per capita GDP/QALY. Per capita GDP/QALY values varied from 0.42 to 6.4 across countries and conditions (Bulgaria: 0.97-6.38; Czech Republic: 0.42-2.76; Hungary: 0.54-3.54; Poland: 0.59-3.90; Romania: 0.77-5.07; Slovakia: 0.55-3.61). While results must be interpreted with caution, calculating pro rata (cost-effective) prices and per capita GDP/QALY ratios based on CUAs can aid reimbursement decision-making in the absence of analyses using local data.

  17. Recombinant TSH stimulated remnant ablation therapy in thyroid cancer: the success rate depends on the definition of ablation success--an observational study.

    Directory of Open Access Journals (Sweden)

    Anouk N A van der Horst-Schrivers

    Full Text Available Patients with differentiated thyroid cancer (DTC are treated with (near-total thyroidectomy followed by remnant ablation. Optimal radioiodine-131 (131I uptake is achieved by withholding thyroid hormone (THW, pretreatment with recombinant human Thyrotropin Stimulating Hormone (rhTSH is an alternative. Six randomized trials have been published comparing THW and rhTSH, however comparison is difficult because an uniform definition of ablation success is lacking. Using a strict definition, we performed an observational study aiming to determine the efficacy of rhTSH as preparation for remnant ablation.Adult DTC patients with, tumor stage T1b to T3, Nx, N0 and N1, M0 were included in a prospective multicenter observational study with a fully sequential design, using a stopping rule. All patients received remnant ablation with 131I using rhTSH. Ablation success was defined as no visible uptake in the original thyroid bed on a rhTSH stimulated 150 MBq 131I whole body scan (WBS 9 months after remnant ablation, or no visible uptake in the original thyroid bed on a post therapeutic WBS when a second high dose was necessary.After interim analysis of the first 8 patients, the failure rate was estimated to be 69% (90% confidence interval (CI 20-86% and the inclusion of new patients had to be stopped. Final analysis resulted in an ablation success in 11 out of 17 patients (65%, 95% CI 38-86%.According to this study, the efficacy of rhTSH in the preparation of 131I ablation therapy is inferior, when using a strict definition of ablation success. The current lack of agreement as to the definition of successful remnant ablation, makes comparison between different ablation strategies difficult. Our results point to the need for an international consensus on the definition of ablation success, not only in routine patient's care but also for scientific reasons.Dutch Trial Registration NTR2395.

  18. Processing condition influence on the characteristics of gold nanoparticles produced by pulsed laser ablation in liquids

    Energy Technology Data Exchange (ETDEWEB)

    Nikov, R.G., E-mail: rosen_nikov@abv.bg [Institute of Electronics, Bulgarian Academy of Sciences, Tzarigradsko Chaussee 72, Sofia 1784 (Bulgaria); Nikolov, A.S.; Nedyalkov, N.N.; Atanasov, P.A. [Institute of Electronics, Bulgarian Academy of Sciences, Tzarigradsko Chaussee 72, Sofia 1784 (Bulgaria); Alexandrov, M.T. [Institute of Experimental Pathology and Parasitology, Bulgarian Academy of Sciences, G. Bonchev Street, Building 25, Sofia 1113 (Bulgaria); Karashanova, D.B. [Institute of Optical Materials and Technologies, Bulgarian Academy of Sciences, G. Bonchev Street, Building 109, Sofia 1113 (Bulgaria)

    2013-06-01

    A study is presented of Au nanoparticles (NPs) created by nanosecond pulsed laser ablation of a solid target in double distilled water. The influence was examined of the laser wavelength on the size, shape and optical properties of the resulting NPs. Three different wavelengths: the fundamental (λ = 1064 nm), second (λ{sub SHG} = 532) and third (λ{sub THG} = 355) harmonic of a Nd:YAG laser at the same fluence were utilized to produce various colloids. Ablation at the wavelength of 532 nm was investigated in more detail to reveal the influence of self-absorption by the already created NPs on their characteristics. The colloid produced was irradiated by λ{sub irrad} = 532 nm (laser energy 40 mJ) at different times up to 25 min after the end of ablation. The initial structure of welded NPs forming wires was modified. Transmission electron microscopy and optical transmission measurements were used to evaluate the shape and size distribution of the NPs.

  19. Managing Expectations: Results from Case Studies of US Water Utilities on Preparing for, Coping with, and Adapting to Extreme Events

    Science.gov (United States)

    Beller-Simms, N.; Metchis, K.

    2014-12-01

    Water utilities, reeling from increased impacts of successive extreme events such as floods, droughts, and derechos, are taking a more proactive role in preparing for future incursions. A recent study by Federal and water foundation investigators, reveals how six US water utilities and their regions prepared for, responded to, and coped with recent extreme weather and climate events and the lessons they are using to plan future adaptation and resilience activities. Two case studies will be highlighted. (1) Sonoma County, CA, has had alternating floods and severe droughts. In 2009, this area, home to competing water users, namely, agricultural crops, wineries, tourism, and fisheries faced a three-year drought, accompanied at the end by intense frosts. Competing uses of water threatened the grape harvest, endangered the fish industry and resulted in a series of regulations, and court cases. Five years later, new efforts by partners in the entire watershed have identified mutual opportunities for increased basin sustainability in the face of a changing climate. (2) Washington DC had a derecho in late June 2012, which curtailed water, communications, and power delivery during a record heat spell that impacted hundreds of thousands of residents and lasted over the height of the tourist-intensive July 4th holiday. Lessons from this event were applied three months later in anticipation of an approaching Superstorm Sandy. This study will help other communities in improving their resiliency in the face of future climate extremes. For example, this study revealed that (1) communities are planning with multiple types and occurrences of extreme events which are becoming more severe and frequent and are impacting communities that are expanding into more vulnerable areas and (2) decisions by one sector can not be made in a vacuum and require the scientific, sectoral and citizen communities to work towards sustainable solutions.

  20. Modeling and validation of microwave ablations with internal vaporization.

    Science.gov (United States)

    Chiang, Jason; Birla, Sohan; Bedoya, Mariajose; Jones, David; Subbiah, Jeyam; Brace, Christopher L

    2015-02-01

    Numerical simulation is increasingly being utilized for computer-aided design of treatment devices, analysis of ablation growth, and clinical treatment planning. Simulation models to date have incorporated electromagnetic wave propagation and heat conduction, but not other relevant physics such as water vaporization and mass transfer. Such physical changes are particularly noteworthy during the intense heat generation associated with microwave heating. In this paper, a numerical model was created that integrates microwave heating with water vapor generation and transport by using porous media assumptions in the tissue domain. The heating physics of the water vapor model was validated through temperature measurements taken at locations 5, 10, and 20 mm away from the heating zone of the microwave antenna in homogenized ex vivo bovine liver setup. Cross-sectional area of water vapor transport was validated through intraprocedural computed tomography (CT) during microwave ablations in homogenized ex vivo bovine liver. Iso-density contours from CT images were compared to vapor concentration contours from the numerical model at intermittent time points using the Jaccard index. In general, there was an improving correlation in ablation size dimensions as the ablation procedure proceeded, with a Jaccard index of 0.27, 0.49, 0.61, 0.67, and 0.69 at 1, 2, 3, 4, and 5 min, respectively. This study demonstrates the feasibility and validity of incorporating water vapor concentration into thermal ablation simulations and validating such models experimentally.

  1. Radiofrequency ablation of two femoral head chondroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Petsas, Theodore [Department of Radiology, University of Patras (Greece); Megas, Panagiotis [Department of Orthopaedic Surgery, University of Patras (Greece)]. E-mail: panmegas@med.upatras.gr; Papathanassiou, Zafiria [Department of Radiology, University of Patras (Greece)

    2007-07-15

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed.

  2. Pediatric Percutaneous Osteoid Osteoma Ablation: Cone-Beam CT with Fluoroscopic Overlay Versus Conventional CT Guidance.

    Science.gov (United States)

    Perry, Brandon C; Monroe, Eric J; McKay, Tyler; Kanal, Kalpana M; Shivaram, Giridhar

    2017-10-01

    To compare technical success, clinical success, complications, radiation dose, and total room utilization time for osteoid osteoma thermal (radiofrequency or microwave) ablation using cone-beam computed tomography (CBCT) with two-axis fluoroscopic navigational overlay versus conventional computed tomography (CT) guidance. A retrospective review was performed to identify all osteoid osteoma ablations performed over a 5.5-year period at a single tertiary care pediatric hospital. Twenty-five ablations (15 radiofrequency and 10 microwave) in 23 patients undergoing fluoroscopic CBCT-guided osteoid osteoma ablation were compared to 35 ablations (35 radiofrequency) in 32 patients undergoing ablation via conventional CT guidance. Dose area product and dose length product were recorded for CBCT and conventional CT, respectively, and converted to effective doses. Technical success, clinical success (cessation of pain and medication use 1 month after ablation), complications, radiation dose, and total room utilization time were compared. All procedures were technically successful. Twenty-two of 25 (88.0%) CBCT and 31 of 35 (88.6%) conventional CT-guided ablations achieved immediate clinical success. There were two minor complications in each group and no major complications. Mean effective radiation dose was significantly lower for CBCT compared to CT guidance (0.12 vs. 0.39 mSv, p = 0.02). Mean total room utilization time for CBCT was longer (133.5 vs. 97.5 min, p = 0.0001). Fluoroscopic CBCT guidance for percutaneous osteoid osteoma ablation yields similar technical and clinical success, reduced radiation dose, and increased total room utilization time compared to conventional CT guidance.

  3. Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: Results of two pilot studies in Belgium

    NARCIS (Netherlands)

    C. Maertens De Noordhout (Charline); B. Devleesschauwer (Brecht); Gielens, L.; Plasmans, M.H.D.; J.A. Haagsma (Juanita); N. Speybroeck (Niko)

    2017-01-01

    textabstractBackground: Utilities and disability weights (DWs) are metrics used for calculating Quality-Adjusted Life Years and Disability-Adjusted Life Years (DALYs), respectively. Utilities can be obtained with multi-attribute instruments such as the EuroQol 5 dimensions questionnaire (EQ-5D). In

  4. A tubular electrode for radiofrequency ablation therapy

    KAUST Repository

    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.

  5. The stepwise multi-photon activation fluorescence guided ablation of melanin

    Science.gov (United States)

    Lai, Zhenhua; Gu, Zetong; DiMarzio, Charles

    2015-02-01

    Previous research has shown that the stepwise multi-photon activation fluorescence (SMPAF) of melanin, activated and excited by a continuous-wave (CW) mode near infrared (NIR) laser, is a low-cost and reliable method for detecting melanin. We have developed a device utilizing the melanin SMPAF to guide the ablation of melanin with a 975 nm CW laser. This method provides the ability of targeting individual melanin particles with micrometer resolution, and enables localized melanin ablation to be performed without collateral damage. Compared to the traditional selective photothermolysis, which uses pulsed lasers for melanin ablation, this method demonstrates higher precision and lower cost. Therefore, the SMPAF guided selective ablation of melanin is a promising tool of melanin ablation for both medical and cosmetic purposes.

  6. Potential of Radiofrequency Ablation in Combination with Immunotherapy in the Treatment of Hepatocellular Carcinoma

    Science.gov (United States)

    Li, Guangfu; Staveley-O’Carroll, Kevin F; Kimchi, Eric T

    2016-01-01

    Radiofrequency ablation (RFA) is an important treatment option for patients with early hepatocellular carcinoma (HCC). RFA offers a reliable, reproducible modality to effectively treat hepatic lesions with minimal collateral damage to the surrounding hepatic parenchyma. In addition to traditional open operative techniques, RFA can be performed percutaneously or laparoscopically to minimize the physiologic insult to the patient. Due to the concomitant hepatic damage and dysfunction that often is present in patients with HCC these factors make RFA a frequently utilized therapeutic option. However, RFA is most efficacious in treating smaller tumors (≤ 2 cm), particularly when an ablation margin of ≥ 4–5 mm can be obtained. RFA has diminishing utility in larger tumors, resulting in reduced three and five year overall survival rates when compared to surgical resection. Multimodal approaches to include RFA with other standard and investigational approaches have become a subject of recent interest. RFA capably produces cellular destruction causing liberation of a substantial amount of antigens, many of which are tumor-specific providing a favorable environment for immune recognition. We propose that utilizing an immunotherapeutic approach in conjunction with RFA is the next logical step in the treatment of HCC. In this review, we summarize how RFA modulates antitumor immunity and works in concert with immunotherapy in the treatment of HCC. The information provided is expected to help the future design of novel RFA-integrated immunotherapies which are able to generate durable and powerful antitumor immune response to achieve optimal tumor control. PMID:28042519

  7. Sepsis-Induced Osteoblast Ablation Causes Immunodeficiency.

    Science.gov (United States)

    Terashima, Asuka; Okamoto, Kazuo; Nakashima, Tomoki; Akira, Shizuo; Ikuta, Koichi; Takayanagi, Hiroshi

    2016-06-21

    Sepsis is a host inflammatory response to severe infection associated with high mortality that is caused by lymphopenia-associated immunodeficiency. However, it is unknown how lymphopenia persists after the accelerated lymphocyte apoptosis subsides. Here we show that sepsis rapidly ablated osteoblasts, which reduced the number of common lymphoid progenitors (CLPs). Osteoblast ablation or inducible deletion of interleukin-7 (IL-7) in osteoblasts recapitulated the lymphopenic phenotype together with a lower CLP number without affecting hematopoietic stem cells (HSCs). Pharmacological activation of osteoblasts improved sepsis-induced lymphopenia. This study demonstrates a reciprocal interaction between the immune and bone systems, in which acute inflammation induces a defect in bone cells resulting in lymphopenia-associated immunodeficiency, indicating that bone cells comprise a therapeutic target in certain life-threatening immune reactions. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Advanced Coats’ disease treated with intravitreal bevacizumab combined with laser vascular ablation

    Directory of Open Access Journals (Sweden)

    Villegas VM

    2014-05-01

    Full Text Available Victor M Villegas,1 Aaron S Gold,1 Audina M Berrocal,2 Timothy G Murray11Ocular Oncology and Retina, Miami, FL, USA; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To evaluate the impact of intravitreal bevacizumab combined with laser vascular ablation in the management of advanced Coats’ disease presenting with exudative retinal detachment.Methods: This was a retrospective review of 24 children that presented with exudative retinal detachments associated with advanced Coats’ disease. Mean patient age was 62 months (range 9–160 months. Presenting signs included retinal detachment in 24 children (100%, vascular telangiectasia in 24 children (100%, and retinal ischemia in 24 children (100%. Twenty of 24 children presented with elevated, vascular leakage in the fovea (83%. Two children presented with sub-retinal fibrosis associated with presumed long-standing retinal detachment without evidence of rhegmatogenous retinal detachment. Ten patients exhibited vascular alterations in the periphery of the second eye without clinical evidence of exudation. All 24 children were treated with a large-spot-size diode laser directly to areas of abnormal telangiectatic vasculature. All 24 children received intravitreal bevacizumab injection. Results: All 24 children had resolution of exudative retinal detachment, ablation of vascular telangiectasia, and anatomic improvement of the retina. No child exhibited progressive retinal detachment and no eye required enucleation. No cases of neovascular glaucoma were seen. Fellow eyes with peripheral vascular alterations showed no progression to exudative vasculopathy during the observation period. Intravitreal bevacizumab injection was not associated with endophthalmitis or systemically-observed complications.Conclusion: Repetitive intravitreal bevacizumab combined with laser vascular ablation may be utilized effectively

  9. Nanosecond pulsed laser ablation of silicon in liquids

    Energy Technology Data Exchange (ETDEWEB)

    Karimzadeh, R.; Anvari, J.Z.; Mansour, N. [Shahid Beheshti University, Department of Physics, Tehran (Iran)

    2009-03-15

    Laser fluence and laser shot number are important parameters for pulse laser based micromachining of silicon in liquids. This paper presents laser-induced ablation of silicon in liquids of the dimethyl sulfoxide (DMSO) and the water at different applied laser fluence levels and laser shot numbers. The experimental results are conducted using 15 ns pulsed laser irradiation at 532 nm. The silicon surface morphology of the irradiated spots has an appearance as one can see in porous formation. The surface morphology exhibits a large number of cavities which indicates as bubble nucleation sites. The observed surface morphology shows that the explosive melt expulsion could be a dominant process for the laser ablation of silicon in liquids using nanosecond pulsed laser irradiation at 532 nm. Silicon surface's ablated diameter growth was measured at different applied laser fluences and shot numbers in both liquid interfaces. A theoretical analysis suggested investigating silicon surface etching in liquid by intense multiple nanosecond laser pulses. It has been assumed that the nanosecond pulsed laser-induced silicon surface modification is due to the process of explosive melt expulsion under the action of the confined plasma-induced pressure or shock wave trapped between the silicon target and the overlying liquid. This analysis allows us to determine the effective lateral interaction zone of ablated solid target related to nanosecond pulsed laser illumination. The theoretical analysis is found in excellent agreement with the experimental measurements of silicon ablated diameter growth in the DMSO and the water interfaces. Multiple-shot laser ablation threshold of silicon is determined. Pulsed energy accumulation model is used to obtain the single-shot ablation threshold of silicon. The smaller ablation threshold value is found in the DMSO, and the incubation effect is also found to be absent. (orig.)

  10. Radiofrequency Ablation for the Treatment of Hepatocellular Carcinoma in Patients with Transjugular Intrahepatic Portosystemic Shunts

    International Nuclear Information System (INIS)

    Park, Jonathan K.; Al-Tariq, Quazi Z.; Zaw, Taryar M.; Raman, Steven S.; Lu, David S.K.

    2015-01-01

    PurposeTo assess radiofrequency (RF) ablation efficacy, as well as the patency of transjugular intrahepatic portosystemic shunts (TIPSs), in patients with hepatocellular carcinoma (HCC).Materials and MethodsRetrospective database review of patients with pre-existing TIPS undergoing RF ablation of HCC was conducted over a 159-month period ending in November 2013. TIPS patency pre- and post-RF ablation was assessed by ultrasound, angiography, and/or contrast-enhanced CT or MRI. Patient demographics and immediate post-RF ablation outcomes and complications were also reviewed.Results19 patients with 21 lesions undergoing 25 RF ablation sessions were included. Child-Pugh class A, B, and C scores were seen in 1, 13, and 5 patients, respectively. Eleven patients (58 %) ultimately underwent liver transplantation. Immediate technical success was seen in all ablation sessions without residual tumor enhancement (100 %). No patients (0 %) suffered liver failure within 1 month of ablation. Pre-ablation TIPS patency was demonstrated in 22/25 sessions (88 %). Of 22 cases with patent TIPS prior to ablation, post-ablation patency was demonstrated in 22/22 (100 %) at immediate post-ablation imaging and in 21/22 (95 %) at last follow-up (1 patient was incidentally noted to have occlusion 31 months later). No immediate complications were observed.ConclusionAblation efficacy was similar to the cited literature values for patients without TIPS. Furthermore, TIPS patency was preserved in the majority of cases. Patients with both portal hypertension and HCC are not uncommonly encountered, and a pre-existing TIPS does not appear to be a definite contraindication for RF ablation

  11. Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation

    International Nuclear Information System (INIS)

    Tacke, J.; Mahnken, A.; Buecker, A.; Guenther, R.W.; Rohde, D.

    2001-01-01

    Purpose: To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutaneous radiofrequency ablation. Materials and Methods: A 5 cm renal cell carcinoma of a 43-year-old drug abusing male with serologically proven HIV, hepatitis B and C infection, who refused surgery, was superselectively embolized using microspheres (size: 500 - 700 μm) and a platinum coil under local anesthesia. Percutaneous radiofrequency ablation using a 7F LeVeen probe (size of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia. Results: The combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was discharged 24 hours after RF ablation. No complications like urinary leaks or fistulas were observed and follow up CT one day and 4 weeks after the radiofrequency intervention revealed no signs of residual tumor growth. Conclusion: The combined transcatheter embolization and percutaneous radiofrequency ablation of renal cell carcinoma has proved technically feasible, effective, and safe in this patient. It may be offered as an alternative treatment to partial or radical nephrectomy under certain circumstances. Abbreviations: RF = radiofrequency ablation; CT = computed tomography; HIV = human immunodeficiency virus. (orig.) [de

  12. Water spray assisted ultrashort laser pulse ablation

    International Nuclear Information System (INIS)

    Silvennoinen, M.; Kaakkunen, J.J.J.; Paivasaari, K.; Vahimaa, P.

    2013-01-01

    Highlights: ► We show the novel method to use multibeam processing with ultrashort pulses efficiently. ► Sprayed thin water layer on ablation zone enhances ablation rate and quality. ► In some cases this method also enables ablation of the deeper and straighter holes compared to ones made without the water layer. ► Method also makes possible to directly write features without the self-organizing structures. - Abstract: We have studied femtosecond ablation under sprayed thin water film and its influence and benefits compared with ablation in the air atmosphere. These have been studied in case of the hole and the groove ablation using IR femtosecond laser. Water enhances the ablation rate and in some situations it makes possible to ablate the holes with a higher aspect ratio. While ablating the grooves, the water spray allows using the high fluences without the generation of the self-organized structures.

  13. Assisted laser ablation: silver/gold nanostructures coated with silica

    Science.gov (United States)

    González-Castillo, J. R.; Rodríguez-González, Eugenio; Jiménez-Villar, Ernesto; Cesar, Carlos Lenz; Andrade-Arvizu, Jacob Antonio

    2017-11-01

    The synthesis processes of metallic nanoparticles have seen a growing interest in recent years, mainly by the potential applications of the phenomenon of localized surface plasmon resonance associated with metallic nanoparticles. This paper shows a fast method to synthesize silver, gold and silver/gold alloy nanoparticles coated with a porous silica shell by the assisted laser ablation method in three steps. The method involves a redox chemical reaction where the reducing agent is supplied in nanometric form by laser ablation. In the first step, a silicon target immersed in water is ablated for several minutes. Later, AgNO3 and HAuCl4 aliquots are added to the solution. The redox reaction between the silver and gold ions and products resulting from ablation process can produce silver, gold or silver/gold alloy nanoparticles coated with a porous silica shell. The influence of the laser pulse energy, ablation time, Ag+ and Au3+ concentration, as well as the Ag+/Au3+ ratio, on optical and structural properties of the nanostructures was investigated. This work represents a step forward in the study of reaction mechanisms that take place during the synthesis of nanoscale materials by the assisted laser ablation technique.

  14. Temperature-controlled radiofrequency ablation of cardiac tissue

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, Adrian

    1999-01-01

    BACKGROUND: A variety of basic factors such as electrode tip pressure, flow around the electrode and electrode orientation influence lesion size during radiofrequency ablation, but importantly is dependent on the chosen mode of ablation. However, only little information is available for the frequ......BACKGROUND: A variety of basic factors such as electrode tip pressure, flow around the electrode and electrode orientation influence lesion size during radiofrequency ablation, but importantly is dependent on the chosen mode of ablation. However, only little information is available...... for the frequently used temperature-controlled mode. The purpose of the present experimental study was to evaluate the impact during temperature-controlled radiofrequency ablation of three basic factors regarding electrode-tissue contact and convective cooling on lesion size. METHODS AND RESULTS: In vitro strips......-controlled radiofrequency ablation increased external cooling of the electrode tip due to either flow of the surrounding liquid or poor electrode tissue contact, as exemplified by perpendicular versus parallel electrode orientation, increases lesion size significantly. This is in contrast to the impact of these factors...

  15. Epicardial Adipose Tissue Thickness and Ablation Outcome of Atrial Fibrillation

    Science.gov (United States)

    Tsao, Hsuan-Ming; Lin, Yenn-Jiang; Yun, Chun-Ho; Lai, Yau-Huei; Chang, Shih-Lin; Lo, Li-Wei; Hu, Yu-Feng; Tuan, Ta-Chuan; Chang, Hung-Yu; Kuo, Jen-Yuan; Yeh, Hung-I; Wu, Tsu-Juey; Hsieh, Ming-Hsiung; Yu, Wen-Chung; Chen, Shih-Ann

    2013-01-01

    Objectives Epicardial fat was closely related to atrial fibrillation (AF). Transthoracic echocardiography (TTE) has been proposed to be a convenient imaging tool in assessing epicardial adipose tissue (EAT). The goal of the present study was to investigate whether the EAT thickness measured on TTE was a useful parameter in predicting procedural outcomes of AF ablations. Methods and Results A total of 227 paroxysmal AF (PAF) and 56 non-paroxysmal AF (non-PAF) patients receiving catheter ablations from 2008-2010 were enrolled. Echocardiography-derived regional EAT thickness from parasternal long-axis view was quantified for each patient. Free of recurrence was defined as the absence of atrial arrhythmias without using antiarrhythmic agents after ablations. The mean EAT thickness of the study population was 6.1 ± 0.8 mm. Non-PAF patients had a thicker EAT than that of PAF patients (7.0 ± 0.7 mm versus 5.9 ± 0.7 mm, p value EAT thickness were independent predictors of recurrence after catheter ablations. At a cutoff value of 6 mm for PAF and 6.9 mm for non-PAF, the measurement of EAT thickness could help us to identify patients at risk of recurrences. Conclusions EAT thickness may serve as a useful parameter in predicting recurrences after AF ablations. Compared to other imaging modalities, TTE can be an alternative choice with less cost and time in assessing the effects of EAT on ablation outcomes. PMID:24066158

  16. Radiofrequency Ablation Treatment for Renal Cell Carcinoma: Early Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seong Hoon; Yoon, Seong Kuk; Cho, Jin Han; Oh, Jong Young; Nam, Kyung Jin; Kwon, Hee Jin; Kim, Su Yeon; Kang, Myong Jin; Choi, Sun Seob; Sung, Gyung Tak [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2008-08-15

    To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43 73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow- up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1 5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17 33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.

  17. Radiofrequency Ablation of Lung Malignancies: Where Do We Stand?

    International Nuclear Information System (INIS)

    Lencioni, Riccardo; Crocetti, Laura; Cioni, Roberto; Mussi, Alfredo; Fontanini, Gabriella; Ambrogi, Marcello; Franchini, Chiara; Cioni, Dania; Fanucchi, Olivia; Gemignani, Raffaello; Baldassarri, Rubia; Angeletti, Carlo Alberto; Bartolozzi, Carlo

    2004-01-01

    Percutaneous radiofrequency (RF) ablation is a minimally invasive technique used to treat solid tumors. Because of its ability to produce large volumes of coagulation necrosis in a controlled fashion, this technique has gained acceptance as a viable therapeutic option for unresectable liver malignancies. Recently, investigation has been focused on the clinical application of RF ablation in the treatment of lung malignancies. In theory, lung tumors are well suited to RF ablation because the surrounding air in adjacent normal parenchyma provides an insulating effect, thus facilitating energy concentration within the tumor tissue. Experimental studies in rabbits have confirmed that lung RF ablation can be safely and effectively performed via a percutaneous, transthoracic approach, and have prompted the start of clinical investigation. Pilot clinical studies have shown that RF ablation enables successful treatment of relatively small lung malignancies with a high rate of complete response and acceptable morbidity, and have suggested that the technique could represent a viable alternate or complementary treatment method for patients with non-small cell lung cancer or lung metastases of favorable histotypes who are not candidates for surgical resection. This article gives an overview of lung RF ablation, discussing experimental animal findings, rationale for clinical application, technique and methodology, clinical results, and complications

  18. Radiofrequency Ablation Treatment for Renal Cell Carcinoma: Early Clinical Experience

    International Nuclear Information System (INIS)

    Park, Seong Hoon; Yoon, Seong Kuk; Cho, Jin Han; Oh, Jong Young; Nam, Kyung Jin; Kwon, Hee Jin; Kim, Su Yeon; Kang, Myong Jin; Choi, Sun Seob; Sung, Gyung Tak

    2008-01-01

    To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43 73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow- up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1 5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17 33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs

  19. Influence of liquid environments on femtosecond laser ablation of silicon

    International Nuclear Information System (INIS)

    Liu Hewei; Chen Feng; Wang Xianhua; Yang Qing; Bian Hao; Si Jinhai; Hou Xun

    2010-01-01

    Liquid-assisted ablation of solids by femtosecond laser pulses has proved to be an efficient tool for highly precise microfabrication, which evokes numerous research interests in recent years. In this paper, we systematically investigate the interaction of femtosecond laser pulses with silicon wafer in water, alcohol, and as a comparison, in air. After producing a series of multiple-shot craters on a silicon wafer in the three types of environments, surface morphologies and femtosecond laser-induced periodic surface structures are comparatively studied via the scanning electron microscope investigations. Meanwhile, the influence of liquid mediums on ablation threshold fluence and ablation depth is also numerically analyzed. The experimental results indicate that the ablation threshold fluences of silicon are reduced by the presence of liquids (water/alcohol) and ablation depths of craters are deepened in ambient water. Furthermore, smoother surfaces tend to be obtained in alcohol-mediated ablation at smaller shot numbers. Finally, the evolution of the femtosecond laser-induced periodic surface structures in air, water and alcohol is also discussed.

  20. Rising Charges and Costs for Pediatric Catheter Ablation

    Science.gov (United States)

    BURNS, KRISTIN M.; EVANS, FRANK; PEARSON, GAIL D.; BERUL, CHARLES I.; KALTMAN, JONATHAN R.

