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Sample records for intraoperative gamma probe

  1. A new method for intraoperative localization of epilepsy focus by means of a gamma probe

    Carneiro Filho, Omar; Vilela Filho, Osvaldo; Ragazzo, Paulo Cesar; Fonseca, Lea Mirian Barbosa da

    2014-01-01

    Objective: to evaluate the utility of a new multimodal image-guided intervention technique to detect epileptogenic areas with a gamma probe as compared with intraoperative electrocorticography. Materials and methods: two symptomatic patients with refractory epilepsy underwent magnetic resonance imaging, videoelectroencephalography, brain SPECT scan, neuropsychological evaluation and were submitted to gamma probe-assisted surgery. Results: in patient 1, maximum radioactive count was initially observed on the temporal gyrus at about 3.5 cm posteriorly to the tip of the left temporal lobe. After corticotomy, the gamma probe indicated maximum count at the head of the hippocampus, in agreement with the findings of intraoperative electrocorticography. In patient 2, maximum count was observed in the occipital region at the transition between the temporal and parietal lobes (right hemisphere). During the surgery, the area of epileptogenic activity mapped at electrocorticography was also delimited, demarcated, and compared with the gamma probe findings. After lesionectomy, new radioactive counts were performed both in the patients and on the surgical specimens (ex-vivo). Conclusion: the comparison between intraoperative electrocorticography and gamma probe-assisted surgery showed similarity of both methods. The advantages of gamma probe include: noninvasiveness, low cost and capacity to demonstrate decrease in the radioactive activity at the site of excision after lesionectomy. (author)

  2. Preliminary evaluation of intraoperative gamma probe detection of the sentinel node

    Sierralta, M P; Jofre, M J [Nuclear Medicine Department, Military Hospital, Santiago (Chile); Iglesis, R; Schwartz, R; Gomez, L; Velez, R [Surgery Department, Military Hospital, Santiago (Chile); Sandoval, R [Pathology Department, Military Hospital, Santiago (Chile)

    2002-09-01

    Introduction: The resurgence of the lymphoscintigraphy with the sentinel node concept and the availability of the intraoperative gamma probe have been proposed to avoid the morbidity of an unnecessary regional node dissection. The aim of the study was to evaluate the intraoperative gamma probe use after lymphoscintigraphy for the localization of the sentinel node. Material and methods: Twenty-nine patients were studied, 18 females (62%), mean age 60 {+-} 19 y.o. (range 24-86 y.o.) at the Military Hospital Nuclear Medicine Department. The reference diagnoses were 66% malignant melanoma, 21 % breast cancer, 10 % head and neck cancer and 3% vulvae cancer. Lymphoscintigraphs were performed with Tc99m-Dextran injected intradermally in four points around the primary lesion or around the biopsy site (for melanoma 500 microCi each one; for breast and head and neck 200 microCi each one). Afterwards, dynamic images were taken, followed by intraoperative gamma probe investigations in order to localize and remove the sentinel node. Additionally, isosulfan blue was injected before the surgery was made. Results: Lymphoscintigraphy was positive to detect sentinel node(s) in 20 patients (69%). During the surgery, 40 sentinel nodes were detected. In 33 cases, the intraoperative gamma probe was performed, of which 88 % were radioactives. In 35 nodes, the isosulfan blue was injected, of which 80 % were dyed. The correlation between both techniques was 75 %. The histology study of 37 samples demonstrated that 86% (n=32) were truly ganglionar nodes. Conclusion: The intraoperative gamma probe after lymphoscintigraphy is a useful technique for the localization of the sentinel node.

  3. Preliminary evaluation of intraoperative gamma probe detection of the sentinel node

    Sierralta, M.P.; Jofre, M.J.; Iglesis, R.; Schwartz, R.; Gomez, L.; Velez, R.; Sandoval, R.

    2002-01-01

    Introduction: The resurgence of the lymphoscintigraphy with the sentinel node concept and the availability of the intraoperative gamma probe have been proposed to avoid the morbidity of an unnecessary regional node dissection. The aim of the study was to evaluate the intraoperative gamma probe use after lymphoscintigraphy for the localization of the sentinel node. Material and methods: Twenty-nine patients were studied, 18 females (62%), mean age 60 ± 19 y.o. (range 24-86 y.o.) at the Military Hospital Nuclear Medicine Department. The reference diagnoses were 66% malignant melanoma, 21 % breast cancer, 10 % head and neck cancer and 3% vulvae cancer. Lymphoscintigraphs were performed with Tc99m-Dextran injected intradermally in four points around the primary lesion or around the biopsy site (for melanoma 500 microCi each one; for breast and head and neck 200 microCi each one). Afterwards, dynamic images were taken, followed by intraoperative gamma probe investigations in order to localize and remove the sentinel node. Additionally, isosulfan blue was injected before the surgery was made. Results: Lymphoscintigraphy was positive to detect sentinel node(s) in 20 patients (69%). During the surgery, 40 sentinel nodes were detected. In 33 cases, the intraoperative gamma probe was performed, of which 88 % were radioactives. In 35 nodes, the isosulfan blue was injected, of which 80 % were dyed. The correlation between both techniques was 75 %. The histology study of 37 samples demonstrated that 86% (n=32) were truly ganglionar nodes. Conclusion: The intraoperative gamma probe after lymphoscintigraphy is a useful technique for the localization of the sentinel node

  4. Somatostatin receptor scintigraphy and intraoperative gamma probe detection in the localisation and treatment of pancreatic insulinoma

    Loh, Nelson K.; Macdonald, William B.; Dunne, Marina L.; Rao, Sudhakar

    2009-01-01

    Full text: Aims: We report a case of insulinoma that was successfully enucleated under radio-guidance after an initial unsuccessful laparotomy. This case highlights the utility of Somatostatin Receptor Scintigraphy (SRS) and gamma probe in the localisation and treatment of neuroendocrine tumours. Methods: The patient presented with recurrent hypoglycaemia. An abdominal CT scan identified a lesion in the uncinate process of the pancreas, however, laparotomy with use of intraoperative ultrasound failed to localise the lesion. SRS with SPECTICT was then requested by the surgical team with a view to radio-guided surgery. Results: SRS demonstrated an octreotide-avid tumour in the posterior uncinate process of the pancreas, and confirmed suitability for radio-guided surgery. At re-exploration, the surgeon was again unable to palpate the lesion or localise it with intraoperative ultrasound, however, the lesion was successfully detected and removed with the use of a gamma probe. A postoperative SRS confirmed complete excision and histopathology was diagnostic of insulinoma. Conclusion: This case highlights the utility of SRS in the intraoperative localisation and surgical excision of neuroendocrine tumours. The lesion was unable to be localised clinically or with intraoperative ultrasound but was successfully detected with scintigraphic techniques. The surgical team acknowledge that the use of a gamma probe enabled enucleation of the insulinoma, which obviated the need for an invasive Whipple's procedure.

  5. Quality control devices for intraoperative gamma probes: physical, technical and radiation protection aspects

    Varela, C.; Diaz, M.; Salvador, F.J.; Hernandez, M.; Jimenez, P.

    2008-01-01

    Now a day, radio guided surgery -a novelty in Nuclear Medicine- is increasingly used. The clinical efficiency of these procedures requires the existence of well-trained professionals and implementation of quality assurance programs. It is essential for achieving the main objective, which is an effective and safe surgical procedure, a reliable performance of the detection device. Probes' parameters must remain within the acceptance limits, so they should be checked periodically. NEMA Standards Publication NU 3-2004 'Performance Measurement and Quality Control Guidelines for Non-Imaging Intraoperative Gamma Probes' recommends 13 tests; although only 3 of them -sensibility in air, visual inspection and power source check- are considered as steadiness tests. Space resolution in a scatter medium is also a test that needs to be carried out. These tests are considerably complex since open radioactive sources are used into a liquid medium in most of the procedures. The immersion of the probe and of the radioactive sources in each case represents both risks of radioactive contamination, and of damages to the equipment. On the other hand, tests in air demand a good reproducibility. Since they are recommended be carried out before any surgery procedure, they also should be easy and quick. This paper presents 3 devices with its accessories for acceptance and quality control tests of intraoperative gamma probes. They were designed and built taking into consideration important aspects of radiological protection to handle the calibration sources and probes, both in air and into a scatter medium. These devices are designed to fit any kind of probe. Regulatory bodies as part of their instrument audits can also use them. (author)

  6. Intraoperative use of gamma-detecting probes to localize neuroendocrine tumor

    Adams, S.; Baum, R.P.

    2000-01-01

    Neuroendocrine tumors are characterized by the expression of different peptides and biogenic amines. These rare tumors tend to grow slowly and are notoriously difficult to localize, at least in the early stages. Surgical removal is the only definitive therapeutic option for neuroendocrine tumors and relief from hyper functional status. The effectiveness of surgical treatment is invariably dependent upon the complete surgical excision of all tumor tissue, because microscopic and occult disease not readily seen by the surgeon may remain in sit, leading to shortened survival. Radio guided surgery (RGS) is an intraoperative technique that enables the surgeon to localize radiolabelled tissue based on the characteristics of the various tissues. For imaging recurrent MTC (Medullary Thyroid Cancer) many radiopharmaceuticals have been used to visualize tumor sites, but none of them has shown excellent sensitivity. Preoperative somatostatin receptor scintigraphy and intraoperative RGS in patients with recurrent MTC demonstrate only part of the tumor sites and cannot visualize small tumor sites (less than 10 mm). In patients with recurrent MTC, intraoperative gamma probe examination is able to localize over 30% more tumor lesions when compared with conventional preoperative imaging modalities and surgical findings. In addition to scintigraphy of the adrenal glands by precursors of adrenal hormones, imaging with a radiolabelled somatostatin analogue is possible; however ( 111 In-DTPA-D-Phe 1 )-pentetreotide is not specific for any adrenal disease or function and the relatively high radioligand accumulation in the kidneys limited the use for detection of tumors in the area of the adrenal glands

  7. Intraoperative use of gamma-detecting probes to localize neuroendocrine tumor

    Adams, S. [Johann Wolfgang Goethe Univ., Frankfurt/Main (Germany). Medical Center, Dept. of Nuclear Medicine; Baum, R.P. [Zentralklinik Bad Berka GmbH, Bad Berka (Germany). Clinic of Nuclear Medicine/PET Center

    2000-03-01

    Neuroendocrine tumors are characterized by the expression of different peptides and biogenic amines. These rare tumors tend to grow slowly and are notoriously difficult to localize, at least in the early stages. Surgical removal is the only definitive therapeutic option for neuroendocrine tumors and relief from hyper functional status. The effectiveness of surgical treatment is invariably dependent upon the complete surgical excision of all tumor tissue, because microscopic and occult disease not readily seen by the surgeon may remain in sit, leading to shortened survival. Radio guided surgery (RGS) is an intraoperative technique that enables the surgeon to localize radiolabelled tissue based on the characteristics of the various tissues. For imaging recurrent MTC (Medullary Thyroid Cancer) many radiopharmaceuticals have been used to visualize tumor sites, but none of them has shown excellent sensitivity. Preoperative somatostatin receptor scintigraphy and intraoperative RGS in patients with recurrent MTC demonstrate only part of the tumor sites and cannot visualize small tumor sites (less than 10 mm). In patients with recurrent MTC, intraoperative gamma probe examination is able to localize over 30% more tumor lesions when compared with conventional preoperative imaging modalities and surgical findings. In addition to scintigraphy of the adrenal glands by precursors of adrenal hormones, imaging with a radiolabelled somatostatin analogue is possible; however ({sup 111}In-DTPA-D-Phe{sup 1})-pentetreotide is not specific for any adrenal disease or function and the relatively high radioligand accumulation in the kidneys limited the use for detection of tumors in the area of the adrenal glands.

  8. Lymphoscintigraphy and intra-operative gamma probe in detection of sentinel lymph node for breast cancer surgery

    Le Ngoc Ha; Le Manh Ha; Bui Quang Bieu

    2011-01-01

    Sentinel lymph node biopsy (SLNB) has been emerged as a highly accurate method of axillary staging in management of breast cancer patients. Sentinel lymph node detection (SLND) by lymphoscintigraphy and intra-operative gamma probe for SLNB have been widely used in the world. Objectives: the purpose of our study was to evaluate the result of techniques using lymphoscintigraphy and intra-operative gamma probe for SLND in breast carcinoma patients. Materials and Methods: 102 patients with early breast carcinoma were enrolled in the study. Lymphoscintigraphy using Tc-99m-human serum albumin colloid, intra-operative gamma probe were undergone for localization and SLNB. Total axillary lymph node was dissected in breast cancer surgery. Results: The success rate of lymphoscintigraphy and SLND was 98.0% (100/102 patients), mean number of sentinel lymph node (SLN)/patient was 1.56 ± 0.79 (ranged 1 - 3), number of lymphatic vessel/SLN was 1.5 ± 0.69 (ranged 1 - 4) and mean time for SLND on lymphoscintigraphy was 4.21 ± 13.4 minutes (2 - 15 minutes). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of radio-guided SLNB for axillary staging was 100%, 70.6%, 41.2%, 100% and 75.6 % respectively. Conclusions: radio-guided SLNB by lymphoscintigraphy and intra-operative gamma probe is feasible and reliable for axillary staging in early breast carcinoma patients. (author)

  9. Radiation Protection Considerations about gamma probe-guided intraoperative sentinel lymph node surgery

    Rodriguez, C.; Jimenez-Hoyuela Garcia, J. L.; Rebollo Aguirre, J. M.; Custodio, A.

    2002-01-01

    The sentinel node concept is based on the sequential dissemination hypothesis. According to it, there's a lymph node (named sentinel node) which is the first receiving cancer cells metastasizing from a primary tumor. Further, others nodes sequentially located might be affected. Surgical performance for several types of cancer includes the complete removal of the tumor and a complete local lymph node dissection (LND). so removing and analyzing the sentinel node may avoid the complete LND. To locate the sentinel node, it's usual the local administration (intradermal injection) of a radiopharmaceutical Tc-99, sulfur colloid (activity about 1 mCi( several hours prior to surgery, and using an intraoperative gamma probe very sensitive to the gamma radiation. Although the activity is injected by the Nuclear Medicine staff, and be exposed to the gamma radiation. In this study we estimated maximum possible doses that would be received by personnel (surgical staff during surgery and pathologists during lumpectomy of the sentinel node). For the surgical staff, to avoid dose errors due to the very low residual activities and not to interfere with the personnel in the surgery room, we estimated doses by taking into account only the physical decay of Tc99m injected. for the pathologists, we estimated the residual activity in the sentinel node with the gamma probe. The highest effective dose rate found was to the surgeon (o,44 μSv/h, respectively. so a surgeon could perform 407 hours/yr, and a pathologist 1717 hours/yr, dedicated exclusively to sentinel node biopsy, before being classified as professionally exposed to radiation, and 4070 and 17170 hours per year, respectively, to surpass the annual limits (national regulations of the European Communities). In short, radiation doses to clinical staff involved in the technique are low, and in normal conditions, by establishing appropriate procedures (precautions during surgery, during manipulation surgical specimen...) control

  10. Is intra-operative gamma probe detection really necessary for inguinal sentinel lymph node biopsy?

    Oliveira Filho, Renato Santos de; Santos, Ivan Dunshe Abranches Oliveira; Ferreira, Lydia Massako; Almeida, Fernando Augusto de; Simoes, Milvia Maria; Enokihara, Silvia; Barbieri, Antonio; Tovo Filho, Reinaldo [Universidade Federal de Sao Paulo (UNIFESP - EPM), SP (Brazil). Disciplina de Cirurgia Plastica

    2000-11-01

    Sentinel node (SN) biopsy has changed the surgical treatment of malignant melanoma. The literature has emphasized the importance of gamma probe detection (GPD) of the SN. Our objective was to evaluate the efficacy of patent blue dye (PBD) and GPD for SN biopsy in different lymphatic basins. Patients with cutaneous malignant melanoma in stages I and II were submitted to biopsy of the SN, identified by PBD and GPD, as part of a research project. Patients were seen at Hospital Sao Paulo by a multidisciplinary group (Plastic Surgery Tumor Branch, Nuclear Medicine and Pathology). 64 patients with localized malignant melanoma were studied. The median age was 46.5 years. The primary tumor was located in the neck, trunk or extremities. Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intraoperative GPD were performed on all patients. The SN was examined by conventional and immuno-histological staining. If the SN was not found or contained micrometastases, only complete lymphadenectomy was performed. The SN was identified by PBD if it was blue-stained, and by GPD if demonstrated activity five times greater than the adipose tissue of the neighborhood. Seventy lymphatic basins were explored. Lymphoscintigraphy showed ambiguous drainage em 7 patients. GPD identified the SN in 68 basins (97%) and PBD in 53 (76%). PBD and GPD identified SN in 100% of the inguinal basins. For the remaining basins both techniques were complementary. A metastatic SN was found in 10 basins. Three patients with negative SN had recurrence (median follow-up=11 months). Although both GPD and PBD are useful and complementary, PBD alone identified the SN in 100% of the inguinal lymphatic basins. (author)

  11. Is intra-operative gamma probe detection really necessary for inguinal sentinel lymph node biopsy?

    Oliveira Filho, Renato Santos de; Santos, Ivan Dunshe Abranches Oliveira; Ferreira, Lydia Massako; Almeida, Fernando Augusto de; Simoes, Milvia Maria; Enokihara, Silvia; Barbieri, Antonio; Tovo Filho, Reinaldo

    2000-01-01

    Sentinel node (SN) biopsy has changed the surgical treatment of malignant melanoma. The literature has emphasized the importance of gamma probe detection (GPD) of the SN. Our objective was to evaluate the efficacy of patent blue dye (PBD) and GPD for SN biopsy in different lymphatic basins. Patients with cutaneous malignant melanoma in stages I and II were submitted to biopsy of the SN, identified by PBD and GPD, as part of a research project. Patients were seen at Hospital Sao Paulo by a multidisciplinary group (Plastic Surgery Tumor Branch, Nuclear Medicine and Pathology). 64 patients with localized malignant melanoma were studied. The median age was 46.5 years. The primary tumor was located in the neck, trunk or extremities. Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intraoperative GPD were performed on all patients. The SN was examined by conventional and immuno-histological staining. If the SN was not found or contained micrometastases, only complete lymphadenectomy was performed. The SN was identified by PBD if it was blue-stained, and by GPD if demonstrated activity five times greater than the adipose tissue of the neighborhood. Seventy lymphatic basins were explored. Lymphoscintigraphy showed ambiguous drainage em 7 patients. GPD identified the SN in 68 basins (97%) and PBD in 53 (76%). PBD and GPD identified SN in 100% of the inguinal basins. For the remaining basins both techniques were complementary. A metastatic SN was found in 10 basins. Three patients with negative SN had recurrence (median follow-up=11 months). Although both GPD and PBD are useful and complementary, PBD alone identified the SN in 100% of the inguinal lymphatic basins. (author)

  12. Sentinel node localisation using pre-operative lymphoscintigraphy and intraoperative gamma probe in early oral cavity cancer

    Ikram, M.; Akhtar, S.; Junaid, M.; Dhari, T.; Zaman, M.U.; Hussain, R.

    2013-01-01

    Objectives: To assess the diagnostic value of sentinel lymph node localisation using pre-operative lymphoscintigraphy and intra-operative gamma probe radio localisation in Pakistani patients suffering from early stage squamous cell carcinoma of the oral cavity. Methods: The prospective case series was conducted between September 2007 and April 2010 at the Aga Khan University Hospital, Karachi. It comprised patients with T1 and T2 oral cavity cancer with clinically and radiologically negative neck. Pre-operative lymphoscintigraphy was performed one day before surgery and intra-operative gamma probe was used to detect sentinel node. Final histo-pathological evaluation was taken as the gold standard. Results: The study comprised 42 patients: 32(76%) males and 10(24%) females. The primary tumour site was buccal mucosa in 25 (60%) patients, and tongue in 17 (40%). Sentinel lymph node was detected in 38 (90%) patients. On final histopathological identification, 7 (17%) patients had cancer in the neck nodes. In all patients with metastasis, sentinel lymph node technique correctly identified the involved neck level. None of the patients revealed metastasis in non-sentinel lymph nodes. Conclusion:Evidence suggested the use of sentinel node biopsy in patients with head and neck squamous cell carcinoma. (author)

  13. Lymphoscintigraphy with intraoperative gamma probe sentinel node detection: clinical impact in patients with head and neck melanomas

    Maccauro, M.; Villano, C.; Aliberti, G.; Ferrani, L.; Castellani, M.R.; Bombardieri, E.; Patuzzo, R.; Santinami, M.; Tshering, D.

    2005-01-01

    Aim. The aims of this paper were to evaluate the clinical relevance of lymphoscintigraphy with intraoperative gamma-probe detection in identifying sentinel nodes (SNs) and to study the prognostic value of SN biopsy in head and neck melanoma patients. Methods. Sixty-one patients had lymphoscintigraphy with intradermal injections of 99m Tc-Nanocoll (40 MBq), 24 h before surgery. Tumor-positive SNs patients underwent total lymph node dissection Postoperative histological examination was performed. Patients were followed up for 1 to 5 years (median 3 years). The tumor relapses and the overall survival were evaluated by means of statistical methods. Results. Lymphoscintigraphy showed lymphatic distribution to more than one basin in 45 patients (74%), in 15 patients one basin was visualized and no basin in 1 patient. In 41 patients the SN was negative for metastases, while in 20 was positive. In a high percentage of patients (30%), metastatic involvement occurred in more than one lymph node basin. During follow-up in the negative SN group, 40 patients remained disease free and 1 relapsed. In the positive SN group, 10 patients remained disease free and 10 relapsed. Recurrence time ranged from 6 to 11 months. The overall survival of the SNs negative group was significantly higher than the positive SN group. Conclusion. This approach was able to distinguish: a) patients with tumor-negative SNs with a favorable clinical course (98% did not relapse, P<0.001); b) patients with tumor-positive SNs with a high rate of tumor relapse (50%, P<0.001). Therefore SN biopsy may give information about prognosis in head and neck melanoma patients

  14. A new method for intraoperative localization of epilepsy focus by means of a gamma probe; Um novo metodo para a localizacao intraoperatoria de foco de epilepsia mediante utilizacao de gamaprobe

    Carneiro Filho, Omar, E-mail: dromarcarneiro@gmail.com [Centro Brasileiro de Medicina Nuclear e Imagem Molecular (CEBRAMEN), Goiania, GO (Brazil); Instituto de Medicina Nuclear, Goiania, GO (Brazil); Vilela Filho, Osvaldo [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Hospital das Clinicas. Servico de Neurocirurgia; Ragazzo, Paulo Cesar [Instituto de Neurologia de Goiania, GO (Brazil). Servico de Eplepsia e Neurofisiologia; Fonseca, Lea Mirian Barbosa da [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Dept. de Radiologia

    2014-01-15

    Objective: to evaluate the utility of a new multimodal image-guided intervention technique to detect epileptogenic areas with a gamma probe as compared with intraoperative electrocorticography. Materials and methods: two symptomatic patients with refractory epilepsy underwent magnetic resonance imaging, videoelectroencephalography, brain SPECT scan, neuropsychological evaluation and were submitted to gamma probe-assisted surgery. Results: in patient 1, maximum radioactive count was initially observed on the temporal gyrus at about 3.5 cm posteriorly to the tip of the left temporal lobe. After corticotomy, the gamma probe indicated maximum count at the head of the hippocampus, in agreement with the findings of intraoperative electrocorticography. In patient 2, maximum count was observed in the occipital region at the transition between the temporal and parietal lobes (right hemisphere). During the surgery, the area of epileptogenic activity mapped at electrocorticography was also delimited, demarcated, and compared with the gamma probe findings. After lesionectomy, new radioactive counts were performed both in the patients and on the surgical specimens (ex-vivo). Conclusion: the comparison between intraoperative electrocorticography and gamma probe-assisted surgery showed similarity of both methods. The advantages of gamma probe include: noninvasiveness, low cost and capacity to demonstrate decrease in the radioactive activity at the site of excision after lesionectomy. (author)

  15. Combined approach of perioperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection for tumor localization and verification of complete tumor resection in breast cancer

    Knopp Michael V

    2007-12-01

    Full Text Available Abstract Background 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT has become an established method for detecting hypermetabolic sites of known and occult disease and is widely used in oncology surgical planning. Intraoperatively, it is often difficult to localize tumors and verify complete resection of tumors that have been previously detected on diagnostic PET/CT at the time of the original evaluation of the cancer patient. Therefore, we propose an innovative approach for intraoperative tumor localization and verification of complete tumor resection utilizing 18F-FDG for perioperative PET/CT imaging and intraoperative gamma probe detection. Methods Two breast cancer patients were evaluated. 18F-FDG was administered and PET/CT was acquired immediately prior to surgery. Intraoperatively, tumors were localized and resected with the assistance of a handheld gamma probe. Resected tumors were scanned with specimen PET/CT prior to pathologic processing. Shortly after the surgical procedure, patients were re-imaged with PET/CT utilizing the same preoperatively administered 18F-FDG dose. Results One patient had primary carcinoma of breast and a metastatic axillary lymph node. The second patient had a solitary metastatic liver lesion. In both cases, preoperative PET/CT verified these findings and demonstrated no additional suspicious hypermetabolic lesions. Furthermore, intraoperative gamma probe detection, specimen PET/CT, and postoperative PET/CT verified complete resection of the hypermetabolic lesions. Conclusion Immediate preoperative and postoperative PET/CT imaging, utilizing the same 18F-FDG injection dose, is feasible and image quality is acceptable. Such perioperative PET/CT imaging, along with intraoperative gamma probe detection and specimen PET/CT, can be used to verify complete tumor resection. This innovative approach demonstrates promise for assisting the oncologic surgeon in localizing and

  16. Lymph scintigraphy and pre- and intraoperative gamma probe measurements for localization of sentinel lymph nodes (SLN) in breast cancer; Lymphszintigraphie sowie prae- und intraoperative Sondenmessung zur Darstellung des Sentinel Lymph Node (SLN) beim Mammakarzinom

    Brenner, W.; Czech, N.; Felde, U. zum; Kampen, W.U.; Henze, E. [Kiel Univ. (Germany). Klinik fuer Nuklearmedizin; Ostertag, H. [Kiel Univ. (Germany). Klinik fuer Gynaekologie und Geburtshilfe; Klutmann, S.; Bohuslavizki, K.H. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Luettges, J.; Sprenger, A. [Kiel Univ. (Germany). Inst. fuer Allgemeine und Pathologische Anatomie

    2000-05-01

    Aim of this study was to prove the clinical value of nuclear medicine procedures to detect the sentinel lymph node (SLN) for SLN biopsy. Methods: In 132 patients with breast cancer we performed lymph scintigraphy of the breast as well as both pre- and intraoperative gamma probe measurements correlating the results with the findings of histopathology. Results: SLN were detectable in 62 of 110 patients according to a sensitivity of 56% when scanning was performed only at 1-2 h p.i. while the sensitivity increased to 86% (19 of 22 pts.) if sequential images were acquired up to 2 h p.i. One or more SLN were identified by a handheld gamma probe transcutaneously prior to surgery in 96% (113 of 118 pts.) of the patients who showed up with no clinically suspected lymph node metastases. Intraoperatively, in additionally 2 patients the SLN could be found resulting in a sensitivity of 97% (115 of 118 pts.). In only 3 patients with clinically no tumor spread to axillary lymph nodes no SLN could be identified by the probe. Skip lesions, i.e. lymph node metastases in patients with tumorfree SLN, occurred in 2 cases: Due to SLN biopsy in these patients lymph node staging was false negative compared to conventional staging by means of axillary lymph node dissection. Conclusion: The results demonstrate a high preoperative detection rate of SLN in patients with breast cancer using lymph scintigraphy and gamma probe measurements. Thus, nuclear medicine is capable of providing the basic requirements for SLN biopsy in the daily routine. (orig.) [German] Ziel der vorliegenden Arbeit im Vorfeld einer geplanten Multicenterstudie zur Wertigkeit der Sentinel-Lymphknoten (SLN) Biopsie war, die Zuverlaessigkeit der SLN-Detektion mit nuklearmedizinischen Methoden im klinischen Routinebetrieb zu ueberpruefen. Methoden: Bei 132 Patientinnen mit stanzbioptisch gesichertem Mammakarzinom fuehrten wir eine Lymphszintigraphie der Brust sowie eine prae- und intraoperative Gammasondenmessung durch und

  17. Use of gamma probe in 131I thyroid uptake studies

    Sarmento, Andrea Gondim Leitao

    2002-11-01

    Evaluation of thyroid uptake by administration of radioactive iodine is a well-defined procedure to assess patient thyroid function. In general, nuclear medicine institutions use gamma cameras coupled to pinhole collimators to perform uptake studies. With the growing use of intraoperative gamma probes in the radioguided surgical techniques, several institutions are purchasing this new and portable equipment, which can technically be also employed to assess patient's thyroid function, permitting further other applications of gamma cameras. The aim of the study was to compare thyroid uptake trails carried out with both gamma camera and intraoperative gamma probe, in order to evaluate the possible use of gamma probe for this purpose. At first a preliminary study of feasibility was carried out using a neck phantom to verify equipment efficiency with known activities of 131 I. Henceforth, work data from 12 patients undergone studies of thyroid uptakes were evaluated, 24 hours after oral administration of 370 kBq of 131 I. The maximum difference observed between the values obtained with both equipment was 60%, which demonstrated the feasibility of the proposed protocol and made clear that gamma probe can be useful for thyroid uptake studies. (author)

  18. The lymphoscintigraphy and intraoperative gamma detection of sentinel lymph node in oral cavity carcinoma

    Zhao Xinming; Zhang Jingmian; Wang Jianfang; Li Dezhi; Sun Li; Dai Chunnuan; He Yang

    2006-01-01

    Objective: To evaluate the role of lymphoscintigraphy and intraoperative gamma probe detection of sentinel lymph node (SLN) in oral cavity carcinoma. Methods: 99 Tc m labeled dextran (DX) was injected submucously at the center of oral cavity carcinoma before operation. The SLN identified by lymphoscintigraphy and intraoperative gamma counter probe were dissected out from the exited tissue. All sentinel and other lymph nodes were sent for pathological examination. Results: In all 33 cases, SLN and other lymph nodes were clear identified by lymphoscintigraphy. Forty-three SLNs were seen, among them 1 in 25 cases, 2 in 6 cases and 3 in 2 cases. Metastases were detected by biopsy in SLN in 9 cases, however, 11 cases showed positive neck lymph node metastases. The sensitivity of SLN gamma detection was 100% and in biopsy sensitivity was 81.82%, accuracy was 93.94%, false positive rate was 0, and false negative rate was 18.18%. Conclusions: Intraoperative gamma probe detection is the reliable approach to identify SLN in oral cavity carcinoma. Lymphoscintigraphy is the base of localization for oral cavity carcinoma. (authors)

  19. Gamma-ray imaging probes

    Wild, W.J.

    1988-01-01

    External nuclear medicine diagnostic imaging of early primary and metastatic lung cancer tumors is difficult due to the poor sensitivity and resolution of existing gamma cameras. Nonimaging counting detectors used for internal tumor detection give ambiguous results because distant background variations are difficult to discriminate from neighboring tumor sites. This suggests that an internal imaging nuclear medicine probe, particularly an esophageal probe, may be advantageously used to detect small tumors because of the ability to discriminate against background variations and the capability to get close to sites neighboring the esophagus. The design, theory of operation, preliminary bench tests, characterization of noise behavior and optimization of such an imaging probe is the central theme of this work

  20. Intra-operative probe for brain cancer: feasibility study

    Vu Thi, M. H.; Charon, Y.; Duval, M. A.; Lefebvre, F.; Menard, L.; Pitre, S.; Pinot, L.; Siebert, R.

    2007-07-01

    The present work aims a new medical probe for surgeons devoted to brain cancers, in particular glioblastoma multiforme. Within the last years, our group has started the development of a new intra-operative beta imaging probe. More recently, we took an alternative approach for the same application: a fluorescence probe. In both cases the purpose is to differentiate normal from tumor brain tissue. In a first step, we developed set-ups capable to measure autofluorescence. They are based on a dedicated epi-fluorescence design and on specific fiber optic probes. Relative signal amplitude, spectral shape and fluorescence lifetime measurements are foreseen to distinguish normal and cancer tissue by analyzing fluorophores like NADH, lipopigments and porphyrines. The autofluorescence spectra are recorded in the 460-640 nm range with a low resolution spectrometer. For lifetime measurements a fast detector (APD) is used together with a TCSPC-carte. Intrinsic wavelength- and time-resolutions are a few nm and 200 ps, respectively. Different samples have been analyzed to validate our new detection system and to allow a first configuration of our medical fluorescence probe. First results from the tissue measurements are shown.

  1. Gamma-Ray Imaging Probes.

    Wild, Walter James

    1988-12-01

    External nuclear medicine diagnostic imaging of early primary and metastatic lung cancer tumors is difficult due to the poor sensitivity and resolution of existing gamma cameras. Nonimaging counting detectors used for internal tumor detection give ambiguous results because distant background variations are difficult to discriminate from neighboring tumor sites. This suggests that an internal imaging nuclear medicine probe, particularly an esophageal probe, may be advantageously used to detect small tumors because of the ability to discriminate against background variations and the capability to get close to sites neighboring the esophagus. The design, theory of operation, preliminary bench tests, characterization of noise behavior and optimization of such an imaging probe is the central theme of this work. The central concept lies in the representation of the aperture shell by a sequence of binary digits. This, coupled with the mode of operation which is data encoding within an axial slice of space, leads to the fundamental imaging equation in which the coding operation is conveniently described by a circulant matrix operator. The coding/decoding process is a classic coded-aperture problem, and various estimators to achieve decoding are discussed. Some estimators require a priori information about the object (or object class) being imaged; the only unbiased estimator that does not impose this requirement is the simple inverse-matrix operator. The effects of noise on the estimate (or reconstruction) is discussed for general noise models and various codes/decoding operators. The choice of an optimal aperture for detector count times of clinical relevance is examined using a statistical class-separability formalism.

  2. Intraoperative radioguidance with a portable gamma camera: a novel technique for laparoscopic sentinel node localisation in urological malignancies

    Vermeeren, L.; Valdes Olmos, R.A.; Vogel, W.V.; Sivro, F.; Hoefnagel, C.A.; Meinhardt, W.; Bex, A.; Poel, H.G. van der; Horenblas, S.

    2009-01-01

    Our aim was to assess the feasibility of intraoperative radioguidance with a portable gamma camera during laparoscopic sentinel node (SN) procedures in urological malignancies. We evaluated the use of the intraoperative portable gamma camera in 20 patients: 16 patients with prostate carcinoma (PCC), 2 patients with renal cell carcinoma (RC) and 2 patients with testicular cancer (TC). Intra/peritumoural injection of 99m Tc-nanocolloid ( 99m Tc) was followed by planar lymphoscintigraphy, SPECT/CT and marking of SN levels. Before laparoscopy a 125 I seed was fixed on the laparoscopic gamma probe as a pointer of SN seeking. The portable gamma camera was set to display the 99m Tc signal for SN localisation and the 125 I signal for SN seeking. Matching of these signals on screen indicated exact SN localisation, and consequently this SN was removed. The mean injected dose was 218 MBq in PCC, 228 MBq in RC and 88 MBq in TC. Pelvic SN were visualised in all PCC patients, with uncommonly located SN in seven patients. SN metastases were found in seven patients (one in a uncommonly located SN). Both RC patients and TC patients had para-aortic SN, which were all tumour free. A total of 59 SN were removed. The portable gamma camera enabled real-time SN display/identification in 18 patients (90%). The use of a portable gamma camera in combination with a laparoscopic gamma probe incorporates intraoperative real-time imaging with improved SN identification in urological malignancies. This procedure might also be useful for SN identification of other deep draining malignancies. (orig.)

  3. Intraoperative radioguidance with a portable gamma camera: a novel technique for laparoscopic sentinel node localisation in urological malignancies

    Vermeeren, L.; Valdes Olmos, R.A.; Vogel, W.V.; Sivro, F.; Hoefnagel, C.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Meinhardt, W.; Bex, A.; Poel, H.G. van der; Horenblas, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands)

    2009-07-15

    Our aim was to assess the feasibility of intraoperative radioguidance with a portable gamma camera during laparoscopic sentinel node (SN) procedures in urological malignancies. We evaluated the use of the intraoperative portable gamma camera in 20 patients: 16 patients with prostate carcinoma (PCC), 2 patients with renal cell carcinoma (RC) and 2 patients with testicular cancer (TC). Intra/peritumoural injection of {sup 99m}Tc-nanocolloid ({sup 99m}Tc) was followed by planar lymphoscintigraphy, SPECT/CT and marking of SN levels. Before laparoscopy a {sup 125}I seed was fixed on the laparoscopic gamma probe as a pointer of SN seeking. The portable gamma camera was set to display the {sup 99m}Tc signal for SN localisation and the {sup 125}I signal for SN seeking. Matching of these signals on screen indicated exact SN localisation, and consequently this SN was removed. The mean injected dose was 218 MBq in PCC, 228 MBq in RC and 88 MBq in TC. Pelvic SN were visualised in all PCC patients, with uncommonly located SN in seven patients. SN metastases were found in seven patients (one in a uncommonly located SN). Both RC patients and TC patients had para-aortic SN, which were all tumour free. A total of 59 SN were removed. The portable gamma camera enabled real-time SN display/identification in 18 patients (90%). The use of a portable gamma camera in combination with a laparoscopic gamma probe incorporates intraoperative real-time imaging with improved SN identification in urological malignancies. This procedure might also be useful for SN identification of other deep draining malignancies. (orig.)

  4. Intraoperative tumor detection: Relative performance of single-element, dual-element, and imaging probes with various collimators

    Hartsough, N.E.; Barrett, H.H.; Barber, H.B.; Woolfenden, J.M.

    1995-01-01

    Accurate tumor staging depends on finding all tumor sites, and curative surgery requires the removal of all cancerous tissue from those sites. One technique for locating tumors is to inject patients before surgery with a radiotracer that is preferentially taken up by cancerous tissue. Then, an intraoperative gamma-sensitive probe is used to locate the tumors. Small (< 1-cm diameter) tumors, often undetectable by external imaging and by the standard surgical inspection with sight and touch, can be found with probes. Simple calculations and measurements with radioactive tumor models show that small tumors should be detected by single-element probes, but often such probes fail to detect these small tumors in practice. This discrepancy is often caused by the use of a uniform background to predict probe performance. Real backgrounds are nonuniform and can decrease probe performance dramatically. Dual-element, coincidence, or imaging probes may solve the background problem. The authors devised a method to predict probe performance in a realistic background which includes variations in normal organ uptakes. They predict the relative performance of both existing probes and those in the design stage so that optimal detector and collimator configurations can be determined. The procedure includes a Monte-Carlo-calculated point-response function, a numerical torso phantom, and measured biodistribution of a monoclonal antibody. The Hotelling Trace Value, a measure of tumor-detection performance, is computed from the probe responses in simulated studies

  5. Comparison of two threshold detection criteria methodologies for determination of probe positivity for intraoperative in situ identification of presumed abnormal 18F-FDG-avid tissue sites during radioguided oncologic surgery.