    2018-01-01

    Introduction Catheter ablation has been shown to be effective for pediatric tachyarrhythmias, but the associated charges and costs have not been described in the recent era. Understanding such contemporary trends may identify ways to keep an effective therapy affordable while optimizing clinical outcomes. Methods We used the 1997-2009 Kids’ Inpatient Databases to examine trends in charges and costs for pediatric catheter ablation and identify determinants of temporal changes. Results There were 7,130 discharges for catheter ablation in the sample. Mean age at ablation was 12.1 ± 0.2 years. Patients with congenital heart disease (CHD) made up 10% of the sample. Complications occurred in 8% of discharges. Mean total charges rose 219% above inflation (from $23,798 ± 1,072 in 1997 to $75,831 ± 2,065 in 2009). From 2003 to 2009, costs rose 25% (from $20,459 ± 780 in 2003 to $25,628 ± 992 in 2009). Charges for ablation increased markedly relative to surgical procedures, but with a similar slope to other catheter-based interventions. Multivariable analysis revealed that year (P pediatric catheter ablation increased relative to other procedures and significantly outstripped inflation. Further study of complications, length of stay, and regional differences may help control rising costs while maintaining quality of care. PMID:23066833

  1. Resin-Impregnated Carbon Ablator: A New Ablative Material for Hyperbolic Entry Speeds

    Science.gov (United States)

    Esper, Jaime; Lengowski, Michael

    2012-01-01

    Ablative materials are required to protect a space vehicle from the extreme temperatures encountered during the most demanding (hyperbolic) atmospheric entry velocities, either for probes launched toward other celestial bodies, or coming back to Earth from deep space missions. To that effect, the resin-impregnated carbon ablator (RICA) is a high-temperature carbon/phenolic ablative thermal protection system (TPS) material designed to use modern and commercially viable components in its manufacture. Heritage carbon/phenolic ablators intended for this use rely on materials that are no longer in production (i.e., Galileo, Pioneer Venus); hence the development of alternatives such as RICA is necessary for future NASA planetary entry and Earth re-entry missions. RICA s capabilities were initially measured in air for Earth re-entry applications, where it was exposed to a heat flux of 14 MW/sq m for 22 seconds. Methane tests were also carried out for potential application in Saturn s moon Titan, with a nominal heat flux of 1.4 MW/sq m for up to 478 seconds. Three slightly different material formulations were manufactured and subsequently tested at the Plasma Wind Tunnel of the University of Stuttgart in Germany (PWK1) in the summer and fall of 2010. The TPS integrity was well preserved in most cases, and results show great promise.

  2. Studying the thermal performance of a bipolar radiofrequency ablation with an improved electrode matrix system: In vitro experiments and modelling

    International Nuclear Information System (INIS)

    Shao, Y.L.; Leo, H.L.; Chua, K.J.

    2017-01-01

    Highlights: • We made judicious modification to the Penne’s equation in the process of developing our model. We consider the liver to consist of tumor and health tissue. The model has been validated with experimental data. • The proposed electrode system can reduce the tissue volume damage outside the electrodes. The designed building unit with 10 mm inter-electrode distance is the optimal choice to achieve desired ablation zone. • The influence of blood vessel is relatively small for using this electrode system. A spatial distance of 13 mm is deemed as the safe distance between the wall of the central probe and the large vessel. • This proposed electrode system demonstrated higher ablation stability even for tissue regions that are close to blood vessels. The system is better suited for matrix-type RFA. - Abstract: Radiofrequency ablation (RFA) is becoming an effective treatment method for both primary tumors and tumors that have metastasized. Large tumors in difficult anatomic locations can be treated by RFA technologies. However, constant size and regular shape of damage zones cannot be obtained by recent RFA technologies. The aim of this study is to optimize the stability of RFA treatment by employing a newly proposed bipolar electrode system. A hepatic RFA mathematical model is developed by the finite element method approach. The model is validated with the experimental data. This model is then used to verify the reliability and stability of the proposed electrode system. Simulated results showed the cross section of the ablation zone utilizing designed electrode system approximates a square. In addition, the fraction of the necrosed tissue with this electrode pattern turned out to be larger than the fraction with single-probe RFA techniques. This system demonstrated higher ablation stability even for tissue regions that are close to blood vessels. The proposed electrode system is better suited for matrix-type RFA.

  3. Study on ablation behavior of silicone rubber based insulation material under the condition of boron oxide particles erosion

    Science.gov (United States)

    Zha, B. L.; Shi, Y. A.; Wang, J. J.; Su, Q. D.

    2018-01-01

    Self-designed oxygen-kerosene ablation system was employed to study the ablation characteristics of silicone rubber based thermal insulation materials under the condition of boron oxide particles erosion. The ablation test was designed with a mass fraction of 1.69% boron oxide particles and particles-free, the microstructure and elemental analysis of the specimens before and after ablation were carried out by Scanning Electron Microscopy (SEM) and Energy Dispersion Spectrum (EDS). Experiment results show that the average mass ablation rate of the materials was 0.0099 g•s‑1 and the average ablation rate was -0.025 mm•s‑1 under the condition of pure gas phase ablation; and the average mass ablation rate of the multiphase ablation test group was 0.1775 g•s‑1, whose average ablation rate was 0.437 mm•s‑1 during the ablation process, the boron oxide particles would adhere a molten layer on the flame contact surface of the specimen, which covering the pores on the material surface, blocking the infiltration channel for the oxidizing component and slowing down the oxidation loss rate of the material below the surface, but because the particles erosion was the main reason for material depletion, the combined effect of the above both led to the upward material ablation rates of Silicone Rubber.

  4. Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Zhou Xiaodong [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China)]. E-mail: zhouxd@fmmu.edu.cn; Ren Xiaolong [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China)]. E-mail: renxiaolong70@hotmail.com; Zhang Jun [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); He Guangbin [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Zheng Minjuan [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Tian Xue [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Li Li [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Zhu Ting [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Zhang Min [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Wang Lei [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Luo Wen [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China)

    2007-05-15

    Purpose: To assess the utility of contrast-enhanced ultrasonography (ceUS) in the assessment of the therapeutic response to high intensity focused ultrasound (HIFU) ablation in patients with uterine fibroid. Materials and methods: Sixty-four patients with a total of 64 uterine fibroids (mean: 5.3 {+-} 1.2 cm; range: 3.2-8.9 cm) treated with HIFU ablation under the ultrasound guidance were evaluated with ceUS after receiving an intravenous bolus injection of a microbubble contrast agent (SonoVue) within 1 week after intervention. We obtained serial ceUS images during the time period from beginning to 5 min after the initiation of the bolus contrast injection. All of the patients underwent a contrast enhanced MRI (ceMRI) and ultrasound guided needle puncture biopsy within 1 week after HIFU ablation. And as a follow-up, all of the patients underwent US at 1, 3, 6 and 12 months after HIFU treatment. The volume change was observed and compared to pre- and post-HIFU ablation. The results of the ceUS were compared with those of the ceMRI in terms of the presence or absence of residual unablated tumor and pathologic change in the treated lesions. Results: On ceUS, diagnostic accuracy was 100%, while residual unablated tumors were found in three uterine fibroids (4.7%) and failed treatment was found in eight uterine fibroids (12.5%). All the 11 fibroids were subjected to additional HIFU ablation. Of the 58 ablated fibroids without residual tumors on both the ceUS and ceMRI after the HIFU ablation, the volumes of all the fibroids decreased in different degrees during the 1 year follow-up USs. And histologic examinations confirmed findings of necrotic and viable tumor tissue, respectively. Conclusion: CEUS is potentially useful for evaluating the early therapeutic effect of percutaneous HIFU ablation for uterine fibroids.

  5. Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography

    International Nuclear Information System (INIS)

    Zhou Xiaodong; Ren Xiaolong; Zhang Jun; He Guangbin; Zheng Minjuan; Tian Xue; Li Li; Zhu Ting; Zhang Min; Wang Lei; Luo Wen

    2007-01-01

    Purpose: To assess the utility of contrast-enhanced ultrasonography (ceUS) in the assessment of the therapeutic response to high intensity focused ultrasound (HIFU) ablation in patients with uterine fibroid. Materials and methods: Sixty-four patients with a total of 64 uterine fibroids (mean: 5.3 ± 1.2 cm; range: 3.2-8.9 cm) treated with HIFU ablation under the ultrasound guidance were evaluated with ceUS after receiving an intravenous bolus injection of a microbubble contrast agent (SonoVue) within 1 week after intervention. We obtained serial ceUS images during the time period from beginning to 5 min after the initiation of the bolus contrast injection. All of the patients underwent a contrast enhanced MRI (ceMRI) and ultrasound guided needle puncture biopsy within 1 week after HIFU ablation. And as a follow-up, all of the patients underwent US at 1, 3, 6 and 12 months after HIFU treatment. The volume change was observed and compared to pre- and post-HIFU ablation. The results of the ceUS were compared with those of the ceMRI in terms of the presence or absence of residual unablated tumor and pathologic change in the treated lesions. Results: On ceUS, diagnostic accuracy was 100%, while residual unablated tumors were found in three uterine fibroids (4.7%) and failed treatment was found in eight uterine fibroids (12.5%). All the 11 fibroids were subjected to additional HIFU ablation. Of the 58 ablated fibroids without residual tumors on both the ceUS and ceMRI after the HIFU ablation, the volumes of all the fibroids decreased in different degrees during the 1 year follow-up USs. And histologic examinations confirmed findings of necrotic and viable tumor tissue, respectively. Conclusion: CEUS is potentially useful for evaluating the early therapeutic effect of percutaneous HIFU ablation for uterine fibroids

  6. Preparation of Graphene Oxide Stabilized Nickel Nanoparticles with Thermal Effusivity Properties by Laser Ablation Method

    OpenAIRE

    Sadrolhosseini, Amir Reza; Noor, A. S. M.; Shameli, Kamyar; Kharazmi, Alireza; Huang, N. M.; Mahdi, M. A.

    2013-01-01

    Nickel nanoparticles were dispersed uniformly in a graphene oxide solution, using a laser ablation technique with different ablation times that ranged from 5 to 20 minutes. The results indicate that the nickel nanoparticle sizes inside the graphene oxide decreased, and the volume fraction for the nickel nanoparticles in the graphene oxide increased with an increasing ablation time. Further, using Fourier Transform Infrared Spectroscopy, the nickel nanoparticles in the graphene oxide demonstra...

  7. Beyond the Price Effect in Time-of-Use Programs: Results from a Municipal Utility Pilot, 2007-2008

    Energy Technology Data Exchange (ETDEWEB)

    Lutzenhiser, Susan; Peters, Jane; Moezzi, Mithra; Woods, James

    2009-08-12

    This paper discusses results of a two-year collaborative research project between the authors and the Demand Response Research Center focused on behavioral response to a voluntary time-of-use pilot rate offered by the Sacramento Municipal Utilities District (SMUD) under the PowerChoice label. The project had two purposes: one was to assess the potential for increasing demand response through the introduction of enhanced information and real-time consumption feedback; the second was to better understand behavioral response to a TOU rate. Three successive waves of telephone surveys collected details about reasons for participation, actions taken, capacities and constraints to altering behavior, and a range of salient conditions, such as demographics and dwelling characteristics. Pre- and post-program interval meter data for participants and a comparison sample of households were also collected and analyzed to consider initial and season-change price effects of the rate and the effect of supplemental information treatments on response. Over half of surveyed participating households reported that they had made a great deal of effort to adjust their electricity consumption to the rate. Despite this, load data analysis revealed only minimal price effects; and, though households subjected to information treatments seemed to have learned from these treatments, load data analysis again detected only minimal effects on load. Given the currently high hopes for behavioral intervention and residential TOU rates, these unexpected results require explanation. We suggest a number of possibilities and discuss some implications for TOU programs, and for understanding demand response behavior and approaches to experiments with TOU rates.

  8. Ablation of Solid Hydrogen in a Plasma

    DEFF Research Database (Denmark)

    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.......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. Theoretical modeling of laser ablation of quaternary bronze alloys: case studies comparing femtosecond and nanosecond LIBS experimental data.

    Science.gov (United States)

    Fornarini, Lucilla; Fantoni, Roberta; Colao, Francesco; Santagata, Antonio; Teghil, Roberto; Elhassan, Asmaa; Harith, Mohamed A

    2009-12-31

    A model, formerly proposed and utilized to understand the formation of laser induced breakdown spectroscopy (LIBS) plasma upon irradiation with nanosecond laser pulses at different fluences and wavelengths, has been extended to the irradiation with femtosecond laser pulses in order to control the fractionation mechanisms which heavily affect the application of laser-ablation-based microanalytical techniques. The model takes into account the different chemico-physical processes occurring during the interaction of an ultrashort laser pulse with a metallic surface. In particular, a two-temperature description, relevant to the electrons and lattice of the substrate, respectively, has been introduced and applied to different ternary and quaternary copper-based alloys subjected to fs and ns ablation both in the visible (527 nm) and in the UV (248 nm). The model has been found able to reproduce the shorter plasma duration experimentally found upon fs laser ablation. Kinetic decay times of several copper (major element) emission lines have been examined together with those relevant to the main plasma parameters. The plasma experimental temperature, derived assuming a Boltzmann distribution, and the electron density following the Saha equation have been compared with the corresponding theoretical data. A satisfactory description of plasma parameters and main matrix constituent composition has been obtained in the time window where local thermal equilibrium was assumed for LIBS data analysis. Improved analytical capabilities are predicted upon delayed detection of plasma emission in femtosecond LIBS, in relation to the better LOD achieved and to the improved data reproducibility expected. Results support the utilization of ultrafast laser sources for trace detection, despite the residual fractionation occurring in the examined range of fluences which affects the linearity of experimental calibration curves built for tin and lead after internal standardization on copper. The

  10. Improved Ablation Resistance of Silicone Rubber Composites by Introducing Montmorillonite and Silicon Carbide Whisker

    Directory of Open Access Journals (Sweden)

    Guangwu Zhang

    2016-08-01

    Full Text Available Montmorillonite (MMT was added to silicone rubber (SR to improve the ablation resistance of the silicone. Following this, different quantities of silicon carbide whiskers (SiCw were incorporated into the MMT/SR to yield a hybrid, ablative composite. The tensile strength and elongation at break of the composite increased after the addition of MMT. The ablation test results showed that MMT helped to form a covering layer by bonding with the silica and other components on the ablated surface. The linear and mass ablation rates exhibited decreases of 22.5% and 18.2%, respectively, in comparison to a control sample. After further incorporation of SiCw as the second filler, the resulting composites exhibited significantly higher tensile strength and ablation resistance, but not particularly lower elongation at break in comparison to the control sample. The SiCw/MMT fillers were beneficial in forming a dense and compact covering layer that delayed the heat and oxygen diffusion into the inner layers, which improved the ablation properties effectively. The remaining whiskers acted as a micro skeleton to maintain the composite’s char strength. Compared to the control sample, the linear and mass ablation rates of the composite after incorporating 6 phr SiCw and 10 phr MMT decreased by 59.2% and 43.6%, respectively. These experimental results showed that the fabricated composites exhibited outstanding mechanical properties and excellent ablation resistance.

  11. Arm studio to intensify the upper limb rehabilitation after stroke: concept, acceptance, utilization and preliminary clinical results.

    Science.gov (United States)

    Buschfort, R; Brocke, J; Hess, A; Werner, C; Waldner, A; Hesse, Stefan

    2010-04-01

    To assess the acceptance, utilization and clinical results of an arm studio designed to intensify treatment of the severely to moderately affected arm after stroke. In line with a distal bilateral approach, the equipment comprised 4 workstations, 1 finger trainer, and 3 machines for bilateral training of selected distal and proximal movements. Open study. Of 119 treated patients after subacute stroke, 30 completed a questionnaire and 24 were assessed. All patients completed 15 sessions, each of 30-45 min duration, on each of 2 workstations. Based on the patients' impairment level they were divided into 3 groups, as follows: group A, plegic; group B, proximal and distal movements but hand non-functional; and group C, able to grasp and release an object. Motor functions were assessed with the Fugl-Meyer Score (FM, 0-66) for groups A (n = 6) and B (n = 6), and the Action Arm Research Test (ARAT, 0-57) for group C (n = 12). No side-effects occurred. The patients regarded the training positively. The initial FM was 8.5 (standard deviation (SD) 3.3) and final FM 21.2 (SD 4.4) for group A, initial FM 25.3 (SD 6.9) and final FM 44.3 (SD 9.1) for group B, and initial ARAT 33.3 (SD 11.2) and final ARAT 43.5 (SD 10.7) for group C. The use of the arm studio to intensify upper limb rehabilitation after stroke is promising, and a controlled study is warranted.

  12. Coverage planning in computer-assisted ablation based on Genetic Algorithm.

    Science.gov (United States)

    Ren, Hongliang; Guo, Weian; Sam Ge, Shuzhi; Lim, Wancheng

    2014-06-01

    An ablation planning system plays a pivotal role in tumor ablation procedures, as it provides a dry run to guide the surgeons in a complicated anatomical environment. Over-ablation, over-perforation or under-ablation may result in complications during the treatments. An optimal solution is desired to have complete tumor coverage with minimal invasiveness, including minimal number of ablations and minimal number of perforation trajectories. As the planning of tumor ablation is a multi-objective problem, it is challenging to obtain optimal covering solutions based on clinician׳s experiences. Meanwhile, it is effective for computer-assisted systems to decide a set of optimal plans. This paper proposes a novel approach of integrating a computational optimization algorithm into the ablation planning system. The proposed ablation planning system is designed based on the following objectives: to achieve complete tumor coverage and to minimize the number of ablations, number of needle trajectories and over-ablation to the healthy tissue. These objectives are taken into account using a Genetic Algorithm, which is capable of generating feasible solutions within a constrained search space. The candidate ablation plans can be encoded in generations of chromosomes, which subsequently evolve based on a fitness function. In this paper, an exponential weight-criterion fitness function has been designed by incorporating constraint parameters that were reflective of the different objectives. According to the test results, the proposed planner is able to generate the set of optimal solutions for tumor ablation problem, thereby fulfilling the aforementioned multiple objectives. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Fractional ablative erbium YAG laser

    DEFF Research Database (Denmark)

    Taudorf, Elisabeth H; Haak, Christina S; Erlendsson, Andrés M

    2014-01-01

    BACKGROUND AND OBJECTIVES: Treatment of a variety of skin disorders with ablative fractional lasers (AFXL) is driving the development of portable AFXLs. This study measures micropore dimensions produced by a small 2,940 nm AFXL using a variety of stacked pulses, and determines a model correlating...... laser parameters with tissue effects. MATERIALS AND METHODS: Ex vivo pig skin was exposed to a miniaturized 2,940 nm AFXL, spot size 225 µm, density 5%, power levels 1.15-2.22 W, pulse durations 50-225 microseconds, pulse repetition rates 100-500 Hz, and 2, 20, or 50 stacked pulses, resulting in pulse...... 190 to 347 µm. CONCLUSIONS: Pulse stacking with a small, low power 2,940 nm AFXL created reproducible shallow to deep micropores, and influenced micropore configuration. Mathematical modeling established relations between laser settings and micropore dimensions, which assists in choosing laser...

  15. Hydrodynamic stability theory of double ablation front structures in inertial confinement fusion

    International Nuclear Information System (INIS)

    Yanez Vico, C.

    2012-11-01

    For moderate-Z materials, the hydrodynamic structure of the ablation region formed by the irradiation of high intensity laser beams differs from that of low-Z materials (hydrogenic ablators). In particular, the role played by the radiative energy flux becomes non-negligible for increasing atomic number material and ended up forming a second ablation front. This structure of two separated ablation fronts, called double ablation (DA) front, was confirmed in the simulations carried out by Fujioka et al. In this work a linear stability theory of DA fronts is developed for direct-drive inertial confinement fusion targets. Two models are proposed. First, a sharp boundary model where the thin front approximation is assumed for both ablation fronts. The information about the corona region that permits to close the sharp boundary model is obtained from a prior self-consistent analysis of the electronic-radiative ablation (ERA) front. Numerical results are presented as well as an analytical approach for the radiation dominated regime of very steep double ablation front structure. Second, a self-consistent numerical method where the finite length of the ablation fronts is considered. Accurate hydrodynamic profiles are taken into account in the theoretical model by means of a fitting parameters method using one-dimensional simulation results. Numerical dispersion relation is compared to the analytical sharp boundary model showing an excellent agreement for the radiation dominated regime, and the stabilization due to smooth profiles. 2D simulations are presented to validate the linear stability theory

  16. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results.

    Science.gov (United States)

    Ehlers, Justis P; Goshe, Jeff; Dupps, William J; Kaiser, Peter K; Singh, Rishi P; Gans, Richard; Eisengart, Jonathan; Srivastava, Sunil K

    2015-10-01

    Optical coherence tomography (OCT) has transformed the clinical management of a myriad of ophthalmic conditions. Applying OCT to ophthalmic surgery may have implications for surgical decision making and patient outcomes. To assess the feasibility and effect on surgical decision making of a microscope-integrated intraoperative OCT (iOCT) system. Report highlighting the 1-year results (March 2014-February 2015) of the RESCAN 700 portion of the DISCOVER (Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery) study, a single-site, multisurgeon, prospective consecutive case series regarding this investigational device. Participants included patients undergoing ophthalmic surgery. Data on clinical characteristics were collected, and iOCT was performed during surgical milestones, as directed by the operating surgeon. A surgeon questionnaire was issued to each surgeon and was completed after each case to evaluate the role of iOCT during surgery and its particular role in select surgical procedures. Percentage of cases with successful acquisition of iOCT (ie, feasibility). Percentage of cases in which iOCT altered surgical decision making (ie, utility). During year 1 of the DISCOVER study, a total of 227 eyes (91 anterior segment cases and 136 posterior segment cases) underwent imaging with the RESCAN 700 system. Successful imaging (eg, the ability to acquire an OCT image of the tissue of interest) was obtained for 224 of 227 eyes (99% [95% CI, 98%-100%]). During lamellar keratoplasty, the iOCT data provided information that altered the surgeon's decision making in 38% of the cases (eg, complete graft apposition when the surgeon believed there was interface fluid). In membrane peeling procedures, iOCT information was discordant with the surgeon's impression of membrane peel completeness in 19% of cases (eg, lack of residual membrane or presence of occult membrane), thus

  17. Difficulties in deciding whether to ablate patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study

    Energy Technology Data Exchange (ETDEWEB)

    Frangos, Savvas; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla [Bank of Cyprus Oncology Centre, Department of Nuclear Medicine, Strovolos, Nicosia (Cyprus); Iakovou, Ioannis P.; Mpalaris, Vassilis; Giannoula, Evanthia I. [Aristotle University, Papageorgiou Hospital, Department of Nuclear Medicine, Thessaloniki (Greece); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States)

    2015-12-15

    We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the ''remnant score'' that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0 % of patients (104 of 336) had primary tumour multifocality, 22.0 % (74) had confirmed cervical lymph node metastases, 37.2 % (125) had unknown nodal status, and 38.1 % (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9 % of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with

  18. Photoactive dye-enhanced tissue ablation for endoscopic laser prostatectomy.

    Science.gov (United States)

    Ahn, Minwoo; Hau, Nguyen Trung; Van Phuc, Nguyen; Oh, Junghwan; Kang, Hyun Wook

    2014-11-01

    Laser light has been widely used as a surgical tool to treat benign prostate hyperplasia (BPH) over 20 years. Recently, application of high laser power up to 200 W was often reported to swiftly remove a large amount of prostatic tissue. The purpose of this study was to validate the feasibility of photoactive dye injection to enhance light absorption and eventually to facilitate tissue vaporization with low laser power. Chicken breast tissue was selected as a target tissue due to minimal optical absorption at the visible wavelength. Four biocompatible photoactive dyes, including amaranth (AR), black dye (BD), hemoglobin powder (HP), and endoscopic marker (EM), were selected and tested in vitro with a customized 532 nm laser system with radiant exposure ranging from 0.9 to 3.9 J/cm(2) . Light absorbance and ablation threshold were measured with UV-Vis spectrometer and Probit analysis, respectively, and compared to feature the function of the injected dyes. Ablation performance with dye-injection was evaluated in light of radiant exposure, dye concentration, and number of injection. Higher light absorption by injected dyes led to lower ablation threshold as well as more efficient tissue removal in the order of AR, BD, HP, and EM. Regardless of the injected dyes, ablation efficiency principally increased with radiant exposure, dye concentration, and number of injection. Among the dyes, AR created the highest ablation rate of 44.2 ± 0.2 µm/pulse due to higher absorbance and lower ablation threshold. High aspect ratios up to 7.1 ± 0.4 entailed saturation behavior in the tissue ablation injected with AR and BD, possibly resulting from plume shielding and increased scattering due to coagulation. Preliminary tests on canine prostate with a hydraulic injection system demonstrated that 80 W with dye injection yielded comparable ablation efficiency to 120 W with no injection, indicating 33% reduced laser power with almost equivalent performance. Due to

  19. A comparison of the characteristics of excimer and femtosecond laser ablation of acrylonitrile butadiene styrene (ABS)

    Science.gov (United States)

    See, Tian Long; Liu, Zhu; Li, Lin; Zhong, Xiang Li

    2016-02-01

    This paper presents an investigation on the ablation characteristics of excimer laser (λ = 248 nm, τ = 15 ns) and femtosecond laser (λ = 800 nm, τ = 100 fs) on ABS polymer sheets. The laser-material interaction parameters (ablation threshold, optical penetration depth and incubation factor) and the changes in material chemical properties were evaluated and compared between the two lasers. The work shows that the ablation threshold and effective optical penetration depth values are dependent on the wavelength of laser beam (photon energy) and the pulse width. The ablation threshold value is lower for the excimer laser ablation of ABS (Fth = 0.087 J/cm2) than that for the femtosecond laser ablation of ABS (Fth = 1.576 J/cm2), demonstrating a more dominating role of laser wavelength than the pulse width in influencing the ablation threshold. The ablation depth versus the logarithmic scale of laser fluence shows two linear regions for the fs laser ablation, not previously known for polymers. The effective optical penetration depth value is lower for excimer laser ablation (α-1 = 223 nm) than that for femtosecond laser ablation (α-1 = 2917 nm). The ablation threshold decreases with increasing number of pulses (NOP) due to the chain scission process that shortens the polymeric chains, resulting in a weaker polymeric configuration and the dependency is governed by the incubation factor. Excimer laser treatment of ABS eliminates the Cdbnd C bond completely through the chain scission process whereas Cdbnd C bond is partially eliminated through the femtosecond laser treatment due to the difference in photon energy of the two laser beams. A reduction in the Cdbnd C bond through the chain scission process creates free radical carbons which then form crosslinks with each other or react with oxygen, nitrogen and water in air producing oxygen-rich (Csbnd O and Cdbnd O bond) and nitrogen-rich (Csbnd N) functional groups.

  20. Ablation lesions in Koch's triangle assessed by three-dimensional myocardial contrast echocardiography

    Directory of Open Access Journals (Sweden)

    Cate Folkert

    2004-12-01

    Full Text Available Abstract Background Myocardial contrast echocardiography (MCE allows visualization of radiofrequency (RF ablation lesions in the left ventricle in an animal model. Aim: To test whether MCE allows visualization of RF and cryo ablation lesions in the human right atrium using three-dimensional echocardiography. Methods 18 patients underwent catheter ablation of a supraventricular tachycardia and were included in this prospective single-blind study. Twelve patients were ablated inside Koch's triangle and 6, who served as controls, outside this area. Three-dimensional echocardiography of Koch's triangle was performed before and after the ablation procedure in all patients, using respiration and ECG gated pullback of a 9 MHz ICE transducer, with and without continuous intravenous echocontrast infusion (SonoVue, Bracco. Two independent observers analyzed the data off-line. Results MCE identified ablation lesions as a low contrast area within the normal atrial myocardial tissue. Craters on the endocardial surface were seen in 10 (83% patients after ablation. Lesions were identified in 11 out of 12 patients (92%. None of the control patients were recognized as having been ablated. The confidence score of the independent echo reviewer tended to be higher when the number of applications increased. Conclusions 1. MCE allows direct visualization of ablation lesions in the human atrial myocardium. 2. Both RF and cryo energy lesions can be identified using MCE.

  1. Immunological effect of local ablation combined with immunotherapy on solid malignancies.

    Science.gov (United States)

    Takahashi, Yusuke; Matsutani, Noriyuki; Nakayama, Takashi; Dejima, Hitoshi; Uehara, Hirofumi; Kawamura, Masafumi

    2017-06-07

    Recent comprehensive investigations clarified that immune microenvironment surrounding tumor cells are deeply involved in tumor progression, metastasis, and response to treatment. Furthermore, several immunotherapeutic trials have achieved successful results, and the immunotherapeutic agents are available in clinical practice. To enhance their demonstrated efficacy, combination of immunotherapy and ablation has begun to emerge. Local ablations have considerable advantages as an alternative therapeutic option, especially its minimal invasiveness. In addition, local ablations have shown immune-regulatory effect in preclinical and clinical studies. Although the corresponding mechanisms are still unclear, the local ablations combined with immunotherapy have been suggested in the treatment of several solid malignancies. This article aims to review the published data on the immune-regulatory effects of local ablations including stereotactic body radiotherapy, cryoablation, radiofrequency ablation, and high-intensity-focused ultrasound. We also discuss the value of local ablations combined with immunotherapy. Local ablations have the potential to improve future patient outcomes; however, the effectiveness and safety of local ablations combined with immunotherapy should be further investigated.

  2. Specifications of nanosecond laser ablation with solid targets, aluminum, silicon rubber, and polymethylmethacrylate (PMMA)

    Science.gov (United States)

    Morshedian, Nader

    2017-09-01

    The ablation parameters such as threshold fluence, etch depth, ablation rate and the effect of material targets were investigated under the interaction of laser pulse with low intensity. The parameters of the laser system are: laser pulse energy in the range of 110-140 mJ, wavelength 1064 nm and pulse duration 20 ns. By macroscopic estimation of the outward images of the ablation and data obtained, we can conclude that the photothermal and photoionization processes have more influence for aluminum ablation. In contrast, for polymer samples, from the macroscopic observation of the border pattern at the irradiated spot, and also the data obtained from the experiment results, we deduce that both chemical change due to heating and photochemical dissociation were effective mechanisms of ablation. However, concerning the two polymer samples, apart from considering the same theoretical ablation model, it is conceived that the photomehanical specifications of PMMA are involved in the ablation parameters. The threshold fluence for an ablation rate of 30 laser shots were obtained as 12.4, 24.64, and 11.71 J cm-2, for aluminum, silicon rubber and polymethylmethacrylate (PMMA) respectively. The ablation rate is exponentially decreased by the laser-shot number, especially for aluminum. Furthermore, the etch depth after 30 laser shots was measured as 180, 630 and 870 μm, for aluminum, silicon rubber and PMMA, respectively.

  3. Interstitial laser-induced thermotherapy of the lung: evaluation of the influence of ablation continuity on ablation size in a swine model.