    Chapman, Gregg J; Povoski, Stephen P; Hall, Nathan C; Murrey, Douglas A; Lee, Robert; Martin, Edward W

    2014-09-13

    Intraoperative in situ identification of (18)F-FDG-avid tissue sites during radioguided oncologic surgery remains a significant challenge for surgeons. The purpose of our study was to evaluate the 1.5-to-1 ratiometric threshold criteria method versus the three-sigma statistical threshold criteria method for determination of gamma detection probe positivity for intraoperative in situ identification of presumed abnormal (18)F-FDG-avid tissue sites in a manner that was independent of the specific type of gamma detection probe used. From among 52 patients undergoing appropriate in situ evaluation of presumed abnormal (18)F-FDG-avid tissue sites during (18)F-FDG-directed surgery using 6 available gamma detection probe systems, a total of 401 intraoperative gamma detection probe measurement sets of in situ counts per second measurements were cumulatively taken. For the 401 intraoperative gamma detection probe measurement sets, probe positivity was successfully met by the 1.5-to-1 ratiometric threshold criteria method in 150/401 instances (37.4%) and by the three-sigma statistical threshold criteria method in 259/401 instances (64.6%) (P < 0.001). Likewise, the three-sigma statistical threshold criteria method detected true positive results at target-to-background ratios much lower than the 1.5-to-1 target-to-background ratio of the 1.5-to-1 ratiometric threshold criteria method. The three-sigma statistical threshold criteria method was significantly better than the 1.5-to-1 ratiometric threshold criteria method for determination of gamma detection probe positivity for intraoperative in situ detection of presumed abnormal (18)F-FDG-avid tissue sites during radioguided oncologic surgery. This finding may be extremely important for reshaping the ongoing and future research and development of gamma detection probe systems that are necessary for optimizing the in situ detection of radioisotopes of higher-energy gamma photon emissions used during radioguided oncologic surgery.

  6. Intraoperative detection of 18F-FDG-avid tissue sites using the increased probe counting efficiency of the K-alpha probe design and variance-based statistical analysis with the three-sigma criteria

    Povoski, Stephen P; Chapman, Gregg J; Murrey, Douglas A; Lee, Robert; Martin, Edward W; Hall, Nathan C

    2013-01-01

    Intraoperative detection of 18 F-FDG-avid tissue sites during 18 F-FDG-directed surgery can be very challenging when utilizing gamma detection probes that rely on a fixed target-to-background (T/B) ratio (ratiometric threshold) for determination of probe positivity. The purpose of our study was to evaluate the counting efficiency and the success rate of in situ intraoperative detection of 18 F-FDG-avid tissue sites (using the three-sigma statistical threshold criteria method and the ratiometric threshold criteria method) for three different gamma detection probe systems. Of 58 patients undergoing 18 F-FDG-directed surgery for known or suspected malignancy using gamma detection probes, we identified nine 18 F-FDG-avid tissue sites (from amongst seven patients) that were seen on same-day preoperative diagnostic PET/CT imaging, and for which each 18 F-FDG-avid tissue site underwent attempted in situ intraoperative detection concurrently using three gamma detection probe systems (K-alpha probe, and two commercially-available PET-probe systems), and then were subsequently surgical excised. The mean relative probe counting efficiency ratio was 6.9 (± 4.4, range 2.2–15.4) for the K-alpha probe, as compared to 1.5 (± 0.3, range 1.0–2.1) and 1.0 (± 0, range 1.0–1.0), respectively, for two commercially-available PET-probe systems (P < 0.001). Successful in situ intraoperative detection of 18 F-FDG-avid tissue sites was more frequently accomplished with each of the three gamma detection probes tested by using the three-sigma statistical threshold criteria method than by using the ratiometric threshold criteria method, specifically with the three-sigma statistical threshold criteria method being significantly better than the ratiometric threshold criteria method for determining probe positivity for the K-alpha probe (P = 0.05). Our results suggest that the improved probe counting efficiency of the K-alpha probe design used in conjunction with the three

  7. Intraoperative detection of ¹⁸F-FDG-avid tissue sites using the increased probe counting efficiency of the K-alpha probe design and variance-based statistical analysis with the three-sigma criteria.

    Povoski, Stephen P; Chapman, Gregg J; Murrey, Douglas A; Lee, Robert; Martin, Edward W; Hall, Nathan C

    2013-03-04

    Intraoperative detection of (18)F-FDG-avid tissue sites during 18F-FDG-directed surgery can be very challenging when utilizing gamma detection probes that rely on a fixed target-to-background (T/B) ratio (ratiometric threshold) for determination of probe positivity. The purpose of our study was to evaluate the counting efficiency and the success rate of in situ intraoperative detection of (18)F-FDG-avid tissue sites (using the three-sigma statistical threshold criteria method and the ratiometric threshold criteria method) for three different gamma detection probe systems. Of 58 patients undergoing (18)F-FDG-directed surgery for known or suspected malignancy using gamma detection probes, we identified nine (18)F-FDG-avid tissue sites (from amongst seven patients) that were seen on same-day preoperative diagnostic PET/CT imaging, and for which each (18)F-FDG-avid tissue site underwent attempted in situ intraoperative detection concurrently using three gamma detection probe systems (K-alpha probe, and two commercially-available PET-probe systems), and then were subsequently surgical excised. The mean relative probe counting efficiency ratio was 6.9 (± 4.4, range 2.2-15.4) for the K-alpha probe, as compared to 1.5 (± 0.3, range 1.0-2.1) and 1.0 (± 0, range 1.0-1.0), respectively, for two commercially-available PET-probe systems (P < 0.001). Successful in situ intraoperative detection of 18F-FDG-avid tissue sites was more frequently accomplished with each of the three gamma detection probes tested by using the three-sigma statistical threshold criteria method than by using the ratiometric threshold criteria method, specifically with the three-sigma statistical threshold criteria method being significantly better than the ratiometric threshold criteria method for determining probe positivity for the K-alpha probe (P = 0.05). Our results suggest that the improved probe counting efficiency of the K-alpha probe design used in conjunction with the three-sigma statistical

  8. Intraoperative probe detecting β{sup −} decays in brain tumour radio-guided surgery

    Solfaroli Camillocci, E., E-mail: elena.solfaroli@roma1.infn.it [Dip. Fisica, Sapienza Univ. di Roma, Roma (Italy); INFN Sezione di Roma, Roma (Italy); Bocci, V.; Chiodi, G. [INFN Sezione di Roma, Roma (Italy); Collamati, F. [INFN Sezione di Roma, Roma (Italy); Dip. Scienze di Base e Applicate per l' Ingegneria, Sapienza Univ. di Roma, Roma (Italy); Donnarumma, R.; Faccini, R.; Mancini Terracciano, C. [Dip. Fisica, Sapienza Univ. di Roma, Roma (Italy); INFN Sezione di Roma, Roma (Italy); Marafini, M. [INFN Sezione di Roma, Roma (Italy); Museo Storico della Fisica e Centro Studi e Ricerche ‘E. Fermi’, Roma (Italy); Mattei, I.; Muraro, S. [Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Roma (Italy); Recchia, L. [INFN Sezione di Roma, Roma (Italy); Rucinski, A. [INFN Sezione di Roma, Roma (Italy); Dip. Scienze di Base e Applicate per l' Ingegneria, Sapienza Univ. di Roma, Roma (Italy); Russomando, A. [Dip. Fisica, Sapienza Univ. di Roma, Roma (Italy); INFN Sezione di Roma, Roma (Italy); Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Roma (Italy); Toppi, M. [Laboratori Nazionali di Frascati dell' INFN, Frascati (Italy); Traini, G. [Dip. Fisica, Sapienza Univ. di Roma, Roma (Italy); INFN Sezione di Roma, Roma (Italy); Morganti, S. [INFN Sezione di Roma, Roma (Italy)

    2017-02-11

    Radio-guided surgery (RGS) is a technique to intraoperatively detect tumour remnants, favouring a radical resection. Exploiting β{sup −} emitting tracers provides a higher signal to background ratio compared to the established technique with γ radiation, allowing the extension of the RGS applicability range. We developed and tested a detector based on para-terphenyl scintillator with high sensitivity to low energy electrons and almost transparent to γs to be used as intraoperative probe for RGS with β{sup −} emitting tracer. Portable read out electronics was customised to match the surgeon needs. This probe was used for preclinical test on specific phantoms and a test on “ex vivo” specimens from patients affected by meningioma showing very promising results for the application of this new technique on brain tumours. In this paper, the prototype of the intraoperative probe and the tests are discussed; then, the results on meningioma are used to make predictions on the performance of the probe detecting residuals of a more challenging and more interesting brain tumour: the glioma.

  9. An improved hand-held four-detector gamma-probe for radioassisted oncological surgery

    Dusi, W; Bollini, D; Moroni, C; Ricard, M

    2000-01-01

    The performance of an improved intraoperative gamma-probe for radioassisted oncological surgery is presented and discussed. The probe is based on a square array of four 5x5 mm sup 2 coplanar CdTe room temperature semiconductor detectors and each detector has an independent read out electronic chain, allowing an original handling of the signal. Therefore, the search for gamma-emission hot points may be carried out in two different, independent ways: (1) Finding out the position of the probe corresponding to the maximum value of the total counting rate, on the basis of a trial and error procedure (typical for the conventional probe; (2) Finding out the position of the probe where both the differences between the counting rate performed by orthogonal, adjacent halves of the array vanish (differential method). This makes the new probe sensitive to the bidimensional gradient of the gamma-ray flux, measured on the scanned plane. Furthermore, the algebraic sign of the difference indicates in which direction the prob...

  10. Radioguided surgery: First experiences with surgical gamma probe

    Vereb, M.; Bakala, J.

    2004-01-01

    Full text: Thanks to the International Atomic Energy Agency and co-operation of the Nuclear Regulatory Authority of the Slovak Republic - International and Public Relations Division, sentinel lymph node detection has been introduced in one of the regional hospitals in Slovakia. Surgical Gamma Probe, the equipment needed for this has been made available. IAEA first of all helped in organizing a workshop on Scintimammography, Sentinel Lymph Node Detection and Intra-Operative Surgical Probe in Breast Cancer, in April 2002. Education of specialists - surgeons, oncologists, and pathologists and of course radiologists helped them to better understand the subject visa-vis nuclear medicine techniques. We also started the sentinel node detection following the two-days protocol. A 57 years old female with newly detected breast carcinoma in right breast, with positive mammography was investigated. Axillary lymph nodes were not palpable. Tc-99m Nanocoll, with particles size ranging 4-100 nm, was administered, 75 MBq peritumorally + 75 MBq subdermally and a dynamic lymphoscintigraphy was acquired which showed migration of the radiotracer. Static views (after 120 min.) demonstrated 4 sentinel lymph nodes in the right axilla. No lymph node was seen in the internal mammary or left axillary region. Next day before operation about 2 ml of patten blue dye was injected around the tumor and breast was compressed for about 10 min. Identification of sentinel lymph node was done with the help of surgical gamma probe and blue tinting. We found 6 nodes, first two were not really sentinel, but they were blue. A breast conservation surgery with standard axillary lymphadenectomy was performed. Pathology revealed invasive ductal carcinoma. We understand the need to establish an algorithm of examination and treatment of patients with newly diagnosed breast carcinoma. This technology requires teamwork of surgeon, nuclear medicine physician and pathologist. Regarding radiation exposure which every

  11. Development of a novel gamma probe for detecting radiation direction

    Pani, R.; Pellegrini, R.; Cinti, M. N.; Longo, M.; Donnarumma, R.; D'Alessio, A.; Borrazzo, C.; Pergola, A.; Ridolfi, S.; De Vincentis, G.

    2016-01-01

    Spatial localization of radioactive sources is currently a main issue interesting different fields, including nuclear industry, homeland security as well as medical imaging. It is currently achieved using different systems, but the development of technologies for detecting and characterizing radiation is becoming important especially in medical imaging. In this latter field, radiation detection probes have long been used to guide surgery, thanks to their ability to localize and quantify radiopharmaceutical uptake even deep in tissue. Radiolabelled colloid is injected into, or near to, the tumor and the surgeon uses a hand-held radiation detector, the gamma probe, to identify lymph nodes with radiopharmaceutical uptkake. The present work refers to a novel scintigraphic goniometric probe to identify gamma radiation and its direction. The probe incorporates several scintillation crystals joined together in a particular configuration to provide data related to the position of a gamma source. The main technical characteristics of the gamma locator prototype, i.e. sensitivity, spatial resolution and detection efficiency, are investigated. Moreover, the development of a specific procedure applied to the images permits to retrieve the source position with high precision with respect to the currently used gamma probes. The presented device shows a high sensitivity and efficiency to identify gamma radiation taking a short time (from 30 to 60 s). Even though it was designed for applications in radio-guided surgery, it could be used for other purposes, as for example homeland security.

  12. Development of a novel gamma probe for detecting radiation direction

    Pani, R.; Pellegrini, R.; Cinti, M.N.; Longo, M.; Donnarumma, R.; Borrazzo, C.; D'Alessio, A.; Pergola, A.; Ridolfi, S.; Vincentis, G. De

    2016-01-01

    Spatial localization of radioactive sources is currently a main issue interesting different fields, including nuclear industry, homeland security as well as medical imaging. It is currently achieved using different systems, but the development of technologies for detecting and characterizing radiation is becoming important especially in medical imaging. In this latter field, radiation detection probes have long been used to guide surgery, thanks to their ability to localize and quantify radiopharmaceutical uptake even deep in tissue. Radiolabelled colloid is injected into, or near to, the tumor and the surgeon uses a hand-held radiation detector, the gamma probe, to identify lymph nodes with radiopharmaceutical uptkake. The present work refers to a novel scintigraphic goniometric probe to identify gamma radiation and its direction. The probe incorporates several scintillation crystals joined together in a particular configuration to provide data related to the position of a gamma source. The main technical characteristics of the gamma locator prototype, i.e. sensitivity, spatial resolution and detection efficiency, are investigated. Moreover, the development of a specific procedure applied to the images permits to retrieve the source position with high precision with respect to the currently used gamma probes. The presented device shows a high sensitivity and efficiency to identify gamma radiation taking a short time (from 30 to 60 s). Even though it was designed for applications in radio-guided surgery, it could be used for other purposes, as for example homeland security

  13. Intraoperative mechanical measurement of bone quality with the DensiProbe.

    Hoppe, Sven; Uhlmann, Michael; Schwyn, Robert; Suhm, Norbert; Benneker, Lorin M

    2015-01-01

    Reduced bone stock can result in fractures that mostly occur in the spine, distal radius, and proximal femur. In case of operative treatment, osteoporosis is associated with an increased failure rate. To estimate implant anchorage, mechanical methods seem to be promising to measure bone strength intraoperatively. It has been shown that the mechanical peak torque correlates with the local bone mineral density and screw failure load in hip, hindfoot, humerus, and spine in vitro. One device to measure mechanical peak torque is the DensiProbe (AO Research Institute, Davos, Switzerland). The device has shown its effectiveness in mechanical peak torque measurement in mechanical testing setups for the use in hip, hindfoot, and spine. In all studies, the correlation of mechanical torque measurement and local bone mineral density and screw failure load could be shown. It allows the surgeon to judge local bone strength intraoperatively directly at the region of interest and gives valuable information if additional augmentation is needed. We summarize methods of this new technique, its advantages and limitations, and give an overview of actual and possible future applications. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  14. Use of gamma probe in {sup 131}I thyroid uptake studies; Utilizacao da sonda a cintilacao na captacao de {sup 131}I pela tireoide

    Sarmento, Andrea Gondim Leitao

    2002-11-01

    Evaluation of thyroid uptake by administration of radioactive iodine is a well-defined procedure to assess patient thyroid function. In general, nuclear medicine institutions use gamma cameras coupled to pinhole collimators to perform uptake studies. With the growing use of intraoperative gamma probes in the radioguided surgical techniques, several institutions are purchasing this new and portable equipment, which can technically be also employed to assess patient's thyroid function, permitting further other applications of gamma cameras. The aim of the study was to compare thyroid uptake trails carried out with both gamma camera and intraoperative gamma probe, in order to evaluate the possible use of gamma probe for this purpose. At first a preliminary study of feasibility was carried out using a neck phantom to verify equipment efficiency with known activities of {sup 131} I. Henceforth, work data from 12 patients undergone studies of thyroid uptakes were evaluated, 24 hours after oral administration of 370 kBq of {sup 131} I. The maximum difference observed between the values obtained with both equipment was 60%, which demonstrated the feasibility of the proposed protocol and made clear that gamma probe can be useful for thyroid uptake studies. (author)

  15. Use of gamma probe in {sup 131}I thyroid uptake studies; Utilizacao da sonda a cintilacao na captacao de {sup 131}I pela tireoide

    Sarmento, Andrea Gondim Leitao

    2002-11-01

    Evaluation of thyroid uptake by administration of radioactive iodine is a well-defined procedure to assess patient thyroid function. In general, nuclear medicine institutions use gamma cameras coupled to pinhole collimators to perform uptake studies. With the growing use of intraoperative gamma probes in the radioguided surgical techniques, several institutions are purchasing this new and portable equipment, which can technically be also employed to assess patient's thyroid function, permitting further other applications of gamma cameras. The aim of the study was to compare thyroid uptake trails carried out with both gamma camera and intraoperative gamma probe, in order to evaluate the possible use of gamma probe for this purpose. At first a preliminary study of feasibility was carried out using a neck phantom to verify equipment efficiency with known activities of {sup 131} I. Henceforth, work data from 12 patients undergone studies of thyroid uptakes were evaluated, 24 hours after oral administration of 370 kBq of {sup 131} I. The maximum difference observed between the values obtained with both equipment was 60%, which demonstrated the feasibility of the proposed protocol and made clear that gamma probe can be useful for thyroid uptake studies. (author)

  16. Theoretical characterization of the spatial resolution intra-operative probes; Caracterizacion teorica de la resolucion espacial de sondas intraoperatorias

    Agramunt Chaler, S.; Jurado Bruggeman, D.; Munoz Montplet, C.

    2013-07-01

    This work intends to check that the characterization of the spatial profiles obtained by a an intraoperative probe in the presence of a point source is possible enough making use only of the parameters down time sensitivity and opening of the collimator. (Author)

  17. 'RIG'- surgical gamma probe for early breast cancer detection

    Walinjkar, P.B.; Singh, Gursharan; Kumar, Umesh; Pendharkar, A.S.; Choudhary, P.S.