    Science.gov (United States)

    Schoellnast, Helmut; Monette, Sebastien; Ezell, Paula C; Keene, Andrew; Quehenberger, Franz; Erinjeri, Joseph P; Solomon, Stephen B

    2013-02-22

    The purpose of this study was to assess the relationship between size and the continuity of energy application in interstitial laser-induced thermotherapy. Percutaneous computed tomography-guided laser ablation (30 W, 600 nm diode) of the lung was performed in 7 Yorkshire pigs; a total of 42 ablation zones were created. Twenty ablations were performed using a continuous cycle of 2 min (protocol A) and 22 ablations were performed using 4 intermittent cycles with a duration of 1 min for each cycle interrupted by a 10-s stop between the cycles (protocol B). The lung was harvested immediately after euthanasia for gross pathology and histopathologic evaluation. Statistical analysis was performed using the Student t test and the Spearman correlation coefficient. Laser ablation resulted in complete necrosis of variable size of lung. The mean ablation zone dimensions (±SD) were 1.9 (±0.4) cm × 1.4 (±0.3) cm for protocol A and 2.2 (±0.5) cm × 1.4 (±0.4) cm for protocol B. The size of the necrosis is not significantly different when comparing a continuous 2-min ablation to a 4-cycle intermittent ablation for 1 min each cycle interrupted by a 10-s stop between the cycles (P = 0.98 and 0.53, respectively).

  4. Histopathology of breast cancer after magnetic resonance-guided high-intensity focused ultrasound and radiofrequency ablation.

    Science.gov (United States)

    Knuttel, Floortje M; Waaijer, Laurien; Merckel, Laura G; van den Bosch, Maurice A A J; Witkamp, Arjen J; Deckers, Roel; van Diest, Paul J

    2016-08-01

    Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation and radiofrequency ablation (RFA) are being researched as possible substitutes for surgery in breast cancer patients. The histopathological appearance of ablated tissue has not been studied in great detail. This study aimed to compare histopathological features of breast cancer after MR-HIFU ablation and RFA. MR-HIFU ablation and RFA were performed in- and ex-vivo. Tumours in six mastectomy specimens were partially ablated with RFA or MR-HIFU. In-vivo MR-HIFU ablation was performed 3-6 days before excision; RFA was performed in the operation room. Tissue was fixed in formalin and processed to haematoxylin and eosin (H&E) and cytokeratin-8 (CK-8)-stained slides. Morphology and cell viability were assessed. Ex-vivo ablation resulted in clear morphological changes after RFA versus subtle differences after MR-HIFU. CK-8 staining was decreased or absent. H&E tended to underestimate the size of thermal damage. In-vivo MR-HIFU resulted in necrotic-like changes. Surprisingly, some ablated lesions were CK-8-positive. Histopathology after in-vivo RFA resembled ex-vivo RFA, with hyper-eosinophilic stroma and elongated nuclei. Lesion borders were sharp after MR-HIFU and indistinct after RFA. Histopathological differences between MR-HIFU-ablated tissue and RF-ablated tissue were demonstrated. CK-8 was more reliable for cell viability assessment than H&E when used directly after ablation, while H&E was more reliable in ablated tissue left in situ for a few days. Our results contribute to improved understanding of histopathological features in breast cancer lesions treated with minimally invasive ablative techniques. © 2016 John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Obtention of Ti nanoparticles by laser ablation

    International Nuclear Information System (INIS)

    Diaz E, J.R.; Escobar A, L.; Camps, E.; Santiago, P.; Ascencio, J.

    2002-01-01

    The obtention of Ti nanoparticles around 5-30 nm diameter through the laser ablation technique is reported. The formation of nanoparticles is carried out in He atmosphere to different pressures, placing directly in Si substrates (100) and in Cu grids. The results show that the work pressure is an important parameter that allows to control the nanoparticles size. Also the plasma characterization results are presented where the Ti II is the predominant specie with an average kinetic energy of 1824 eV. (Author)

  7. A comparison of the characteristics of excimer and femtosecond laser ablation of acrylonitrile butadiene styrene (ABS)

    Energy Technology Data Exchange (ETDEWEB)

    See, Tian Long, E-mail: tianlong.see@postgrad.manchester.ac.uk [Corrosion and Protection Centre, School of Materials, The Mill, The University of Manchester, M13 9PL Manchester (United Kingdom); Laser Processing Research Centre, School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, M13 9PL Manchester (United Kingdom); Liu, Zhu [Corrosion and Protection Centre, School of Materials, The Mill, The University of Manchester, M13 9PL Manchester (United Kingdom); Li, Lin [Laser Processing Research Centre, School of Mechanical, Aerospace and Civil Engineering, The University of Manchester, M13 9PL Manchester (United Kingdom); Zhong, Xiang Li [Corrosion and Protection Centre, School of Materials, The Mill, The University of Manchester, M13 9PL Manchester (United Kingdom)

    2016-02-28

    Highlights: • Ablation threshold for excimer laser is lower compared to femtosecond laser. • Effective optical penetration depth for excimer laser is lower compared to femtosecond laser. • Two ablation characteristic regimes are observed for femtosecond laser ablation. • Reduction of C=C bond following excimer or fs laser ablation is observed. • Addition of oxygen- and nitrogen-rich functional groups is observed. - Abstract: This paper presents an investigation on the ablation characteristics of excimer laser (λ = 248 nm, τ = 15 ns) and femtosecond laser (λ = 800 nm, τ = 100 fs) on ABS polymer sheets. The laser–material interaction parameters (ablation threshold, optical penetration depth and incubation factor) and the changes in material chemical properties were evaluated and compared between the two lasers. The work shows that the ablation threshold and effective optical penetration depth values are dependent on the wavelength of laser beam (photon energy) and the pulse width. The ablation threshold value is lower for the excimer laser ablation of ABS (F{sub th} = 0.087 J/cm{sup 2}) than that for the femtosecond laser ablation of ABS (F{sub th} = 1.576 J/cm{sup 2}), demonstrating a more dominating role of laser wavelength than the pulse width in influencing the ablation threshold. The ablation depth versus the logarithmic scale of laser fluence shows two linear regions for the fs laser ablation, not previously known for polymers. The effective optical penetration depth value is lower for excimer laser ablation (α{sup −1} = 223 nm) than that for femtosecond laser ablation (α{sup −1} = 2917 nm). The ablation threshold decreases with increasing number of pulses (NOP) due to the chain scission process that shortens the polymeric chains, resulting in a weaker polymeric configuration and the dependency is governed by the incubation factor. Excimer laser treatment of ABS eliminates the C=C bond completely through the chain scission process whereas

  8. Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial.

    Science.gov (United States)

    Michalowsky, Bernhard; Flessa, Steffen; Eichler, Tilly; Hertel, Johannes; Dreier, Adina; Zwingmann, Ina; Wucherer, Diana; Rau, Henriette; Thyrian, Jochen René; Hoffmann, Wolfgang

    2018-01-01

    The objectives of this cross-sectional analysis were to determine healthcare resource utilization and cost for community-dwelling patients with dementia (PWD) from a payer's and societal perspective, and to analyze the associations between costs and sociodemographic and clinical variables. Analysis of healthcare costs from a payer's perspective was based on a sample of 425 PWD, analysis of healthcare costs from societal perspective on a subsample of 254 PWD and their informal caregivers. Frequency of healthcare resource utilization was assessed by means of questionnaires. Informal care and productivity losses were assessed by using the Resource Utilization in Dementia questionnaire (RUD). Costs were monetarized using standardized unit costs. To analyze the associations, multiple linear regression models were used. Total annual costs per PWD valued 7016€ from a payer's and 25,877€ from a societal perspective, meaning that societal cost is approximately three and a half times as much as payer's expenditures. Costs valuated 5456 € for medical treatments, 1559 € for formal care, 18,327€ for informal care. Productivity losses valued 1297€ for PWD caregivers. Informal care could vary substantially (-21%; +33%) concerning different valuation methods. Medical care costs decreased significantly with progression of dementia and with age. Costs of care double over the stages of dementia. Formal care costs were significantly higher for PWD living alone and informal care costs significantly lower for PWD with an employed caregiver. For all cost categories, deficits in daily living activities were major cost drivers.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. Radiofrequency ablation of liver metastases

    International Nuclear Information System (INIS)

    Pereira, P.L.; Clasen, S.; Schmidt, D.; Wiskirchen, J.; Tepe, G.; Claussen, C.D.; Boss, A.; Gouttefangeas, C.; Burkart, C.

    2004-01-01

    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.) [de

  11. [Radiofrequency ablation of liver metastases].

    Science.gov (United States)

    Pereira, P L; Clasen, S; Boss, A; Schmidt, D; Gouttefangeas, C; Burkart, C; Wiskirchen, J; Tepe, G; Claussen, C D

    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.

  12. Endometrial ablation with paracervical block

    NARCIS (Netherlands)

    Penninx, Josien P. M.; Mol, Ben Willem; Bongers, Marlies Y.

    2009-01-01

    OBJECTIVE: To evaluate the safety, feasibility and efficacy of endometrial ablation under local anesthesia. STUDY DESIGN: A prospective cohort study was performed at the gynecology department of a large teaching hospital. Women with dysfunctional uterine bleeding were included to undergo NovaSure

  13. Hydrodynamic instabilities in an ablation front

    Energy Technology Data Exchange (ETDEWEB)

    Piriz, A R; Portugues, R F [E.T.S.I. Industriales, Universidad de Castilla-La Mancha, 13071 Ciudad Real (Spain)

    2004-06-01

    The hydrodynamic stability of an ablation front is studied for situations in which the wavelength of the perturbations is larger than the distance to the critical surface where the driving radiation is absorbed. An analytical model is presented, and it shows that under conditions in which the thermal flux is limited within the supercritical region of the ablative corona, the front may behave like a flame or like an ablation front, depending on the perturbation wavelength. For relatively long wavelengths the critical and ablation surfaces practically lump together into a unique surface and the front behaves like a flame, whereas for the shortest wavelengths the ablation front substructure is resolved.

  14. Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Morasco, Benjamin J; Pietrzak, Robert H; Blanco, Carlos; Grant, Bridget F; Hasin, Deborah; Petry, Nancy M

    2006-01-01

    Pathologic gambling is believed to be associated with adverse health consequences, but no prior studies have rigorously evaluated these relationships. We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling. A total of 43,093 adults aged 18 years and older were evaluated in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions. Self-reported medical diagnoses and past-year medical services used were assessed. Pathologic gamblers were more likely than low-risk individuals to have been diagnosed with tachycardia (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.05-2.97), angina (OR = 2.35; 95% CI = 1.33-4.15), cirrhosis (OR = 3.90; 95% CI = 1.11-13.72), and other liver disease (OR = 2.98; 95% CI = 1.07-8.26). Gambling severity was also associated with higher rates of medical utilization with pathologic gamblers more likely than low-risk individuals to have been treated in the emergency room in the year before the survey (OR = 1.98; 95% CI = 1.27-3.09). Significant effects of gambling severity remained even after controlling for demographic characteristics (age, gender, ethnicity, marital status, education, income, and region of the country) and behavioral risk factors such as body mass index, alcohol abuse and dependence, nicotine dependence, and mood and anxiety disorders. A lifetime diagnosis of pathologic gambling is associated with several medical disorders and increased medical utilization, perhaps leading to a burden on healthcare costs in the United States.

  15. Effect of ablation geometry on the dynamics, composition, and geometrical shape of thin film plasma

    Science.gov (United States)

    Mondal, Alamgir; Singh, R. K.; Kumar, Ajai

    2018-01-01

    The characteristics of plasma plume produced by front and back ablation of thin films have been investigated using fast imaging and optical emission spectroscopy. Ablation geometry dependence of the plume dynamics, its geometrical aspect and composition is emphasized. Also, the effect of an ambient environment and the beam diameter of an ablating laser on the front and back ablations is briefly discussed. Analysis of time resolved images and plasma parameters indicates that the energetic and spherical plasma formed by front ablation is strikingly different in comparison to the slow and nearly cylindrical plasma plume observed in the case of back ablation. Further shock formation, plume confinement, thermalization and validity of different expansion models in these two ablation geometries are also presented. The present study demonstrates the manipulation of kinetic energy, shape, ion/neutral compositions and directionality of the expanding plume by adjusting the experimental configuration, which is highly relevant to its utilization in various applications e.g., generation of energetic particles, tokamak edge plasma diagnostics, thin film deposition, etc.

  16. Incidence and Cause of Hypertension During Adrenal Radiofrequency Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Yamakado, Koichiro, E-mail: yama@clin.medic.mie-u.ac.jp; Takaki, Haruyuki [Mie University School of Medicine, Department of Interventional Radiology (Japan); Yamada, Tomomi [Mie University School of Medicine, Department of Translational Medicine (Japan); Yamanaka, Takashi; Uraki, Junji; Kashima, Masataka; Nakatsuka, Atsuhiro; Takeda, Kan [Mie University School of Medicine, Department of Interventional Radiology (Japan)

    2012-12-15

    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 < 0.0498). Procedural systolic blood pressure was significantly correlated with serum epinephrine (R{sup 2} = 0.68, P < 0.0001) and norepinephrine (R{sup 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.

  17. Predictive analysis of optical ablation in several dermatological tumoral tissues

    Science.gov (United States)

    Fanjul-Vélez, F.; Blanco-Gutiérrez, A.; Salas-García, I.; Ortega-Quijano, N.; Arce-Diego, J. L.

    2013-06-01

    Optical techniques for treatment and characterization of biological tissues are revolutionizing several branches of medical praxis, for example in ophthalmology or dermatology. The non-invasive, non-contact and non-ionizing character of optical radiation makes it specially suitable for these applications. Optical radiation can be employed in medical ablation applications, either for tissue resection or surgery. Optical ablation may provide a controlled and clean cut on a biological tissue. This is particularly relevant in tumoral tissue resection, where a small amount of cancerous cells could make the tumor appear again. A very important aspect of tissue optical ablation is then the estimation of the affected volume. In this work we propose a complete predictive model of tissue ablation that provides an estimation of the resected volume. The model is based on a Monte Carlo approach for the optical propagation of radiation inside the tissue, and a blow-off model for tissue ablation. This model is applied to several types of dermatological tumoral tissues, specifically squamous cells, basocellular and infiltrative carcinomas. The parameters of the optical source are varied and the estimated resected volume is calculated. The results for the different tumor types are presented and compared. This model can be used for surgical planning, in order to assure the complete resection of the tumoral tissue.

  18. Management of Atrio-Esophageal Fistula Following Left Atrial Ablation.

    Science.gov (United States)

    Yousuf, Tariq; Keshmiri, Hesam; Bulwa, Zachary; Kramer, Jason; Sharjeel Arshad, Hafiz Muhammad; Issa, Rasha; Woznicka, Daniel; Gordon, Paul; Abi-Mansour, Pierre

    2016-02-01

    Currently, no guidelines have been established for the treatment of atrio-esophageal fistula (AEF) secondary to left atrial ablation therapy. After comprehensive literature review, we aim to make suggestions on the management of this complex complication and also present a case series. We performed a review of the existing literature on AEF in the setting of atrial ablation. Using keywords atrial fibrillation, atrial ablation, fistula formation, atrio-esophageal fistula, complications, interventions, and prognosis, a search was made using the medical databases PUBMED and MEDLINE for reports in English from 2000 to April 2015. A statistical analysis was performed to compare the three different intervention arms: medical management, stent placement and surgical intervention. The results of our systematic review confirm the high mortality rate associated with AEF following left atrial ablation and the necessity to diagnose atrio-esophageal injury in a timely manner. The mortality rates of this complication are 96% with medical management alone, 100% with stent placement, and 33 % with surgical intervention. Atrio-esophageal injury and subsequent AEF is an infrequent but potentially fatal complication of atrial ablation. Early, prompt, and definitive surgical intervention is the treatment of choice.

  19. Predictors of mental health service utilization in the 12 months before imprisonment: analysis of results from a national prisons survey.

    Science.gov (United States)

    Farrell, Michael; Boys, Annabel; Singleton, Nicola; Meltzer, Howard; Brugha, Traolach; Bebbington, Paul; Jenkins, Rachel; Coid, Jeremy; Lewis, Glyn; Marsden, John

    2006-01-01

    To describe the self-reported history of health service utilization and help-seeking to those who are drug-dependent in the period of time prior to imprisonment. A cross-section survey of 3142 sentenced or remand prisoners in English prisons completed private, face-to-face interviews with trained Office for National Statistics staff covering a full structured psychiatric assessment interview. Specific questions about service utilization prior to imprisonment were included, as were questions on patterns of drug use and dependence prior to imprisonment. Receipt of any form of help was demographically most strongly associated with being older, white and female. Women were about twice as likely as men to report having received help for mental or emotional problems. Older age was also consistently associated with greater levels of reporting having received help, for both genders but only for use of general practitioners. Being black was strongly associated with reduced likelihood of receiving help and this was maintained after adjusting for other sociodemographic variables. Opioid dependence alone or opioid dependence with stimulant dependence, psychiatric disorder alone and probable psychosis were all most predictive of service use in the 12 months prior to imprisonment. In the year prior to imprisonment, the majority of mental health needs of these individual prisoners were not able to access help prior to imprisonment. Future strategies should aim for better health access before, during and after imprisonment.

  20. The Clinical Utility of Next Generation Sequencing Results in a Community-Based Hereditary Cancer Risk Program.

    Science.gov (United States)

    Bunnell, A E; Garby, C A; Pearson, E J; Walker, S A; Panos, L E; Blum, Joanne L

    2017-02-01

    Since the 2013 Supreme Court ruling on BRCA1/BRCA2 patenting, hereditary cancer gene panels now include BRCA1 and BRCA2, making these panels an option for first-tier testing. However, questions remain about the clinical utility and implications of these panels for medical management with inclusion of genes of unknown to moderate penetrance. To better understand how use of these panels affected our practice, we reviewed patients who underwent testing in our clinic from July 1, 2013 through May 23, 2014. Indications for testing included personal and/or family history of breast and/or ovarian cancer. A total of 136 patients underwent panel testing via a single commercial laboratory; 12 (8.8 %) patients were positive for a pathogenic or likely pathogenic mutation (four BRCA2 mutations, two TP53 mutations, one CDH1 mutation, two ATM mutations, and one patient each with a CHEK2, NBN, or PALB2 mutation). Of these positive patients, 100 % met the National Comprehensive Cancer Network (NCCN) guidelines for Hereditary Breast and Ovarian Cancer genetic testing (2.2014). Mutations in seven of twelve (58 %) patients led to changes in medical management; three of seven (43 %) had a non-BRCA1 or BRCA2 gene mutation. Our findings suggest that there is clinical utility of panels that include genes of unknown to moderate penetrance.

  1. Evaluating Proposed Investments in Power System Reliability and Resilience: Preliminary Results from Interviews with Public Utility Commission Staff

    Energy Technology Data Exchange (ETDEWEB)

    LaCommare, Kristina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Larsen, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Eto, Joseph [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-01-01

    Policymakers and regulatory agencies are expressing renewed interest in the reliability and resilience of the U.S. electric power system in large part due to growing recognition of the challenges posed by climate change, extreme weather events, and other emerging threats. Unfortunately, there has been little or no consolidated information in the public domain describing how public utility/service commission (PUC) staff evaluate the economics of proposed investments in the resilience of the power system. Having more consolidated information would give policymakers a better understanding of how different state regulatory entities across the U.S. make economic decisions pertaining to reliability/resiliency. To help address this, Lawrence Berkeley National Laboratory (LBNL) was tasked by the U.S. Department of Energy Office of Energy Policy and Systems Analysis (EPSA) to conduct an initial set of interviews with PUC staff to learn more about how proposed utility investments in reliability/resilience are being evaluated from an economics perspective. LBNL conducted structured interviews in late May-early June 2016 with staff from the following PUCs: Washington D.C. (DCPSC), Florida (FPSC), and California (CPUC).

  2. Comparison of pediatric self reports and parent proxy reports utilizing PROMIS: Results from a chiropractic practice-based research network.

    Science.gov (United States)

    Alcantara, Joel; Ohm, Jeanne; Alcantara, Junjoe

    2017-11-01

    To measure the cross-informant variant of pediatric quality of life (QoL) based on self-reports and parent proxy measures. A secondary analysis of baseline data obtained from two independent studies measuring the QoL based on the pediatric PROMIS-25 self-report and the PROMIS parent-proxy items banks. A scoring manual associated raw scores to a T score metric (mean = 50; SD = 10). Reliability of QoL ratings utilized the ICC while comparison of mean T Scores utilized the unpaired t-test. A total of 289 parent-child dyads comprised our study responders. Average age for parents and children was 41.27 years and 12.52 years, respectively. The mean T score (child self-report: parent proxy) for each QoL domains were: mobility (50.82:52.58), anxiety (46.73:44.21), depression (45.18:43.60), fatigue (45.59:43.92), peer-relationships (52.15:52.88) and pain interference (47.47:44.80). Parents tend to over-estimate their child's QoL based on measures of anxiety, depression, fatigue, peer-relationships and pain interference. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Radiofrequency ablation of atrial tachyarrhythmias in adults with tetralogy of Fallot - predictors of success and outcome.

    Science.gov (United States)

    Ezzat, Vivienne A; Ryan, Matthew J; O'Leary, Justin; Ariti, Cono; Deanfield, John; Pandya, Bejal; Cullen, Shay; Walker, Fiona; Khan, Fakhar; Abrams, Dominic J; Lambiase, Pier D; Lowe, Martin D

    2017-03-01

    Adults with tetralogy of Fallot experience atrial tachyarrhythmias; however, there are a few data on the outcomes of radiofrequency ablation. We examined the characteristics, outcome, and predictors of recurrence of atrial tachyarrhythmias after radiofrequency ablation in tetralogy of Fallot patients. Methods/results Retrospective data were collected from 2004 to 2013. In total, 56 ablations were performed on 37 patients. We identified two matched controls per case: patients with tetralogy of Fallot but no radiofrequency ablation and not known to have atrial tachyarrhythmias. Acute success was 98%. Left atrial arrhythmias increased in frequency over time. The mean follow-up was 41 months; 78% were arrhythmia-free. Number of cardiac surgeries, age, and presence of atrial fibrillation were predictors of recurrence. Lone cavo-tricuspid isthmus-dependent flutter reduced the likelihood of atrial fibrillation. Right and left atria in patients with tetralogy of Fallot were larger in ablated cases than controls. NYHA class was worse in cases and improved after ablation; baseline status predicted death. Of matched non-ablated controls, a number of them had atrial fibrillation. These patients were excluded from the case-control study but analysed separately. Most of them had died during follow-up, whereas of the matched ablated cases all were alive and the majority in sinus rhythm. Patients with tetralogy of Fallot and atrial tachyarrhythmias have more dilated atria than those without atrial tachyarrhythmias. Radiofrequency ablation improves functional status. Left atrial ablation is more commonly required with repeat procedures. There is a high prevalence of atrial tachyarrhythmias, particularly atrial fibrillation, in patients with tetralogy of Fallot; early radiofrequency ablation may have a protective effect against this.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Endoscopic ultrasound-guided ethanol ablation of pancreatic neuroendocrine tumours: A case study and literature review.

    Science.gov (United States)

    Armellini, Elia; Crinò, Stefano F; Ballarè, Marco; Pallio, Socrate; Occhipinti, Pietro

    2016-02-10

    Here we offer a review of the literature regarding endoscopic ultrasound-guided ethanol ablation for pancreatic neuroendocrine tumours and describe the case of a cystic tumour completely ablated after a multisession procedure. A total of 35 PubMed indexed cases of treated functioning and non-functioning pancreatic neuroendocrine tumours resulted from our search, 29 of which are well-documented and summarised. Endoscopic ultrasound-guided ethanol ablation appears as a local, minimally invasive treatment of pancreatic neuroendocrine tumours, suitable for selected patients. This technique appears feasible, relatively safe and efficient, especially when applied to symptom relief in functioning tumours, aiming at loss of endocrine secretion. For non-functioning tumours, where the goal is complete tissue ablation, eus guided ethanol ablation can provide good results for patients who are unfit for surgery or for those who refuse surgical resection. Its role in "fit for surgery" patients requires assessment through further studies.

  6. B4C-MODIFIED SiO2-PHENOLIC Composites for Enhanced Ablation Resistance

    Science.gov (United States)

    Li, Maoyuan; Lu, Lin; Dai, Zhen; Hong, Yiqiang; Chen, Weiwei; Zhang, Yuping; Qiao, Yingjie

    In the present paper, the silica-phenolic composite (S-Ph) composites with different amount of B4C were prepared, and the ablation tests of these composites were carried out using oxygen-acetylene jet. The ablation process was systematically investigated. The addition of B4C with appropriate amount can efficiently improve the ablation resistance of S-Ph. The results showed that S-Ph containing B4C powder of 2wt.% exhibited the lowest linear and mass ablation rate. The influence mechanism for the results was analyzed deeply. The surface morphologies, phase composition, density and thermal conductivity of composites were characterized using a scanning electron microscope (SEM), X-Ray Diffraction (XRD), Archimedes method, and thermal conductivity meter, respectively. The present investigation will provide a theoretical basis for the preparation of the ablation resistant material.

  7. Hydrodynamic model for ultra-short pulse ablation of hard dental tissue

    Energy Technology Data Exchange (ETDEWEB)

    London, R.A.; Bailey, D.S.; Young, D.A.; Alley, W.E.; Feit, M.D.; Rubenchik, A.M. [Lawrence Livermore National Lab., CA (United States); Neev, J. [Beckman Laser Inst., Irvine, CA (United States)

    1996-02-29

    A computational model for the ablation of tooth enamel by ultra-short laser pulses is presented. The role of simulations using this model in designing and understanding laser drilling systems is discussed. Pulses of duration 300 fsec and intensity greater than 10{sup 12} W/cm{sup 2} are considered. Laser absorption proceeds via multi-photon initiated plasma mechanism. The hydrodynamic response is calculated with a finite difference method, using an equation of state constructed from thermodynamic functions including electronic, ion motion, and chemical binding terms. Results for the ablation efficiency are presented. An analytic model describing the ablation threshold and ablation depth is presented. Thermal coupling to the remaining tissue and long-time thermal conduction are calculated. Simulation results are compared to experimental measurements of the ablation efficiency. Desired improvements in the model are presented.

  8. Complications associated with radiofrequency ablation of pulmonary veins.

    Science.gov (United States)

    Madrid Pérez, J M; García Barquín, P M; Villanueva Marcos, A J; García Bolao, J I; Bastarrika Alemañ, G

    Radiofrequency ablation is an efficacious alternative in patients with symptomatic atrial fibrillation who do not respond to or are intolerant to at least one class I or class III antiarrhythmic drug. Although radiofrequency ablation is a safe procedure, complications can occur. Depending on the location, these complications can be classified into those that affect the pulmonary veins themselves, cardiac complications, extracardiac intrathoracic complications, remote complications, and those that result from vascular access. The most common complications are hematomas, arteriovenous fistulas, and pseudoaneurysms at the puncture site. Some complications are benign and transient, such as gastroparesis or diaphragmatic elevation, whereas others are potentially fatal, such as cardiac tamponade. Radiologists must be familiar with the complications that can occur secondary to pulmonary vein ablation to ensure early diagnosis and treatment. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Aggregation effect on absorbance spectrum of laser ablated gold nanoparticles

    Science.gov (United States)

    Isnaeni; Irmaniar; Herbani, Y.

    2017-04-01

    Plasmon of gold nanoparticles is one of the hot topics nowadays due to various possible applications. The application is determined by plasmon peak in absorbance spectrum. We have fabricated gold nanoparticles using laser ablation technique and studied the influence of CTAB (Cetyl trimethylammonium bromide) effect on the optical characterization of fabricated gold nanoparticles. We ablated a gold plate using NdYAG pulsed laser at 1064 nm wavelength, 10 Hz pulse frequency at low energy density. We found there are two distinctive plasmon peaks, i.e., primary and secondary peaks, where the secondary peak is the main interests of this work. Our simulation results have revealed that the secondary plasmon peak is affected by random aggregation of gold nanoparticles. Our research leads to good techniques on fabrication of colloidal gold nanoparticles in aqueous solution using laser ablation technique.

  10. Laser ablation/ionization studies in a glow discharge

    International Nuclear Information System (INIS)

    Hess, K.R.; Harrison, W.W.

    1985-01-01

    The pin cathode glow discharge is used in the laboratory as an atomization/ionization source for a variety of applications, including solids mass spectrometry. Coupled with a tunable dye laser, the glow discharge may also serve as an atom reservoir for resonance ionization mass spectrometry in which the laser ionizes the discharge sputtered atoms. By tightly focusing the laser onto solid samples, various ablation effects may also be investigated. The laser may be used to generate an ionized plasma which may be directly analyzed by mass spectrometry. Alternatively, the ablated neutral atoms may be used in post-ablation excitation/ionization processes, in this case the glow discharge. The results of these investigations are the basis of this paper

  11. Water content contribution in calculus phantom ablation during Q-switched Tm:YAG laser lithotripsy.

    Science.gov (United States)

    Zhang, Jian J; Rajabhandharaks, Danop; Xuan, Jason Rongwei; Wang, Hui; Chia, Ray W J; Hasenberg, Tom; Kang, Hyun Wook

    2015-01-01

    Q-switched (QS) Tm:YAG laser ablation mechanisms on urinary calculi are still unclear to researchers. Here, dependence of water content in calculus phantom on calculus ablation performance was investigated. White gypsum cement was used as a calculus phantom model. The calculus phantoms were ablated by a total 3-J laser pulse exposure (20 mJ, 100 Hz, 1.5 s) and contact mode with N=15 sample size. Ablation volume was obtained on average 0.079, 0.122, and 0.391  mm3 in dry calculus in air, wet calculus in air, and wet calculus in-water groups, respectively. There were three proposed ablation mechanisms that could explain the effect of water content in calculus phantom on calculus ablation performance, including shock wave due to laser pulse injection and bubble collapse, spallation, and microexplosion. Increased absorption coefficient of wet calculus can cause stronger spallation process compared with that caused by dry calculus; as a result, higher calculus ablation was observed in both wet calculus in air and wet calculus in water. The test result also indicates that the shock waves generated by short laser pulse under the in-water condition have great impact on the ablation volume by Tm:YAG QS laser.