    2004-01-01

    Breast cancer is one of the most common cancers in women, which if detected in early stage can be effectively treated and cured. Early detection is carried out by collecting a sentinel lymph node (SLN) and testing it for cancer. The surgical gamma probe is a hand-held device used in the localization of SLN. It enables the localization of the active node. Isotope Applications Division, BARC has developed indigenously a RIG Surgical Gamma Probe in consultation with the doctors from Rajiv Gandhi Cancer Institute and Research Centre, New Delhi. The system consists of microcomputer-based gamma counting system that displays the number of pulses detected by the probe in counts per second and has an audible signal in direct correlation with the count density. The detector probe is based on the scintillation detector housed in a stainless steel housing with lead collimator. The physical parameters are a high sensitivity of 5000 cps/MBq at probe tip with good spatial resolution. The performance of this probe was clinically evaluated on the basis of spatial resolution and accuracy to detect the active node. (author)

  18. The Complimentary Role of Methoxy-Isobutyl-Isonitrile and Hand-Held Gamma Probe in Adamantinoma

    Maharaj, Masha; Korowlay, Nisaar; Ellmann, Prof

    2016-01-01

    Adamantinoma is a rare locally aggressive osteolytic tumor that is found 90% of the time in the diaphysis of the tibia with the remaining lesions found in the fibula and long tubular bones. A case of adamantinoma of the tibia is presented. The added value of nuclear medicine investigations in the workup of this patient is described. A three-phase whole body 99mTc-methylene diphosphonate bone and a whole body 99mTc-methoxy-isobutyl-isonitrile scans were complimentary in the demarcation of viable bone tumor and the assessment of the remainder of the bone and soft tissue to exclude other sites. Intra-operative assistance with a hand-held gamma probe, guided the biopsy of the most metabolically active tumor tissue. Histology revealed a biphasic tumor composed of epithelial and fibrous components, in keeping with an adamantinoma. PMID:26912979

  19. In situ lake pollutant survey using prompt-gamma probe

    Jiunnhsing Chao; Chien Chung

    1991-01-01

    An aluminium-made neutron-gamma probe, consisting of a 1.5 μg 252 Cf neutron source and a high purity germanium detector, was mounted on a mobile floating platform to survey chlorine pollutant concentration in lake water in situ. Laboratory tests for determining the probe operating depth and in situ field trials of a polluted lake were conducted; evaluation of radiation exposure to workers on board was carried out. The polluted chlorine concentration in lake water was found to be 86 ppm, with minimal radiation exposure for the operating crew on board. (author)

  20. Integrated ultrasound and gamma imaging probe for medical diagnosis

    Pani, R.; Pellegrini, R.; Cinti, M. N.; Polito, C.; Orlandi, C.; Fabbri, A.; Vincentis, G. De

    2016-01-01

    In the last few years, integrated multi-modality systems have been developed, aimed at improving the accuracy of medical diagnosis correlating information from different imaging techniques. In this contest, a novel dual modality probe is proposed, based on an ultrasound detector integrated with a small field of view single photon emission gamma camera. The probe, dedicated to visualize small organs or tissues located at short depths, performs dual modality images and permits to correlate morphological and functional information. The small field of view gamma camera consists of a continuous NaI:Tl scintillation crystal coupled with two multi-anode photomultiplier tubes. Both detectors were characterized in terms of position linearity and spatial resolution performances in order to guarantee the spatial correspondence between the ultrasound and the gamma images. Finally, dual-modality images of custom phantoms are obtained highlighting the good co-registration between ultrasound and gamma images, in terms of geometry and image processing, as a consequence of calibration procedures

  1. Intraoperative Scintigraphy Using a Large Field-of-View Portable Gamma Camera for Primary Hyperparathyroidism: Initial Experience

    Nathan C. Hall

    2015-01-01

    Full Text Available Background. We investigated a novel technique, intraoperative 99 mTc-Sestamibi (MIBI imaging (neck and excised specimen (ES, using a large field-of-view portable gamma camera (LFOVGC, for expediting confirmation of MIBI-avid parathyroid adenoma removal. Methods. Twenty patients with MIBI-avid parathyroid adenomas were preoperatively administered MIBI and intraoperatively imaged prior to incision (neck and immediately following resection (neck and/or ES. Preoperative and intraoperative serum parathyroid hormone monitoring (IOPTH and pathology (path were also performed. Results. MIBI neck activity was absent and specimen activity was present in 13/20 with imaging after initial ES removal. In the remaining 7/20 cases, residual neck activity and/or absent ES activity prompted excision of additional tissue, ultimately leading to complete hyperfunctioning tissue excision. Postexcision LFOVGC ES imaging confirmed parathyroid adenoma resection 100% when postresection imaging qualitatively had activity (ES and/or no activity (neck. The mean ± SEM time saving using intraoperative LFOVGC data to confirm resection versus first IOPTH or path result would have been 22.0 ± 2 minutes (specimen imaging and 26.0 ± 3 minutes (neck imaging. Conclusion. Utilization of a novel real-time intraoperative LFOVGC imaging approach can provide confirmation of MIBI-avid parathyroid adenoma removal appreciably faster than IOPTH and/or path and may provide a valuable adjunct to parathyroid surgery.

  2. Influence of the temperature in the measurement of the gamma automatic probe Gamma Tracer

    Caveda R, C.A.; Dominguez L, O.; Alonso A, D.; Montalvan E, A.; Fabelo B, O.

    2006-01-01

    In the following work an analysis of the existent relationship among the measurement of the absorbed dose rate in air due to the environmental gamma radiation and the temperature, magnitudes measured to intervals of 10 minutes by the gamma probe Gamma Tracer located in the post of occident of the National Net of Environmental Radiological Surveillance (RNVRA), in the Center of Protection and Hygiene of the Radiations (CPHR) is made. For it its were analyzed near 100,000 measurements corresponding to the period 2004-2005. For a better processing and interpretation of the data, these were analyzed with one frequency time zone and monthly using the Gamma Red software to which was necessary to add it some options. Finally it was submitted the probe to a heating process inside a stove. The results of the carried out experiments confirmed that the absorbed dose rate in air due to the environmental gamma radiation depends potentially of the probe temperature in the range of environmental temperature to which is subjected daily the same one. (Author)

  3. The added value of a portable gamma camera for intraoperative detection of sentinel lymph node in squamous cell carcinoma of the oral cavity: A case report.

    Mayoral, M; Paredes, P; Sieira, R; Vidal-Sicart, S; Marti, C; Pons, F

    2014-01-01

    The use of sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity is still subject to debate although some studies have reported its feasibility. The main reason for this debate is probably due to the high false-negative rate for floor-of-mouth tumors per se. We report the case of a 54-year-old man with a T1N0 floor-of-mouth squamous cell carcinoma who underwent the sentinel lymph node procedure. Lymphoscintigraphy and SPECT/CT imaging were performed for lymphatic mapping with a conventional gamma camera. Sentinel lymph nodes were identified at right Ib, left IIa and Ia levels. However, these sentinel lymph nodes were difficult to detect intraoperatively with a gamma probe owing to the activity originating from the injection site. The use of a portable gamma camera made it possible to localize and excise all the sentinel lymph nodes. This case demonstrates the usefulness of this tool to improve sentinel lymph node detecting in floor-of-mouth tumors, especially those close to the injection area. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  4. Dual-head gamma camera system for intraoperative localization of radioactive seeds

    Arsenali, B; Viergever, M A; Gilhuijs, K G A; De Jong, H W A M; Beijst, C; Dickerscheid, D B M

    2015-01-01

    Breast-conserving surgery is a standard option for the treatment of patients with early-stage breast cancer. This form of surgery may result in incomplete excision of the tumor. Iodine-125 labeled titanium seeds are currently used in clinical practice to reduce the number of incomplete excisions. It seems likely that the number of incomplete excisions can be reduced even further if intraoperative information about the location of the radioactive seed is combined with preoperative information about the extent of the tumor. This can be combined if the location of the radioactive seed is established in a world coordinate system that can be linked to the (preoperative) image coordinate system. With this in mind, we propose a radioactive seed localization system which is composed of two static ceiling-suspended gamma camera heads and two parallel-hole collimators. Physical experiments and computer simulations which mimic realistic clinical situations were performed to estimate the localization accuracy (defined as trueness and precision) of the proposed system with respect to collimator-source distance (ranging between 50 cm and 100 cm) and imaging time (ranging between 1 s and 10 s). The goal of the study was to determine whether or not a trueness of 5 mm can be achieved if a collimator-source distance of 50 cm and imaging time of 5 s are used (these specifications were defined by a group of dedicated breast cancer surgeons). The results from the experiments indicate that the location of the radioactive seed can be established with an accuracy of 1.6 mm  ±  0.6 mm if a collimator-source distance of 50 cm and imaging time of 5 s are used (these experiments were performed with a 4.5 cm thick block phantom). Furthermore, the results from the simulations indicate that a trueness of 3.2 mm or less can be achieved if a collimator-source distance of 50 cm and imaging time of 5 s are used (this trueness was achieved for all 14 breast phantoms which

  5. SIG XX - A generation of intelligent gamma ray probes

    Rusu, Al.; Bartos, D.; Constantin, F.; Caragheopol, Gh.; Cruceru, I.; Lupu, A.; Serbina, L.

    2003-01-01

    Nowadays, the radioprotection activities are governed by the ALARA principle. To comply with, we have decided to use scintillators, due to their high efficiency. The surface mounted devices allow the design of the entire gross gamma ray measuring system into a volume of about 0.5 liters. The microcontrollers having an EPROM of 4k bytes offer the opportunity to run resident programmes dedicated to: data acquisition, local processing, data transmission, and system supervising. Such an intelligence is embedded into SIG XX probes. By designing an array of such probes, one can easily obtain a portal monitor, an area monitor and so on, each of them under the the control of a PC. A few modifications may transform an intelligent probe into a portable instrument for radioprotection. In such a case, to make the probe shorter, replacing the photomultiplier by a photodiode, is an attractive goal. To reach it, a dedicated charge preamplifier has to be developed. The works and results on SIG XX probes and charge preamplifier are reported. (authors)

  6. SIG XX - a generation of intelligent gamma ray probes

    Rusu, Al.; Bartos, D.; Constantin, F.; Caragheopol, Gh; Cruceru, I.; Lupu, A.; Serbina, L.

    2005-01-01

    Full text: Nowadays, the radioprotection activities are governed by the ALARA principle. To comply with, we have decided to use scintillators, due to their large efficiency. The surface mounted devices allow the design of the entire gross gamma ray measuring system into a volume of about 0.5 liters. The microcontrollers having an EPROM of 4k bytes offer the opportunity to run resident programmes dedicated to data acquisition, local processing, data communication, system supervising. Such an intelligence is embedded into SIG XX probes. By designing an array of such probes, one can easily obtain a portal monitor, an area monitor and so on, each of them under the the control of a PC. A few modifications may transform an intelligent probe into a portable instrument for radioprotection. In such a case, to make the probe shorter, replacing the photomultiplier by a photodiode, is an attractive goal. To reach it, a dedicated charge preamplifier has to be developed. The works and results on SIG XX probes and charge preamplifier are reported. (author)

  7. Gamma Ray Bursts as Cosmological Probes with EXIST

    Hartmann, Dieter; EXIST Team

    2006-12-01

    The EXIST mission, studied as a Black Hole Finder Probe within NASA's Beyond Einstein Program, would, in its current design, trigger on 1000 Gamma Ray Bursts (GRBs) per year (Grindlay et al, this meeting). The redshift distribution of these GRBs, using results from Swift as a guide, would probe the z > 7 epoch at an event rate of > 50 per year. These bursts trace early cosmic star formation history, point to a first generation of stellar objects that reionize the universe, and provide bright beacons for absorption line studies with groundand space-based observatories. We discuss how EXIST, in conjunction with other space missions and future large survey programs such as LSST, can be utilized to advance our understanding of cosmic chemical evolution, the structure and evolution of the baryonic cosmic web, and the formation of stars in low metallicity environments.

  8. Innovative Design of a Laparoscopic Probe for Non-Invasive Intraoperative Detection of Small Endoluminal Digestive Tumours

    Bogdan Mocan

    2015-12-01

    Full Text Available The present paper highlights the design methodology, the prototype development and the ex-vivo testing of a sensing laparoscopic probe that could be used by surgeons and by surgeon’s assistive robotic systems for detection of small endoluminal digestive tumours. The proposed design framework guides the decision-makers towards a superior balance between quality, efficiency and surgical procedure issues in medical instruments development. A prototype of the sensitive laparoscopic probe for non-invasive intraoperative detection of small endoluminal digestive tumours was developed. The prototype was tested in ex-vivo experimental conditions – open and laparoscopic surgery. The results reveals that the developed prototype is easy to use, adequate and efficient in precise detection of small endoluminal digestive tumours in-between 60÷85% of cases.

  9. PET-Probe: Evaluation of Technical Performance and Clinical Utility of a Handheld High-Energy Gamma Probe in Oncologic Surgery.

    Gulec, Seza A; Daghighian, Farhad; Essner, Richard

    2016-12-01

    Positron emission tomography (PET) has become an invaluable part of patient evaluation in surgical oncology. PET is less than optimal for detecting lesions PET-positive lesions can be challenging as a result of difficulties in surgical exposure. We undertook this investigation to assess the utility of a handheld high-energy gamma probe (PET-Probe) for intraoperative identification of 18 F-deoxyglucose (FDG)-avid tumors. Forty patients underwent a diagnostic whole-body FDG-PET scan for consideration for surgical exploration and resection. Before surgery, all patients received an intravenous injection of 7 to 10 mCi of FDG. At surgery, the PET-Probe was used to determine absolute counts per second at the known tumor site(s) demonstrated by whole-body PET and at adjacent normal tissue (at least 4 cm away from tumor-bearing sites). Tumor-to-background ratios were calculated. Thirty-two patients (80%) underwent PET-Probe-guided surgery with therapeutic intent in a recurrent or metastatic disease setting. Eight patients underwent surgery for diagnostic exploration. Anatomical locations of the PET-identified lesions were neck and supraclavicular (n = 8), axilla (n = 5), groin and deep iliac (n = 4), trunk and extremity soft tissue (n = 3), abdominal and retroperitoneal (n = 19), and lung (n = 2). PET-Probe detected all PET-positive lesions. The PET-Probe was instrumental in localization of lesions in 15 patients that were not immediately apparent by surgical exploration. The PET-Probe identified all lesions demonstrated by PET scanning and, in selected cases, was useful in localizing FDG-avid disease not seen with conventional PET scanning.

  10. Clinical applications of gamma-detection probes - radioguided surgery

    Schneebaum, S.; Stadler, J.; Skornick, Y.

    1999-01-01

    Radioguided surgery (RGS) is a surgical technique that enables the surgeon to identify tissue ''marked'' by a radionuclide before surgery, based on the tissue characteristics, the radioactive tracer and its carrying molecule, or the affinity of both. Thus, yet another tool has been added to the inspection and palpation traditionally used by the surgeon. Current clinical applications of radioguided surgery are: radioimmunoguided surgery (RIGS) for colon cancer, sentinel-node mapping for malignant melanoma (which has become state-of-the-art), sentinel-node mapping for breast, vulvar and penile cancer, and detection of parathyroid adenoma and bone tumour (such as osteid osteoma). Although the same gamma-detecting probe (GDP) may be used for all these applications, the carrier substance and the radionuclide differ. MoAb and peptides are used for RIGS, sulphur colloid for sentinel-node mapping, iodine-125 for RIGS, technetium-99m for sentinel node, parathyroid and bone. The mode of injection also differs, but there are some common principles of gamma-guided surgery. RIGS enables the surgeon to corroborate tumour existence, find occult metastases, and assess the margins of resection; this may result in a change on the surgical plan. Sentinel lymph-node (SLN) scintigraphy for melanoma guides the surgeon to find the involved lymph nodes for lymph-node dissection. SLN for breast cancer is being investigated with promising results. This procedure has also changed the outlook of lymph-node pathology by giving the pathologist designated tissue samples for more comprehensive examination. Gamma-guided surgery will result in more accurate and less unnecessary surgery, better pathology and, hopefully, in better patient survival. (orig.)

  11. Indirect probes of the trilinear Higgs coupling: $gg \\to h$ and $h \\to \\gamma \\gamma$

    Gorbahn, Martin

    2016-10-18

    In the framework of the Standard Model effective field theory, we examine the indirect constraints on the trilinear Higgs coupling $\\lambda$ that arise from Higgs production in gluon-gluon-fusion and diphoton Higgs decays. We calculate 2-loop contributions to the $gg \\to h$ and $h \\to \\gamma \\gamma$ amplitudes that are affected by modifications of the trilinear Higgs-boson vertex. This calculation involves both the computation of anomalous dimensions and finite matching corrections. Based on our new results, we analyse the sensitivity of present and future measurements of the $hgg$ and $h \\gamma \\gamma$ couplings to shifts in $\\lambda$. Under the assumption that $O_6 = - \\lambda \\left (H^\\dagger H \\right )^3$ is the only dimension-6 operator that alters the trilinear Higgs interactions, we find that at present the considered loop-level probes provide stronger constraints than $pp \\to 2h$. At future high-energy colliders indirect ${\\cal O} (5)$ determinations of the trilinear Higgs coupling may be possible, ma...

  12. Portable optical fiber probe-based spectroscopic scanner for rapid cancer diagnosis: a new tool for intraoperative margin assessment.

    Niyom Lue

    Full Text Available There continues to be a significant clinical need for rapid and reliable intraoperative margin assessment during cancer surgery. Here we describe a portable, quantitative, optical fiber probe-based, spectroscopic tissue scanner designed for intraoperative diagnostic imaging of surgical margins, which we tested in a proof of concept study in human tissue for breast cancer diagnosis. The tissue scanner combines both diffuse reflectance spectroscopy (DRS and intrinsic fluorescence spectroscopy (IFS, and has hyperspectral imaging capability, acquiring full DRS and IFS spectra for each scanned image pixel. Modeling of the DRS and IFS spectra yields quantitative parameters that reflect the metabolic, biochemical and morphological state of tissue, which are translated into disease diagnosis. The tissue scanner has high spatial resolution (0.25 mm over a wide field of view (10 cm × 10 cm, and both high spectral resolution (2 nm and high spectral contrast, readily distinguishing tissues with widely varying optical properties (bone, skeletal muscle, fat and connective tissue. Tissue-simulating phantom experiments confirm that the tissue scanner can quantitatively measure spectral parameters, such as hemoglobin concentration, in a physiologically relevant range with a high degree of accuracy (<5% error. Finally, studies using human breast tissues showed that the tissue scanner can detect small foci of breast cancer in a background of normal breast tissue. This tissue scanner is simpler in design, images a larger field of view at higher resolution and provides a more physically meaningful tissue diagnosis than other spectroscopic imaging systems currently reported in literatures. We believe this spectroscopic tissue scanner can provide real-time, comprehensive diagnostic imaging of surgical margins in excised tissues, overcoming the sampling limitation in current histopathology margin assessment. As such it is a significant step in the development of a

  13. Influence of the temperature in the measurement of the gamma automatic probe Gamma Tracer; Influencia de la temperatura en la medicion de la sonda gamma automatica Gamma Tracer

    Caveda R, C.A.; Dominguez L, O.; Alonso A, D. [CPHR, Calle 20 No. 4113 e/41 y 47, Playa, C.P. 11300, A.P. 6195, C.P. 10600 La Habana (Cuba); Montalvan E, A.; Fabelo B, O. [CIAC, Ave. Finlay Km 2 1/2, Rpto. Puerto Principe, Camaguey 70800 (Cuba)]. e-mail: caveda@cphr.edu.cu

    2006-07-01

    In the following work an analysis of the existent relationship among the measurement of the absorbed dose rate in air due to the environmental gamma radiation and the temperature, magnitudes measured to intervals of 10 minutes by the gamma probe Gamma Tracer located in the post of occident of the National Net of Environmental Radiological Surveillance (RNVRA), in the Center of Protection and Hygiene of the Radiations (CPHR) is made. For it its were analyzed near 100,000 measurements corresponding to the period 2004-2005. For a better processing and interpretation of the data, these were analyzed with one frequency time zone and monthly using the Gamma Red software to which was necessary to add it some options. Finally it was submitted the probe to a heating process inside a stove. The results of the carried out experiments confirmed that the absorbed dose rate in air due to the environmental gamma radiation depends potentially of the probe temperature in the range of environmental temperature to which is subjected daily the same one. (Author)

  14. Utility of an intraoperabive gamma probe in the surgical management of secondary or tertiary hyperparathyroidism

    Jorna, Francisca H.; Jager, Pieter L.; Lemstra, Clara; Wiggers, Theo; Stegeman, Coen A.; Plukker, John T. M.

    BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism. METHODS: The value of the probe in guiding resection

  15. Intraoperative handheld probe for 3D imaging of pediatric benign vocal fold lesions using optical coherence tomography (Conference Presentation)

    Benboujja, Fouzi; Garcia, Jordan; Beaudette, Kathy; Strupler, Mathias; Hartnick, Christopher J.; Boudoux, Caroline

    2016-02-01

    Excessive and repetitive force applied on vocal fold tissue can induce benign vocal fold lesions. Children affected suffer from chronic hoarseness. In this instance, the vibratory ability of the folds, a complex layered microanatomy, becomes impaired. Histological findings have shown that lesions produce a remodeling of sup-epithelial vocal fold layers. However, our understanding of lesion features and development is still limited. Indeed, conventional imaging techniques do not allow a non-invasive assessment of sub-epithelial integrity of the vocal fold. Furthermore, it remains challenging to differentiate these sub-epithelial lesions (such as bilateral nodules, polyps and cysts) from a clinical perspective, as their outer surfaces are relatively similar. As treatment strategy differs for each lesion type, it is critical to efficiently differentiate sub-epithelial alterations involved in benign lesions. In this study, we developed an optical coherence tomography (OCT) based handheld probe suitable for pediatric laryngological imaging. The probe allows for rapid three-dimensional imaging of vocal fold lesions. The system is adapted to allow for high-resolution intra-operative imaging. We imaged 20 patients undergoing direct laryngoscopy during which we looked at different benign pediatric pathologies such as bilateral nodules, cysts and laryngeal papillomatosis and compared them to healthy tissue. We qualitatively and quantitatively characterized laryngeal pathologies and demonstrated the added advantage of using 3D OCT imaging for lesion discrimination and margin assessment. OCT evaluation of the integrity of the vocal cord could yield to a better pediatric management of laryngeal diseases.

  16. Janus probe, a detection system for high energy reactor gamma-ray spectrometry

    Gold, R.; Kaiser, B.J.

    1980-03-01

    In reactor environments, gamma-ray spectra are continuous and the absolute magnitude as well as the general shape of the gamma continuum are of paramount importance. Consequently, conventional methods of gamma-ray detection are not suitable for in-core gamma-ray spectrometry. To meet these specific needs, a method of continuous gamma-ray spectrometry, namely Compton Recoil Gamma-Ray Spectrometry, was developed for in-situ observations of reactor environments. A new gamma-ray detection system has been developed which extends the applicability of Compton Recoil Gamma-Ray Spectrometry up to roughly 7 MeV. This detection system is comprised of two separate Si(Li) detectors placed face-to-face. Hence this new detection system is called the Janus probe. Also shown is the block diagram of pulse processing instrumentation for the Janus probe. This new gamma probe not only extends the upper energy limit of in-core gamma-ray spectrometry, but in addition possesses other fundamental advantages

  17. Experimental study of the conditions for universal calibration curve for the gamma-gamma probes in 2Π-geometry

    Gyurcsak, J.; Chau, N.D.

    1989-01-01

    We present the results of the measurements performed in order of establishing the possibility of constructing the universal calibration curves for gamma-gamma density probes. It has been proved that the unit λ p , in which the source-detector distance should be expressed, has the character of a mean free path of the photons forming the high-energetic part of the spectrum. 8 refs., 12 figs., 7 tabs. (author)

  18. Study of the contribution of the radon in the measurement with an automatic gamma probe

    Caveda Ramos, C.A.; Dominguez Levy, O.; Alonso Abad, D.; Montalvan Estrada, A.; Fabelo Bonet, O.

    2008-01-01

    In this work, study about the influence of the radon in the daily measurements of the dose rate absorbed in air due to the environmental gamma radiation is achieved. This magnitude is measured each ten minutes for the Gamma Tracer probe, which is located in the western station of the National Network of Environmental Radiological Surveillance of the Republic of Cuba, this station belongs to the Center of Protection and Hygiene of the Radiations (CPHR). For achieving such study approximately 157 680 measurements of the gamma dose rate corresponding the period 2004-2006 were analyzed. The gamma probe used has two independent counter channels which are both complemented with a Geiger-Muller detector; also it can only detect gamma radiation and perform measurements of the gamma dose rate between 8.7 n Gy/h and 8.7 mGy/h. This probe is located at the height of 3.5 m and is exposed to the sun rays directly. For improving the interpretation of the data, the average of all the values of gamma dose rate was calculated, for each hour of the 365 days of the year. The values were also monthly averaged out. The data were processed by employing the software Gamma Red which was improved by adding some options. A comparison between the results obtained and the annual radon variation internationally published was made. With the present study, it was proved that the main contribution to the daily measurements of the dose rate absorbed in the air due to environmental gamma radiation, on stable weather conditions, is associated with the radon daughters which emit gamma radiation. (author)

  19. Sensitivity of self-powered detector probes to electron and gamma-ray fields

    Lone, M A; Wong, P Y [Atomic Energy of Canada Ltd., Chalk River, ON (Canada)

    1996-12-31

    A self-powered detector (SPD) is a simple, passive device that consists of a coaxial probe with a metallic outer sleeve, a mineral oxide insulating layer, and a metallic inner core. SPD`s are used in nuclear reactors to monitor neutron and gamma fields. Responses of SPD`s to electrons and {gamma}-rays of various energies were investigated with Monte Carlo simulations. Transmission filters were studied for the design of threshold SPD probes used for online monitoring of the energy spectrum of high-power industrial electron accelerator beams. Filters were also investigated for the enhancement of {gamma}-ray sensitivity of an SPD placed in a mixed electron and {gamma}-ray field. (author). 30 refs., 1 tab., 8 figs.

  20. Probing Intrinsic Properties of Short Gamma-Ray Bursts with Gravitational Waves.

    Fan, Xilong; Messenger, Christopher; Heng, Ik Siong

    2017-11-03

    Progenitors of short gamma-ray bursts are thought to be neutron stars coalescing with their companion black hole or neutron star, which are one of the main gravitational wave sources. We have devised a Bayesian framework for combining gamma-ray burst and gravitational wave information that allows us to probe short gamma-ray burst luminosities. We show that combined short gamma-ray burst and gravitational wave observations not only improve progenitor distance and inclination angle estimates, they also allow the isotropic luminosities of short gamma-ray bursts to be determined without the need for host galaxy or light-curve information. We characterize our approach by simulating 1000 joint short gamma-ray burst and gravitational wave detections by Advanced LIGO and Advanced Virgo. We show that ∼90% of the simulations have uncertainties on short gamma-ray burst isotropic luminosity estimates that are within a factor of two of the ideal scenario, where the distance is known exactly. Therefore, isotropic luminosities can be confidently determined for short gamma-ray bursts observed jointly with gravitational waves detected by Advanced LIGO and Advanced Virgo. Planned enhancements to Advanced LIGO will extend its range and likely produce several joint detections of short gamma-ray bursts and gravitational waves. Third-generation gravitational wave detectors will allow for isotropic luminosity estimates for the majority of the short gamma-ray burst population within a redshift of z∼1.

  1. Probing the $WW \\gamma$ vertex at hadron colliders

    Papavassiliou, J

    1999-01-01

    We present a new, model independent method for extracting bounds for the anomalous $\\gamma WW$ couplings from hadron collider experiments. At the partonic level we introduce a set of three observables which are constructed from the unpolarized differential cross-section for the process $d\\bar{u}\\to W^{-}\\gamma$ by appropriate convolution with a set of simple polynomials depending only on the center-of-mass angle. One of these observables allows for the direct determination of the anomalous coupling usually denoted by presence of a radiation zero. The other two observables impose two sum rules on the remaining three anomalous couplings. The inclusion of the structure functions is discussed in detail for both $p\\bar{p}$ and $pp$ colliders. We show that, whilst for $p\\bar{p}$ experiments this can be accomplished straightforwardly, in the $pp$ case one has to resort to somewhat more elaborate techniques, such as the binning of events according to their longitudinal momenta.

  2. Neutron and gamma probes: Their use in agronomy. Second edition

    2003-01-01

    Water is an essential requirement for life on the planet. It is often the single most limiting factor in crop and livestock production. Water is a scarce resource in many urban and rural environments worldwide. According to the FAO, the global demand for fresh water is doubling every 21 years. The quality of the finite water supplies is also under threat from industrial, agricultural and domestic sources of pollution. The majority of crops are grown under rain-fed conditions and adequate water supply is the main factor limiting crop production in semi-arid and sub-humid regions. On the other hand, currently 20% of the world's arable land is under irrigation providing 35 to 40% of all agricultural production. Irrigation mismanagement poses a serious threat to the environment through groundwater pollution and salinization. It is therefore, essential that water resources be used efficiently by regular monitoring of soil-water status in the unsaturated zone. The neutron depth probe, a nuclear-based technique, is utilized worldwide for this purpose. The neutron moisture gauge, since its introduction some 40 years ago, can now be considered a routine method in soil water studies. Many developments have since been introduced, in particular electronic components, which have significantly improved performance and expanded applications. Although the neutron scattering method is routinely utilised in many developed countries, its use is still limited in developing countries due to several factors. Neutron depth probes contain radioactive sources, which will present health and environmental hazards if a probe is improperly used, stored or disposed of. National and international legislation and regulations must be complied with. The strategic objective of the sub-program Soil and Water Management and Crop Nutrition of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture is to develop and promote the adoption of nuclear-based technologies for optimising soil

  3. PROBING EXTRAGALACTIC DUST THROUGH NEARBY GAMMA-RAY BURST AFTERGLOWS

    Liang, S. L.; Li Aigen

    2010-01-01

    The quantities and wavelength dependencies of the dust extinction along the lines of sight toward 33 nearby gamma-ray bursts (GRBs) with redshifts z V derived from the Drude approach is generally larger by a factor of ∼2-5 than that inferred by assuming a SMC-type template extinction law. Consistent with previous studies, the extinction-to-gas ratio is mostly smaller than that of the MW, and does not seem to correlate with the shape of the extinction curve. It is shown that the standard silicate-graphite interstellar grain model closely reproduces the extinction curves of all 33 GRBs host galaxies. For these 33 bursts at z < 2, we find no evidence for the evolution of the dust extinction, dust sizes, and relative abundances of silicate to graphite on redshifts.

  4. Neutron and gamma probes: Their use in agronomy

    Bacchi, O.O.; Reichart, K.; Calvache, M.

    2002-01-01

    The concept of this training manual originated during a regional training workshop on the use of neutron probe in water and nutrient balance studies, organized in 1997 in the frame of an IAEA Regional Technical Co-operation Project for Latin America entitle Plant Nutrition, Water and Soil Management, for which the integrated approach was adopted. The original version (in Spanish) was a comprehensive manual covering theoretical and practical aspects required for the proper utilization of the equipment. The contributions of the peer reviewers, editors and technical translators of the three versions in English, French and Spanish have greatly enhanced the content and quality of the manual. It is hoped that this manual will be useful for future training events and serve as a key reference to soil/water scientists in the field of sustainable management of scarce water resources in both rain-fed and irrigated agricultural production systems

  5. Gamma-ray bursts and their use as cosmic probes

    2017-01-01

    Since the launch of the highly successful and ongoing Swift mission, the field of gamma-ray bursts (GRBs) has undergone a revolution. The arcsecond GRB localizations available within just a few minutes of the GRB alert has signified the continual sampling of the GRB evolution through the prompt to afterglow phases revealing unexpected flaring and plateau phases, the first detection of a kilonova coincident with a short GRB, and the identification of samples of low-luminosity, ultra-long and highly dust-extinguished GRBs. The increased numbers of GRB afterglows, GRB-supernova detections, redshifts and host galaxy associations has greatly improved our understanding of what produces and powers these immense, cosmological explosions. Nevertheless, more high-quality data often also reveal greater complexity. In this review, I summarize some of the milestones made in GRB research during the Swift era, and how previous widely accepted theoretical models have had to adapt to accommodate the new wealth of observational data. PMID:28791158

  6. Optimization of in situ prompt gamma-ray analysis using a HPGe-252Cf probe

    Chien Chung; Jiunnhsing Chao

    1991-01-01

    Application of in situ measurements by the neutron-induced prompt gamma-ray activation analysis (PGAA) technique to geochemical analysis and mineral survey have been investigated. An in situ survey of water pollutants by PGAA techniques was first proposed in the authors' previous study, where a 2.7-μg 252 Cf neutron source used in connection with a gamma-ray detecting system to determine water pollutants was described. In this paper the authors describe a modified detection probe designed and constructed to look for the optimum conditions of various-intensity 252 Cf neutron sources in measurement of some elements in lake water. Detecting efficiencies at high-energy regions and detection limits for elements commonly found in polluted lakes were evaluated and predicted to investigate the potential application of the probe for in situ measurements

  7. MAGNETIC STRUCTURES IN GAMMA-RAY BURST JETS PROBED BY GAMMA-RAY POLARIZATION

    Yonetoku, Daisuke; Murakami, Toshio; Morihara, Yoshiyuki; Takahashi, Takuya; Wakashima, Yudai; Yonemochi, Hajime; Sakashita, Tomonori; Fujimoto, Hirofumi; Kodama, Yoshiki [College of Science and Engineering, School of Mathematics and Physics, Kanazawa University, Kakuma, Kanazawa, Ishikawa 920-1192 (Japan); Gunji, Shuichi; Toukairin, Noriyuki [Department of Physics, Faculty of Science, Yamagata University, 1-4-12, Koshirakawa, Yamagata, Yamagata 990-8560 (Japan); Mihara, Tatehiro [Cosmic Radiation Laboratory, RIKEN, 2-1, Hirosawa, Wako City, Saitama 351-0198 (Japan); Toma, Kenji, E-mail: yonetoku@astro.s.kanazawa-u.ac.jp [Department of Earth and Space Science, Osaka University, Toyonaka 560-0043 (Japan)

    2012-10-10

    We report polarization measurements in two prompt emissions of gamma-ray bursts, GRB 110301A and GRB 110721A, observed with the gamma-ray burst polarimeter (GAP) on borad the IKAROS solar sail mission. We detected linear polarization signals from each burst with polarization degree of {Pi} = 70 {+-} 22% with statistical significance of 3.7{sigma} for GRB 110301A, and {Pi} = 84{sup +16}{sub -28}% with 3.3{sigma} confidence level for GRB 110721A. We did not detect any significant change of polarization angle. These two events had shorter durations and dimmer brightness compared with GRB 100826A, which showed a significant change of polarization angle, as reported in Yonetoku et al. Synchrotron emission model can be consistent with the data of the three GRBs, while the photospheric quasi-thermal emission model is not favored. We suggest that magnetic field structures in the emission region are globally ordered fields advected from the central engine.

  8. Gamma-Ray Pulsar Light Curves as Probes of Magnetospheric Structure

    Harding, A. K.

    2016-01-01

    The large number of gamma-ray pulsars discovered by the Fermi Gamma-Ray Space Telescope since its launch in 2008 dwarfs the handful that were previously known. The variety of observed light curves makes possible a tomography of both the ensemble-averaged field structure and the high-energy emission regions of a pulsar magnetosphere. Fitting the gamma-ray pulsar light curves with model magnetospheres and emission models has revealed that most of the high-energy emission, and the particles acceleration, takes place near or beyond the light cylinder, near the current sheet. As pulsar magnetosphere models become more sophisticated, it is possible to probe magnetic field structure and emission that are self-consistently determined. Light curve modeling will continue to be a powerful tool for constraining the pulsar magnetosphere physics.

  9. Improving gross count gamma-ray logging in uranium mining with the NGRS probe

    Carasco C.

    2018-01-01

    Full Text Available AREVA Mines and the Nuclear Measurement Laboratory of CEA Cadarache are collaborating to improve the sensitivity and precision of uranium concentration measurement by means of gamma ray logging. The determination of uranium concentration in boreholes is performed with the Natural Gamma Ray Sonde (NGRS based on a NaI(Tl scintillation detector. The total gamma count rate is converted into uranium concentration using a calibration coefficient measured in concrete blocks with known uranium concentration in the AREVA Mines calibration facility located in Bessines, France. Until now, to take into account gamma attenuation in a variety of boreholes diameters, tubing materials, diameters and thicknesses, filling fluid densities and compositions, a semi-empirical formula was used to correct the calibration coefficient measured in Bessines facility. In this work, we propose to use Monte Carlo simulations to improve gamma attenuation corrections. To this purpose, the NGRS probe and the calibration measurements in the standard concrete blocks have been modeled with MCNP computer code. The calibration coefficient determined by simulation, 5.3 s-1.ppmU-1 ± 10%, is in good agreement with the one measured in Bessines, 5.2 s-1.ppmU-1. Based on the validated MCNP model, several parametric studies have been performed. For instance, the rock density and chemical composition proved to have a limited impact on the calibration coefficient. However, gamma self-absorption in uranium leads to a nonlinear relationship between count rate and uranium concentration beyond approximately 1% of uranium weight fraction, the underestimation of the uranium content reaching more than a factor 2.5 for a 50 % uranium weight fraction. Next steps will concern parametric studies with different tubing materials, diameters and thicknesses, as well as different borehole filling fluids representative of real measurement conditions.

  10. Improving gross count gamma-ray logging in uranium mining with the NGRS probe

    Carasco, C.; Pérot, B.; Ma, J.-L.; Toubon, H.; Dubille-Auchère, A.

    2018-01-01

    AREVA Mines and the Nuclear Measurement Laboratory of CEA Cadarache are collaborating to improve the sensitivity and precision of uranium concentration measurement by means of gamma ray logging. The determination of uranium concentration in boreholes is performed with the Natural Gamma Ray Sonde (NGRS) based on a NaI(Tl) scintillation detector. The total gamma count rate is converted into uranium concentration using a calibration coefficient measured in concrete blocks with known uranium concentration in the AREVA Mines calibration facility located in Bessines, France. Until now, to take into account gamma attenuation in a variety of boreholes diameters, tubing materials, diameters and thicknesses, filling fluid densities and compositions, a semi-empirical formula was used to correct the calibration coefficient measured in Bessines facility. In this work, we propose to use Monte Carlo simulations to improve gamma attenuation corrections. To this purpose, the NGRS probe and the calibration measurements in the standard concrete blocks have been modeled with MCNP computer code. The calibration coefficient determined by simulation, 5.3 s-1.ppmU-1 ± 10%, is in good agreement with the one measured in Bessines, 5.2 s-1.ppmU-1. Based on the validated MCNP model, several parametric studies have been performed. For instance, the rock density and chemical composition proved to have a limited impact on the calibration coefficient. However, gamma self-absorption in uranium leads to a nonlinear relationship between count rate and uranium concentration beyond approximately 1% of uranium weight fraction, the underestimation of the uranium content reaching more than a factor 2.5 for a 50 % uranium weight fraction. Next steps will concern parametric studies with different tubing materials, diameters and thicknesses, as well as different borehole filling fluids representative of real measurement conditions.