  12. TU-AB-201-06: Evaluation of Electromagnetically Guided High- Dose Rate Brachytherapy for Ablative Treatment of Lung Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Pinkham, D.W.; Shultz, D.; Loo, B.W.; Sung, A.; Diehn, M.; Fahimian, B.P. [Stanford University, Stanford, CA (United States)

    2015-06-15

    Purpose: The advent of electromagnetic navigation bronchoscopy has enabled minimally invasive access to peripheral lung tumors previously inaccessible by optical bronchoscopes. As an adjunct to Stereotactic Ablative Radiosurgery (SABR), implantation of HDR catheters can provide focal treatments for multiple metastases and sites of retreatments. The authors evaluate a procedure to deliver ablative doses via Electromagnetically-Guided HDR (EMG-HDR) to lung metastases, quantify the resulting dosimetry, and assess its role in the comprehensive treatment of lung cancer. Methods: A retrospective study was conducted on ten patients, who, from 2009 to 2011, received a hypo-fractionated SABR regimen with 6MV VMAT to lesions in various lobes ranging from 1.5 to 20 cc in volume. A CT visible pathway was delineated for EM guided placement of an HDR applicator (catheter) and dwell times were optimized to ensure at least 98% prescription dose coverage of the GTV. Normal tissue doses were calculated using inhomogeneity corrections via a grid-based Boltzmann solver (Acuros-BV-1.5.0). Results: With EMG-HDR, an average of 83% (+/−9% standard deviation) of each patient’s GTV received over 200% of the prescription dose, as compared to SABR where the patients received an average maximum dose of 125% (+/−5%). EMG-HDR enabled a 59% (+/−12%) decrease in the aorta maximum dose, a 63% (+/−26%) decrease in the spinal cord max dose, and 57% (+/−23%) and 70% (+/−17%) decreases in the volume of the body receiving over 50% and 25% of the prescription dose, respectively. Conclusion: EMG-HDR enables delivery of higher ablative doses to the GTV, while concurrently reducing surrounding normal tissue doses. The single catheter approach shown here is limited to targets smaller than 20 cc. As such, the technique enables ablation of small lesions and a potentially safe and effective retreatment option in situations where external beam utility is limited by normal tissue constraints.

  13. [Mechanism of ablation with nanosecond pulsed electric field].

    Science.gov (United States)

    Cen, Chao; Chen, Xin-hua; Zheng, Shu-sen

    2015-11-01

    Nanosecond pulsed electric field ablation has been widely applied in clinical cancer treatment, while its molecular mechanism is still unclear. Researchers have revealed that nanosecond pulsed electric field generates nanopores in plasma membrane, leading to a rapid influx of Ca²⁺; it has specific effect on intracellular organelle membranes, resulting in endoplasmic reticulum injuries and mitochondrial membrane potential changes. In addition, it may also change cellular morphology through damage of cytoskeleton. This article reviews the recent research advances on the molecular mechanism of cell membrane and organelle changes induced by nanosecond pulsed electric field ablation.

  14. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Walfridsson, H; Walfridsson, U; Nielsen, J Cosedis

    2015-01-01

    AIMS: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF....... In this substudy, we evaluated the effect of these treatment modalities on the Health-Related Quality of Life (HRQoL) and symptom burden of patients at 12 and 24 months. METHODS AND RESULTS: During the study period, 294 patients were enrolled in the MANTRA-PAF trial and randomized to receive AAD (N = 148) or RFA...

  15. Virtual In-Silico Modeling Guided Catheter Ablation Predicts Effective Linear Ablation Lesion Set for Longstanding Persistent Atrial Fibrillation: Multicenter Prospective Randomized Study.

    Science.gov (United States)

    Shim, Jaemin; Hwang, Minki; Song, Jun-Seop; Lim, Byounghyun; Kim, Tae-Hoon; Joung, Boyoung; Kim, Sung-Hwan; Oh, Yong-Seog; Nam, Gi-Byung; On, Young Keun; Oh, Seil; Kim, Young-Hoon; Pak, Hui-Nam

    2017-01-01

    Objective: Radiofrequency catheter ablation for persistent atrial fibrillation (PeAF) still has a substantial recurrence rate. This study aims to investigate whether an AF ablation lesion set chosen using in-silico ablation (V-ABL) is clinically feasible and more effective than an empirically chosen ablation lesion set (Em-ABL) in patients with PeAF. Methods: We prospectively included 108 patients with antiarrhythmic drug-resistant PeAF (77.8% men, age 60.8 ± 9.9 years), and randomly assigned them to the V-ABL ( n = 53) and Em-ABL ( n = 55) groups. Five different in-silico ablation lesion sets [1 pulmonary vein isolation (PVI), 3 linear ablations, and 1 electrogram-guided ablation] were compared using heart-CT integrated AF modeling. We evaluated the feasibility, safety, and efficacy of V-ABL compared with that of Em-ABL. Results: The pre-procedural computing time for five different ablation strategies was 166 ± 11 min. In the Em-ABL group, the earliest terminating blinded in-silico lesion set matched with the Em-ABL lesion set in 21.8%. V-ABL was not inferior to Em-ABL in terms of procedure time ( p = 0.403), ablation time ( p = 0.510), and major complication rate ( p = 0.900). During 12.6 ± 3.8 months of follow-up, the clinical recurrence rate was 14.0% in the V-ABL group and 18.9% in the Em-ABL group ( p = 0.538). In Em-ABL group, clinical recurrence rate was significantly lower after PVI+posterior box+anterior linear ablation, which showed the most frequent termination during in-silico ablation (log-rank p = 0.027). Conclusions: V-ABL was feasible in clinical practice, not inferior to Em-ABL, and predicts the most effective ablation lesion set in patients who underwent PeAF ablation.

  16. Current and future technology for minimally invasive ablation of renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Branden G Duffey

    2010-01-01

    Full Text Available Purpose of Review : To provide an overview of the technologic advancements in the field of ablative therapy, focusing on the treatment of renal neoplasms. Materials and Methods : A MEDLINE search was performed using each specific ablative technique name as the search term. Articles written in the English language were selected for review. In cases of multiple reports by a single institution, the most recent report was utilized. Pertinent articles specific to the technologic advancement in ablative therapy were selected for review. Recent Findings : Intermediate-term oncologic outcomes of radiofrequency ablation (RFA and cryoablation (CA for the treatment of small renal masses are encouraging. For thermal therapies, molecular adjuvants to enhance cellular kill and local control have been developed. Improvements in microwave technology have allowed for reductions in antenna size and increases in ablation size. Laparoscopic high-intensity focused ultrasound (HIFU probes have been developed to overcome the limitations of transcutaneous energy delivery, but HIFU remains experimental for the treatment of renal lesions. Irreversible electroporation (IRE, a novel nonthermal ablative technique, is currently undergoing clinical investigation in human subjects. Histotripsy causes mechanical destruction of targeted tissue and shows promise in treating renal and prostate pathology. Summary : Ablative techniques are commonly utilized in the primary treatment of urologic malignancies. The purpose of this review is to discuss technologic advances in ablative therapies with emphasis on the treatment of renal masses. RFA and CA show acceptable intermediate-term efficacy and technical refinement continues. Emerging technologies, including microwave thermotherapy, IRE, HIFU and histotripsy, are described with emphasis on the mechanism of cellular kill, energy delivery, and stage in clinical development.

  17. Utilization of Hyaluronate and Incidence of Septic Knee Arthritis in Adults: Results from the Korean National Claim Registry.

    Science.gov (United States)

    Lee, Young-Kyun; Kim, Ki-Choul; Ha, Yong-Chan; Koo, Kyung-Hoi

    2015-09-01

    Septic arthritis of the knee has been reported recently in adult patients who were administered hyaluronate. We evaluated the incidence of septic knees and the utilization of hyaluronate in the Korean adult population using nationwide data from the Health Insurance Review and Assessment Service (HIRA). All new admissions to the clinics or hospitals for septic knees were recorded in the HIRA database which was established by the Korean government and covers the Korean population using the International Classification of Diseases-10 revision code. We evaluated the incidence of septic arthritis of the knees in the population above 50 years of age. Hyaluronate prescription data was also collected from the HIRA database. In 2012, the incidence of septic knees was 2.7 per 100,000 persons in men and 4.2 per 100,000 persons in women, respectively. The age-adjusted incidence of septic knees increased by 6.7% per year (95% confidence interval, 3.3 to 10.1), and the annual number of prescriptions of hyaluronate increased about 1.5-fold during the study period. Cautious aseptic technique is required when hyaluronate is administered in adult patients with osteoarthritis of the knee due to the concerns of the risk of septic arthritis.

  18. Autoinducer 2 Signaling via the Phosphotransferase FruA Drives Galactose Utilization by Streptococcus pneumoniae, Resulting in Hypervirulence

    Directory of Open Access Journals (Sweden)

    Claudia Trappetti

    2017-01-01

    Full Text Available Communication between bacterial cells is crucial for the coordination of diverse cellular processes that facilitate environmental adaptation and, in the case of pathogenic species, virulence. This is achieved by the secretion and detection of small signaling molecules called autoinducers, a process termed quorum sensing. To date, the only signaling molecule recognized by both Gram-positive and Gram-negative bacteria is autoinducer 2 (AI-2, synthesized by the metabolic enzyme LuxS (S-ribosylhomocysteine lyase as a by-product of the activated methyl cycle. Homologues of LuxS are ubiquitous in bacteria, suggesting a key role in interspecies, as well as intraspecies, communication. Gram-negative bacteria sense and respond to AI-2 via the Lsr ABC transporter system or by the LuxP/LuxQ phosphorelay system. However, homologues of these systems are absent from Gram-positive bacteria and the AI-2 receptor is unknown. Here we show that in the major human pathogen Streptococcus pneumoniae, sensing of exogenous AI-2 is dependent on FruA, a fructose-specific phosphoenolpyruvate-phosphotransferase system that is highly conserved in Gram-positive pathogens. Importantly, AI-2 signaling via FruA enables the bacterium to utilize galactose as a carbon source and upregulates the Leloir pathway, thereby leading to increased production of capsular polysaccharide and a hypervirulent phenotype.

  19. Irreversible electroporation ablation area enhanced by synergistic high- and low-voltage pulses.

    Directory of Open Access Journals (Sweden)

    Chenguo Yao

    Full Text Available Irreversible electroporation (IRE produced by a pulsed electric field can ablate tissue. In this study, we achieved an enhancement in ablation area by using a combination of short high-voltage pulses (HVPs to create a large electroporated area and long low-voltage pulses (LVPs to ablate the electroporated area. The experiments were conducted in potato tuber slices. Slices were ablated with an array of four pairs of parallel steel electrodes using one of the following four electric pulse protocols: HVP, LVP, synergistic HVP+LVP (SHLVP or LVP+HVP. Our results showed that the SHLVPs more effectively necrotized tissue than either the HVPs or LVPs, even when the SHLVP dose was the same as or lower than the HVP or LVP doses. The HVP and LVP order mattered and only HVPs+LVPs (SHLVPs treatments increased the size of the ablation zone because the HVPs created a large electroporated area that was more susceptible to the subsequent LVPs. Real-time temperature change monitoring confirmed that the tissue was non-thermally ablated by the electric pulses. Theoretical calculations of the synergistic effects of the SHLVPs on tissue ablation were performed. Our proposed SHLVP protocol provides options for tissue ablation and may be applied to optimize the current clinical IRE protocols.

  20. Human cornea wound healing in organ culture after Er:YAG laser ablation

    Science.gov (United States)

    Shen, Jin-Hui; Joos, Karen M.; Robinson, Richard D.; Shetlar, Debra J.; O'Day, Denis M.

    1998-06-01

    Purpose: To study the healing process in cultured human corneas after Er:YAG laser ablation. Methods: Human cadaver corneas within 24 hours post mortem were ablated with a Q- switched Er:YAG laser at 2.94 micrometer wavelength. The radiant exposure was 500 mJ/cm2. The cornea was cultured on a tissue supporting frame immediately after the ablation. Culture media consisted of 92% minimum essential media, 8% fetal bovine serum, 0.125% HEPES buffer solution, 0.125% gentamicin, and 0.05% fungizone. The entire tissue frame and media container were kept in an incubator at 37 degrees Celsius and 5% CO2. Serial macroscopic photographs of the cultured corneas were taken during the healing process. Histology was performed after 30 days of culture. Results: A clear ablated crater into the stroma was observed immediately after the ablation. The thickness of thermal damage ranges between 1 and 25 micrometer. Haze development within the crater varies from the third day to the fourteenth day according to the depth and the roughness of the crater. Histologic sections of the cultured cornea showed complete re- epithelization of the lased area. Loose fibrous tissue is observed filling the ablated space beneath the epithelium. The endothelium appeared unaffected. Conclusions: The intensity and time of haze development appears dependent upon the depth of the ablation. Cultured human corneas may provide useful information regarding the healing process following laser ablation.

  1. Laser Ablation for Medical Applications

    Science.gov (United States)

    Hayashi, Ken-Ichi

    Medical applications of laser are measurement, laser surgery, in-situ monitoring, and processing of medical devices. In this paper, author briefly reviews the trends of medical applications, describes some new applications, and then discuss about the future trends and problems of medical applications. At present, the domestic market of laser equipment for medical applications is nearly 1/10 of that for industrial applications, which has registered significant growth continuously. Laser surgery as a minimum invasive surgery under arthroscope is expected to decrease the pain of patients. Precise processing such as cutting and welding is suitable for manufacturing medical devices. Pulsed laser deposition has been successfully applied to the thin film coating. The corneal refractive surgery by ArF excimer laser has been widely accepted for its highly safe operation. Laser ablation for retinal implant in the visual prosthesis is one of the promising applications of laser ablation in medicine. New applications with femtosecond laser are expected in the near future.

  2. Characteristics of Cavotricuspid Isthmus Ablation for Atrial Flutter Guided by Novel Parameters Using a Contact Force Catheter.

    Science.gov (United States)

    Gould, Paul A; Booth, Cameron; Dauber, Kieran; Ng, Kevin; Claughton, Andrew; Kaye, Gerald C

    2016-12-01

    This study sought to investigate specific contact force (CF) parameters to guide cavotricuspid isthmus (CTI) ablation and compare the outcome with a historical control cohort. Patients (30) undergoing CTI ablation were enrolled prospectively in the Study cohort and compared with a retrospective Control cohort of 30 patients. Ablation in the Study cohort was performed using CF parameters >10 g and g. The Control cohort underwent traditionally guided CTI ablation. Traditional parameters (electrogram and impedance change) were assessed in both cohorts. All ablations regardless of achieving targets were included in data analysis. Bidirectional CTI block was achieved in all of the Study and 27 of the Control cohort. Atrial flutter recurred in 3 (10%) patients (follow-up 564 ± 212 days) in the study cohort and in 3 (10%) patients (follow-up 804 ± 540 days) in the Control cohort. There were no major complications in either cohort. Traditional parameters correlated poorly with CF parameters. In the Study cohort, flutter recurrence was associated with significantly lower FTI and ablation duration, but was not associated with total average CF. CTI ablation can be safely performed using CF parameters guiding ablation, with similar long-term results to a historical ablation control group. Potentially CF parameters may provide adjunctive information to enable a more efficient CTI ablation. Further research is required to confirm this. © 2016 Wiley Periodicals, Inc.

  3. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    International Nuclear Information System (INIS)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo; Seo, Ye Young; Ryu, Ji Young

    2015-01-01

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients

  4. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Seo, Ye Young [Dept. of Nuclear Medicine, College of Medicine, The Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of); Ryu, Ji Young [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-12-15

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

  5. Oophorectomy versus radiation ablation of ovarian function in patients with metastatic carcinoma of the breast

    International Nuclear Information System (INIS)

    Lees, A.W.; Giuffre, C.; Burns, P.E.; Hurlburt, M.E.; Jenkins, H.J.

    1980-01-01

    A retrospective study of two methods of ovarian ablation as primary therapy for metastatic carcinoma of the breast was carried out using records from this cancer institute. Sixty-one radiation and 97 surgical ovarian ablations, performed from 1972 to 1977, were assessed. Over-all response was similar for the surgical and irradiation groups. Survival from the time of ovarian ablation was greater in both groups in those who responded positively than in those who did not. Factors other than estrogen receptor status can determine the response of patients with metastatic carcinoma of the breast to ovarian ablation. The results indicate that clinical determinates and not the efficiency of one method over the other should be the main criteria for choosing between ovarian ablation by irradiation or by oophorectomy

  6. Pulsed Laser Ablation and Deposition with the Thomas Jefferson National Accelerator Facility Free Electron Laser

    Science.gov (United States)

    Reilly, Anne; Allmond, Chris; Shinn, Michelle

    2002-05-01

    We have been conducting some of the first experiments in pulsed laser ablation and deposition with the Thomas Jefferson National Accelerator Facility Free Electron Laser (TJNAF-FEL). The wavelength tunability, high average power (up to 1.72 kW), very high repetition rate (cw rate up to 74 MHz) and ultrafast pulses ( 650 fs) of the TJNAF-FEL present a combination of parameters unmatched by any laser, which has marked benefits for ablation and deposition. We will be presenting results on ablation of metals (Co,NiFe,Ti,Nb). Comparison with thin films deposited with a standard nanosecond laser source and an ultrafast low-repetition rate laser system show the advantage of using the FEL to produce high quality films at high deposition rates. Preliminary optical spectroscopy studies of the ablation plume and electron/ion emission studies during ablation will also be presented.

  7. Theoretical and experimental analysis of the impact on ablation depth of microchannel milling using femtosecond laser

    Science.gov (United States)

    Lei, Chen; Pan, Zhang; Jianxiong, Chen; Tu, Yiliu

    2018-04-01

    The plasma brightness cannot be used as a direct indicator of ablation depth detection by femtosecond laser was experimentally demonstrated, which led to the difficulty of depth measurement in the maching process. The tests of microchannel milling on the silicon wafer were carried out in the micromachining center in order to obtain the influences of parameters on the ablation depth. The test results showed that the defocusing distance had no significant impact on ablation depth in LAV effective range. Meanwhile, the reason of this was explained in this paper based on the theoretical analysis and simulation calculation. Then it was proven that the ablation depth mainly depends on laser fluence, step distance and scanning velocity. Finally, a research was further carried out to study the laser parameters which relate with the microchannel ablation depth inside the quartz glass for more efficiency and less cost in processing by femtosecond laser.

  8. Treatment planning for prostate focal laser ablation in the face of needle placement uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Cepek, Jeremy, E-mail: jcepek@robarts.ca; Fenster, Aaron [Robarts Research Institute, London, Ontario N6A 5K8, Canada and Biomedical Engineering, The University of Western Ontario, London, Ontario N6A 5B9 (Canada); Lindner, Uri; Trachtenberg, John [Department of Surgical Oncology, Division of Urology, University Health Network, Toronto, Ontario M5G 2C4 (Canada); Davidson, Sean R. H. [Ontario Cancer Institute, University Health Network, Toronto, Ontario M5G 2M9 (Canada); Haider, Masoom A. [Department of Medical Imaging, Sunnybrook Health Sciences Center, Toronto, Ontario M4N 3M5, Canada and Department of Medical Imaging, University of Toronto, Toronto, Ontario M5S 2J7 (Canada); Ghai, Sangeet [Department of Medical Imaging, University Health Network, Toronto, Ontario M5G 2M9 (Canada)

    2014-01-15

    Purpose: To study the effect of needle placement uncertainty on the expected probability of achieving complete focal target destruction in focal laser ablation (FLA) of prostate cancer. Methods: Using a simplified model of prostate cancer focal target, and focal laser ablation region shapes, Monte Carlo simulations of needle placement error were performed to estimate the probability of completely ablating a region of target tissue. Results: Graphs of the probability of complete focal target ablation are presented over clinically relevant ranges of focal target sizes and shapes, ablation region sizes, and levels of needle placement uncertainty. In addition, a table is provided for estimating the maximum target size that is treatable. The results predict that targets whose length is at least 5 mm smaller than the diameter of each ablation region can be confidently ablated using, at most, four laser fibers if the standard deviation in each component of needle placement error is less than 3 mm. However, targets larger than this (i.e., near to or exceeding the diameter of each ablation region) require more careful planning. This process is facilitated by using the table provided. Conclusions: The probability of completely ablating a focal target using FLA is sensitive to the level of needle placement uncertainty, especially as the target length approaches and becomes greater than the diameter of ablated tissue that each individual laser fiber can achieve. The results of this work can be used to help determine individual patient eligibility for prostate FLA, to guide the planning of prostate FLA, and to quantify the clinical benefit of using advanced systems for accurate needle delivery for this treatment modality.

  9. Efficacy of needle-placement technique in radiofrequency ablation for treatment of lumbar facet arthropathy

    Directory of Open Access Journals (Sweden)

    Loh JT

    2015-10-01

    Full Text Available Jeffrey T Loh,1 Andrea L Nicol,1 David Elashoff,2 F Michael Ferrante,1 1Department of Anesthesiology, David Geffen School of Medicine, 2Department of Biomathematics, University of California Los Angeles, Los Angeles, CA, USA Background: Many studies have assessed the efficacy of radiofrequency ablation to denervate the facet joint as an interventional means of treating axial low-back pain. In these studies, varying procedural techniques were utilized to ablate the nerves that innervate the facet joints. To date, no comparison studies have been performed to suggest superiority of one technique or even compare the prevalence of side effects and complications. Materials and methods: A retrospective chart review was performed on patients who underwent a lumbar facet denervation procedure. Each patient's chart was analyzed for treatment technique (early versus advanced Australian, preprocedural visual numeric scale (VNS score, postprocedural VNS score, duration of pain relief, and complications. Results: Pre- and postprocedural VNS scores and change in VNS score between the two groups showed no significant differences. Patient-reported benefit and duration of relief was greater in the advanced Australian technique group (P=0.012 and 0.022, respectively. The advanced Australian technique group demonstrated a significantly greater median duration of relief (4 months versus 1.5 months, P=0.022. Male sex and no pain-medication use at baseline were associated with decreased postablation VNS scores, while increasing age and higher preablation VNS scores were associated with increased postablation VNS scores. Despite increasing age being associated with increased postablation VNS scores, age and the advanced Australian technique were found to confer greater patient self-reported treatment benefit. Conclusion: The advanced Australian technique provides a significant benefit over the early Australian technique for the treatment of lumbar facet pain, both in

  10. Mid-IR enhanced laser ablation molecular isotopic spectrometry

    Science.gov (United States)

    Brown, Staci; Ford, Alan; Akpovo, Codjo A.; Johnson, Lewis

    2016-08-01

    A double-pulsed laser-induced breakdown spectroscopy (DP-LIBS) technique utilizing wavelengths in the mid-infrared (MIR) for the second pulse, referred to as double-pulse LAMIS (DP-LAMIS), was examined for its effect on detection limits compared to single-pulse laser ablation molecular isotopic spectrometry (LAMIS). A MIR carbon dioxide (CO2) laser pulse at 10.6 μm was employed to enhance spectral emissions from nanosecond-laser-induced plasma via mid-IR reheating and in turn, improve the determination of the relative abundance of isotopes in a sample. This technique was demonstrated on a collection of 10BO and 11BO molecular spectra created from enriched boric acid (H3BO3) isotopologues in varying concentrations. Effects on the overall ability of both LAMIS and DP-LAMIS to detect the relative abundance of boron isotopes in a starting sample were considered. Least-squares fitting to theoretical models was used to deduce plasma parameters and understand reproducibility of results. Furthermore, some optimization for conditions of the enhanced emission was achieved, along with a comparison of the overall emission intensity, plasma density, and plasma temperature generated by the two techniques.

  11. Practice makes perfect: relationship between hospital procedure volume and permanent pacemaker implantation after paroxysmal supraventricular tachycardia ablation.

    Science.gov (United States)

    Agarwal, Vratika; Shah, Neeraj; Mehta, Kathan; Agarwal, Anand; Willner, Jonathan; Lafferty, James

    2017-11-01

    Paroxysmal supraventricular tachycardia (PSVT) ablation can result in injury to the atrioventricular (AV) node causing complete heart block requiring permanent pacemaker (PPM) implantation. Few studies have examined the impact of hospital PSVT ablation volume and PPM implantation rates post ablation. We included adult patients from the Nationwide Inpatient Sample (NIS) database, from 1998 to 2011, using ICD-9 diagnoses codes 427.0 and 427.89 for PSVT and ICD-9 procedure code 37.34 for ablation. Patients with concomitant arrhythmias, prior pacemaker/defibrillator implants, or pre-existing sinus node dysfunction were excluded. Multivariate logistic regression analysis was performed to identify predictors of PPM implantation. There were 119,938 PSVT ablations from 1998 to 2011 with a mean age of 54.6 ± 17.5 years and 64.1% females. The overall PPM implantation rate was 3.2%. PPM implantation rates in the first (1-14 ablations/year), second (15-32 ablations/year), and third (> 32/ablations/year) tertiles of annual PSVT ablation volume were respectively 4.4, 3.3, and 1.9% (p  32 PSVT ablations/year compared to hospitals performing ≤ 14 PSVT ablations/year was 0.54 (95% confidence interval 0.3-0.9, p = 0.026). PPM implantation rates are significantly lower in hospitals performing > 32 PSVT ablations/year, indicating that hospital experience is an important determinant of outcomes after PSVT ablation.

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

    International Nuclear Information System (INIS)

    Clasen, Stephan; Rempp, Hansjörg; Hoffmann, Rüdiger; Graf, Hansjörg; Pereira, Philippe L.; Claussen, Claus D.

    2014-01-01

    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

  13. The effect of ablation sequence and duration on lesion shape using rapidly pulsed radiofrequency energy through multiple electrodes.

    Science.gov (United States)

    McRury, I D; Diamond, S; Falwell, G; Schlichting, A; Wilson, C

    2000-04-01

    Sequences of energy application to multiple electrodes and a study of ablation duration with distal tip and multi-electrode ablations were explored with a radiofrequency controller that distributes energy from a generator to up to 4 electrodes with various duty cycles. In vitro ablations were performed on bovine left ventricle in circulating blood and lesions in goats were performed to verify the in vitro results. All of the ablation sequences with simultaneous electrode activation of contiguous electrodes resulted in deeper lesions than those created in sequence. There was also no scalloping of the lesion if contiguous electrodes were activated simultaneously. During all distal tip ablations, lesion volume and depth was greater after 3 minutes of energy delivery than after 1 minute, but did not increase from 3 minutes to 5 minutes. There was a significant increase in multi-electrode ablation lesion depth with each additional minute in the ablation cycle. The in vivo ablations verified these results at 120 and 300 second ablations. Pulsed energy distal tip ablations resulted in deeper lesions than continuous only if power amplitudes over 50 W were employed. In conclusion, contiguous electrodes in simultaneous use create lesions that resemble one large lesion rather than two lesions positioned next to each other. Multi-electrode ablation lesions continue to grow at ablation durations of up to 5 minutes compared to distal tip lesions which reach steady-state between 1 and 3 minutes. Pulsed energy delivery to distal tips may result in deeper lesions than conventional if high powers are employed.

  14. Radiofrequency ablation for the treatment of gastric antral vascular ectasia

    DEFF Research Database (Denmark)

    Dray, X.; Repici, A.; Gonzalez, P.

    2014-01-01

    Background and study aims: The traditional endoscopic treatment for gastric antral vascular ectasia (GAVE) is argon plasma coagulation, but results are not always positive. Radiofrequency ablation (RFA) is a new endoscopic therapy that may be an attractive option for the treatment of GAVE. The aim...

  15. Wavefront-optimized ablation versus topography-guided customized ablation in myopic LASIK: comparative study of higher order aberrations.

    Science.gov (United States)

    El Awady, Hatem E; Ghanem, Asaad A; Saleh, Sameh M

    2011-01-01

    To compare the outcomes of wavefront-optimized ablation and topography-guided ablation in fellow eyes of patients undergoing laser in situ keratomileusis (LASIK) for myopia. This prospective study included 84 patients who underwent LASIK in both eyes: wavefront-optimized ablation in one eye (group I) and topography-guided ablation in the fellow eye (group II). The Moria2 microkeratome with a 110 single-use head (Moria, Antony, France) was used to create a superior hinged flap and the Allegretto Wave Excimer Laser (Alcon/Wavelight Light Laser Technologie GmbH, Erlangen, Germany) for photoablation. The Allegretto wave analyzer was used to measure the ocular aberrations before and 6 months after LASIK. Refractive visual outcomes and ocular aberration changes were compared between the two treatment modalities. Six months postoperatively, the mean uncorrected visual acuity of group II was statistically better than that of group I (P = .02). Seventy percent of group I and 83% of group II achieved a postoperative spherical equivalent refraction of ±0.5 diopters. The postoperative total root-mean-square of higher order aberrations (HOAs) of group II was smaller than that of group I, but the difference was not statistically significant (P = .51). There was a decrease in most of the individual terms of HOAs in group II, but it was only statistically significant in Z(3) (-1) (P = .04). The reverse occurred in group I, where most of the individual terms of HOAs increased, but it was not statistically significant. Significant improvement was only noted in Z(5) (3) (P = .05) and Z(5) (5) (P = .04). Both wavefront-optimized ablation and topography-guided ablation provided good refractive results, but the latter induced fewer HOAs. Copyright 2011, SLACK Incorporated.

  16. Producing Uniform Lesion Pattern in HIFU Ablation

    Science.gov (United States)

    Zhou, Yufeng; Kargl, Steven G.; Hwang, Joo Ha

    2009-04-01

    High intensity focused ultrasound (HIFU) is emerging as a modality for treatment of solid tumors. The temperature at the focus can reach over 65° C denaturing cellular proteins resulting in coagulative necrosis. Typically, HIFU parameters are the same for each treated spot in most HIFU control systems. Because of thermal diffusion from nearby spots, the size of lesions will gradually become larger as the HIFU therapy progresses, which may cause insufficient treatment of initial spots, and over-treatment of later ones. It is found that the produced lesion pattern also depends on the scanning pathway. From the viewpoint of the physician creating uniform lesions and minimizing energy exposure are preferred in tumor ablation. An algorithm has been developed to adaptively determine the treatment parameters for every spot in a theoretical model in order to maintain similar lesion size throughout the HIFU therapy. In addition, the exposure energy needed using the traditional raster scanning is compared with those of two other scanning pathways, spiral scanning from the center to the outside and from the outside to the center. The theoretical prediction and proposed algorithm were further evaluated using transparent gel phantoms as a target. Digital images of the lesions were obtained, quantified, and then compared with each other. Altogether, dynamically changing treatment parameters can improve the efficacy and safety of HIFU ablation.