  11. Probing a Possible Vacuum Refractive Index with Gamma-Ray Telescopes

    Ellis, John; Nanopoulos, D V; PH-TH

    2009-01-01

    We have used a stringy model of quantum space-time foam to suggest that the vacuum may exhibit a non-trivial refractive index depending linearly on gamma-ray energy: eta -1 ~ E_gamma/M_QG1, where M_QG1 is some mass scale typical of quantum gravity that may be ~ 10^18 GeV: see Phys. Lett. B 665, 412 (2008) and references therein. The MAGIC, HESS and Fermi gamma-ray telescopes have recently probed the possible existence of such an energy-dependent vacuum refractive index. All find indications of time-lags for higher-energy photons, but cannot exclude the possibility that they are due to intrinsic delays at the sources. However, the MAGIC and HESS observations of time-lags in emissions from AGNs Mkn 501 and PKS 2155-304 are compatible with each other and a refractive index depending linearly on the gamma-ray energy, with M_QG1 ~ 10^18 GeV. We combine their results to estimate the time-lag Delta t to be expected for the highest-energy photon from GRB 080916c measured by the Fermi telescope, which has an energy ~ ...

  12. The efficacy of low and high dose (99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism.

    Gencoglu, Esra Arzu; Aktas, Ayse

    2014-01-01

    The aim of this study was to compare the efficacy of low- and high-dose (99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands via gamma probe in secondary hyperparathyroidism. This retrospective study was conducted using a prospective database of 59 patients who had undergone radioguided subtotal parathyroidectomy between 2004-2012. The patients were studied in 2 groups. Group 1 (n=31) received 37 MBq (99m)Tc-MIBI intravenously in the surgical room approximately 10 min before the beginning of the intervention and surgery was performed under gamma probe guidance. Group 2 (n=28) received 555 MBq (99m)Tc- MIBI intravenously 2h before surgery, which was also performed under gamma probe guidance. Intraoperative gamma probe findings, laboratory findings, and histopathological findings were evaluated together. Using acceptance of the histopathological findings as gold standard, sensitivity and specificity of intraoperative gamma probe for identifying hyperplastic parathyroid glands was 98% and 100%, respectively, in both groups. In the light of these findings, it is concluded that the low-dose (99m)Tc-MIBI protocol might be preferable for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism patients because it was observed to be as effective as the high-dose (99m)Tc-MIBI protocol. Furthermore, the low-dose protocol does not have the disadvantages that are associated with the high-dose protocol. Copyright © 2014 Elsevier España, S.L. and SEMNIM. All rights reserved.

  13. Sensitivity of self-powered detector probes to electron and gamma-ray fields

    Lone, M.A.; Wong, P.Y.

    1995-01-01

    A self-powered detector (SPD) is a simple, passive device that consists of a coaxial probe with a metallic outer sleeve, a mineral oxide insulating layer, and a metallic inner core. SPD's are used in nuclear reactors to monitor neutron and gamma fields. Responses of SPD's to electrons and γ-rays of various energies were investigated with Monte Carlo simulations. Transmission filters were studied for the design of threshold SPD probes used for online monitoring of the energy spectrum of high-power industrial electron accelerator beams. Filters were also investigated for the enhancement of γ-ray sensitivity of an SPD placed in a mixed electron and γ-ray field. (author). 30 refs., 1 tab., 8 figs

  14. Compact and maintenance-free radio probes for environmental surveillance of the gamma dose rate

    Genrich, V.

    1998-01-01

    The author reports on his experience with the operation of radio data networks for the continuous observation of the gamma dose rate in nuclear installations. Practically at every location (within) the installation the hermetically sealed probes can record the measurement values. Moreover, the probes have proved successful in environmental surveillance where they typically work in the form of measurement rings in 10 to 30 km distance. All measurement data are organized in the form of a data base. They can be disposed of in the form of an SQL-server in the computer network (LAN) of the power plant or the institution in charge of environmental surveillance. In comparison to conventional, e.g. cable-bound measurement networks with the new radio transmission technology there are numerous advantages: - minimal cost for projection - minimal cost for installation due to simple fixing - quasi-mobile use with highest possible flexibility - maintenance-free operation and high degree of operating reliability. (orig.) [de

  15. Practical use of chemical probes for reactive oxygen species produced in biological systems by {gamma}-irradiation

    Lee, Min Hee; Moon, Yu Ran; Chung, Byung Yeoup; Kim, Jae-Sung [Radiation Research Division for Bio-technology, Korea Atomic Energy Research Institute, 1266 Sinjeong-dong, Jeongeup-si, Jeollabuk-do 580-185 (Korea, Republic of); Lee, Kang-Soo [Crop Production and Technology Major, Chonbuk National University, Jeonju 561-756 (Korea, Republic of); Cho, Jae-Young [Bio-environmental Science Major, Chonbuk National University, Jeonju 561-756 (Korea, Republic of); Kim, Jin-Hong [Radiation Research Division for Bio-technology, Korea Atomic Energy Research Institute, 1266 Sinjeong-dong, Jeongeup-si, Jeollabuk-do 580-185 (Korea, Republic of)], E-mail: jhongkim@kaeri.re.kr

    2009-05-15

    Application of chemical probes, for detection of reactive oxygen species (ROS), was tested during {gamma}-irradiation. The ethanol/{alpha}-(4-pyridyl-1-oxide)-N-tert-butylnitrone (4-POBN) and 3,3'-diaminobenzidine (DAB) were structurally stable enough to detect {sup {center_dot}}OH and H{sub 2}O{sub 2}, increasingly generated by {gamma}-irradiation up to 1000 Gy. Interestingly, the production rate of H{sub 2}O{sub 2}, but not {sup {center_dot}}OH, during {gamma}-irradiation, was significantly different between in vitro systems of lettuce and spinach. These results suggest that 4-POBN and DAB could be utilized as a semi-quantitative probe to quantify {sup {center_dot}}OH and H{sub 2}O{sub 2}, produced by {gamma}-irradiation up to 1000 Gy.

  16. Self-powered detector probes for electron and gamma-ray beam monitoring in high-power industrial accelerators

    Lone, M.A.

    1992-08-01

    A self-powered detector (SPD) is a simple passive device that consists of a coaxial probe with a metallic outer sleeve, a mineral oxide insulating layer, and a metallic inner core. SPDs are used in nuclear reactors for monitoring neutron and gamma ray fields. Responses of various SPDs to electron and gamma ray beams from industrial accelerators were investigated with Monte Carlo simulations. By judicious choice of transmission filters, threshold SPD probes were investigated for on-line monitoring of the beam energy spectrum of the high-power IMPELA industrial electron accelerator. (Author) (14 figs, 16 refs.)

  17. Development of gamma probe for radiation surveys of the bottoms of surface waters

    Lee, D.R.; Welch, S.J.; St Aubin, M.J.; Dal Bianco, R.

    1992-01-01

    We have developed a practical method for mapping variations in gamma activity and electrical conductivity of submerged sediments. Prototype probes are being constructed and tested. The first prototype was essentially a background survey meter (Jones, 1979) packaged in a 53-cm-long by 5.4-cm-diameter waterproof vehicle. This tubular vehicle was towed by boat in contact with the bottom sediments of lakes and rivers. Originally, this vehicle was designed (and is still frequently used) for locating groundwater and contaminant entry areas in surface waters. By logging geographic position and sediment variables, it has been possible to produce contour maps in areas of interest. Thus it is possible to optimize environmental analysis and avoid the 'hit or miss' approach of traditional bottom-sediment surveys. (author)

  18. Development of gamma probe technique for monitoring rooting pattern of pearl millet under field conditions

    Vittal, K.P.R.; Subbiah, B.V.

    1982-01-01

    For the root distribution studies, methods are not available to measure the growth in situ and in toto under field conditions without destroying the plants. A non-destructive method was developed for measuring the gamma activity in root using a probe that was administered through the stem. Five isotopes viz. 86 Rb, 134 Cs, 59 Fe, 65 Zn and 54 Mn tested, were found to represent almost similar rooting pattern for pearl millet from flowering to harvesting stages. Among these isotopes 59 Fe was found to be suitable for field use. This method also enabled to successfully monitor the root activity over time and avoided the sampling errors. Since laboratory processing of samples was eliminated, the process of measurement was hastened. (author)

  19. Investigation of LaBr3:Ce probe for gamma-ray spectroscopy and dosimetry

    Maghraby, Ahmed M.; Alzimami, K. S.; Alkhorayef, M. A.; Alsafi, K. G.; Ma, A.; Alfuraih, A. A.; Alghamdi, A. A.; Spyrou, N. M.

    2014-02-01

    The main thrust of this work is the investigation of performance of relatively new commercial LaBr3:Ce probe (Inspector 1000™ with LaBr3:Ce crystal) for gamma-ray spectroscopy and dosimetry measurements in comparison to LaCl3:Ce and NaI:Tl scintillators. The crystals were irradiated by a wide range of energies (57Co, 22Na, 18F, 137Cs and 60Co). The study involved recording of detected spectra and measurement of energy resolution, photopeak efficiency, internal radioactivity measurements as well as dose rate. The Monte Carlo package, Geant4 Application for Tomographic Emission (GATE) was used to validate the experiments. Overall results showed very good agreement between the measurements and the simulations. The LaBr3:Ce crystal has excellent energy resolution, energy resolutions of (3.37±0.05)% and (2.98±0.07)% for a 137Cs 662 keV and a 60Co 1332 keV gamma-ray point sources respectively, were recorded. The disadvantage of the lanthanum halide scintillators is their internal radioactivity. Inspector 1000™ with LaBr3:Ce scintillator has shown an accurate and quick dose measurements at Positron Emission Tomography (PET) Units which allows accurate assessment of the radiation dose received by staff members compared to the use of electronic personal dosimeters (EPD).

  20. Portable gamma and thermal neutron probe using a 6LiI(Eu) crystal

    Carneiro, Clemente J.G.; Araujo, Geraldo P.; Milian, Felix M.; Barbosa, Jurandir C.; Garcia, Fermin; Oliveira, Arno H.; Silva, Mario R.S.; Penna, Rodrigo

    2011-01-01

    Europium-activated lithium-6 iodide is a scintillator used for gamma and neutron counting. A portable detection system was built based on this scintillator. This system has three modules: the scintillator, a 10 m liquid light guide, and a Hamamatsu photon counting head H9319 used as a light pulse digitizer. Data transfer, measurement time and other necessary adjustment can be controlled by software from the PC through the RS-232C interface. The scintillator, a crystal of 6 LiI(Eu), is a small cylinder with 3 mm diameter and 40 mm length completely sealed in an aluminum tube coupled to the light guide. The small size of the scintillator increases the neutron/gamma count ratio, since 2 to 3 mm of thickness of this crystal absorbs all thermal neutrons. Intensities of X and gamma rays, and thermal neutrons can be recorded for time intervals of 10 ms to 1 s storing up to 10000 countings. The system was calibrated for measuring radiation doses for validating numerical models in dosimetry. Two characteristic reinforce this application, measurements can be done at several meters away from the radiation source and also inside of water. In addition, it was used to build nuclear probes based on Compton scattering or neutron moderation in porous media by attaching an AmBe source to the top of the aluminum tube. Tests were done to determine the reproducibility of counting rates. Background counting was measured at several temperatures to verify the influence of dark current of PMT. Sealed AmBe, low activity Am, and X rays sources were used for studies of radiation counting statistics. X rays apparatus was used to correlate counting rates measured with the 6 LiI(Eu) detection system and doses measured with an ionization chamber at several distances from the X ray source. (author)

  1. Portable gamma and thermal neutron probe using a {sup 6}LiI(Eu) crystal

    Carneiro, Clemente J.G.; Araujo, Geraldo P.; Milian, Felix M.; Barbosa, Jurandir C.; Garcia, Fermin [Universidade Estadual de Santa Cruz (UESC), Ilheus, BA (Brazil). Centro de Pesquisas em Ciencias e Tecnologias das Radiacoes (CPqCTR); Oliveira, Arno H.; Silva, Mario R.S.; Penna, Rodrigo [Universidade Federal de Minas Gerais (DEN-UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear

    2011-07-01

    Europium-activated lithium-6 iodide is a scintillator used for gamma and neutron counting. A portable detection system was built based on this scintillator. This system has three modules: the scintillator, a 10 m liquid light guide, and a Hamamatsu photon counting head H9319 used as a light pulse digitizer. Data transfer, measurement time and other necessary adjustment can be controlled by software from the PC through the RS-232C interface. The scintillator, a crystal of {sup 6}LiI(Eu), is a small cylinder with 3 mm diameter and 40 mm length completely sealed in an aluminum tube coupled to the light guide. The small size of the scintillator increases the neutron/gamma count ratio, since 2 to 3 mm of thickness of this crystal absorbs all thermal neutrons. Intensities of X and gamma rays, and thermal neutrons can be recorded for time intervals of 10 ms to 1 s storing up to 10000 countings. The system was calibrated for measuring radiation doses for validating numerical models in dosimetry. Two characteristic reinforce this application, measurements can be done at several meters away from the radiation source and also inside of water. In addition, it was used to build nuclear probes based on Compton scattering or neutron moderation in porous media by attaching an AmBe source to the top of the aluminum tube. Tests were done to determine the reproducibility of counting rates. Background counting was measured at several temperatures to verify the influence of dark current of PMT. Sealed AmBe, low activity Am, and X rays sources were used for studies of radiation counting statistics. X rays apparatus was used to correlate counting rates measured with the {sup 6}LiI(Eu) detection system and doses measured with an ionization chamber at several distances from the X ray source. (author)

  2. Gamma-ray bursts as cosmological probes: ΛCDM vs. conformal gravity

    Diaferio, Antonaldo; Ostorero, Luisa; Cardone, Vincenzo

    2011-01-01

    ΛCDM, for the currently preferred cosmological density Ω 0 and cosmological constant Ω Λ , predicts that the Universe expansion decelerates from early times to redshift z ≈ 0.9 and accelerates at later times. On the contrary, the cosmological model based on conformal gravity predicts that the cosmic expansion has always been accelerating. To distinguish between these two very different cosmologies, we resort to gamma-ray bursts (GRBs), which have been suggested to probe the Universe expansion history at z > 1, where identified type Ia supernovae (SNe) are rare. We use the full Bayesian approach to infer the cosmological parameters and the additional parameters required to describe the GRB data available in the literature. For the first time, we use GRBs as cosmological probes without any prior information from other data. In addition, when we combine the GRB samples with SNe, our approach neatly avoids all the inconsistencies of most numerous previous methods that are plagued by the so-called circularity problem. In fact, when analyzed properly, current data are consistent with distance moduli of GRBs and SNe that can respectively be, in a variant of conformal gravity, ∼ 15 and ∼ 3 magnitudes fainter than in ΛCDM. Our results indicate that the currently available SN and GRB samples are accommodated equally well by both ΛCDM and conformal gravity and do not exclude a continuous accelerated expansion. We conclude that GRBs are currently far from being effective cosmological probes, as they are unable to distinguish between these two very different expansion histories

  3. Assessment of the geometric coincidence of neutron and gamma probe measurements with solo 40 and CPN 501 B

    Valles, V.; Guiresse, M.; Tcherbakov, R.

    1989-01-01

    The distance between the gamma and neutron probe measurement centres was determined for the Nardeux Solo 40 and CPN 501 B probes. The centre of the spheres of influence was localized using a water-air interface constituted by a metal cylinder filled with 200 liters of water. For Solo 40, the discrepancy between the two measurement centres was 6 cm. This shift value, which is quite acceptable, does not require any correction for these measurements, even when the soil is heterogeneous. For CNP 501 B, the discrepancy between the neutron and gamma measurement was 11 cm, i.e. nearly twice the value observed with Solo 40. In soils with a marked vertical heterogeneity, it therefore seems preferable to operate a 11 cm shift of the probe between the moisture and density measurements [fr

  4. [Evaluation of the efficacy of sentinel node detection in breast cancer: chronological course and influence of the incorporation of an intra-operative portable gamma camera].

    Goñi Gironés, E; Vicente García, F; Serra Arbeloa, P; Estébanez Estébanez, C; Calvo Benito, A; Rodrigo Rincón, I; Camarero Salazar, A; Martínez Lozano, M E

    2013-01-01

    To define the sentinel node identification rate in breast cancer, the chronological evolution of this parameter and the influence of the introduction of a portable gamma camera. A retrospective study was conducted using a prospective database of 754 patients who had undergone a sentinel lymph node biopsy between January 2003 and December 2011. The technique was mixed in the starting period and subsequently was performed with radiotracer intra-peritumorally administered the day before of the surgery. Until October 2009, excision of the sentinel node was guided by a probe. After that date, a portable gamma camera was introduced for intrasurgical detection. The SN was biopsied in 725 out of the 754 patients studied. The resulting technique global effectiveness was 96.2%. In accordance with the year of the surgical intervention, the identification percentage was 93.5% in 2003, 88.7% in 2004, 94.3% in 2005, 95.7% in 2006, 93.3% in 2007, 98.8% in 2008, 97.1% in 2009 and 99.1% in 2010 and 2011. There was a significant difference in the proportion of identification before and after the incorporation of the portable gamma camera of 4.6% (95% CI of the difference 2-7.2%, P = 0.0037). The percentage of global identification exceeds the recommended level following the current guidelines. Chronologically, the improvement for this parameter during the study period has been observed. These data suggest that the incorporation of a portable gamma camera had an important role. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  5. Effect of intermediate zone during gamma-gamma and X-ray spectrum logging of quarry wells with inversive probes

    Artsybashev, V.A.; Volkov, A.A.

    1981-01-01

    Experimental and calculated data on the effect of intermediate zone on results of gamma-gamma and X-ray spectrum logging of quarry wells at chalcopyrite deposits are presented. The measurements have been carried out using 57 Co and 109 Cd sources for intermediate zone represented by water, air and mud. Requirements for technical conditions of wells have been formulated. According to the requirements the application of gamma- gamma method is possible when the thickness of the intermediate zone does not exceed several millimetres and that of X-ray spectrum method - when the thickness does not exceed several hundredths of a millimetre [ru

  6. Enhanced treatment of osteoid osteoma by intraoperative isotopic marking: a case report

    Haddam, A.; Bsiss, A.; Ech charraq, I.; BenRais, N.; Bakriga, B.; Moustain, M.R.; Hamama, J.

    2009-01-01

    Osteoid osteomas are small-sized benign painful bony tumours. Their complete surgical ablation consists in the proper treatment. The use of a portable Gamma probe allows to accurately localize the osteoid osteoma after radiolabelling and to reduce the size of incision and the bony ablation. We report the case of a patient having benefited from an isotopic intraoperative localization of an osteoid osteoma in the left tibia. Discussion chapter includes a comprehensive review of literature. (authors)

  7. Minimum dimensions of rock models for calibration of radiometric probes for the neutron-gamma well logging

    Czubek, J.A.; Lenda, A.

    1979-01-01

    The minimum dimensions have been calculated assuring 91, 96 and 98 % of the probe response in respect to the infinite medium. The models are of cylindrical form, the probe (source-to-detector distance equal to 60 or 90 cm) being placed on the model axis, symmetrically with respect to the two end-faces. All the models are ''embedded'' in various media, such as: air, sand of 40% porosity and completely saturated with water, sand of 30 % porosity and of moisture content equal to 10 %, and water. The models are of three types of material: sandstone, limestone and dolomite, with various porosities, ranging from 0 to 100 %. The probe response is due to gamma rays arising from the radiativecapture of thermal neutrons. The calculations were carried out for the highest energy line of gamma rays arising in given litology. Gamma-ray flux from the neutron radiative capture has been calculated versus rock porosity and model dimensions and radiation migration lengths determined for given litologies. The minimum dimensions of cylindrical models are given as functions of: porosity, probe length (source-to-detector distance) lithology of model and type of medium surrounding our model. (author)

  8. Looking inside jets: optical polarimetry as a probe of Gamma-Ray Bursts physics

    Kopac, D.; Mundell, C.