  17. Fundamental Mechanisms of Pulsed Laser Ablation of Biological Tissue

    Science.gov (United States)

    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

  18. Radiofrequency Ablation of Hepatic Cysts : Case Report

    International Nuclear Information System (INIS)

    Lee, Ye Ri; Kim, Pyo Nyun

    2005-01-01

    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

  19. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  20. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Directory of Open Access Journals (Sweden)

    Miller JD

    2015-01-01

    Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities

  1. Ablation experiment and threshold calculation of titanium alloy irradiated by ultra-fast pulse laser

    Directory of Open Access Journals (Sweden)

    Buxiang Zheng

    2014-02-01

    Full Text Available The interaction between an ultra-fast pulse laser and a material's surface has become a research hotspot in recent years. Micromachining of titanium alloy with an ultra-fast pulse laser is a very important research direction, and it has very important theoretical significance and application value in investigating the ablation threshold of titanium alloy irradiated by ultra-fast pulse lasers. Irradiated by a picosecond pulse laser with wavelengths of 1064 nm and 532 nm, the surface morphology and feature sizes, including ablation crater width (i.e. diameter, ablation depth, ablation area, ablation volume, single pulse ablation rate, and so forth, of the titanium alloy were studied, and their ablation distributions were obtained. The experimental results show that titanium alloy irradiated by a picosecond pulse infrared laser with a 1064 nm wavelength has better ablation morphology than that of the green picosecond pulse laser with a 532 nm wavelength. The feature sizes are approximately linearly dependent on the laser pulse energy density at low energy density and the monotonic increase in laser pulse energy density. With the increase in energy density, the ablation feature sizes are increased. The rate of increase in the feature sizes slows down gradually once the energy density reaches a certain value, and gradually saturated trends occur at a relatively high energy density. Based on the linear relation between the laser pulse energy density and the crater area of the titanium alloy surface, and the Gaussian distribution of the laser intensity on the cross section, the ablation threshold of titanium alloy irradiated by an ultra-fast pulse laser was calculated to be about 0.109 J/cm2.

  2. Results of the surgical correction of urinary stress incontinence according to the type of transobturator tape utilized

    Directory of Open Access Journals (Sweden)

    Bárbara Padilla-Fernández

    2013-09-01

    Full Text Available Objectives: To analyze the short and long term results of tapes of different materials used to treat stress urinary incontinence (SUI. A secondary objective was to evaluate the ability to adjust the tape after implantation. Materials and methods: Retrospective chart review of 355 patients with SUI operated between March 2003 and October 2011. Eight different types of transobturator tapes were used: Gynecare TVT-O®, Monarc®, SAFYRE®, Contasure KIM®, I-Stop®, DynaMesh®, Aris® Bandellete and Swing-band®. Results and complications were recorded. Results: The mean age at operation was 61 years. Correction of SUI was achieved in 87.88% of cases. The best results were obtained with Contasure KIM® (98.26 % continence. The tape was well tolerated and was elastic enough to be able to be adjusted 48-72 hours after implantation without deformation. Slings with macropores and over lock stiches on the superior and inferior borders presented the lower rates of postoperative urinary retention, pain, perior postoperative bleeding and urinary tract infections. Conclusions: Transobturator tension free tapes require a short operation time and have a low complication rate. The possibility of adjustment in the early postoperative period increases the success rate and reduces complications. Knotless meshes with macropores and over lock stiches appear to be better balanced, are quite resistant to stretching and deformation when readjusted after implantation and present a low infection rate.

  3. Dynamic frame selection for in vivo ultrasound temperature estimation during radiofrequency ablation

    International Nuclear Information System (INIS)

    Daniels, Matthew J; Varghese, Tomy

    2010-01-01

    Minimally invasive therapies such as radiofrequency ablation have been developed to treat cancers of the liver, prostate and kidney without invasive surgery. Prior work has demonstrated that ultrasound echo shifts due to temperature changes can be utilized to track the temperature distribution in real time. In this paper, a motion compensation algorithm is evaluated to reduce the impact of cardiac and respiratory motion on ultrasound-based temperature tracking methods. The algorithm dynamically selects the next suitable frame given a start frame (selected during the exhale or expiration phase where extraneous motion is reduced), enabling optimization of the computational time in addition to reducing displacement noise artifacts incurred with the estimation of smaller frame-to-frame displacements at the full frame rate. A region of interest that does not undergo ablation is selected in the first frame and the algorithm searches through subsequent frames to find a similarly located region of interest in subsequent frames, with a high value of the mean normalized cross-correlation coefficient value. In conjunction with dynamic frame selection, two different two-dimensional displacement estimation algorithms namely a block matching and multilevel cross-correlation are compared. The multi-level cross-correlation method incorporates tracking of the lateral tissue expansion in addition to the axial deformation to improve the estimation performance. Our results demonstrate the ability of the proposed motion compensation using dynamic frame selection in conjunction with the two-dimensional multilevel cross-correlation to track the temperature distribution.

  4. Experimental studies of laser-ablated zirconium carbide plasma plumes: Fuel corrosion diagnostic development

    International Nuclear Information System (INIS)

    Wantuck, P.J.; Butt, D.P.; Sappey, A.D.

    1992-01-01

    Understanding the corrosion behavior of nuclear fuel materials, such as refractory carbides, in a high temperature hydrogen environment is critical for several proposed nuclear thermal propulsion (NTP) concepts. Monitoring the fuel corrosion products is important not only for understanding corrosion characteristics, but to assess the performance of an actual, operating nuclear propulsion system as well. In this paper, we describe an experimental study initiated to develop, test, and subsequently utilize non-intrusive, laser-based diagnostics to characterize the gaseous product species which are expected to evolve during the exposure of representative fuel samples to hydrogen. Laser ablation is used to produce high temperature, vapor plumes from solid solution, uranium-free, zirconium carbide (ZrC) forms for probing by other laser diagnostic methods; predominantly laser-induced fluorescence (LIF). We discuss the laser ablation technique, results of plume emission measurements, as well as the use of planar LIF to image both the ZrC plumes and actual NTP fuel corrosion constituents

  5. Acute and long term outcomes of catheter ablation using remote magnetic navigation for the treatment of electrical storm in patients with severe ischemic heart failure

    DEFF Research Database (Denmark)

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

    2015-01-01

    failure (SIHF) is still limited. METHODS: Forty consecutive SIHF patients (left ventricular ejection fraction, 21 ± 6.9%) presenting with ES underwent ablation using RMN. All the patients received implantable cardioverter-defibrillators (ICDs) either before or after ablation. Acute ablation success...... was defined as noninducibility of any sustained monophasic VT at the end of the procedure. Long-term analysis addressed VT recurrence, ICD therapies and all-cause death. ES was acutely suppressed by ablation in all patients. RESULTS: Acute ablation success was obtained in 32 of 40 (80%) patients...

  6. Laser ablation of titanium in liquid in external electric field

    Energy Technology Data Exchange (ETDEWEB)

    Serkov, A.A. [Wave Research Center of A.M. Prokhorov General Physics Institute of the Russian Academy of Sciences, 38, Vavilov Street, 119991 Moscow (Russian Federation); The Federal State Educational Institution of Higher Professional Education, “Moscow Institute of Physics and Technology (State University)”, 9 Institutskiy per., 141700, Dolgoprudny, Moscow Region (Russian Federation); Barmina, E.V., E-mail: barminaev@gmail.com [Wave Research Center of A.M. Prokhorov General Physics Institute of the Russian Academy of Sciences, 38, Vavilov Street, 119991 Moscow (Russian Federation); Shafeev, G.A. [Wave Research Center of A.M. Prokhorov General Physics Institute of the Russian Academy of Sciences, 38, Vavilov Street, 119991 Moscow (Russian Federation); National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 31, Kashirskoye Highway, 115409 Moscow (Russian Federation); Voronov, V.V. [A.M. Prokhorov General Physics Institute of the Russian Academy of Sciences, 38, Vavilov Street, 119991 Moscow (Russian Federation)

    2015-09-01

    Highlights: • Ablation of a bulk Ti target by 10 ps laser pulses in liquid is experimentally studied in external DC electric field. • Applied cathodic bias leads to increase in average size of self-organized nanostructures formed upon ablation of titanium target. • Laser ablation of Ti target in external electric field results in generation of elongated titanium oxide nanoparticles. - Abstract: Ablation of a bulk Ti target by 10 ps laser pulses in water is experimentally studied in external DC electric field. It is demonstrated that both lateral size of nanostructures (NS) on Ti surface and their density depend on the electric field applied to the target. Scanning Electron Microscopy of NS reveals the shift of their size distribution function toward larger sizes with applied field (cathodic bias, 25 V DC). Density of mushroom-like NS with applied electric field amounts to 10{sup 10} cm{sup −2}. X-ray diffraction of generated nanoparticles (NPs) shows difference in the crystallographic structure of NPs of non-stoichiometric Ti oxides generated with and without electric field. This conclusion is corroborated with the optical absorption spectroscopy of obtained colloids. Transmission Electron Microscopy of NPs also shows difference in morphology of particles produced with and without cathodic bias. The results are interpreted on the basis of instability of the melt on Ti surface in the electric field.

  7. results

    Directory of Open Access Journals (Sweden)

    Salabura Piotr

    2017-01-01

    Full Text Available HADES experiment at GSI is the only high precision experiment probing nuclear matter in the beam energy range of a few AGeV. Pion, proton and ion beams are used to study rare dielectron and strangeness probes to diagnose properties of strongly interacting matter in this energy regime. Selected results from p + A and A + A collisions are presented and discussed.

  8. Ablation of TRPM5 in Mice Results in Reduced Body Weight Gain and Improved Glucose Tolerance and Protects from Excessive Consumption of Sweet Palatable Food when Fed High Caloric Diets.

    Directory of Open Access Journals (Sweden)

    Marie H Larsson

    Full Text Available The calcium activated cation channel transient receptor potential channel type M5 (TRPM5 is part of the downstream machinery of the taste receptors and have been shown to play a central role in taste signalling. In addition it is also found in other types of chemosensory cells in various parts of the body as well as in pancreatic β-cells. The aim of this study was to investigate the effects of TRPM5 gene ablation on body weight, insulin sensitivity and other metabolic parameters in long-term high caloric diet induced obesity. Trpm5-/- mice gained significantly less body weight and fat mass on both palatable carbohydrate and fat rich cafeteria diet and 60% high fat diet (HFD and developed less insulin resistance compared to wild type mice. A main finding was the clearly improved glucose tolerance in Trpm5-/- mice compared to wild type mice on cafeteria diet, which was independent of body weight. In addition, it was shown that Trpm5-/- mice consumed the same amount of calories when fed a HFD only or a HFD in combination with a palatable chocolate ball, which is in contrast to wild type mice that increased their caloric intake when fed the combination, mainly due to excessive consumption of the chocolate ball. Thus the palatable sugar containing diet induced overeating was prevented in Trpm5-/- mice. This indicates that sweet taste induced overeating may be a cause for the increased energy intake and glucose intolerance development seen for wild type mice on a sugar and high fat rich cafeteria diet compared to when on a high fat diet. This study point to an important role for the taste signalling system and TRPM5 in diet induced glucose intolerance.

  9. Ablation of TRPM5 in Mice Results in Reduced Body Weight Gain and Improved Glucose Tolerance and Protects from Excessive Consumption of Sweet Palatable Food when Fed High Caloric Diets.

    Science.gov (United States)

    Larsson, Marie H; Håkansson, Pernilla; Jansen, Frank P; Magnell, Kerstin; Brodin, Peter

    2015-01-01

    The calcium activated cation channel transient receptor potential channel type M5 (TRPM5) is part of the downstream machinery of the taste receptors and have been shown to play a central role in taste signalling. In addition it is also found in other types of chemosensory cells in various parts of the body as well as in pancreatic β-cells. The aim of this study was to investigate the effects of TRPM5 gene ablation on body weight, insulin sensitivity and other metabolic parameters in long-term high caloric diet induced obesity. Trpm5-/- mice gained significantly less body weight and fat mass on both palatable carbohydrate and fat rich cafeteria diet and 60% high fat diet (HFD) and developed less insulin resistance compared to wild type mice. A main finding was the clearly improved glucose tolerance in Trpm5-/- mice compared to wild type mice on cafeteria diet, which was independent of body weight. In addition, it was shown that Trpm5-/- mice consumed the same amount of calories when fed a HFD only or a HFD in combination with a palatable chocolate ball, which is in contrast to wild type mice that increased their caloric intake when fed the combination, mainly due to excessive consumption of the chocolate ball. Thus the palatable sugar containing diet induced overeating was prevented in Trpm5-/- mice. This indicates that sweet taste induced overeating may be a cause for the increased energy intake and glucose intolerance development seen for wild type mice on a sugar and high fat rich cafeteria diet compared to when on a high fat diet. This study point to an important role for the taste signalling system and TRPM5 in diet induced glucose intolerance.

  10. Endovascular Radiofrequency Ablation for Varicose Veins

    Science.gov (United States)

    2011-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost–effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad

  11. Management strategies to utilize salt affected soils. Isotopic and conventional research methods. Results of a co-ordinated research programme

    International Nuclear Information System (INIS)

    1995-07-01

    This document summarizes the results of a co-ordinated research programme on ''The Use of Nuclear Techniques for Improvement of Crop Production in Salt-affected Soils''. It aims at providing scientists experimental evidence of demonstrating technical feasibility of biological amelioration of salt affected soils as an alternative option of using expensive chemical amendments in soil reclamation complementing engineering structures of farm drainage systems or option of leaving the saline areas as barren lands in spite of the fact that arable agricultural lands have exhausted. 68 refs, 26 figs, 32 tabs

  12. Utilization of natural variations in the abundance of nitrogen-15 as a tracer in hydrogeology - Initial results

    International Nuclear Information System (INIS)

    Letolle, R.; Mariotti, A.

    1974-01-01

    Nitrogen compounds dissolved in natural waters exhibit considerable variations in nitrogen-15 content (more than 10 per mille). The authors describe briefly the analytical techniques used in measuring δ 15 N, the main features of the isotopic cycle of nitrogen and the results obtained so far. A simplified model of the nitrogen cycle and its isotopic implications is presented; with this model one can deduce from a number of observed variations the physical or biological mechanism (or mechanisms) involved. Isotopic studies of nitrogen may be a useful additional tool for detecting and interpreting certain forms of pollution. (author) [fr

  13. Utility of p16 Immunohistochemistry in Evaluating Negative Cervical Biopsies Following High-risk Pap Test Results.

    Science.gov (United States)

    Shain, Alana F; Kwok, Shirley; Folkins, Ann K; Kong, Christina S

    2018-01-01

    The Lower Anogenital Squamous Terminology (LAST) Standardization Project for human papilloma virus (HPV)-associated lesions specifically recommends the use of p16 immunohistochemistry (IHC) as an adjunct to morphologic assessment of cervical biopsies interpreted as negative or low-grade squamous intraepithelial lesion (LSIL) from patients with prior high-risk Pap test results (high-grade squamous intraepithelial lesion [HSIL], atypical squamous cells cannot exclude HSIL, atypical glandular cells [AGC], or HPV16 atypical squamous cells of undetermined significance [ASC-US]). The impetus for this recommendation is to increase detection of missed high-grade disease. However, the quality of evidence supporting this recommendation was lower than that for the other LAST recommendations addressing improved consistency in the diagnosis of HSIL with the use of p16. A database search spanning 10 years identified 341 cases (encompassing 736 discrete biopsy specimens) interpreted as negative for dysplasia from 330 patients with a prior high-risk Pap result (atypical squamous cells cannot exclude HSIL, HSIL, atypical glandular cells, not otherwise specified [AGC-NOS], atypical endocervical cells--NOS [AEC-NOS], and AEC-favor neoplastic). p16 IHC was performed and detected missed abnormalities in 11/341 (3.2%) cases. The abnormalities corresponded to missed foci of HSIL (cervical intraepithelial neoplasia [CIN] 2) (n=1), SIL-indeterminate grade (n=7), atypical squamous metaplasia (n=2), and LSIL [CIN1]) (n=1). Subsequent histologic follow-up identified HSIL or greater in 6/8 (75%) p16 cases versus 20/79 (25.3%) p16 cases (P=0.0079). p16 IHC performed on biopsies interpreted as negative from patients with prior high-risk Pap test results increased the detection rate of missed SIL. A p16 result also significantly increased the likelihood of HSIL on subsequent biopsy. Although further studies are required to determine what percentage of missed HSIL justifies the additional cost

  14. Preliminary investigation results as applied to utilization of Ukrainian salt formations for disposal of high-level radioactive waste

    International Nuclear Information System (INIS)

    Shekhunova, S.B.; Khrushchov, D.P.; Petrichenko, O.I.

    1994-01-01

    The salt-bearing formations have been investigated in five regions of Ukraine. Upper Devonian and Lower Permian evaporite formations in Dnieper-Donets Depression and in the NW part of Donets basin are considered to be promising for disposal of high-level radioactive waste (HLRW). Rock salt occurs there either as bedded salts or as salt pillows and salt diapirs. Preliminary studies have resulted in selection of several candidate sites that show promise for construction of a subsurface pilot lab. Ten salt domes and two sites in bedded salts have been proposed for further exploration. Based on microstructural studies it is possible to separate the body of a salt structure and to locate within its limits the rock salt structure and to locate within its limits the rock salt blocks of different genesis, i.e.: (a) blocks characteristic of initial undisturbed sedimentary structure; (b) flow zones; (c) sliding planes; (d) bodies of loose or uncompacted rock salt. Ultramicrochemical examination of inclusions in halite have shown that they are composed of more than 40 minerals. It is emphasized that to assess suitability of a structure for construction of subsurface lab, and also the potential construction depth intervals, account should be taken of the results of ultra microchemical and microstructural data

  15. Laser Ablation Increases PEM/Catalyst Interfacial Area

    Science.gov (United States)

    Whitacre, Jay; Yalisove, Steve

    2009-01-01

    An investigational method of improving the performance of a fuel cell that contains a polymer-electrolyte membrane (PEM) is based on the concept of roughening the surface of the PEM, prior to deposition of a thin layer of catalyst, in order to increase the PEM/catalyst interfacial area and thereby increase the degree of utilization of the catalyst. The roughening is done by means of laser ablation under carefully controlled conditions. Next, the roughened membrane surface is coated with the thin layer of catalyst (which is typically platinum), then sandwiched between two electrode/catalyst structures to form a membrane/ele c t - rode assembly. The feasibility of the roughening technique was demonstrated in experiments in which proton-conducting membranes made of a perfluorosulfonic acid-based hydrophilic, protonconducting polymer were ablated by use of femtosecond laser pulses. It was found that when proper combinations of the pulse intensity, pulse-repetition rate, and number of repetitions was chosen, the initially flat, smooth membrane surfaces became roughened to such an extent as to be converted to networks of nodules interconnected by filaments (see Figure 1). In further experiments, electrochemical impedance spectroscopy (EIS) was performed on a pristine (smooth) membrane and on two laser-roughened membranes after the membranes were coated with platinum on both sides. Some preliminary EIS data were interpreted as showing that notwithstanding the potential for laser-induced damage, the bulk conductivities of the membranes were not diminished in the roughening process. Other preliminary EIS data (see Figure 2) were interpreted as signifying that the surface areas of the laser-roughened membranes were significantly greater than those of the smooth membrane. Moreover, elemental analyses showed that the sulfur-containing molecular groups necessary for proton conduction remained intact, even near the laser-roughened surfaces. These preliminary results can be taken

  16. Utilidade do Ultrassom intracardíaco no isolamento de veias pulmonares usando cateter-balão a laser Utilidad del ultrasonido intracardíaco en el aislamiento de venas pulmonares usando catéter-balón láser Utility of intracardiac ultrasound imaging to guide pulmonary vein ablation using laser balloon catheter

    Directory of Open Access Journals (Sweden)

    Luiz Leite

    2009-12-01

    . Se obtuvo el aislamiento completo en 38/59 (64%, y fue significantemente más común sin derrame: [30/38 (79% versus 8/23 (35%, pBACKGROUND: Pulmonary vein isolation (PVI with balloon catheter has been used as the endpoint for AF ablation. OBJECTIVE: To determine the usefulness of intracardiac ultrasound (ICUS to guide PVI using laser balloon catheter. METHODS: 59 PVs were ablated in 27 dogs. Doppler imaging was used to identify blood flow leaks between PV and balloon. After each energy delivery, the circular mapping catheter was repositioned to check if isolation had been achieved. The leak position was then correlated with the gap position at the pathological study. Multivariate logistic regression analysis was undertaken. RESULTS: 59 PV were ablated. Mean burn time was 279±177 sec, mean balloon diameter was 23±3 mm, and mean balloon length was 25±4 mm. Complete isolation was achieved in 38/59 (64% cases, and it was significantly more common when there was no leak: [30/38 (79% versus 8/23 (35%, p<0.001]. This occurred regardless of time of laser application (302±223 sec. vs. 266±148 sec., p=ns, laser power (3.5 W/cm, 4.5 W/cm, and 5.5 W/cm, balloon diameter (24± 3 mm vs. 22± 3 mm, p=ns and length (27±4 mm vs. 24±4mm, p=ns. The positive predictive value for predicting incomplete isolation was 65% and the negative predictive value was 83%. CONCLUSION: An identifiable leak between PV and the LBA device seen at the ICUS is predictive of lower PV isolation rates. ICUS may be useful for leak detection to avoid ineffective energy application during circumferential PV ablation. This could also be helpful when other types of energy are used.

  17. Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease: a randomised controlled phase 2 trial.

    Science.gov (United States)

    Vietti Violi, Naïk; Duran, Rafael; Guiu, Boris; Cercueil, Jean-Pierre; Aubé, Christophe; Digklia, Antonia; Pache, Isabelle; Deltenre, Pierre; Knebel, Jean-François; Denys, Alban

    2018-03-01

    the radiofrequency ablation group. At 2 years, six (6%) of 98 lesions had local tumour progression in the microwave ablation group as did 12 (12%) of 104 in the radiofrequency ablation group (risk ratio 1·62, 95% CI 0·66-3·94; p=0·27). Complications were infrequent, with only two grade 4 complications (two events of arterial bleeding requiring embolisation, both in the microwave ablation group) and three grade 3 complications (pneumothorax; lesion of the umbilical vein; and intrahepatic segmental necrosis, all in the radiofrequency ablation group). No treatment-related deaths were reported. Although we did not find that microwave ablation was more effective than radiofrequency ablation for treatment of hepatocellular carcinoma lesions of 4 cm or smaller, our results show that the proportion of lesions with local tumour progression at 2 years of follow-up was low with both tested percutaneous methods. Microsulis (AngioDynamics). Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. A randomized prospective long-term (>1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980 nm laser ablation of the great saphenous vein.

    Science.gov (United States)

    Sydnor, Malcolm; Mavropoulos, John; Slobodnik, Natalia; Wolfe, Luke; Strife, Brian; Komorowski, Daniel

    2017-07-01

    Purpose To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted at one year and then at yearly intervals for patient satisfaction. Results Post-procedure pain ( p radiofrequency ablation group. Improvements in venous clinical severity score were noted through six months in both groups (endovenous laser ablation 6.6 to 1; radiofrequency ablation 6.2 to 1) with no significant difference in venous clinical severity score ( p = 0.4066) or measured adverse effects; 89 endovenous laser ablation and 87 radiofrequency patients were interviewed at least 12 months out with a mean long-term follow-up of 44 and 42 months ( p = 0.1096), respectively. There were four treatment failures in each group, and every case was correctable with further treatment. Overall, there were no significant differences with regard to patient satisfaction between radiofrequency ablation and endovenous laser ablation ( p = 0.3009). There were no cases of deep venous thrombosis in either group at any time during this study. Conclusions Radiofrequency ablation and endovenous laser ablation are highly effective and safe from both anatomic and clinical standpoints over a multi-year period and neither modality achieved superiority over the other.

  19. The relationship between healthy lifestyle and hospital utilization among adults with diabetes: results from a national cohort in Taiwan.

    Science.gov (United States)

    Li, Chia-Lin; Sheu, Ji-Tian; Wang, Ting-Ann; Wen, Yu-Ping; Chao, Minston; Chang, Hsing-Yi

    2015-04-01

    The aim of this study was to investigate whether adopting healthy lifestyle habits, such as engaging in leisure time physical activity (LTPA), adopting recommended dietary patterns, and not smoking, are associated with reduced hospitalizations over 1 year among adults with diabetes. We analyzed data from a national sample of people aged 18 years and above with self-reported physician-diagnosed diabetes (n = 664) through linkage to the 2001 National Health Interview Survey in Taiwan and the 2002 National Health Insurance claims data. Multivariate analysis showed that participants reporting greater than 150 min/wk of moderate-intensity activity had a significantly lower chance for hospitalization (odds ratio = 0.52; 95% confidence interval [CI] = 0.27-0.98), fewer admissions (incidence rate ratio [IRR] = 0.58; 95% CI = 0.33-1.00), and fewer hospital bed days (IRR = 0.42; 95% CI = 0.20-0.92) compared with inactive individuals. Diet control and smoking status did not significantly predict hospital use after controlling for other factors. Our findings indicate that increased LTPA results in reduced hospitalization among adults with diabetes. © 2014 APJPH.

  20. Ecological and environmental data as under-utilized national resources: results of the TIE/ACCESS program

    Energy Technology Data Exchange (ETDEWEB)

    Armentano, T.V.; Loucks, O.L.

    1979-06-01

    The goal of The Institute of Energy (TIE) 1977 to 1979 ACCESS program was to define the national need for ecological and environmental data and the extent to which present data documentation and archiving are meeting this need. The principal steps focussed on current data documentation and research in government, private and academic sectors of the natural science technical community, particularly as they bear on the accessibility of environmental data to secondary users. The extent to which existing data services are satisfying the needs of data users also was emphasized. The results indicate that the potential contributions which existing data and models could make are not being achieved because of inconsistencies in data documentation, inadequate communication between data suppliers and data users, and a lack of overall coordination of the data bases in national research and monitoring programs. A nationally coordinated network is proposed which focuses on regional data centers and ties together the hierarchy of data bases (national, state, and local) with the broad spectrum of potential users. The network concept includes immediate development of a comprehensive catalog of data resources in each region, with later production of a data abstract journal as one of two methods for communicating between regional and local data centers and the user community.

  1. Caregiving associated with selected cancer risk behaviors and screening utilization among women: cross-sectional results of the 2009 BRFSS

    Directory of Open Access Journals (Sweden)

    Reeves Katherine W

    2012-08-01

    Full Text Available Abstract Background Informal caregiving is increasingly common as the U.S. population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System. Methods Women age ≥41 with data on breast and cervical cancer screening were included (weighted frequency 3,478,000 women. Cancer screening was classified according to American Cancer Society guidelines. We evaluated the association of caregiving with cancer risk behaviors (obesity, physical activity, alcohol intake, smoking status, and fruit/vegetable consumption and cancer screening (mammography, clinical breast exam [CBE], and Pap test using logistic regression overall and with stratification on age ( Results Caregivers had greater odds of being obese, physically active, and current smokers. Subgroup analyses revealed that caregiving was associated with obesity in younger women and whites, and with less obesity in older women. Also, caregiving was associated with smoking only among younger women and non-whites. Caregivers had greater odds of ever having had a mammogram or CBE, yet there was no association with mammogram, CBE, or Pap test within guidelines. Conclusions Caregiving was associated with some health behaviors that increase cancer risk, yet not with cancer screening within guidelines. Effects of caregiving by age and race require confirmation by additional studies.

  2. Pre-Ablation Thyroglobulin Levels and Persistence / Recurrence Associated to Early Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Arturo Mejía López

    2014-01-01

    Full Text Available Introduction: Differentiated thyroid cancer is the most frequent endocrine neoplasm in the world and its incidence is growing rapidly. The relationship between levels of pre-ablation thyroglobulin (Tg and early persistence/recurrence of differentiated thyroid cancer was studied. Materials and Methods: 91 patients with papillary thyroid cancer who underwent post-surgical ablation with radioactive iodine registered in the Fundacion Cardioinfantil between January 2006 and January 2010 were evaluated. The analysis of the results was performed using the SPSS statistical package and the research hypothesis was evaluated using nonparametric methods. Results: The disease progressed in 20 patients during the first year post-ablation, at the end of this period (p=0.000 a significant relationship between pre-ablation Tg and disease status was found. In the group of individuals by whom the disease progressed there was no significant change in Tg between the first and the second semester post-ablation (p = 0.554; there were no cases of recurrence/persistence in those with levels less than or equal to 2.7 ng/mL; 80 % of these cases involved individuals with initial levels higher than 24 ng/mL. Conclusion: In patients with papillary thyroid cáncer the serum pre-ablation Tg is related to the disease status at the end of the first year post-ablation. The persistence/recurrence is less frequent in low levels and more frequent in higher levels.

  3. Prospective assessment of stereotactic ablative surgery for intractable major depression.

    Science.gov (United States)

    Shields, Donald C; Asaad, Wael; Eskandar, Emad N; Jain, Felipe A; Cosgrove, G Rees; Flaherty, Alice W; Cassem, Edwin H; Price, Bruce H; Rauch, Scott L; Dougherty, Darin D

    2008-09-15

    Despite therapeutic advances for major depression, a subset of patients with this disorder does not respond to conventional treatment. Stereotactic ablative procedures such as anterior cingulotomy have been performed in severely affected, treatment-resistant patients, but the long-term results of such procedures are not fully understood. Findings are reported for 33 patients with severe treatment-resistant major depression who underwent ablative stereotactic procedures (dorsal anterior cingulotomy followed if necessary by subcaudate tractotomy). Preoperative and long-term postoperative Beck Depression Inventory scores were obtained along with postoperative Clinical Global Improvement values. Both were analyzed to evaluate patients' responses to the surgical procedure(s). At mean follow-up of 30 months after one or more stereotactic ablative procedures, 11 patients (33.3%) were classified as responders, 14 (42.4%) were partial responders, and 8 (24.2%) did not respond to the surgical procedure(s). Among those (17) who underwent only one procedure, seven (41.2%) responded, whereas six (35.3%) and four (23.5%) showed partial or no response, respectively. Among patients who required multiple surgical procedures, four patients (25%) responded, whereas eight (50%) and four (25%) patients demonstrated partial or no responses, respectively, at long-term follow-up evaluations. Approximately 75% of depression patients previously resistant to antidepressant therapies received partial or substantial benefit from stereotactic ablative procedures. Those requiring only a single anterior cingulotomy tended to demonstrate more pronounced responses than patients who underwent multiple surgical procedures.

  4. Dynamics of tissue shrinkage during ablative temperature exposures

    International Nuclear Information System (INIS)

    Rossmann, Christian; Haemmerich, Dieter; Garrett-Mayer, Elizabeth; Rattay, Frank

    2014-01-01

    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)

  5. Ultrasound-guided radiofrequency ablation of thyroid gland: a preliminary study in dogs

    International Nuclear Information System (INIS)

    Choi, Ji Won; Yoo, Seung Min; Kwak, Seo Hyun

    2005-01-01

    The purpose of this study was to evaluate the possibility of using radiofrequency ablation as the treatment modality for the benign or malignant thyroid nodules in humans. Therefore, we examined the results of using radiofrequency ablation on the thyroid glands in dogs, in respect of the extent of the ablated tissue and the complications. Five dogs (10 lobes of the thyroid glands) were included in this study. US-guided radiofrequency ablation was undertaken with a 10 mm, uncovered 17 gauge cool-tip needle. The power and duration was 20 wattage and 1 minute in five thyroid lobes (group 1) and 20 wattage and 2 minutes in another 5 thyroid lobes (group 2). The ultrasound scans and the pre-and post-enhancement CT scans were undertaken before and immediately after the procedures, and at 24 hours, 72 hours and 1 week later. The US and CT findings of the ablated tissue and complications were evaluated. Blood sampling was done at the pre-procedure time and 1 week later for evaluating the functional status of the thyroid gland. Laryngoscopy was done at the pre-procedure and post-procedure times, and at 24 hours, 72 hours and 1 week later for the evaluation of any recurrent laryngeal nerve palsy. The echo pattern of the ablated thyroid gland at immediately after the radiofrequency ablation appeared as poorly marginated and hyperechoic. On the US obtained 24 hours after radiofrequency ablation, the echo pattern of the ablated thyroid gland was hypoechoic. The maximum diameters after RFA were 9.4 ρ 0.5 mm in group I and 11.4 ρ 0.5 mm in group II. The pre-enhanced CT scan taken at immediately after the radiofrequency ablation showed ill defined hypodense areas in the ablated thyroid gland. Differentiation between the normal and abnormal portions of the thyroid gland was difficult on the contrast enhanced CT scan. Complications induced by radiofrequency ablation were one recurrent laryngeal nerve palsy, two perforations of esophagus and five thickenings of the esophageal wall

  6. Characterization of extreme ultraviolet laser ablation mass spectrometry for actinide trace analysis and nanoscale isotopic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Green, Tyler; Kuznetsov, Ilya; Willingham, David; Naes, Benjamin E.; Eiden, Gregory C.; Zhu, Zihua; Chao, W.; Rocca, Jorge J.; Menoni, Carmen S.; Duffin, Andrew M.

    2017-01-01

    The purpose of this research was to characterize Extreme Ultraviolet Time-of-Flight (EUV TOF) Laser Ablation Mass Spectrometry for high spatial resolution elemental and isotopic analysis. We compare EUV TOF results with Secondary Ionization Mass Spectrometry (SIMS) to orient the EUV TOF method within the overall field of analytical mass spectrometry. Using the well-characterized NIST 61x glasses, we show that the EUV ionization approach produces relatively few molecular ion interferences in comparison to TOF SIMS. We demonstrate that the ratio of element ion to element oxide ion is adjustable with EUV laser pulse energy and that the EUV TOF instrument has a sample utilization efficiency of 0.014%. The EUV TOF system also achieves a lateral resolution of 80 nm and we demonstrate this lateral resolution with isotopic imaging of closely spaced particles or uranium isotopic standard materials.

  7. Hyperkalaemia after radiofrequency ablation of hepatocellular carcinoma

    NARCIS (Netherlands)

    Verhoevena, BH; Haagsma, EB; Appeltans, BMG; Slooff, MJH; de Jong, KP

    Radiofrequency ablation of liver tumours is a useful therapy for otherwise unresectable tumours. The complication rate is said to be low. In this case report we describe hyperkalaemia after radiofrequency ablation of a hepatocellular carcinoma in a patient with end-stage renal insufficiency. (C)

  8. Ablation Techniques for Mahaim Fiber Tachycardia

    Directory of Open Access Journals (Sweden)

    Shomu Bohora

    2009-03-01

    Full Text Available Mahaim fiber exhibits atrio-ventricular node like properties and generally is localized at the lateral aspect of the tricuspid annulus. Of the varying methods for localization, ablation at the site of Mahaim potential is the most accepted and successful method. Radiofrequency ablation of Mahaim fiber has high success rates.

  9. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    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...

  10. The Atrial Fibrillation Ablation Pilot Study

    DEFF Research Database (Denmark)

    Arbelo, Elena; Brugada, Josep; Hindricks, Gerhard

    2014-01-01

    AIMS: The Atrial Fibrillation Ablation Pilot Study is a prospective registry designed to describe the clinical epidemiology of patients undergoing an atrial fibrillation (AFib) ablation, and the diagnostic/therapeutic processes applied across Europe. The aims of the 1-year follow-up were to analy...

  11. Testing and evaluation of light ablation decontamination

    International Nuclear Information System (INIS)

    Demmer, R.L.; Ferguson, R.L.

    1994-10-01

    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. Testing and evaluation of light ablation decontamination

    Energy Technology Data Exchange (ETDEWEB)

    Demmer, R.L.; Ferguson, R.L.

    1994-10-01

    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.

  13. High Heat Flux Block Ablator-in-Honeycomb Heat Shield Using Ablator/Aerogel-Filled Foam, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Ultramet and ARA Ablatives Laboratory previously developed and demonstrated advanced foam-reinforced carbon/phenolic ablators that offer substantially increased high...

  14. [Endometrial ablation with thermal balloon, experience in a private hospital].

    Science.gov (United States)

    Quesnel-García-Benítez, C; Sánchez-Aranda, A; López-Rioja, M J

    2016-04-01

    Traditionally, the treatment for menorrhagia includes pharmacological therapies (hormones and uterotonics) or surgical (dilatation/curettage and hysterectomy). Recently the FDA approved a non-invasive therapeutic option, known as endometrial ablation. Which it consists in a thermal balloon delivers (ThermaChoice y Thermablate EAS) which energy destroys the uterine lining, thus reducing the bleeding and even producing amenorrhea. And could offer other benefits such as reduction of the surgical time, and therefore: anesthesia time, postoperative complications and costs. Highlighting a greater patient satisfaction. Describe the demographic characteristics, outcomes and patient satisfaction, which were treated with endometrial ablation for menorrhagia. A descriptive, observational and retrospective study. During a period of 11 years (March 2012 to December 2013), in a private hospital, that includes 124 patients with menorrhagia, which were treated with endometrial ablation: 53 (43%) ThermaChoice y 71 (57%) Thermablate EAS. We used T Student and Fisher method to study the results. The 124 patients (100%) achieve all the criteria's of endometrial ablation according ACOG (American College of Obstetricians and Gynecologists) were candidates for. The mean age of our patients were 38 years old, who didn't respond to pharmacologic treatment had a definitive contraception. Among these women, 119 (96%) had a reduction in bleeding en the first 12 months, 25 (31%) presented with amenorrhea and 1 (<1%) required a surgical approach. Overall, 119 patients (96%) were satisfied with their results. Endometrial ablation is an approved FDA treatment for menorrhagia, which is safe, accessible and effective. With an easy implementation and low rate of complications.

  15. Pilot Study to Assess Safety and Clinical Outcomes of Irreversible Electroporation for Partial Gland Ablation in Men with Prostate Cancer

    Science.gov (United States)

    Murray, Katie S.; Ehdaie, Behfar; Musser, John; Mashni, Joseph; Srimathveeravalli, Govindarajan; Durack, Jeremy C.; Solomon, Stephen B.; Coleman, Jonathan A.

    2016-01-01

    Purpose Partial prostate gland ablation is a strategy to manage localized prostate cancer. Irreversible electroporation can ablate localized soft tissues. We sought to describe 30- and 90-day complications and intermediate-term functional outcomes in men undergoing prostate gland ablation using irreversible electroporation. Materials and Methods We reviewed the charts of 25 patients with prostate cancer who underwent prostate gland ablation using irreversible electroporation as a primary procedure and who were followed for at least 6 months. Results Median follow-up was 10.9 months. Grade 3 complications occurred in 2 patients including epididymitis (1) and urinary tract infection (1). Fourteen patients experienced grade ≤ 2 complications, mainly transient urinary symptoms, hematuria, and urinary tract infections. Of 25 patients, 4 (16%) had cancer in the zone of ablation on routine follow-up biopsy at 6 months. Of those with normal urinary function at baseline, 88% and 94% reported normal urinary function at 6 and 12 months after prostate gland ablation, respectively. By 12 months, only 1 patient with normal erectile function at baseline reported new difficulty with potency and only 2 patients (8%) required a pad for urinary incontinence. Conclusions Prostate gland ablation with irreversible electroporation is feasible and safe in selected men with localized prostate cancer. Intermediate-term urinary and erectile function outcomes appear reasonable. Irreversible electroporation is effective in ablation of tumor-bearing prostate tissue, as a majority of men had no evidence of residual cancer on biopsy 6 months after prostate gland ablation. PMID:27113966

  16. Advances in laser ablation of materials

    International Nuclear Information System (INIS)

    Singh, R.K.; Lowndes, D.H.; Chrisey, D.B.; Fogarassy, E.; Narayan, J.

    1998-01-01

    The symposium, Advances in Laser Ablation of Materials, was held at the 1998 MRS Spring Meeting in San Francisco, California. The papers in this symposium illustrate the advances in pulsed laser ablation for a wide variety of applications involving semiconductors, superconductors, metals, ceramics, and polymers. In particular, advances in the deposition of oxides and related materials are featured. Papers dealing with both fundamentals and the applications of laser ablation are presented. Topical areas include: fundamentals of ablation and growth; in situ diagnostics and nanoscale synthesis advances in laser ablation techniques; laser surface processing; pulsed laser deposition of ferroelectric, magnetic, superconducting and optoelectronic thin films; and pulsed laser deposition of carbon-based and polymeric materials. Sixty papers have been processed separately for inclusion on the data base

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... 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...

  18. Effort on calibration of infrared spark ablation of copper with synthetic copper standards

    Energy Technology Data Exchange (ETDEWEB)

    Wienold, Julia, E-mail: julia.wienold@bam.de; Traub, Heike; Bresch, Harald; Seeger, Stefan; Recknagel, Sebastian; Kipphardt, Heinrich

    2011-06-15

    Two types of copper samples, compact certified copper reference materials and calibration samples prepared from liquid doped, pressed copper powders, were studied in terms of accuracy of obtained calibration functions originating from infrared spark ablation. Additionally, corresponding particle size distributions of the aerosols from infrared spark ablation were recorded. It is shown that the differences in quantification results, originating from the two sets of calibration functions, could not mainly be ascribed to different particle size distributions of the two copper sample types. Possible other causes, as different ablation rates, parts of melting and differences of the chemical constitutions of the two sample types were explored.

  19. Possible electronic entropy-driven mechanism for non-thermal ablation of metals

    Science.gov (United States)

    Tanaka, Yuta; Tsuneyuki, Shinji

    2018-04-01

    The physical mechanism of metal ablation induced by femtosecond laser irradiation was investigated in this study. Calculations based on finite-temperature density functional theory indicate that condensed copper becomes unstable at high electron temperatures due to an electronic entropy effect. Based on these results, an electronic entropy-driven mechanism is proposed to explain the metal ablation. Furthermore, a mathematical model is developed to simulate the ablation depth, where the effect of the electronic entropy is included. This mathematical model can quantitatively describe the experimental data in the low-laser-fluence region, where the electronic entropy effect is determined to be especially important.

  20. Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

    Energy Technology Data Exchange (ETDEWEB)

    Wimmer, Thomas, E-mail: thomas.wimmer@medunigraz.at; Srimathveeravalli, Govindarajan; Gutta, Narendra [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Ezell, Paula C. [The Rockefeller University, Research Animal Resource Center, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College (United States); Monette, Sebastien [The Rockefeller University, Laboratory of Comparative Pathology, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College (United States); Maybody, Majid; Erinjery, Joseph P.; Durack, Jeremy C. [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Coleman, Jonathan A. [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

    2015-02-15

    PurposeNumerical simulations are used for treatment planning in clinical applications of irreversible electroporation (IRE) to determine ablation size and shape. To assess the reliability of simulations for treatment planning, we compared simulation results with empiric outcomes of renal IRE using computed tomography (CT) and histology in an animal model.MethodsThe ablation size and shape for six different IRE parameter sets (70–90 pulses, 2,000–2,700 V, 70–100 µs) for monopolar and bipolar electrodes was simulated using a numerical model. Employing these treatment parameters, 35 CT-guided IRE ablations were created in both kidneys of six pigs and followed up with CT immediately and after 24 h. Histopathology was analyzed from postablation day 1.ResultsAblation zones on CT measured 81 ± 18 % (day 0, p ≤ 0.05) and 115 ± 18 % (day 1, p ≤ 0.09) of the simulated size for monopolar electrodes, and 190 ± 33 % (day 0, p ≤ 0.001) and 234 ± 12 % (day 1, p ≤ 0.0001) for bipolar electrodes. Histopathology indicated smaller ablation zones than simulated (71 ± 41 %, p ≤ 0.047) and measured on CT (47 ± 16 %, p ≤ 0.005) with complete ablation of kidney parenchyma within the central zone and incomplete ablation in the periphery.ConclusionBoth numerical simulations for planning renal IRE and CT measurements may overestimate the size of ablation compared to histology, and ablation effects may be incomplete in the periphery.

  1. Pellet-plasma interaction: Local disturbances caused by pellet ablation in tokamaks

    International Nuclear Information System (INIS)

    Lengyel, L.L.

    1989-01-01

    The local disturbance amplitudes caused by ablating pellets in tokamaks are computed in the framework of a magnetohydrodynamic model supplemented by the neutral gas plasma shielding ablation model. The model computes, for a given number of pellet particles locally deposited, the time histories of the ablatant cloud parameters, such as cloud radius, cloud length, electron density, temperature and cloud beta, at a succession of magnetic flux surfaces. The cloud radius thus determined may be fed back into the ablation model, thus adjusting the effect of the shielding cloud on the ablation rate. The model is applied to typical plasma parameter ranges of existing and planned tokamaks. The results show that the ablating pellets may cause massive local disturbances in tokamaks, depending upon the number of particles locally deposited. The peaks of these disturbances are of a spike nature, lasting only a few microseconds (Alfven time-scale). The characteristic decay time of the 'quasi-steady' disturbance values that characterize the after-spike period is of the order of several milliseconds (hydrodynamic time-scale). The peak electron density values may be as high as 10 23 to 10 25 m -3 , with the associated beta peaks exceeding unity. The 'quasi-steady' values of the electron density and the ablatant beta may be of the order of 10 22 to 10 24 m -3 and unity, respectively. Furthermore, the results show the strong dependence of the ablation rate on the dynamic characteristics of the ablatant cloud surrounding the pellet. (author). 25 refs, 6 figs, 2 tabs

  2. Planning Irreversible Electroporation in the Porcine Kidney: Are Numerical Simulations Reliable for Predicting Empiric Ablation Outcomes?

    International Nuclear Information System (INIS)

    Wimmer, Thomas; Srimathveeravalli, Govindarajan; Gutta, Narendra; Ezell, Paula C.; Monette, Sebastien; Maybody, Majid; Erinjery, Joseph P.; Durack, Jeremy C.; Coleman, Jonathan A.; Solomon, Stephen B.

    2015-01-01

    PurposeNumerical simulations are used for treatment planning in clinical applications of irreversible electroporation (IRE) to determine ablation size and shape. To assess the reliability of simulations for treatment planning, we compared simulation results with empiric outcomes of renal IRE using computed tomography (CT) and histology in an animal model.MethodsThe ablation size and shape for six different IRE parameter sets (70–90 pulses, 2,000–2,700 V, 70–100 µs) for monopolar and bipolar electrodes was simulated using a numerical model. Employing these treatment parameters, 35 CT-guided IRE ablations were created in both kidneys of six pigs and followed up with CT immediately and after 24 h. Histopathology was analyzed from postablation day 1.ResultsAblation zones on CT measured 81 ± 18 % (day 0, p ≤ 0.05) and 115 ± 18 % (day 1, p ≤ 0.09) of the simulated size for monopolar electrodes, and 190 ± 33 % (day 0, p ≤ 0.001) and 234 ± 12 % (day 1, p ≤ 0.0001) for bipolar electrodes. Histopathology indicated smaller ablation zones than simulated (71 ± 41 %, p ≤ 0.047) and measured on CT (47 ± 16 %, p ≤ 0.005) with complete ablation of kidney parenchyma within the central zone and incomplete ablation in the periphery.ConclusionBoth numerical simulations for planning renal IRE and CT measurements may overestimate the size of ablation compared to histology, and ablation effects may be incomplete in the periphery

  3. Non-Invasive Targeted Peripheral Nerve Ablation Using 3D MR Neurography and MRI-Guided High-Intensity Focused Ultrasound (MR-HIFU): Pilot Study in a Swine Model.

    Science.gov (United States)

    Huisman, Merel; Staruch, Robert M; Ladouceur-Wodzak, Michelle; van den Bosch, Maurice A; Burns, Dennis K; Chhabra, Avneesh; Chopra, Rajiv

    2015-01-01

    Ultrasound (US)-guided high intensity focused ultrasound (HIFU) has been proposed for noninvasive treatment of neuropathic pain and has been investigated in in-vivo studies. However, ultrasound has important limitations regarding treatment guidance and temperature monitoring. Magnetic resonance (MR)-imaging guidance may overcome these limitations and MR-guided HIFU (MR-HIFU) has been used successfully for other clinical indications. The primary purpose of this study was to evaluate the feasibility of utilizing 3D MR neurography to identify and guide ablation of peripheral nerves using a clinical MR-HIFU system. Volumetric MR-HIFU was used to induce lesions in the peripheral nerves of the lower limbs in three pigs. Diffusion-prep MR neurography and T1-weighted images were utilized to identify the target, plan treatment and immediate post-treatment evaluation. For each treatment, one 8 or 12 mm diameter treatment cell was used (sonication duration 20 s and 36 s, power 160-300 W). Peripheral nerves were extracted < 3 hours after treatment. Ablation dimensions were calculated from thermal maps, post-contrast MRI and macroscopy. Histological analysis included standard H&E staining, Masson's trichrome and toluidine blue staining. All targeted peripheral nerves were identifiable on MR neurography and T1-weighted images and could be accurately ablated with a single exposure of focused ultrasound, with peak temperatures of 60.3 to 85.7°C. The lesion dimensions as measured on MR neurography were similar to the lesion dimensions as measured on CE-T1, thermal dose maps, and macroscopy. Histology indicated major hyperacute peripheral nerve damage, mostly confined to the location targeted for ablation. Our preliminary results indicate that targeted peripheral nerve ablation is feasible with MR-HIFU. Diffusion-prep 3D MR neurography has potential for guiding therapy procedures where either nerve targeting or avoidance is desired, and may also have potential for post

  4. Real time determination of the laser ablated mass by means of electric field-perturbation measurement

    Science.gov (United States)

    Pacheco, P.; Álvarez, J.; Sarmiento, R.; Bredice, F.; Sánchez-Aké, C.; Villagrán-Muniz, M.; Palleschi, V.

    2018-04-01

    A Nd:YAG ns-pulsed laser was used to ablate Al, Cd and Zn targets, which were placed between the plates of a planar charged capacitor. The plasma generates a transient redistribution of the electrical charges on the plates that can be measured as a voltage drop across a resistor connected to the ground plate. This signal is proportional to the capacitor applied voltage, the distance between the plates and the total number of ions produced in the ablation process which in turn is related to the laser energy and the ablated mass. After a series of pulses, the targets were weighed on a thermogravimetric balance to measure the ablated mass. Our results show that the electrical signal measured on the resistor is univocally related to the ablated mass from the target. Therefore, after a proper calibration depending on the material and the experimental geometry, the electrical signal can be used for real time quantitative measurement of the ablated mass in pulsed laser generated plasma experiments. The experiments were repeated on an aluminum target, with and without the presence of the external electric field in order to determine the possible influence of the applied electric field on the ablated mass.

  5. Data Fitting to Study Ablated Hard Dental Tissues by Nanosecond Laser Irradiation.

    Directory of Open Access Journals (Sweden)

    Y Al-Hadeethi

    Full Text Available Laser ablation of dental hard tissues is one of the most important laser applications in dentistry. Many works have reported the interaction of laser radiations with tooth material to optimize laser parameters such as wavelength, energy density, etc. This work has focused on determining the relationship between energy density and ablation thresholds using pulsed, 5 nanosecond, neodymium-doped yttrium aluminum garnet; Nd:Y3Al5O12 (Nd:YAG laser at 1064 nanometer. For enamel and dentin tissues, the ablations have been performed using laser-induced breakdown spectroscopy (LIBS technique. The ablation thresholds and relationship between energy densities and peak areas of calcium lines, which appeared in LIBS, were determined using data fitting. Furthermore, the morphological changes were studied using Scanning Electron Microscope (SEM. Moreover, the chemical stability of the tooth material after ablation has been studied using Energy-Dispersive X-Ray Spectroscopy (EDX. The differences between carbon atomic % of non-irradiated and irradiated samples were tested using statistical t-test. Results revealed that the best fitting between energy densities and peak areas of calcium lines were exponential and linear for enamel and dentin, respectively. In addition, the ablation threshold of Nd:YAG lasers in enamel was higher than that of dentin. The morphology of the surrounded ablated region of enamel showed thermal damages. For enamel, the EDX quantitative analysis showed that the atomic % of carbon increased significantly when laser energy density increased.

  6. Adrenergic innervation of the developing chick heart: neural crest ablations to produce sympathetically aneural hearts

    International Nuclear Information System (INIS)

    Kirby, M.; Stewart, D.

    1984-01-01

    Ablation of various regions of premigratory trunk neural crest which gives rise to the sympathetic trunks was used to remove sympathetic cardiac innervation. Neuronal uptake of [ 3 H]-norepinephrine was used as an index of neuronal development in the chick atrium. Following ablation of neural crest over somites 10-15 or 15-20, uptake was significantly decreased in the atrium at 16 and 17 days of development. Ablation of neural crest over somites 5-10 and 20-25 caused no decrease in [ 3 H]-norepinephrine uptake. Removal of neural crest over somites 5-25 or 10-20 caused approximately equal depletions of [ 3 H]-norepinephrine uptake in the atrium. Cardiac norepinephrine concentration was significantly depressed following ablation of neural crest over somites 5-25 but not over somites 10-20. Light-microscopic and histofluorescent preparations confirmed the absence of sympathetic trunks in the region of the normal origin of the sympathetic cardiac nerves following neural crest ablation over somites 10-20. The neural tube and dorsal root ganglia were damaged in the area of the neural-crest ablation; however, all of these structures were normal cranial and caudal to the lesioned area. Development of most of the embryos as well as the morphology of all of the hearts was normal following the lesion. These results indicate that it is possible to produce sympathetically aneural hearts by neural-crest ablation; however, sympathetic cardiac nerves account for an insignificant amount of cardiac norepinephrine

  7. Data Fitting to Study Ablated Hard Dental Tissues by Nanosecond Laser Irradiation.

    Science.gov (United States)

    Al-Hadeethi, Y; Al-Jedani, S; Razvi, M A N; Saeed, A; Abdel-Daiem, A M; Ansari, M Shahnawaze; Babkair, Saeed S; Salah, Numan A; Al-Mujtaba, A

    2016-01-01

    Laser ablation of dental hard tissues is one of the most important laser applications in dentistry. Many works have reported the interaction of laser radiations with tooth material to optimize laser parameters such as wavelength, energy density, etc. This work has focused on determining the relationship between energy density and ablation thresholds using pulsed, 5 nanosecond, neodymium-doped yttrium aluminum garnet; Nd:Y3Al5O12 (Nd:YAG) laser at 1064 nanometer. For enamel and dentin tissues, the ablations have been performed using laser-induced breakdown spectroscopy (LIBS) technique. The ablation thresholds and relationship between energy densities and peak areas of calcium lines, which appeared in LIBS, were determined using data fitting. Furthermore, the morphological changes were studied using Scanning Electron Microscope (SEM). Moreover, the chemical stability of the tooth material after ablation has been studied using Energy-Dispersive X-Ray Spectroscopy (EDX). The differences between carbon atomic % of non-irradiated and irradiated samples were tested using statistical t-test. Results revealed that the best fitting between energy densities and peak areas of calcium lines were exponential and linear for enamel and dentin, respectively. In addition, the ablation threshold of Nd:YAG lasers in enamel was higher than that of dentin. The morphology of the surrounded ablated region of enamel showed thermal damages. For enamel, the EDX quantitative analysis showed that the atomic % of carbon increased significantly when laser energy density increased.

  8. Catheter ablation of epicardial ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Takumi Yamada, MD, PhD

    2014-08-01

    Full Text Available Ventricular tachycardias (VTs can usually be treated by endocardial catheter ablation. However, some VTs can arise from the epicardial surface, and their substrate can be altered only by epicardial catheter ablation. There are two approaches to epicardial catheter ablation: transvenous and transthoracic. The transvenous approach through the coronary venous system (CVS has been commonly used because it is easily accessible. However, this approach may be limited by the distribution of the CVS and insufficient radiofrequency energy delivery. Transthoracic epicardial catheter ablation has been developed to overcome these limitations of the transvenous approach. It is a useful supplemental or even preferred strategy to eliminate epicardial VTs in the electrophysiology laboratory. This technique has been applied for scar-related VTs secondary to often non-ischemic cardiomyopathy and sometimes ischemic cardiomyopathy, and idiopathic VTs as the epicardial substrates of these VTs have become increasingly recognized. When endocardial ablation and epicardial ablation through the CVS are unsuccessful, transthoracic epicardial ablation should be the next option. Intrapericardial access is usually obtained through a subxiphoidal pericardial puncture. This approach might not be possible in patients with pericardial adhesions caused by prior cardiac surgery or pericarditis. In such cases, a hybrid procedure involving surgical access with a subxiphoid pericardial window and a limited anterior or lateral thoracotomy might be a feasible and safe method of performing an epicardial catheter ablation in the electrophysiology laboratory. Potential complications associated with this technique include bleeding and collateral damage to the coronary arteries and phrenic nerve. Although the risk of these complications is low, electrophysiologists who attempt epicardial catheter ablation should know the complications associated with this technique, how to minimize their

  9. A New Radiofrequency Ablation Procedure to Treat Sacroiliac Joint Pain.

    Science.gov (United States)

    Cheng, Jianguo; Chen, See Loong; Zimmerman, Nicole; Dalton, Jarrod E; LaSalle, Garret; Rosenquist, Richard

    2016-01-01

    Low back pain may arise from disorders of the sacroiliac joint in up to 30% of patients. Radiofrequency ablation (RFA) of the nerves innervating the sacroiliac joint has been shown to be a safe and efficacious strategy. We aimed to develop a new RFA technique to relieve low back pain secondary to sacroiliac joint disorders. Methodology development with validation through prospective observational non-randomized trial (PONRT). Academic multidisciplinary health care system, Ohio, USA. We devised a guide-block to facilitate accurate placement of multiple electrodes to simultaneously ablate the L5 dorsal ramus and lateral branches of the S1, S2, and S3 dorsal rami. This was achieved by bipolar radiofrequency ablation (b-RFA) to create a strip lesion from the lateral border of the base of the sacral superior articular process (L5-S1 facet joint) to the lateral border of the S3 sacral foramen. We applied this technique in 31 consecutive patients and compared the operating time, x-ray exposure time and dose, and clinical outcomes with patients (n = 62) who have been treated with the cooled radiofrequency technique. Patients' level of pain relief was reported as 80% pain relief at one, 3, 6, and 12 months after the procedure. The relationship between RFA technique and duration of pain relief was evaluated using interval-censored multivariable Cox regression. The new technique allowed reduction of operating time by more than 50%, x-ray exposure time and dose by more than 80%, and cost by more than $1,000 per case. The percent of patients who achieved > 50% pain reduction was significantly higher in the b-RFA group at 3, 6, and 12 months follow-up, compared to the cooled radiofrequency group. No complications were observed in either group. Although the major confounding factors were taken into account in the analysis, use of historical controls does not balance observed and unobserved potential confounding variables between groups so that the reported results are potentially

  10. LAPAROSCOPIC NEPHRECTOMY USING RADIOFREQUENCY THERMAL ABLATION

    Directory of Open Access Journals (Sweden)

    B. Ya. Alekseev

    2012-01-01

    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.

  11. Emerging indications of endoscopic radiofrequency ablation

    Science.gov (United States)

    Becq, Aymeric; Camus, Marine; Rahmi, Gabriel; de Parades, Vincent; Marteau, Philippe

    2015-01-01

    Introduction Radiofrequency ablation (RFA) is a well-validated treatment of dysplastic Barrett's esophagus. Other indications of endoscopic RFA are under evaluation. Results Four prospective studies (total 69 patients) have shown that RFA achieved complete remission of early esophageal squamous intra-epithelial neoplasia at a rate of 80%, but with a substantial risk of stricture. In the setting of gastric antral vascular ectasia, two prospective monocenter studies, and a retrospective multicenter study, (total 51 patients), suggest that RFA is efficacious in terms of reducing transfusion dependency. In the setting of chronic hemorrhagic radiation proctopathy, a prospective monocenter study and a retrospective multicenter study (total 56 patients) suggest that RFA is an efficient treatment. A retrospective comparative study (64 patients) suggests that RFA improves stents patency in malignant biliary strictures. Conclusions Endoscopic RFA is an upcoming treatment modality in early esophageal squamous intra-epithelial neoplasia, as well as in gastric, rectal, and biliary diseases. PMID:26279839

  12. Renaissance of laser interstitial thermal ablation.

    Science.gov (United States)

    Missios, Symeon; Bekelis, Kimon; Barnett, Gene H

    2015-03-01

    Laser interstitial thermal therapy (LITT) is a minimally invasive technique for treating intracranial tumors, originally introduced in 1983. Its use in neurosurgical procedures was historically limited by early technical difficulties related to the monitoring and control of the extent of thermal damage. The development of magnetic resonance thermography and its application to LITT have allowed for real-time thermal imaging and feedback control during laser energy delivery, allowing for precise and accurate provision of tissue hyperthermia. Improvements in laser probe design, surgical stereotactic targeting hardware, and computer monitoring software have accelerated acceptance and clinical utilization of LITT as a neurosurgical treatment alternative. Current commercially available LITT systems have been used for the treatment of neurosurgical soft-tissue lesions, including difficult to access brain tumors, malignant gliomas, and radiosurgery-resistant metastases, as well as for the ablation of such lesions as epileptogenic foci and radiation necrosis. In this review, the authors aim to critically analyze the literature to describe the advent of LITT as a neurosurgical, laser excision tool, including its development, use, indications, and efficacy as it relates to neurosurgical applications.