    2015-07-01

    It is broadly accepted that gamma-ray bursts (GRBs) are powered by accretion of matter by black holes, formed during massive stellar collapse, which launch ultra-relativistic, collimated outflows or jets. The nature of the progenitor star, the structure of the jet, and thus the underlying mechanisms that drive the explosion and provide collimation, remain some of the key unanswered questions. To approach these problems, and in particular the role of magnetic fields in GRBs, early time-resolved polarimetry is the key, because it is the only direct probe of the magnetic fields structure. Using novel fast RINGO polarimeter developed for use on the 2-m robotic optical Liverpool Telescope, we have made the first measurements of optical linear polarization of the early optical afterglows of GRBs, finding linear percentage polarization as high as 30% and, for the first time, making time-resolved polarization measurements. I will present the past 8 years of RINGO observations, discuss how the results fit into the GRB theoretical picture, and highlight recent data, in particular high-time resolution multi-colour optical photometry performed during the prompt GRB phase, which also provides some limits on polarization.

  9. Intraoperative electrocorticography

    Gabriela Alcaraz

    2017-01-01

    Full Text Available Intraoperative electrocorticography (ECoG is the recording of electrophysiological activity from electrodes placed directly on the exposed surface of brain, during surgery for epilepsy and tumor resection. The ECoG is helpful in defining the seizure onset and spread within the cortical surface and delineation of the interface between epileptogenic zones and functional cortex substance of the brain. Intraoperative ECoG is an invasive procedure, it is performed during surgery mostly commonly during awake craniotomy but at times during general anaesthesia. As most anesthetic agents will affect ECoG, they should be minimized or stopped prior to any recording. Activation of intraoperative epileptiform activity may also be required if there are no spontaneous discharges. The appropriate management of the anesthetic during the time of ECoG is critical for its success. There are limitations and some controversies to all the uses of intraoperative ECoG, thus each center will set their own indications, criteria, and protocols.

  10. Probing Pre-Galactic Metal Enrichment with High-Redshift Gamma-Ray Bursts

    Wang, F. Y.; Bromm, Volker; Greif, Thomas H.; Stacy, Athena; Dai, Z. G.; Loeb, Abraham; Cheng, K. S.

    2012-01-01

    We explore high-redshift gamma-ray bursts (GRBs) as promising tools to probe pre-galactic metal enrichment. We utilize the bright afterglow of a Population III (Pop III) GRB exploding in a primordial dwarf galaxy as a luminous background source, and calculate the strength of metal absorption lines that are imprinted by the first heavy elements in the intergalactic medium (IGM). To derive the GRB absorption line diagnostics, we use an existing highly resolved simulation of the formation of a first galaxy which is characterized by the onset of atomic hydrogen cooling in a halo with virial temperature approximately greater than10(exp 4) K.We explore the unusual circumburst environment inside the systems that hosted Pop III stars, modeling the density evolution with the self-similar solution for a champagne flow. For minihalos close to the cooling threshold, the circumburst density is roughly proportional to (1 + z) with values of about a few cm(exp -3). In more massive halos, corresponding to the first galaxies, the density may be larger, n approximately greater than100 cm(exp -3). The resulting afterglow fluxes are weakly dependent on redshift at a fixed observed time, and may be detectable with the James Webb Space Telescope and Very Large Array in the near-IR and radio wavebands, respectively, out to redshift z approximately greater than 20. We predict that the maximum of the afterglow emission shifts from near-IR to millimeter bands with peak fluxes from mJy to Jy at different observed times. The metal absorption line signature is expected to be detectable in the near future. GRBs are ideal tools for probing the metal enrichment in the early IGM, due to their high luminosities and featureless power-law spectra. The metals in the first galaxies produced by the first supernova (SN) explosions are likely to reside in low-ionization stages (C II, O I, Si II and Fe II). We show that, if the afterglow can be observed sufficiently early, analysis of the metal lines may

  11. Preliminary results of a gamma-ray burst study in the Konus experiment on the Venera-11 and Venera-12 space probes

    Mazets, Y.P.; Golentskii, S.V.; Ilinskii, V.N.; Panov, V.N.; Aptekar, R.L.

    Twenty-one gamma-ray bursts and 68 solar flares in the hard X-ray range were detected on Venera-11 and Venera-12 space probes during the initial 50-day observation period. Major characteristics of the equipment used and preliminary data on the temporal structure and energy spectra of the gamma-ray bursts are considered. The pattern of gamma-ray burst frequency distribution vs. intensity, N(S), is established

  12. Single fiber beta detector for stereotactic biopsy and intraoperative lumpectomy of breast cancer

    Atac, M.; Nalcioglu, O.; Roeck, W.W.

    1996-10-01

    We have developed an intraoperative probe for use in early detection of breast cancer and aiding lumpectomy. The probe consists of a small plastic scintillator, 0.8mm dia and 3mm long, coupled to a single clear optical-fiber strand, and solid state photomultiplier. Due to the small size of the probe, it can be placed inside of a small gauge biopsy needle. The scintillator is very efficient in detecting betas and positrons while being very in efficient to energetic gammas due to small size and low density. High quantum efficiency, 80%, and high gain obtainable, solid state photomultiplier makes the probe very low noise device in detecting beta particles. Intrinsic resolution of the probe is expected to be around 1 mm. Preliminary results using beta sources and a rat bearing R320 adenocarcinoma tumor were very successful

  13. A very accurate method for sentinel lymph node investigation: Gamma detecting probe associated with SPECT examination for depth

    Ascoli, G.; Cinti, P.; Nonni, M.; Rossi, B.

    2002-01-01

    Aim: aim of this study is to magnify the lymphoscintigraphy examination by gamma probe with SPECT acquisition for very accurate detection of depth of axilla node in patients affected by melanoma. Methods: according to physiological peculiarities the lymphatic system plays a very important role and represents the most important barrier to neoplastic cells spreading. The 'sentinel node' is the first lymph node draining the affected area. The tendency for surgery is a 'preventive' axillary dissection, even in presence of a clinically negative examination. In fact a high percentage of clinically negative lymph node shows a positive histology (presence of metastatic cells). The nuclear medicine method for researching 'sentinel node' is represented by a regional lymphoscintigraphy with normal gamma camera with a large field of view followed by examination with gamma detecting probe and, in following day, controlled in operating room to confirm the presence of the node early identified. We have completed this protocol with SPECT examination of affected axilla by use of injected laboratory capillary around axilla to perform an exact investigation of node depth. Discussion: Our experience in 150 cases in 18 months shows 100% of axilla 'sentinel node' detection, 25 cases with positive histologic examination and subsequently axillary dissection. Conclusions: In conclusion the scintigraphic examination with lymphoscintigraphy represents a good tool for management of patient with melanoma and the use of ''targeting' with collimated SPECT represent a very aid for the surgeon in reduction time for detection and dissection of lymph node, with high reduction of anesthesia duration

  14. Using gamma-ray bursts to probe the cosmic intergalactic medium

    Sudilovsky, Vladimir

    2014-01-01

    Gamma-ray bursts (GRBs) rapidly liberate enormous amounts of energy through the cataclysmic destruction of an individual massive object. GRBs are the most energetic events in the Universe, boasting isotropic equivalent energy releases of E∝10 51-54 erg in time scales of seconds - more energy than even active galaxies in the same time-frame. These transient events represent the ultimate high energy laboratories, and their afterglows are readily detectable from ground-based observatories out to cosmological distances out to z∝8. For this reason, GRBs are a natural tool to probe the early universe. To this end, programs to quickly measure the photometric and spectroscopic properties of GRB afterglows are providing a wealth of data that enable us to characterize the physical properties of both the burst itself and its host environment. In addition to providing extremely poignant information on the burst and its medium, GRB afterglow spectra show the presence of matter intervening along the line of sight. MgII, an important tracer of α-element processes and thus of star formation and galaxies, has been measured in ∝ 60% of GRB afterglow spectra. Surprisingly, MgII is only found in ∝30% of quasar spectra. This discrepancy in the number density dn/dz of intervening MgII absorbers implies that there are significant observational biases in either the spectroscopic samples of either GRB afterglows or quasars. In this work, we review the MgII issue and the biases proposed to explain it. We find that observations of other tracer systems (namely CIV) do not show the same overdensity, and thus conclude that solution to the MgII problem is related to the geometry of the sight-line relative to the absorbers. We conclude that an observational bias stemming from dust extinction arising from MgII cannot explain such a large discrepancy. Finally, we search for a signal of the MgII discrepancy in the transverse direction by computing the GRB-galaxy two point correlation

  15. Using gamma-ray bursts to probe the cosmic intergalactic medium

    Sudilovsky, Vladimir

    2014-05-28

    Gamma-ray bursts (GRBs) rapidly liberate enormous amounts of energy through the cataclysmic destruction of an individual massive object. GRBs are the most energetic events in the Universe, boasting isotropic equivalent energy releases of E∝10{sup 51-54} erg in time scales of seconds - more energy than even active galaxies in the same time-frame. These transient events represent the ultimate high energy laboratories, and their afterglows are readily detectable from ground-based observatories out to cosmological distances out to z∝8. For this reason, GRBs are a natural tool to probe the early universe. To this end, programs to quickly measure the photometric and spectroscopic properties of GRB afterglows are providing a wealth of data that enable us to characterize the physical properties of both the burst itself and its host environment. In addition to providing extremely poignant information on the burst and its medium, GRB afterglow spectra show the presence of matter intervening along the line of sight. MgII, an important tracer of α-element processes and thus of star formation and galaxies, has been measured in ∝ 60% of GRB afterglow spectra. Surprisingly, MgII is only found in ∝30% of quasar spectra. This discrepancy in the number density dn/dz of intervening MgII absorbers implies that there are significant observational biases in either the spectroscopic samples of either GRB afterglows or quasars. In this work, we review the MgII issue and the biases proposed to explain it. We find that observations of other tracer systems (namely CIV) do not show the same overdensity, and thus conclude that solution to the MgII problem is related to the geometry of the sight-line relative to the absorbers. We conclude that an observational bias stemming from dust extinction arising from MgII cannot explain such a large discrepancy. Finally, we search for a signal of the MgII discrepancy in the transverse direction by computing the GRB-galaxy two point correlation

  16. LHCb: Probing photon polarization in Bs->phi gamma decay at LHCb

    Shchutska, L

    2008-01-01

    The radiative decay Bs->phi gamma is one of the benchmark channels in the physics programme of the LHCb experiment. It provides the possibility to test the Standard Model through the indirect measurement of the photon polarization in b->s gamma transition. The statistical uncertainty in the wrong polarization fraction of photons is estimated to be ~0.2 with the 2 fb^{-1} of integrated luminosity.

  17. Rapid intraoperative parathyroid hormone assay--more than just a comfort measure.

    Hanif, F

    2012-02-03

    BACKGROUND: Minimally invasive radio-guided parathyroidectomy (MIRP) has been embraced as an acceptable therapeutic approach to primary hyperparathyroidism. Preoperative sestamibi scanning has facilitated this technique. Here we evaluate the addition of a rapid intraoperative parathyroid hormone (iPTH) assay for patients undergoing MIRP. METHODS: A series of 51 patients underwent sestamibi localization of parathyroid glands followed by MIRP for primary hyperparathyroidism. Using peripheral venous samples, iPTH levels were measured prior to gland excision, as well as post-excision at 5, 10, and 15 minutes, taking a 50% reduction in iPTH level as indicative of complete excision. Next, changes in serum iPTH were compared with preoperative and postoperative changes in serum calcium, as well as levels of intraoperative ex-vivo radiation counts taken by hand-held gamma probe. RESULTS: In this series, a drop of greater than 50% in iPTH levels was observed in 94% of patients (n=48). Moreover, a significant drop in iPTH occurred within 10 minutes of excision in the majority (n=42) of cases (P<0.004). Changes in iPTH were comparable with the therapeutic reduction in calcium levels, as well as with the change in intraoperative ex-vivo gamma counts. CONCLUSIONS: This study demonstrates that the addition of an iPTH assay to MIRP provides a quick and reliable intraoperative diagnostic modality in confirming correct adenoma removal. Moreover, it precludes the requirement of frozen section.

  18. Gamma-ray bursts from stellar remnants - Probing the universe at high redshift

    Wijers, R.A.M.J.; Bloom, J.S.; Bagla, J.S.; Natarajan, P.

    1998-01-01

    A gamma-ray burst (GRB) releases an amount of energy similar to that of a supernova explosion, which combined with its rapid variability suggests an origin related to neutron stars or black holes. Since these compact stellar remnants form from the most massive stars not long after their birth, GRBs

  19. Density measurement by means of once scattered gamma radiation the ETG probe, principles and equipment

    Joergensen, J.L.; Oelgaard, P.L.; Berg, F.

    1987-01-01

    The Department of Electrophysics, the Technical University of Denmark, and the Danish National Road Laboratory have together developed a new patent claimed device for measurements of the in situ density of materials. This report describes the principles of the system and some experimental results. The system is based on the once scattered gamma radiation. In a totally non-destructive and fast way it is possible to measure the density of up to 25 cm thick layers. Furthermore, an estimate of the density variation through the layer may be obtained. Thus the gauge represents a new generation of equipment for e.g. compaction control of road constructions. (author)

  20. Probing the Extragalactic Cosmic-Ray Origin with Gamma-Ray and Neutrino Backgrounds

    Globus, Noemie; Piran, Tsvi [Racah Institute of Physics, The Hebrew University, 91904 Jerusalem (Israel); Allard, Denis; Parizot, Etienne [Laboratoire Astroparticule et Cosmologie, Université Paris Diderot/CNRS, 10 rue A. Domon et L. Duquet, F-75205 Paris Cedex 13 (France)

    2017-04-20

    GeV–TeV gamma-rays and PeV–EeV neutrino backgrounds provide a unique window on the nature of the ultra-high-energy cosmic rays (UHECRs). We discuss the implications of the recent Fermi -LAT data regarding the extragalactic gamma-ray background and related estimates of the contribution of point sources as well as IceCube neutrino data on the origin of the UHECRs. We calculate the diffuse flux of cosmogenic γ -rays and neutrinos produced by the UHECRs and derive constraints on the possible cosmological evolution of UHECR sources. In particular, we show that the mixed-composition scenario considered in Globus et al., which is in agreement with both (i) Auger measurements of the energy spectrum and composition up to the highest energies and (ii) the ankle-like feature in the light component detected by KASCADE-Grande, is compatible with both the Fermi -LAT measurements and with current IceCube limits. We also discuss the possibility for future experiments to detect associated cosmogenic neutrinos and further constrain the UHECR models, including possible subdominant UHECR proton sources.

  1. Adenoma paratiroideo ectópico mediastinal: Diagnóstico por sonda de detección gamma y resección por videotoracoscopia Ectopic mediastinal parathyroid adenoma: Detection with a radioisotopic probe and resolution with videothoracoscopy

    Daniel Moncet

    2006-10-01

    Full Text Available Presentamos el caso de una mujer de 66 años con diagnóstico de hiperparatiroidismo primario por adenoma paratiroideo ectópico mediastinal realizado por gammagrafía paratiroidea con 99mtc-metoxi-isobutil-isonitrito (Tc99-MIBI. Fue intervenida exitosamente mediante la técnica de videotoracoscopia. Durante el procedimiento se utilizó la medición de parathormona y a los 10 minutos de extirpado el adenoma se obtuvo un descenso mayor del 50% del basal. La sonda de detección gamma no fue efectiva in situ por la superposición del radioisótopo con el miocardio pero confirmó la radioactividad dentro del quirófano una vez extirpado el adenoma. La paciente normalizó los valores de calcemia y parathormona en el postoperatorio y permaneció normocalcémica luego de 9 meses de seguimiento. En nuestro caso, la localización prequirúrgica y el monitoreo de parathormona intraoperatoria fueron de gran utilidad para el éxito quirúrgico, la sonda detectora marcada con Tc99-MIBI no fue efectiva in situ pero confirmó la radioactividad una vez extirpado el adenoma. El tratamiento quirúrgico endoscópico por videotoracoscopia fue bien tolerado, menos doloroso que la toracotomía y acortó el tiempo de internación.We report a 66 years old woman with a diagnosis of primary hyperparathyroidism. Localization to mediastinum was obtained with parathyroid scintigraphy using 99mtc-methoxy-isobutyl-isonitrite (Tc99-MIBI. The patient was successfully operated upon by means of a videothora-coscopic approach. During the procedure serum parathormone was measured before and 10 minutes after adenomectomy, showing a more than 50% reduction from the basal level. An attempt to detect the precise site of the adenoma with a Tc99-MIBI probe was unsuccessful because of its proximity to the myocardium, but radioactivity was confirmed on the surgical specimen after resection. The patient's calcemia and parathormone levels became normal during the postoperative course and she

  2. Probing dark matter annihilation in the Galaxy with antiprotons and gamma rays

    Cuoco, Alessandro; Heisig, Jan; Korsmeier, Michael; Krämer, Michael, E-mail: cuoco@physik.rwth-aachen.de, E-mail: heisig@physik.rwth-aachen.de, E-mail: korsmeier@physik.rwth-aachen.de, E-mail: mkraemer@physik.rwth-aachen.de [Institute for Theoretical Particle Physics and Cosmology, RWTH Aachen University, 52056 Aachen (Germany)

    2017-10-01

    A possible hint of dark matter annihilation has been found in Cuoco, Korsmeier and Krämer (2017) from an analysis of recent cosmic-ray antiproton data from AMS-02 and taking into account cosmic-ray propagation uncertainties by fitting at the same time dark matter and propagation parameters. Here, we extend this analysis to a wider class of annihilation channels. We find consistent hints of a dark matter signal with an annihilation cross-section close to the thermal value and with masses in range between 40 and 130 GeV depending on the annihilation channel. Furthermore, we investigate in how far the possible signal is compatible with the Galactic center gamma-ray excess and recent observation of dwarf satellite galaxies by performing a joint global fit including uncertainties in the dark matter density profile. As an example, we interpret our results in the framework of the Higgs portal model.

  3. Probing stochastic inter-galactic magnetic fields using blazar-induced gamma ray halo morphology

    Duplessis, Francis [Physics Department, Arizona State University, Tempe, AZ 85287 (United States); Vachaspati, Tanmay, E-mail: fdupless@asu.edu, E-mail: tvachasp@asu.edu [Maryland Center for Fundamental Physics, University of Maryland, College Park, MD 20742 (United States)

    2017-05-01

    Inter-galactic magnetic fields can imprint their structure on the morphology of blazar-induced gamma ray halos. We show that the halo morphology arises through the interplay of the source's jet and a two-dimensional surface dictated by the magnetic field. Through extensive numerical simulations, we generate mock halos created by stochastic magnetic fields with and without helicity, and study the dependence of the halo features on the properties of the magnetic field. We propose a sharper version of the Q-statistics and demonstrate its sensitivity to the magnetic field strength, the coherence scale, and the handedness of the helicity. We also identify and explain a new feature of the Q-statistics that can further enhance its power.

  4. $^{80m}$Br/$^{80}$Br a new electron-$\\gamma$ - PAC Probe

    Correia, J G; Araújo, J P; Marques, J G; Soares, J C; Melo, A A

    2001-01-01

    Conversion electron-$\\gamma$ PAC measurements of the 49 keV - 37 keV cascade in $^{80}$Br through the intermediate 2$^{-}$ state with T$_{1/2}$=7.4 ns were performed with a system of two magnetic lens spectrometers and two BaF$_{2}$ scintillation detectors. The parent $^{80m}$Br activity with half-life of 4.4 hrs was implanted into Ni, Zn and graphite at the ISOLDE separator at CERN. The observed interaction frequency in the nickel matrix is in good agreement with the known value of the hyperfine field for Br in Ni and the magnetic moment of the 2$^{-}$ state. From the measured quadrupole interaction in Zn and graphite the electric field gradients at Br were obtained.