  13. Pain perception description after advanced surface ablation

    Directory of Open Access Journals (Sweden)

    Sobas EM

    2017-04-01

    Full Text Available Eva M Sobas,1,2 Sebastián Videla,3,4 Amanda Vázquez,1 Itziar Fernández,1,5 Miguel J Maldonado,1 José-Carlos Pastor1,6,7 1Instituto Universitario de Oftalmobiología Aplicada (IOBA, Universidad de Valladolid, Valladolid, Spain; 2Facultad de Enfermería, Universidad de Valladolid, Valladolid Spain; 3Laboratorios Dr. Esteve S.A., Barcelona, Spain; 4Department of Experimental and Health Sciences, Facultad de Ciencias de la Salud y de la Vida, Universidad Pompeu Fabra, Barcelona, Spain; 5Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN, Valladolid, Spain; 6Department of Ophthalmology, Hospital Clínico Universitario, Valladolid, Spain; 7Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain Purpose: The objective of this study was to characterize the evolution of ocular pain after advanced surface ablation (ASA to improve strategies in postoperative pain management.Methods: This was a multicenter, prospective, descriptive, cohort study. The inclusion criteria were healthy individuals ≥18 years old receiving bilateral alcohol-assisted surface ablation with epithelial removal. Pain intensity was evaluated with the visual analog scale (VAS and the numeric pain rating scale before and after surgery. Comorbidities (photophobia, burning, tearing, and foreign body sensation and Hospital Anxiety and Depression (HAD questionnaire were evaluated before and at 6 hours after surgery. Postoperative treatments included cold patch, topical cold antibiotics, topical steroids, and benzodiazepines.Results: Thirty-two consecutive patients having similar profiles of postoperative pain evolution were included. At 0.5 hour after ASA, the pain score by VAS was 37±20 mm, and the maximum pain, 61±31 mm, occurred at 24 hours. Afterward, it decreased progressively until 72 hours after surgery (19±20 mm. Most patients (81% scored >60 mm, and

  14. Comparison of the Effectiveness of Ablative and Non-Ablative Fractional Laser Treatments for Early Stage Thyroidectomy Scars

    Directory of Open Access Journals (Sweden)

    Jin-Uk Jang

    2016-11-01

    Full Text Available BackgroundOpen thyroidectomy is conventionally performed at the anterior side of neck, which is a body part with a comparatively great degree of open exposure; due to this, postoperative scarring may cause distress in patients. We aimed to compare the effects of ablative and nonablative fractional laser treatments on thyroidectomy scars. We examined medical records in a retrospective manner and analyzed scars based on their digital images by using the modified Manchester Scar Scale (mMSS.MethodsBetween February 2012 and May 2013, 55 patients with thyroidectomy scars were treated with ablative (34 patients or nonablative (21 patients fractional laser. Each patient underwent 4 laser treatment sessions in 3–4 week intervals, 1–2 months postoperatively. Scar improvement was assessed using patient images and the mMSS scale.ResultsThe mean decrease in scar score was 3.91 and 3.47 in the ablative and nonablative groups, respectively; the reduction between 2 groups did not exhibit any significant difference (P=0.16. We used the scale once again to individually evaluate scar attributes. The nonablative group accounted for a considerably higher color score value (P=0.03; the ablative group accounted for a considerably higher contour score value (P<0.01. Patient satisfaction was high and no complications occurred.ConclusionsBoth types of fractional laser treatments can be used successfully for thyroidectomy scar treatment with minimal complications; however, results indicate that higher effectiveness may be obtained from the use of ablative and nonablative lasers for hypertrophic scars and early erythematous scars, respectively. Therefore, the appropriate laser for scar treatment should be selected according to its specific characteristics.

  15. Microscopic and macroscopic modeling of femtosecond laser ablation of metals

    Energy Technology Data Exchange (ETDEWEB)

    Povarnitsyn, Mikhail E., E-mail: povar@ihed.ras.ru; Fokin, Vladimir B.; Levashov, Pavel R.

    2015-12-01

    Highlights: • We model laser ablation of aluminum using microscopic and macroscopic approaches. • We examine the domain of applicability for hydrodynamics and molecular dynamics. • Molecular dynamics describes ultra-fast processes of melting and fragmentation. • Hydrodynamics with a model of nucleation agrees well with molecular dynamics. • Both computational methods give similar ablation crater depths. - Abstract: Simulation of femtosecond laser ablation of a bulk aluminum target is performed using two complementary approaches. The first method is single-fluid two-temperature hydrodynamics (HD) completed with a two-temperature equation of state (EOS). The second approach is a combination of classical molecular dynamics (MD) and a continuum model of a free electron subsystem. In both methods, an identical and accurate description of optical and transport properties of the electron subsystem is based on wide-range models reproducing effects of electron heat wave propagation, electron–phonon/ion coupling and laser energy absorption on a time-dependent profile of the dielectric function. For simulation of homogeneous nucleation in a metastable liquid phase, a kinetic model of nucleation is implemented in the HD approach. The phase diagrams of the EOS and MD potential are in good agreement that gives opportunity to compare the dynamics of laser ablation obtained by both methods directly. Results of simulation are presented in the range of incident fluences 0.1–20 J/cm{sup 2} and match well with experimental findings for an ablation crater depth. The MD accurately reproduces nonequilibrium phase transitions and takes into account surface effects on nanoscale. The HD approach demonstrates good qualitative agreement with the MD method in the dynamics of phase explosion and spallation. Other advantages and disadvantages of both approaches are examined and discussed.

  16. UV solid state laser ablation of intraocular lenses

    Science.gov (United States)

    Apostolopoulos, A.; Lagiou, D. P.; Evangelatos, Ch.; Spyratou, E.; Bacharis, C.; Makropoulou, M.; Serafetinides, A. A.

    2013-06-01

    Commercially available intraocular lenses (IOLs) are manufactured from silicone and acrylic, both rigid (e.g. PMMA) and foldable (hydrophobic or hydrophilic acrylic biomaterials), behaving different mechanical and optical properties. Recently, the use of apodizing technology to design new diffractive-refractive multifocals improved the refractive outcome of these intraocular lenses, providing good distant and near vision. There is also a major ongoing effort to refine laser refractive surgery to correct other defects besides conventional refractive errors. Using phakic IOLs to treat high myopia potentially provides better predictability and optical quality than corneal-based refractive surgery. The aim of this work was to investigate the effect of laser ablation on IOL surface shaping, by drilling circular arrays of holes, with a homemade motorized rotation stage, and scattered holes on the polymer surface. In material science, the most popular lasers used for polymer machining are the UV lasers, and, therefore, we tried in this work the 3rd and the 5th harmonic of a Q-switched Nd:YAG laser (λ=355 nm and λ=213 nm respectively). The morphology of the ablated IOL surface was examined with a scanning electron microscope (SEM, Fei - Innova Nanoscope) at various laser parameters. Quantitative measurements were performed with a contact profilometer (Dektak-150), in which a mechanical stylus scanned across the surface of gold-coated IOLs (after SEM imaging) to measure variations in surface height and, finally, the ablation rates were also mathematically simulated for depicting the possible laser ablation mechanism(s). The experimental results and the theoretical modelling of UV laser interaction with polymeric IOLs are discussed in relation with the physical (optical, mechanical and thermal) properties of the material, in addition to laser radiation parameters (laser energy fluence, number of pulses). The qualitative aspects of laser ablation at λ=213 nm reveal a

  17. Experimental investigation on thermal ablation of carbon-fiber/epoxy composite irradiated by continuous wave laser

    Science.gov (United States)

    He, Minbo; Ma, Zhiliang; Chen, Linzhu; Lin, Xinwei; Zhou, Menglian

    2015-05-01

    The tests of carbon-fiber/epoxy composite laminates, subjected to a tangential gas-flow and 1070 nm continuous wave laser are carried out to acquire the ablation laws of samples on the conditions of different gas-flow. Simultaneously, considered the images from camera of large dynamic range, the damage laws of samples are also obtained for various laser power densities. Experimental results reveal that, without airflow on sample surface, the smoke caused by laser heating can be quickly on fire which causes a burn damage on the surface of samples so that the mass loss is most of all. However, the tangential airflow can remove away the smoke which has a weakening effect on the energy of incidence laser. So the ablation depth has an obvious increase in laser irradiation area. Unlike airflow, nitrogen flow can obviously restrain oxidation ablation on surface so that the ablation damage in laser irradiation area is relatively not severe. On the other hand, as laser power density increases, the mass loss of samples continues to rise but isn't proportional. And the ablation heat with the increase of power density shows a complex change. Below power density of 390 W/cm2, the mass loss mainly depends on the pyrolysis of epoxy while the ablation heat has a gradual decrease. Along with power density increasing but less than 1330 W/cm2 , the oxidation ablation of carbon fibers will be a leading factor and the ablation heat shows a little increase. Above power density of 1330 W/cm2 , the carbon fibers turn up the phenomenon of sublimation. What's more, airflow removed effects will be enhanced in high temperature. In this case, the ablation heat again has a trend of decrease.

  18. Effect of Twisted Fiber Anisotropy in Cardiac Tissue on Ablation with Pulsed Electric Fields.

    Science.gov (United States)

    Xie, Fei; Zemlin, Christian W

    2016-01-01

    Ablation of cardiac tissue with pulsed electric fields is a promising alternative to current thermal ablation methods, and it critically depends on the electric field distribution in the heart. We developed a model that incorporates the twisted anisotropy of cardiac tissue and computed the electric field distribution in the tissue. We also performed experiments in rabbit ventricles to validate our model. We find that the model agrees well with the experimentally determined ablation volume if we assume that all tissue that is exposed to a field greater than 3 kV/cm is ablated. In our numerical analysis, we considered how tissue thickness, degree of anisotropy, and electrode configuration affect the geometry of the ablated volume. We considered two electrode configurations: two parallel needles inserted into the myocardium ("penetrating needles" configuration) and one circular electrode each on epi- and endocardium, opposing each other ("epi-endo" configuration). For thick tissues (10 mm) and moderate anisotropy ratio (a = 2), we find that the geometry of the ablated volume is almost unaffected by twisted anisotropy, i.e. it is approximately translationally symmetric from epi- to endocardium, for both electrode configurations. Higher anisotropy ratio (a = 10) leads to substantial variation in ablation width across the wall; these variations were more pronounced for the penetrating needle configuration than for the epi-endo configuration. For thinner tissues (4 mm, typical for human atria) and higher anisotropy ratio (a = 10), the epi-endo configuration yielded approximately translationally symmetric ablation volumes, while the penetrating electrodes configuration was much more sensitive to fiber twist. These results suggest that the epi-endo configuration will be reliable for ablation of atrial fibrillation, independently of fiber orientation, while the penetrating electrode configuration may experience problems when the fiber orientation is not consistent across the

  19. Effect of Twisted Fiber Anisotropy in Cardiac Tissue on Ablation with Pulsed Electric Fields.

    Directory of Open Access Journals (Sweden)

    Fei Xie

    Full Text Available Ablation of cardiac tissue with pulsed electric fields is a promising alternative to current thermal ablation methods, and it critically depends on the electric field distribution in the heart.We developed a model that incorporates the twisted anisotropy of cardiac tissue and computed the electric field distribution in the tissue. We also performed experiments in rabbit ventricles to validate our model. We find that the model agrees well with the experimentally determined ablation volume if we assume that all tissue that is exposed to a field greater than 3 kV/cm is ablated. In our numerical analysis, we considered how tissue thickness, degree of anisotropy, and electrode configuration affect the geometry of the ablated volume. We considered two electrode configurations: two parallel needles inserted into the myocardium ("penetrating needles" configuration and one circular electrode each on epi- and endocardium, opposing each other ("epi-endo" configuration.For thick tissues (10 mm and moderate anisotropy ratio (a = 2, we find that the geometry of the ablated volume is almost unaffected by twisted anisotropy, i.e. it is approximately translationally symmetric from epi- to endocardium, for both electrode configurations. Higher anisotropy ratio (a = 10 leads to substantial variation in ablation width across the wall; these variations were more pronounced for the penetrating needle configuration than for the epi-endo configuration. For thinner tissues (4 mm, typical for human atria and higher anisotropy ratio (a = 10, the epi-endo configuration yielded approximately translationally symmetric ablation volumes, while the penetrating electrodes configuration was much more sensitive to fiber twist.These results suggest that the epi-endo configuration will be reliable for ablation of atrial fibrillation, independently of fiber orientation, while the penetrating electrode configuration may experience problems when the fiber orientation is not consistent

  20. Ventricular Tachycardia with ICD Shocks: When to Medicate and When to Ablate.

    Science.gov (United States)

    AbdelWahab, Amir; Sapp, John

    2017-09-13

    Ventricular tachycardia occurrence in implantable cardioverter defibrillator (ICD) patients may result in shock delivery and is associated with increased morbidity and mortality. In addition, shocks may have deleterious mechanical and psychological effects. Prevention of ventricular tachycardia (VT) recurrence with the use of antiarrhythmic drugs or catheter ablation may be warranted. Antiarrhythmic drugs are limited by incomplete efficacy and an unfavorable adverse effect profile. Catheter ablation can be effective but acute complications and long-term VT recurrence risk necessitating repeat ablation should be recognized. A shared clinical decision process accounting for patients' cardiac status, comorbidities, and goals of care is often required. There are four published randomized trials of catheter ablation for sustained monomorphic VT (SMVT) in the setting of ischemic heart disease; there are no randomized studies for non-ischemic ventricular substrates. The most recent trial is the VANISH trial which randomly allocated patients with ICD, prior infarction, and SMVT despite first-line antiarrhythmic drug therapy to catheter ablation or more aggressive antiarrhythmic drug therapy. During 28 months of follow-up, catheter ablation resulted in a 28% relative risk reduction in the composite endpoint of death, VT storm, and appropriate ICD shock (p = 0.04). In a subgroup analysis, patients having VT despite amiodarone had better outcomes with ablation as compared to increasing amiodarone dose or adding mexiletine. There is evidence for the effectiveness of both catheter ablation and antiarrhythmic drug therapy for patients with myocardial infarction, an implantable defibrillator, and VT. If sotalol is ineffective in suppressing VT, either catheter ablation or initiation of amiodarone is a reasonable option. If VT occurs despite amiodarone therapy, there is evidence that catheter ablation is superior to administration of more aggressive antiarrhythmic drug therapy

  1. Relativistic nuclear technology (RNT) for energy production and utilization of spent nuclear fuel. The results of first experiments on physical justification of RNT

    International Nuclear Information System (INIS)

    Baldin, A.; Belov, E.; Chilap, V.

    2011-01-01

    An essentially new scheme of the electronuclear method - relativistic nuclear technology (RNT) - is considered. This is based on the use of the neutron spectrum forming in the deep subcritical active core, much harder than created in chain fission process. It is shown that an application of RNT for utilization of the radioactive nuclear wastes and energy production seems to be very promising. The results of the first experiments carried out at JINR demonstrate the validity of basic principles of RNT. In particular, these point to the essential (twofold) growth of beam power gain in massive (315 kg) uranium target irradiated with deuterons with increasing energy from 1 to 4 GeV

  2. Chemically assisted laser ablation ICP mass spectrometry.

    Science.gov (United States)

    Hirata, Takafumi

    2003-01-15

    A new laser ablation technique combined with a chemical evaporation reaction has been developed for elemental ratio analysis of solid samples using an inductively coupled plasma mass spectrometer (ICPMS). Using a chemically assisted laser ablation (CIA) technique developed in this study, analytical repeatability of the elemental ratio measurement was successively improved. To evaluate the reliability of the CLA-ICPMS technique, Pb/U isotopic ratios were determined for zircon samples that have previously been analyzed by other techniques. Conventional laser ablation for Pb/U shows a serious elemental fractionation during ablation mainly due to the large difference in elemental volatility between Pb and U. In the case of Pb/U ratio measurement, a Freon R-134a gas (1,1,1,2-tetrafluoroethane) was introduced into the laser cell as a fluorination reactant. The Freon gas introduced into the laser cell reacts with the ablated sample U, and refractory U compounds are converted to a volatile U fluoride compound (UF6) under the high-temperature condition at the ablation site. This avoids the redeposition of U around the ablation pits. Although not all the U is reacted with Freon, formation of volatile UF compounds improves the transmission efficiency of U. Typical precision of the 206Pb/238U ratio measurement is 3-5% (2sigma) for NIST SRM 610 and Nancy 91500 zircon standard, and the U-Pb age data obtained here show good agreement within analytical uncertainties with the previously reported values. Since the observed Pb/U ratio for solid samples is relatively insensitive to laser power and ablation time, optimization of ablation conditions or acquisition parameters no longer needs to be performed on a sample-to-sample basis.

  3. Percutaneous ablation of the gallbladder

    International Nuclear Information System (INIS)

    Saini, S.; Mueller, P.R.; Girard, M.; Lee, M.J.; Goldberg, M.; Brink, J.A.; Flotte, T.J.; Ribiero, R.; Ferrucci, J.T.

    1990-01-01

    This paper examines the feasibility of using Holmium: yttrium-aluminum-garnet (YAG) laser to permanently obliterate the cystic duct and then using chemical sclerosants to ablate the gallbladder mucosa. Percutaneous cholecystostomy was performed in 30 domestic pigs. The cystic duct was cannulated and while the laser fiber was withdrawn at a rate of 0.5 cm/sec, pulsed laser energy (10 Hz) was delivered. Animals were sacrificed immediately (n = 7), at 72 hours (n = 4), and 6 weeks (n = 19). In the 6-week group, gallbladder sclerosis (95% alcohol plus sodium tetradecyl sulfate) was performed in 13 animals immediately after occluding the cystic duct. Control animals were included in each group

  4. Thermal protection system ablation sensor

    Science.gov (United States)

    Gorbunov, Sergey (Inventor); Martinez, Edward R. (Inventor); Scott, James B. (Inventor); Oishi, Tomomi (Inventor); Fu, Johnny (Inventor); Mach, Joseph G. (Inventor); Santos, Jose B. (Inventor)

    2011-01-01

    An isotherm sensor tracks space vehicle temperatures by a thermal protection system (TPS) material during vehicle re-entry as a function of time, and surface recession through calibration, calculation, analysis and exposed surface modeling. Sensor design includes: two resistive conductors, wound around a tube, with a first end of each conductor connected to a constant current source, and second ends electrically insulated from each other by a selected material that becomes an electrically conductive char at higher temperatures to thereby complete an electrical circuit. The sensor conductors become shorter as ablation proceeds and reduced resistance in the completed electrical circuit (proportional to conductor length) is continually monitored, using measured end-to-end voltage change or current in the circuit. Thermocouple and/or piezoelectric measurements provide consistency checks on local temperatures.

  5. Numerical analysis of laser ablation using the axisymmetric two-temperature model

    Science.gov (United States)

    Dziatkiewicz, Jolanta; Majchrzak, Ewa

    2018-01-01

    Laser ablation of the axisymmetric micro-domain is analyzed. To describe the thermal processes occurring in the micro-domain the two-temperature hyperbolic model supplemented by the boundary and initial conditions is used. This model takes into account the phase changes of material (solid-liquid and liquid-vapour) and the ablation process. At the stage of numerical computations the finite difference method with staggered grid is used. In the final part the results of computations are shown.

  6. Long-term survival following radiofrequency ablation of colorectal liver metastases

    DEFF Research Database (Denmark)

    Babawale, Simeon Niyi; Jensen, Thomas Mandøe; Frøkjær, Jens Brøndum

    2015-01-01

    were evaluated, both before and after ablation therapies, with contrast enhanced computerised tomography and contrast enhanced ultrasonography. Histological evidence of malignant liver metastases was obtained in the few instances where contrast enhanced ultrasonography gave equivocal results. Accesses......AIM: To retrospectively evaluate the long-term survival of patients that received radiofrequency ablation (RFA) therapies of colorectal liver metastases. METHODS: In 2005 to 2008, RFA of 105 colorectal liver metastases (CRLM) were performed on 49 patients in our institution. The liver metastases...

  7. XPS investigations on the UV-laser ablation mechanism of poly(ether imide)

    Energy Technology Data Exchange (ETDEWEB)

    Wambach, J.; Kunz, T.; Schnyder, B.; Koetz, R.; Wokaun, A. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1999-08-01

    UV-Laser ablated samples of poly(ether imide) [Kapton{sup TM}] were studied with small-spot XPS. Applying fluences above the threshold level (0.167 J/cm{sup 2}) resulted in the expected behaviour of a decline of both nitrogen and oxygen. Below the threshold level a hint for an altered ablation mechanism was found. (author) 1 fig., 5 refs.

  8. Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Na, Dong Gyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Jung, So Lyung [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-03-15

    Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the optimal use of radiofrequency ablation for thyroid nodules. These recommendations are based on a comprehensive analysis of the current literature, the results of multicenter studies, and expert consensus.

  9. On the features of Gemenid meteorites luminosity and ablation in the Earth's atmosphere

    International Nuclear Information System (INIS)

    Babadzanov, P.B.; Konovalova, N.A.

    2006-01-01

    Among 11 bright Geminid meteors photographed at the Institute of Astrophysics, Tajik Academy of Science, 3 displayed distinct high-frequency (more than 100 Hz) pulsations of brightness, or flickering. Different possible meteoroid ablation mechanisms causing the flickering of the bright Geminids are discussed. The obtained results allow us to conclude that the observed high-frequency flickering of Geminid fireballs may be explained by an auto fluctuating mechanism of the meteoroid ablation

  10. Radiofrequency Ablation, MR Thermometry, and High-Spatial-Resolution MR Parametric Imaging with a Single, Minimally Invasive Device

    Science.gov (United States)

    Ertürk, M. Arcan; Sathyanarayana Hegde, Shashank

    2016-01-01

    Purpose To develop and demonstrate in vitro and in vivo a single interventional magnetic resonance (MR)–active device that integrates the functions of precise identification of a tissue site with the delivery of radiofrequency (RF) energy for ablation, high-spatial-resolution thermal mapping to monitor thermal dose, and quantitative MR imaging relaxometry to document ablation-induced tissue changes for characterizing ablated tissue. Materials and Methods All animal studies were approved by the institutional animal care and use committee. A loopless MR imaging antenna composed of a tuned microcable either 0.8 or 2.2 mm in diameter with an extended central conductor was switched between a 3-T MR imaging unit and an RF power source to monitor and perform RF ablation in bovine muscle and human artery samples in vitro and in rabbits in vivo. High-spatial-resolution (250–300-μm) proton resonance frequency shift MR thermometry was interleaved with ablations. Quantitative spin-lattice (T1) and spin-spin (T2) relaxation time MR imaging mapping was performed before and after ablation. These maps were compared with findings from gross tissue examination of the region of ablated tissue after MR imaging. Results High-spatial-resolution MR imaging afforded temperature mapping in less than 8 seconds for monitoring ablation temperatures in excess of 85°C delivered by the same device. This produced irreversible thermal injury and necrosis. Quantitative MR imaging relaxation time maps demonstrated up to a twofold variation in mean regional T1 and T2 after ablation versus before ablation. Conclusion A simple, integrated, minimally invasive interventional probe that provides image-guided therapy delivery, thermal mapping of dose, and detection of ablation-associated MR imaging parametric changes was developed and demonstrated. With this single-device approach, coupling-related safety concerns associated with multiple conductor approaches were avoided. © RSNA, 2016 Online

  11. Magnetic resonance imaging guidance for the optimization of ventricular tachycardia ablation.

    Science.gov (United States)

    Mukherjee, Rahul K; Whitaker, John; Williams, Steven E; Razavi, Reza; O'Neill, Mark D

    2018-03-23

    Catheter ablation has an important role in the management of patients with ventricular tachycardia (VT) but is limited by modest long-term success rates. Magnetic resonance imaging (MRI) can provide valuable anatomic and functional information as well as potentially improve identification of target sites for ablation. A major limitation of current MRI protocols is the spatial resolution required to identify the areas of tissue responsible for VT but recent developments have led to new strategies which may improve substrate assessment. Potential ways in which detailed information gained from MRI may be utilized during electrophysiology procedures include image integration or performing a procedure under real-time MRI guidance. Image integration allows pre-procedural magnetic resonance (MR) images to be registered with electroanatomical maps to help guide VT ablation and has shown promise in preliminary studies. However, multiple errors can arise during this process due to the registration technique used, changes in ventricular geometry between the time of MRI and the ablation procedure, respiratory and cardiac motion. As isthmus sites may only be a few millimetres wide, reducing these errors may be critical to improve outcomes in VT ablation. Real-time MR-guided intervention has emerged as an alternative solution to address the limitations of pre-acquired imaging to guide ablation. There is now a growing body of literature describing the feasibility, techniques, and potential applications of real-time MR-guided electrophysiology. We review whether real-time MR-guided intervention could be applied in the setting of VT ablation and the potential challenges that need to be overcome.

  12. The impact of photovoltaic (PV) installations on downwind particulate matter concentrations: Results from field observations at a 550-MWAC utility-scale PV plant.

    Science.gov (United States)

    Ravikumar, Dwarakanath; Sinha, Parikhit

    2017-10-01

    With utility-scale photovoltaic (PV) projects increasingly developed in dry and dust-prone geographies with high solar insolation, there is a critical need to analyze the impacts of PV installations on the resulting particulate matter (PM) concentrations, which have environmental and health impacts. This study is the first to quantify the impact of a utility-scale PV plant on PM concentrations downwind of the project site. Background, construction, and post-construction PM 2.5 and PM 10 (PM with aerodynamic diameters construction through a wind-shielding effect. The results show that the (1) confidence intervals of the mean PM concentrations during construction overlap with or are lower than background concentrations for three of the four BAM stations; and (2) post-construction PM 2.5 and PM 10 concentrations downwind of the PV installation are significantly lower than the background concentrations at three of the four BAM stations. At the fourth BAM station, downwind post-construction PM 2.5 and PM 10 concentrations increased marginally by 5.7% and 2.6% of the 24-hr ambient air quality standards defined by the U.S. Environmental Protection Agency, respectively, when compared with background concentrations, with the PM 2.5 increase being statistically insignificant. This increase may be due to vehicular emissions from an access road near the southwest corner of the site or a drainage berm near the south station. The findings demonstrate the overall environmental benefit of downwind PM emission abatement from a utility-scale PV installation in desert conditions due to wind shielding. With PM emission reductions observed within 10 months of completion of construction, post-construction monitoring of downwind PM levels may be reduced to a 1-yr period for other projects with similar soil and weather conditions. This study is the first to analyze impact of a utility photovoltaic (PV) project on downwind particulate matter (PM) concentration in desert conditions. The PM

  13. Energy distribution of ions produced by laser ablation of silver in vacuum

    DEFF Research Database (Denmark)

    Christensen, Bo Toftmann; Schou, Jørgen; Canulescu, Stela

    2013-01-01

    the ablation process. A silver target in vacuum was irradiated with a Nd:YAG laser at a wavelength of 355nm and detailed measurements of the time-resolved angular distribution of plume ions were made. In contrast to earlier work, the beam spot was circular such that any flip-over effect of the plume is avoided......The ion energy in a silver ablation plume for fluence in the range of 0.6–2.4Jcm−2, typical for a pulsed laser deposition (PLD) experiment has been investigated. In this fluence range the ion fraction of the ablated particles becomes gradually dominant and can be utilized to characterize...

  14. Analysis of internal ablation for the thermal control of aerospace vehicles

    Science.gov (United States)

    Camberos, Jose A.; Roberts, Leonard

    1989-01-01

    A new method of thermal protection for transatmospheric vehicles is introduced. The method involves the combination of radiation, ablation and transpiration cooling. By placing an ablating material behind a fixed-shape, porous outer shield, the effectiveness of transpiration cooling is made possible while retaining the simplicity of a passive mechanism. A simplified one-dimensional approach is used to derive the governing equations. Reduction of these equations to non-dimensional form yields two parameters which characterize the thermal protection effectiveness of the shield and ablator combination for a given trajectory. The non-dimensional equations are solved numerically for a sample trajectory corresponding to glide re-entry. Four typical ablators are tested and compared with results obtained by using the thermal properties of water. For the present level of analysis, the numerical computations adequately support the analytical model.

  15. Dynamic stabilization of Rayleigh-Taylor instability: Experiments with Newtonian fluids as surrogates for ablation fronts

    International Nuclear Information System (INIS)

    Rodriguez Prieto, G.; Piriz, A. R.; Lopez Cela, J. J.; Tahir, N. A.

    2013-01-01

    A previous theory on dynamic stabilization of Rayleigh-Taylor instability at interfaces between Newtonian fluids is reformulated in order to make evident the analogy of this problem with the related one on dynamic stabilization of ablation fronts in the framework of inertial confinement fusion. Explicit analytical expressions are obtained for the boundaries of the dynamically stable region which turns out to be completely analogue to the stability charts obtained for the case of ablation fronts. These results allow proposing experiments with Newtonian fluids as surrogates for studying the case of ablation fronts. Experiments with Newtonian fluids are presented which demonstrate the validity of the theoretical approach and encourage to pursue experimental research on ablation fronts to settle the feasibility of dynamic stabilization in the inertial confinement fusion scenario.

  16. Comparison of transcatheter laser and direct-current shock ablation of endocardium near tricuspid anulus

    Science.gov (United States)

    Zhang, Yu-Zhen; Wang, Shi-Wen; Li, Junheng

    1993-03-01

    Forty to eighty percent of the patients with accessory pathways (APs) manifest themselves by tachyarrhythmias. Many of these patients needed either life-long medical therapy or surgery. In order to avoid the discomfort and expenses in surgical procedures, closed chest percutaneous catheter ablation of APs became a potentially desirable therapeutic approach. Many investigations indicated that ablation of right APs by transcatheter direct current (dc) shock could cause life-threatening arrhythmias, right coronary arterical (RCA) spasm, etc. With the development of transcatheter laser technique, it has been used in drug-incurable arrhythmias. The results show that laser ablation is much safer than surgery and electric shock therapy. The purpose of this study is to explore the effectiveness, advantages, and complications with transcatheter Nd:YAG laser and dc shock in the ablation of right atrioventricular accessory pathways in the atrium near the tricuspid annulus (TA) in 20 dogs.

  17. Implementation of Radiation, Ablation, and Free Energy Minimization Modules for Coupled Simulations of Hypersonic Flow

    Science.gov (United States)

    Gnoffo, Peter A.; Johnston, Christopher O.; Thompson, Richard A.

    2009-01-01

    A description of models and boundary conditions required for coupling radiation and ablation physics to a hypersonic flow simulation is provided. Chemical equilibrium routines for varying elemental mass fraction are required in the flow solver to integrate with the equilibrium chemistry assumption employed in the ablation models. The capability also enables an equilibrium catalytic wall boundary condition in the non-ablating case. The paper focuses on numerical implementation issues using FIRE II, Mars return, and Apollo 4 applications to provide context for discussion. Variable relaxation factors applied to the Jacobian elements of partial equilibrium relations required for convergence are defined. Challenges of strong radiation coupling in a shock capturing algorithm are addressed. Results are presented to show how the current suite of models responds to a wide variety of conditions involving coupled radiation and ablation.

  18. A comparison of hydro-instabilities in CH, HDC, and beryllium ablators on NIF

    Science.gov (United States)

    Smalyuk, V. A.; Robey, H. F.; Ali, S.; Berzak Hopkins, L. F.; Casey, D. T.; Celliers, P. M.; Clark, D. S.; Felker, S. J.; Field, J. E.; Haan, S. W.; Hammel, B. A.; Hsing, W. W.; Kroll, J. J.; Landen, O. L.; Lepape, S.; Macphee, A. G.; Martinez, D.; Milovich, J.; Nikroo, A.; Pickworth, L.; Stadermann, M.; Weber, C. R.; Kline, J.; Loomis, E.; Yi, A.

    2017-10-01

    A comparison of the hydrodynamic growth in plastic, high-density carbon, and beryllium ablators will be presented in indirect-drive implosions on National Ignition Facility. This comparison is based on experimentally measured instabilities in all phases of implosions for the three ablators. The 2-D and 3-D perturbations were measured at the ablation-surface with the Hydrodynamic Growth Radiography platform. In the deceleration phase of implosions, innovative self-emission and ``self-backlight'' techniques were used. Results of the 3-D perturbation growth including engineering features will also be presented for convergence up to 20 and compared for the three ablators. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  19. Recurrence of arrhythmia following short-term oral AMIOdarone after CATheter ablation for atrial fibrillation

    DEFF Research Database (Denmark)

    Darkner, Stine; Chen, Xu; Hansen, Jim

    2014-01-01

    later recurrence. METHODS AND RESULTS: In a two-centre, randomized, double-blind, placebo-controlled study, we randomized a total of 212 patients undergoing AF ablation. Patients were stratified according to type of AF (paroxysmal/persistent) and history of previous AF ablation and randomly assigned...... to 8 weeks of oral amiodarone therapy or matched placebo following catheter ablation. Patients were followed for 6 months. Analyses were performed according to the intention-to-treat principle. Of 212 enrolled patients [median age 61 (inter-quartile range 54-66), 83% male, 50% paroxysmal, 29...... period. CONCLUSION: Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the 6-month follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during...

  20. Stress assisted selective ablation of ITO thin film by picosecond laser

    Science.gov (United States)

    Farid, Nazar; Chan, Helios; Milne, David; Brunton, Adam; M. O'Connor, Gerard

    2018-01-01

    Fast selective pattering with high precession on 175 nm ITO thin film with IR ps lasers is investigated. Ablation parameters are optimized with detailed studies on the scribed depth, topography, and particle generation using AFM and SEM. A comparison of 10 and 150 ps laser revealed that the shorter pulse (10 ps) laser is more appropriate in selective and partial ablation; up to 20 nm resolution for controlled depth with multipulses having energy below the damage threshold is demonstrated. The experimental results are interpreted to involve stress assisted ablation mechanism for the 10 ps laser while thermal ablation along with intense melting occurs for 150 ps laser. The transition between these regimes is estimated to occur at approximately 30 ps.

  1. Three dimensional characterization of laser ablation craters using high resolution X-ray computed tomography

    Science.gov (United States)

    Galmed, A. H.; du Plessis, A.; le Roux, S. G.; Hartnick, E.; Von Bergmann, H.; Maaza, M.

    2018-01-01

    Laboratory X-ray computed tomography is an emerging technology for the 3D characterization and dimensional analysis of many types of materials. In this work we demonstrate the usefulness of this characterization method for the full three dimensional analysis of laser ablation craters, in the context of a laser induced breakdown spectroscopy setup. Laser induced breakdown spectroscopy relies on laser ablation for sampling the material of interest. We demonstrate here qualitatively (in images) and quantitatively (in terms of crater cone angles, depths, diameters and volume) laser ablation crater analysis in 3D for metal (aluminum) and rock (false gold ore). We show the effect of a Gaussian beam profile on the resulting crater geometry, as well as the first visual evidence of undercutting in the rock sample, most likely due to ejection of relatively large grains. The method holds promise for optimization of laser ablation setups especially for laser induced breakdown spectroscopy.

  2. Ablation front rayleigh taylor dispersion curve in indirect drive

    International Nuclear Information System (INIS)

    Budil, K.S.; Lasinski, B.; Edwards, M.J.; Wan, A.S.; Remington, B.A.; Weber, S.V.; Glendinning, S.G.; Suter, L.; Stry, P.

    2000-01-01

    The Rayleigh-Taylor (RT) instability, which occurs when a lower-density fluid accelerates a higher-density layer, is common in nature. At an ablation front a sharp reduction in the growth rate of the instability at short wave-lengths can occur, in marked contrast to the classical case where growth rates are highest at the shortest wavelengths. Theoretical and numerical investigations of the ablative RT instability are numerous and differ considerably on the level of stabilization expected. We present here the results of a series of laser experiments designed to probe the roll-over and cutoff region of the ablation-front RT dispersion curve in indirect drive. Aluminum foils with imposed sinusoidal perturbations ranging in wavelength from 10 to 70 pm were ablatively accelerated with a radiation drive generated in a gold cylindrical hohlraum. A strong shock wave compresses the package followed by an ∼2 ns period of roughly constant acceleration and the experiment is diagnosed via face-on radiography. Perturbations with wavelengths (ge) 20 (micro)m experienced substantial growth during the acceleration phase while shorter wavelengths showed a sharp drop off in overall growth. These experimental results compared favorably to calculations with a 2-D radiation-hydrodynamics code, however, the growth is significantly affected by the rippled shock launched by the drive. We performed numerical simulations to elucidate the influence of the rippled shock wave on the eventual growth of the perturbations, allowing comparisons to the analytic model developed by Betti et al. This combination of experiments, simulations and analytic modeling illustrates the qualitative simplicity yet quantitative complexity of the compressible RT instability. We have measured the Rayleigh-Taylor (RT) dispersion curve for a radiatively-driven sample in a series of experiments on the Nova laser facility. Planar aluminum foils were ablatively-accelerated and the subsequent perturbation growth was

  3. Observation of the stabilizing effect of a laminated ablator on the ablative Rayleigh-Taylor instability.

    Science.gov (United States)

    Masse, L; Casner, A; Galmiche, D; Huser, G; Liberatore, S; Theobald, M

    2011-05-01

    A laminated ablator is explored as an alternative concept for stabilizing the ablative Rayleigh-Taylor instability which develops in inertial fusion targets. Experiments measuring the growth of the Rayleigh-Taylor instability of laminated planar foils are reported. Consistent with both theory and simulations, a significant reduction of the perturbation growth is experimentally observed for laminated ablators in comparison to what is observed for classical uniform ablators. Such an enhanced hydrodynamic stability opens opportunities for the design of high-gain inertial fusion targets. © 2011 American Physical Society

  4. Partial splenic ablation in preparation for renal transplantation in children.

    Science.gov (United States)

    Guzzetta, P C; Stolar, C H; Potter, B M; Broadman, L; Ruley, E J

    1983-12-01

    Patients with end-stage renal disease who develop hypersplenism, patients with mild neutropenia, and those patients whose WBC fails to increase in response to cortisol administration will develop significant neutropenia following transplantation with routine doses of azathioprine. This "intolerance" of azathioprine mandates a reduction in the dose of azathioprine often resulting in allograft rejection. Splenectomy will prevent azathioprine-induced neutropenia, but the hazards of splenectomy in these immunosuppressed patients have led to attempts to salvage at least part of the spleen. Partial splenic ablation by embolization has been utilized in adults prior to transplantation to prevent azathioprine-induced neutropenia while preserving the spleen's protective mechanisms against infection. Eight children in our series of transplant candidates required a reduction of splenic function to prevent azathioprine induced neutropenia. One child had a functioning renal allograft but had recurrent neutropenia limiting the azathioprine dose. Partial splenic embolization was attempted in four children and was initially successful in two. Both patients later developed recurrent neutropenia and needed partial splenectomy. The two patients in whom partial splenic embolization was unsuccessful and five further patients in whom embolization was not attempted also underwent partial splenectomy. Approximately 75% to 80% of the spleen was resected. Six children have since undergone renal transplantation and one child had a transplant with chronic rejection at the time of partial splenectomy. Routine doses of azathioprine have been used in these children with no episodes of neutropenia or sepsis observed. We recommend partial splenectomy in those children requiring renal transplantation who are at risk for development of azathioprine induced neutropenia.

  5. Robustness of the healthcare utilization results from the Rotavirus Efficacy and Safety Trial (REST evaluating the human-bovine (WC3 reassortant pentavalent rotavirus vaccine (RV5

    Directory of Open Access Journals (Sweden)

    Van Damme Pierre

    2010-06-01

    Full Text Available Abstract Background The Rotavirus Efficacy and Safety Trial was a placebo-controlled Phase III study that evaluated the safety and efficacy of a three-dose pentavalent rotavirus vaccine (RV5 including its effect on healthcare utilization for rotavirus gastroenteritis (RVGE. The per-protocol (PP analyses, which counted events occurring 14 days after dose 3 among infants without protocol violations, have already been published. This paper evaluates the consistency of the healthcare utilization results based on the modified intention to treat (MITT analyses with the PP analyses. The MITT analyses include all infants receiving at least one dose of vaccine or placebo and follow-up begins after dose 1. The paper also explores the consistency of the results for different subgroups of the study population with different types of surveillance. Methods Data on healthcare utilization for acute gastroenteritis were collected via telephone interviews after administration of the first dose. Parents were either contacted every 6 weeks or every 2 weeks depending on the substudy in which they were enrolled. Those contacted every 2 weeks were also asked to complete symptom diaries. Poisson regression was used to evaluate the effect of RV5 on the rates of RVGE-associated healthcare encounters in all of the analyses. Results In the first 2 years after vaccination, RV5 reduced the combined rate of hospitalizations and emergency department (ED visits 88.9% (95% CI: 84.9, 91.9 for all RVGE regardless of serotype in the MITT analysis compared with a 94.5% (95% CI: 91.2, 96.6 reduction based on the G1-G4 PP analysis. By type of surveillance, the rate reductions for the G1-G4 PP analysis were 91.0% (95% CI: 81.7, 95.5 and 95.9% (95% CI: 92.2, 97.8 among parents contacted every 2 weeks (number evaluable = 4,451 and every 6 weeks (number evaluable = 52,683 respectively. Conclusions Our analyses demonstrated that the effect of RV5 on reducing the rate of hospitalizations

  6. Thoracoscopic sympathectomy ganglia ablation in the management ...

    African Journals Online (AJOL)

    Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: A decade experience in a single institution. D Kravarusic, E Freud. Abstract. Background: Hyperhidrosis can cause significant professional and social handicaps. Surgery is the preferred treatment modality for hyperhidrosis.

  7. Ablative Ceramic Foam Based TPS, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — A novel composite material ablative TPS for planetary vehicles that can survive a dual heating exposure is proposed. NextGen's TPS concept is a bi-layer functional...

  8. Anatomic Twist to a Straightforward Ablation

    Directory of Open Access Journals (Sweden)

    Mandeep Singh Randhawa, MD

    2013-03-01

    Full Text Available Atrioventricular (AV junction ablation for treatment of refractory atrial fibrillation is a well defined, standardized procedure and the simplest of commonly performed radiofrequency ablations in the field of cardiac electrophysiology. We report successful AV junction ablation using an inferior approach in a case of inferior vena cava interruption. Inability during the procedure to initially pass the ablation catheter into the right ventricle, combined with low amplitude electrograms, led to suspicion of an anatomic abnormality. This was determined to be a heterotaxy syndrome with inferior vena cava interruption and azygos continuation, draining in turn into the superior vena cava. Advancing Schwartz right 0 (SRO sheath through the venous abnormality into the right atrium allowed adequate catheter stability to successfully induce complete AV block with radiofrequency energy.

  9. Simple spherical ablative-implosion model

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, F.J.; Steele, J.T.; Larsen, J.T.

    1980-06-23

    A simple model of the ablative implosion of a high-aspect-ratio (shell radius to shell thickness ratio) spherical shell is described. The model is similar in spirit to Rosenbluth's snowplow model. The scaling of the implosion time was determined in terms of the ablation pressure and the shell parameters such as diameter, wall thickness, and shell density, and compared these to complete hydrodynamic code calculations. The energy transfer efficiency from ablation pressure to shell implosion kinetic energy was examined and found to be very efficient. It may be possible to attach a simple heat-transport calculation to our implosion model to describe the laser-driven ablation-implosion process. The model may be useful for determining other energy driven (e.g., ion beam) implosion scaling.

  10. Selective Laser Ablation and Melting, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — In this project Advratech will develop a new additive manufacturing (AM) process called Selective Laser Ablation and Melting (SLAM). The key innovation in this...

  11. Introduction to Laser Ablation Video Supplement.

    Science.gov (United States)

    Barnett, Gene H; Sloan, Andrew E; Tatsui, Claudio E

    2018-04-01

    Laser ablation (also known as laser interstitial thermal therapy [LITT]) has emerged as an important new technology for treating various disorders of the brain and spine. As with any new or emerging technology, there is a learning curve for its optimal use, and video tutorials can be important learning tools to help bridge gaps in knowledge for those who wish to become more familiar with laser ablation. In this special supplement to Neurosurgical Focus, videos illustrate laser ablation's use in the treatment of epilepsy and failed radiosurgery, as well as technical aspects of performing these procedures in eloquent brain and in the spine. We hope that these videos will enable you to enhance your understanding of the evolving use of laser ablation for disorders of the brain or spine. It is the editors' sincere hope that this will be helpful either in your own practice or in determining whether to refer to a neurosurgical colleague experienced in this field.

  12. A moderating role for gender in racial/ethnic disparities in alcohol services utilization: Results from the 2000-2010 National Alcohol Surveys

    Science.gov (United States)

    Zemore, Sarah E.; Murphy, Ryan D.; Mulia, Nina; Gilbert, Paul A.; Martinez, Priscilla; Bond, Jason; Polcin, Douglas L.

    2014-01-01

    Background Few nationally representative studies have examined racial/ethnic disparities in alcohol services utilization. Further, little is known about whether racial/ethnic disparities generalize across genders, and what factors account for these disparities. Thus, we aimed to describe the combined impact of race/ethnicity and gender on alcohol services utilization, and to explore roles for social influence factors in explaining racial/ethnic and gender disparities. Methods Data were pooled across the 2000, 2005, and 2010 National Alcohol Surveys. Outcomes included lifetime utilization of any services, specialty alcohol treatment, and Alcoholics Anonymous (AA). Social influence factors were assessed as lifetime social pressures (i.e., pressures from a partner, friends, and/or family), legal consequences, and work-related consequences. Core analyses included only those with a lifetime alcohol use disorder (AUD). Results Analyses revealed a pattern of lower services utilization among Latinos and Blacks (vs. Whites) and women (vs. men); further, race-by-gender interactions revealed that Black-White differences were limited to women, and provided some evidence of stronger Latino-White disparities among women (vs. men). Illustrating these patterns, among women, only 2.5% of Latinas and 3.4% of Blacks with a lifetime AUD accessed specialty treatment, vs. 6.7% of Whites; among men, corresponding figures were 6.8% for Latinos, 12.2% for Blacks, and 10.1% for Whites. Racial/ethnic differences were typically robust (or stronger) when controlling for demographics and AUD severity. Evidence did not support a role for measured social influence factors in racial/ethnic disparities, but did suggest that these factors contribute to gender disparities, particularly among Whites and Blacks. Discussion Findings for substantial Latino-White and Black-White disparities, especially among women, highlight the need for continuing research on explanatory factors and the development of

  13. Active contour configuration model for estimating the posterior ablative margin in image fusion of real-time ultrasound and 3D ultrasound or magnetic resonance images for radiofrequency ablation: an experimental study.

    Science.gov (United States)

    Lee, Junkyo; Lee, Min Woo; Choi, Dongil; Cha, Dong Ik; Lee, Sunyoung; Kang, Tae Wook; Yang, Jehoon; Jo, Jaemoon; Bang, Won-Chul; Kim, Jongsik; Shin, Dongkuk

    2017-12-21

    The purpose of this study was to evaluate the accuracy of an active contour model for estimating the posterior ablative margin in images obtained by the fusion of real-time ultrasonography (US) and 3-dimensional (3D) US or magnetic resonance (MR) images of an experimental tumor model for radiofrequency ablation. Chickpeas (n=12) and bovine rump meat (n=12) were used as an experimental tumor model. Grayscale 3D US and T1-weighted MR images were pre-acquired for use as reference datasets. US and MR/3D US fusion was performed for one group (n=4), and US and 3D US fusion only (n=8) was performed for the other group. Half of the models in each group were completely ablated, while the other half were incompletely ablated. Hyperechoic ablation areas were extracted using an active contour model from real-time US images, and the posterior margin of the ablation zone was estimated from the anterior margin. After the experiments, the ablated pieces of bovine rump meat were cut along the electrode path and the cut planes were photographed. The US images with the estimated posterior margin were compared with the photographs and post-ablation MR images. The extracted contours of the ablation zones from 12 US fusion videos and post-ablation MR images were also matched. In the four models fused under real-time US with MR/3D US, compression from the transducer and the insertion of an electrode resulted in misregistration between the real-time US and MR images, making the estimation of the ablation zones less accurate than was achieved through fusion between real-time US and 3D US. Eight of the 12 post-ablation 3D US images were graded as good when compared with the sectioned specimens, and 10 of the 12 were graded as good in a comparison with nicotinamide adenine dinucleotide staining and histopathologic results. Estimating the posterior ablative margin using an active contour model is a feasible way of predicting the ablation area, and US/3D US fusion was more accurate than US

  14. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Science.gov (United States)

    Miller, Jeffrey D; Lenhart, Gregory M; Bonafede, Machaon M; Basinski, Cindy M; Lukes, Andrea S; Troeger, Kathleen A

    2015-01-01

    Objectives Abnormal uterine bleeding (AUB) interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA) provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods A health state transition (semi-Markov) model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial) and $3,000 (Medicaid); cost savings versus hysterectomy were $6,500 (commercial) and $8,900 (Medicaid). Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar

  15. Soft x-ray laser ablation of metals and dielectrics

    Science.gov (United States)

    Faenov, A.; Pikuz, T.; Ishino, M.; Inogamov, N.; Zhakhovsky, V.; Skobelev, I.; Hasegawa, N.; Nishikino, M.; Kando, M.; Kodama, R.; Kawachi, T.

    2017-05-01

    We present an overview of our systematic studies of the surface modifications resulting from the interactions of both single and multiple picosecond soft x-ray laser (SXRL) pulses with materials, such as gold (Au), copper (Cu), aluminum (Al), and lithium fluoride (LiF). We show experimentally the possibility of the precise nanometer size structures ( 10-40 nm) formation on their surfaces by ultra-low ( 10-30 mJ/cm2 ) fluencies of single picosecond SXRL pulse. Comparison experimental results with the atomistic model of ablation, which was developed for the single SXRL shot interaction with dielectrics and metals, is provided. Theoretical description of surface nanostructures is considered and is shown that such structures are formed after laser illumination in a process of mechanical spallation of ultrathin surface layer of molten metal. Spallation is accompanied by a strong foaming of melt, breaking of foam, and freezing of foam remnants. Those remnants form chaotic nanostructures, which are observed in experiments. Our measurements show that electron temperature of matter under irradiation of SXRL was lower than 1 eV. The model calculation also predicts that the ablation induced by the SXRL can create the significant low electron temperature. Our results demonstrate that tensile stress created in LiF and metals by short SXRL pulse can produce spallative ablation of target even for drastically small fluencies, which open new opportunities for material nano processing.

  16. Radiofrequency ablation of lung and liver lesions using CT fluoroscopy

    International Nuclear Information System (INIS)

    Chai, A.; Glenn, D.

    2002-01-01

    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

  17. Effects of picosecond laser repetition rate on ablation of Cr12MoV cold work mold steel

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Baoye; Deng, Leimin; Liu, Peng; Zhang, Fei; Duan, Jun, E-mail: duans@hust.edu.cn; Zeng, Xiaoyan

    2017-07-01

    In this paper, the effects of pulse repetition rate on ablation efficiency and quality of Cr12MoV cold work mold steel have been studied using a picosecond (ps) pulse Nd:YVO{sub 4} laser system at λ= 1064 nm. The experimental results of area ablation on target surface reveal that laser repetition rate plays a significant role in controlling ablation efficiency and quality. Increasing the laser repetition rate, while keeping a constant mean power improves the ablation efficiency and quality. For each laser mean power, there is an optimal repetition rate to achieve a higher laser ablation efficiency with low surface roughness. A high ablation efficiency of 42.29, 44.11 and 47.52 μm{sup 3}/mJ, with surface roughness of 0.476, 0.463 and 0.706 μm could be achieved at laser repetition rate of 10 MHz, for laser mean power of 15, 17 and 19 W, respectively. Scanning electron microcopy images revels that the surface morphology evolves from rough with numerous craters, to flat without pores when we increased the laser repetition rate. The effects of laser repetition rate on the heat accumulation, plasma shield and ablation threshold were analyzed by numerical simulation, spectral analysis and multi-laser shot, respectively. The synergetic effects of laser repetition rate on laser ablation rate and machining quality were analyzed and discussed systemically in this paper.

  18. Micrometeoroid ablation simulated in the laboratory

    Science.gov (United States)

    Sternovsky, Zoltan; Thomas, Evan W.; DeLuca, Michael; Horanyi, Mihaly; Janches, Diego; Munsat, Tobin L.; Plane, John M. C.

    2016-04-01

    A facility is developed to simulate the ablation of micrometeoroids in laboratory conditions, which also allows measuring the ionization probability of the ablated material. An electrostatic dust accelerator is used to generate iron and meteoric analog particles with velocities 10-50 km/s. The particles are then introduced into a cell filled with nitrogen, air or carbon dioxide gas with pressures adjustable in the 0.02 - 0.5 Torr range, where the partial or complete ablation of the particle occurs over a short distance. An array of biased electrodes is used to collect the ionized products with spatial resolution along the ablating particles' path, allowing thus the study of the temporal resolution of the process. A simple ablation model is used to match the observations. For completely ablated particles the total collected charge directly yields the ionization efficiency for. The measurements using iron particles in N2 and air are in relatively good agreement with earlier data. The measurements with CO2 and He gases, however, are significantly different from the expectations.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Laser Ablation Experiments on the Tamdakht H5 Chondrite

    Science.gov (United States)

    White, Susan M.; Stern, Eric

    2017-01-01

    High-powered lasers were used to induce ablation and to form fusion crusts in the lab on Tamdakht H5 chondrites and basalt. These ground tests were undertaken to improve our understanding, and ultimately improve our abilty to model and predict, meteoroid ablation during atmospheric entry. The infrared fiber laser at the LHMEL facilty, operated in the continuous wave (i.e. non-pulsed) mode, provided radiation surface heat flux at levels similar to meteor entry for these tests. Results are presented from the first round of testing on samples of Tamdakht H5 ordinary chondrite which were ex-posed to entry-relevant heating rates between 2 and 10 kWcm2.

  1. Computational Modeling of Ablation on an Irradiated Target

    Science.gov (United States)

    Mehmedagic, Igbal; Thangam, Siva

    2017-11-01

    Computational modeling of pulsed nanosecond laser interaction with an irradiated metallic target is presented. The model formulation involves ablation of the metallic target irradiated by pulsed high intensity laser at normal atmospheric conditions. Computational findings based on effective representation and prediction of the heat transfer, melting and vaporization of the targeting material as well as plume formation and expansion are presented along with its relevance for the development of protective shields. In this context, the available results for a representative irradiation from 1064 nm laser pulse is used to analyze various ablation mechanisms, variable thermo-physical and optical properties, plume expansion and surface geometry. Funded in part by U. S. Army ARDEC, Picatinny Arsenal, NJ.

  2. Aerospace Laser Ignition/Ablation Variable High Precision Thruster

    Science.gov (United States)

    Campbell, Jonathan W. (Inventor); Edwards, David L. (Inventor); Campbell, Jason J. (Inventor)

    2015-01-01

    A laser ignition/ablation propulsion system that captures the advantages of both liquid and solid propulsion. A reel system is used to move a propellant tape containing a plurality of propellant material targets through an ignition chamber. When a propellant target is in the ignition chamber, a laser beam from a laser positioned above the ignition chamber strikes the propellant target, igniting the propellant material and resulting in a thrust impulse. The propellant tape is advanced, carrying another propellant target into the ignition chamber. The propellant tape and ignition chamber are designed to ensure that each ignition event is isolated from the remaining propellant targets. Thrust and specific impulse may by precisely controlled by varying the synchronized propellant tape/laser speed. The laser ignition/ablation propulsion system may be scaled for use in small and large applications.

  3. Utility of the T-SPOT®.TB test's borderline category to increase test resolution for results around the cut-off point.

    Science.gov (United States)

    Rego, Karen; Pereira, Kristen; MacDougall, James; Cruikshank, William

    2018-01-01

    Accurate identification of individuals with TB infection, is required to achieve the WHO's End TB Strategy goals. While there is general acceptance that the T-SPOT.TB test borderline category provides an opportunity to increase test resolution of results around the test cut-off point, this has not been investigated. 645,947 tests were analyzed to determine frequency of borderline results, effect of age and time between tests and associations between subjects' clinical risk factors and retest results. 645,947 tests produced 93.5% negatives, 4% positives, 0.6% invalids, and 1.8% borderlines. Within the borderline results, 5044 were repeated, with 59.2%, 20.0% and 20.2% resolving to negative, positive and borderline, respectively. Age of subject did not affect retest results; however, time between tests indicated that retest resolution occurred with greatest frequency after 90 days. TB risk factors were provided for 2640 subjects and 17% of low risk subjects with a high initial borderline resolved to negative while 27.6% of subjects with high risk and an initial low borderline resolved to positive, suggesting that these subjects could have been inappropriately classified if using a single cut-off point test with no borderline category. This study demonstrates the utility of the T-SPOT.TB test's borderline category to increase test resolution around the test cut-off point. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Stability of contamination-free gold and silver nanoparticles produced by nanosecond laser ablation of solid targets in water

    Energy Technology Data Exchange (ETDEWEB)

    Nikov, R.G., E-mail: rosen_nikov@abv.bg [Institute of Electronics, Bulgarian Academy of Sciences, Tzarigradsko shousse 72, Sofia 1784 (Bulgaria); Nikolov, A.S.; Nedyalkov, N.N. [Institute of Electronics, Bulgarian Academy of Sciences, Tzarigradsko shousse 72, Sofia 1784 (Bulgaria); Dimitrov, I.G. [Institute of Electronics, Bulgarian Academy of Sciences, Tzarigradsko shousse 72, Sofia 1784 (Bulgaria); Institute of Experimental Pathology and Parasitology, Bulgarian Academy of Sciences, G. Bonchev Street, bl. 25, Sofia 1113 (Bulgaria); Atanasov, P.A. [Institute of Electronics, Bulgarian Academy of Sciences, Tzarigradsko shousse 72, Sofia 1784 (Bulgaria); Alexandrov, M.T. [Institute of Experimental Pathology and Parasitology, Bulgarian Academy of Sciences, G. Bonchev Street, bl. 25, Sofia 1113 (Bulgaria)

    2012-09-15

    Highlights: Black-Right-Pointing-Pointer Au and Ag colloids were prepared by nanosecond laser ablation of solids in water. Black-Right-Pointing-Pointer The alteration of the produced colloids during one month was investigated. Black-Right-Pointing-Pointer Optical transmission spectra of the samples were measured from 350 to 800 nm. Black-Right-Pointing-Pointer TEM measurements were made of as-prepared colloids and on the 30-th day. Black-Right-Pointing-Pointer Zeta potential measurements were performed of as-prepared samples. - Abstract: Preparation of noble metal nanoparticle (NPs) colloids using pulsed laser ablation in water has an inherent advantage compared to the different chemical methods used, especially when biological applications of the colloids are considered. The fabrication method is simple and the NPs prepared in this way are contamination free. The method of laser ablation of a solid target in water is applied in the present work in order to obtain gold and silver NP colloids. The experiment was preformed by using the fundamental wavelength (1064 nm) of a Nd:YAG laser system. The target immersed in double distilled water was irradiated for 20 min by laser pulses with duration of 15 ns and repetition rate of 10 Hz. The sedimentation and aggregation of NPs in the colloids, stored at constant temperature, as a function of the time after preparation were investigated. The analyses are based on optical transmission spectroscopy in UV and vis regions. The change of the plasmon resonance wavelength as a function of time was studied. Zeta potential measurement was also utilized to measure the charge of the NPs in the colloids. The size distribution of the NPs and its change in time was determined by transmission electron microscopy (TEM). On the basis of the results obtained, the optimal conditions of post fabrication manipulation with gold and silver colloids are defined in view of producing stable NPs with a narrow size distribution.

  5. Analysis and removal of ITER relevant materials and deposits by laser ablation

    International Nuclear Information System (INIS)

    Xiao, Qingmei; Huber, Alexander; Philipps, Volker; Sergienko, Gennady; Gierse, Niels; Mertens, Philippe; Hai, Ran; Ding, Hongbin

    2014-01-01

    The analysis of the deposition of eroded wall material on the plasma-facing materials in fusion devices is one of the crucial issues to maintain the plasma performance and to fulfill safety requirements with respect to tritium retention by co-deposition. Laser ablation with minimal damage to the plasma facing material is a promising method for in situ monitori