  5. $^{80}$Br $^{80}$Br-a new electron-gamma PAC probe

    Correia, J G; Araújo, J P; Marques, J G; Soares, J C; Melo, A A

    2001-01-01

    Conversion electron-gamma PAC measurements of the 49-37 keV cascade in /sup 80/Br through the intermediate 2/sup -/ state with T/sub 1/2 /=7.4 ns were performed with a system of two magnetic lens spectrometers and two BaF/sub 2/ scintillation detectors. The parent /sup 80m/Br activity with a halflife of 4.4 hrs was implanted into Ni, Zn and graphite at the ISOLDE separator at CERN. The observed interaction frequency in the nickel matrix is in good agreement with the known value of the hyperfine field for Br in Ni and the magnetic moment of the 2/sup -/ state. From the measured quadrupole interaction in Zn and graphite the electric field gradients at Br were obtained. (7 refs).

  6. Probing Gamma-ray Emission of Geminga & Vela with Non-stationary Models

    Yating Chai

    2016-06-01

    Full Text Available It is generally believed that the high energy emissions from isolated pulsars are emitted from relativistic electrons/positrons accelerated in outer magnetospheric accelerators (outergaps via a curvature radiation mechanism, which has a simple exponential cut-off spectrum. However, many gamma-ray pulsars detected by the Fermi LAT (Large Area Telescope cannot be fitted by simple exponential cut-off spectrum, and instead a sub-exponential is more appropriate. It is proposed that the realistic outergaps are non-stationary, and that the observed spectrum is a superposition of different stationary states that are controlled by the currents injected from the inner and outer boundaries. The Vela and Geminga pulsars have the largest fluxes among all targets observed, which allows us to carry out very detailed phase-resolved spectral analysis. We have divided the Vela and Geminga pulsars into 19 (the off pulse of Vela was not included and 33 phase bins, respectively. We find that most phase resolved spectra still cannot be fitted by a simple exponential spectrum: in fact, a sub-exponential spectrum is necessary. We conclude that non-stationary states exist even down to the very fine phase bins.

  7. Handy-type gamma probe-guided sentinel lymph node biopsy for breast cancer under ambulatory local anesthesia

    Fujiwara, Ikuya; Nagata, Hiroaki; Takaki, Wataru

    2016-01-01

    Prior to surgery for clinically node-negative breast cancer, we diagnosed metastases on the basis of permanent sections and sentinel lymph node biopsy (SNB) using the combined radio isotope (RI)/blue dye method with a hand-type gamma probe under ambulatory local anesthesia. SNB was performed for 99 patients with 103 lesions, including 4 patients with bilateral breast cancer. We achieved an identification rate of 100%, in which the identification pattern included detection by RI and blue-dye in 65 patients (63.1%), detection by RI alone in 37 patients (35.9%), and blue-dye alone in one patient (1.0%). Sentinel lymph node metastasis was macrometastasis in 21 patients (20.4%), micrometastasis in 8 patients (7.8%), and isolated tumor cells in patients (4.9%). In the 80 patients who did not undergo post-SNB axillary lymph node dissection, the median observation period was 33 months and there were no recurrences in the axillary lymph nodes observed. Although the present procedure requires two surgeries, it is a useful method that enables metastasis detection and highly accurate SNB. (author)

  8. Calibration, field-testing, and error analysis of a gamma-ray probe for in situ measurement of dry bulk density

    Bertuzzi, P.; Bruckler, L.; Gabilly, Y.; Gaudu, J.C.

    1987-01-01

    This paper describes a new gamma-ray probe for measuring dry bulk density in the field. This equipment can be used with three different tube spacings (15, 20 and 30 cm). Calibration procedures and local error analyses are proposed for two cases: (1) for the case where the access tubes are parallel, calibration equations are given for three tube spacings. The linear correlation coefficient obtained in the laboratory is satisfactory (0.999), and a local error analysis shows that the standard deviation in the measured dry bulk density is small (+/- 0.02 g/cm 3 ); (2) when the access tubes are not parallel, a new calibration procedure is presented that accounts for and corrects measurement bias due to the deviating probe spacing. The standard deviation associated with the measured dry bulk density is greater (+/- 0.05 g/cm 3 ), but the measurements themselves are regarded as unbiased. After comparisons of core samplings and gamma-ray probe measurements, a field validation of the gamma-ray measurements is presented. Field validation was carried out on a variety of soils (clay, clay loam, loam, and silty clay loam), using gravimetric water contents that varied from 0.11 0.27 and dry bulk densities ranging from 1.30-1.80 g°cm -3 . Finally, an example of dry bulk density field variability is shown, and the spatial variability is analyzed in regard to the measurement errors

  9. Gamma rays as probe of fission and quasi-fission dynamics in the reaction 32S + 197Au near the Coulomb barrier

    Pulcini, A.; Vardaci, E.; Kozulin, E.; Ashaduzzaman, M.; Borcea, C.; Bracco, A.; Brambilla, S.; Calinescu, S.; Camera, F.; Ciemala, M.; de Canditiis, B.; Dorvaux, O.; Harca, I. M.; Itkis, I.; Kirakosyan, V. V.; Knyazheva, G.; Kozulina, N.; Kolesov, I. V.; La Rana, G.; Maj, A.; Matea, I.; Novikov, K.; Petrone, C.; Quero, D.; Rath, P.; Saveleva, E.; Schmitt, C.; Sposito, G.; Stezowski, O.; Trzaska, W. H.; Wilson, J.

    2018-05-01

    Compound nucleus fission and quasi-fission are both binary decay channels whose common properties make the experimental separation between them difficult. A way to achieve this separation could be to probe the angular momentum of the binary fragments. This can be done detecting gamma rays in coincidence with the two fragments. As a case study, the reaction 32S + 197Au near the Coulomb barrier has been performed at the Tandem ALTO facility at IPN ORSAY. ORGAM and PARIS, two different gamma detectors arrays, are coupled with the CORSET detector, a two-arm time-of-flight spectrometer. TOF-TOF data were analyzed to reconstruct the mass-energy distribution of the primary fragments coupled with gamma multiplicity and spectroscopic analysis. Preliminary results of will be shown.

  10. Probing the Cosmic Gamma-Ray Burst Rate with Trigger Simulations of the Swift Burst Alert Telescope

    Lien, Amy; Sakamoto, Takanori; Gehrels, Neil; Palmer, David M.; Barthelmy, Scott D.; Graziani, Carlo; Cannizzo, John K.

    2013-01-01

    The gamma-ray burst (GRB) rate is essential for revealing the connection between GRBs, supernovae and stellar evolution. Additionally, the GRB rate at high redshift provides a strong probe of star formation history in the early universe. While hundreds of GRBs are observed by Swift, it remains difficult to determine the intrinsic GRB rate due to the complex trigger algorithm of Swift. Current studies of the GRB rate usually approximate the Swift trigger algorithm by a single detection threshold. However, unlike the previously own GRB instruments, Swift has over 500 trigger criteria based on photon count rate and additional image threshold for localization. To investigate possible systematic biases and explore the intrinsic GRB properties, we develop a program that is capable of simulating all the rate trigger criteria and mimicking the image threshold. Our simulations show that adopting the complex trigger algorithm of Swift increases the detection rate of dim bursts. As a result, our simulations suggest bursts need to be dimmer than previously expected to avoid over-producing the number of detections and to match with Swift observations. Moreover, our results indicate that these dim bursts are more likely to be high redshift events than low-luminosity GRBs. This would imply an even higher cosmic GRB rate at large redshifts than previous expectations based on star-formation rate measurements, unless other factors, such as the luminosity evolution, are taken into account. The GRB rate from our best result gives a total number of 4568 +825 -1429 GRBs per year that are beamed toward us in the whole universe.

  11. Intraoperative radiation therapy

    Dobelbower Junior, R.R.

    1987-01-01

    A briefly history of intraoperative radiotherapy is presented. The equipment used is described and the treatment with superficial X-ray beams, orthovoltage X-ray beams and megavoltage electron beams are discussed. The effect on normal tissues and the clinical use of intraoperative radiotherapy in several Kind of cancer is studied. (M.A.C.) [pt

  12. Large-scale anisotropy in the extragalactic gamma-ray background as a probe for cosmological antimatter

    Gao, Yi-Tian; Stecker, Floyd W.; Gleiser, Marcelo; Cline, David B.

    1990-01-01

    Intrinsic anisotropies in the extragalactic gamma-ray background (EGB), which should be detectable with the forthcoming Gamma Ray Observatory, can be used to examine some of the mechanisms proposed to explain its origin, one of which, the baryon-symmetric big bang (BSBB) model, is investigated here. In this simulation, large domains containing matter and antimatter galaxies produce gamma rays by annihilation at the domain boundaries. This mechanism can produce mountain-chain-shaped angular fluctuations in the EGB flux.

  13. [Intraoperative multidimensional visualization].

    Sperling, J; Kauffels, A; Grade, M; Alves, F; Kühn, P; Ghadimi, B M

    2016-12-01

    Modern intraoperative techniques of visualization are increasingly being applied in general and visceral surgery. The combination of diverse techniques provides the possibility of multidimensional intraoperative visualization of specific anatomical structures. Thus, it is possible to differentiate between normal tissue and tumor tissue and therefore exactly define tumor margins. The aim of intraoperative visualization of tissue that is to be resected and tissue that should be spared is to lead to a rational balance between oncological and functional results. Moreover, these techniques help to analyze the physiology and integrity of tissues. Using these methods surgeons are able to analyze tissue perfusion and oxygenation. However, to date it is not clear to what extent these imaging techniques are relevant in the clinical routine. The present manuscript reviews the relevant modern visualization techniques focusing on intraoperative computed tomography and magnetic resonance imaging as well as augmented reality, fluorescence imaging and optoacoustic imaging.

  14. The angular power spectrum of the diffuse gamma-ray background as a probe of Galactic dark matter substructure

    Siegal-Gaskins, Jennifer M.

    2009-01-01

    Dark matter annihilation in Galactic substructure produces diffuse gamma-ray emission of remarkably constant intensity across the sky, and in general this signal dominates over the smooth halo signal at angles greater than a few tens of degrees from the Galactic Center. The large-scale isotropy of the emission from substructure suggests that it may be difficult to extract this Galactic dark matter signal from the extragalactic gamma-ray background. I show that dark matter substructure induces...

  15. PET Probe-Guided Surgery in Patients with Breast Cancer: Proposal for a Methodological Approach

    ORSARIA, PAOLO; CHIARAVALLOTI, AGOSTINO; FIORENTINI, ALESSANDRO; PISTOLESE, CHIARA; VANNI, GIANLUCA; VITTORIA GRANAI, ALESSANDRA; VARVARAS, DIMITRIOS; DANIELI, ROBERTA; SCHILLACI, ORAZIO; PETRELLA, GIUSEPPE; CLAUDIO BUONOMO, ORESTE

    2017-01-01

    Background: Although it is valuable for detecting distant metastases, identifying recurrence, and evaluating responses to chemotherapy, the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) in assessing locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. In the current report, we describe a new PET probe-based clinical approach, with evaluation of the technical performance of a handheld high-energy gamma probe for intraoperative localization of breast carcinomas, and evaluation of lymph node metastases during radio-guided oncological surgery. Patients and Methods: Three patients underwent a PET/CT scan immediately prior to surgery following the standard clinical protocol. Intraoperatively, tumors were localized and resected with the assistance of a hand-held gamma probe. PET-guided assessment of the presence or absence of regional nodal spread of malignancy was compared with the reference standard of histopathological examination. Results: In all three cases, perioperative 18F-FDG PET/CT imaging and intraoperative gamma probe detection verified complete resection of the hypermetabolic lesions and demonstrated no additional suspicious occult disease. Conclusion: This innovative approach demonstrates great promise for providing real-time access to metabolic and morphological tumor information that may lead to an optimal disease-tailored approach. In carefully selected indications, a PET probe can be a useful adjunct in surgical practice, but further trials with a larger number of patients need to be performed to verify these findings. PMID:28064227

  16. In situ prompt gamma-ray measurement of river water salinity in northern Taiwan using HPGe-252Cf probe

    Jiunnhsing Chao; Chien Chung

    1991-01-01

    A portable HPGe- 252 Cf probe dedicated to in situ survey of river water salinity was placed on board a fishing boat to survey the Tamsui River in northern Taiwan. The variation of water salinity is surveyed by measuring the 6111 keV chlorine prompt photopeak along the river. Results indicate that the probe can be used as a salinometer for rapid, in situ measurement in polluted rivers or sea. (author)

  17. Development of surgical gamma probes with TlBr semiconductors and CsI(Tl) scintillators crystals

    Costa, Fabio Eduardo da

    2006-01-01

    Radio guided surgery, using probes with radiation detectors, has been prominence in the medical area in the last decade. This technique consists in injecting a radioactive substance to concentrate in tumour and assist the localization during the surgical procedure. The radio guided surgeries allowing the identification of lymph node has revolutioned the behavior of tumour in initial stadium when are being spread by lymphatic way. The conditions imposed to the surgery due the proximity between some lymph nodes, demands of the probes, a small diameters and capacity of individual identification of these lymph nodes radiolabelled by a specific tracer. The international market supplies these probes with CdTe semiconductors and scintillators, but there is some time lack a promptly technical assistance in the Brazilian market. This work developed probes with national technology, using CsI(Tl) scintillators crystals and, in substitution to CdTe crystals semiconductors, the TlBr crystal, that is a new semiconductor detector in a world-wide development, with advantages in relation to the CdTe. Both crystals have been grown in IPEN. All the necessary electronics, specially, the preamplifier, that was also a restrictive factor for development of these types of probe in the country, have been developed with components found in the national market. Systematic measures of spatial resolution, spatial selectivity, maximum sensitivity and quality of the shielding have been carried the probes development. The results have shown that the probes, one with the CsI(Tl) crystal and another with TlBr semiconductor presented the requested performance in the international literature for radio guided probes. (author)

  18. A novel intra-operative positron imager for rapid localization of tumor margins

    Sabet, Hamid; Stack, Brendan C.; Nagarkar, Vivek V.

    2014-03-01

    We have developed an intra-operative and compact imaging tool for surgeons to detect PET- positive lesions. Currently, most such probes on the market are non-imaging, and provide no ancillary information of surveyed areas, such as clear delineations of malignant tissues. Our probe consists of a novel hybrid scintillator coupled to a compact silicon photomultiplier (SiPM) array with associated front-end electronics encapsulated in an ergonomic housing. Pulse shape discrimination electronics has been implemented and integrated into the downstream data acquisition system. The hybrid scintillator consists of a 0.4 mm thick layer of CsI:Tl scintillator coupled to a 1 mm thick LYSO crystal. To achieve high spatial resolution, CsI:Tl is pixelated to 0.5×0.5 mm2 pixels using laser ablation technique. While CsI:Tl act as beta-sensitive scintillator, LYSO senses the gamma radiation and can be used to navigate the probe to the locations of interest. The gamma response is also subtracted from the beta image for improved SNR and contrast. To achieve accurate centroid position estimation and uniform beta sensitivity over the entire imaging area, the LYSO thickness is optimized such that it acts as scintillation light diffuser by spreading CsI:Tl light over multiple SiPM pixels. The results show that the response of the two scintillators exposed to radiation could be easily distinguished based on their pulse shapes. The probe's spatial resolution is beta radiation even in presence of strong gamma background.

  19. In situ prompt gamma-ray activation analysis of water pollutants using a shallow 252Cf-HPGe probe

    Chung Chien; Tseng Tzucheng

    1988-01-01

    A shallow 252 Cf-HPGe probe used for in situ prompt γ-ray activation of water pollutants is described. A 2.7 μg 252 Cf neutron source and a 10% HPGe detector are inserted into a waterproof stainless steel probe, which is designed to be submerged and recovered in field operation. A laboratory test is performed to obtain the neutron flux distribution and prompt γ-ray contribution to the HPGe detector counts from around the submerged probe. The concentrations of toxic cadmium and chlorine in water are determined in the prompt γ-ray spectrum. The detection limit of industrial pollutants and some improvements of the current design are discussed. (orig.)

  20. Intraoperative cranial nerve monitoring.

    Harper, C Michel

    2004-03-01

    The purpose of intraoperative monitoring is to preserve function and prevent injury to the nervous system at a time when clinical examination is not possible. Cranial nerves are delicate structures and are susceptible to damage by mechanical trauma or ischemia during intracranial and extracranial surgery. A number of reliable electrodiagnostic techniques, including nerve conduction studies, electromyography, and the recording of evoked potentials have been adapted to the study of cranial nerve function during surgery. A growing body of evidence supports the utility of intraoperative monitoring of cranial nerve nerves during selected surgical procedures.

  1. Neutron and gamma probes: Their use in agronomy. Second edition; Sondas de neutrones y gamma: Sus aplicaciones en agronomia. Segunda edicion

    NONE

    2003-02-01

    Water is an essential requirement for life on the planet. It is often the single most limiting factor in crop and livestock production. Water is a scarce resource in many urban and rural environments worldwide. According to the FAO, the global demand for fresh water is doubling every 21 years. The quality of the finite water supplies is also under threat from industrial, agricultural and domestic sources of pollution. The majority of crops are grown under rain-fed conditions and adequate water supply is the main factor limiting crop production in semi-arid and sub-humid regions. On the other hand, currently 20% of the world's arable land is under irrigation providing 35 to 40% of all agricultural production. Irrigation mismanagement poses a serious threat to the environment through groundwater pollution and salinization. It is therefore, essential that water resources be used efficiently by regular monitoring of soil-water status in the unsaturated zone. The neutron depth probe, a nuclear-based technique, is utilized worldwide for this purpose. The neutron moisture gauge, since its introduction some 40 years ago, can now be considered a routine method in soil water studies. Many developments have since been introduced, in particular electronic components, which have significantly improved performance and expanded applications. Although the neutron scattering method is routinely utilised in many developed countries, its use is still limited in developing countries due to several factors. Neutron depth probes contain radioactive sources, which will present health and environmental hazards if a probe is improperly used, stored or disposed of. National and international legislation and regulations must be complied with. The strategic objective of the sub-program Soil and Water Management and Crop Nutrition of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture is to develop and promote the adoption of nuclear-based technologies for optimising soil

  2. TeV gamma rays from 3C 279 - A possible probe of origin and intergalactic infrared radiation fields

    Stecker, F. W.; De Jager, O. C.; Salamon, M. H.

    1992-01-01

    The gamma-ray spectrum of 3C 279 during 1991 June exhibited a near-perfect power law between 50 MeV and over 5 GeV with a differential spectral index of -(2.02 +/- 0.07). If extrapolated, the gamma-ray spectrum of 3C 279 should be easily detectable with first-generation air Cerenkov detectors operating above about 0.3 TeV provided there is no intergalactic absorption. However, by using model-dependent lower and upper limits for the extragalactic infrared background radiation field, a sharp cutoff of the 3C 279 spectrum is predicted at between about 0.1 and about 1 TeV. The sensitivity of present air Cerenkov detectors is good enough to measure such a cutoff, which would provide the first opportunity to obtain a measurement of the extragalactic background infrared radiation field.

  3. Intraoperative ultrasound in neurosurgery

    Velasco, J.; Manzanares, R.; Fernandez, L.; Hernando, A.; Ramos, M. del Mar; Garcia, R.

    1996-01-01

    The present work is a review of the major indications for intraoperative ultrasound in the field of neurosurgery, stressing the exploratory method and describing what we consider to be the most illustrative cases. We attempt to provide a thorough view of this constantly developing technique which, despite its great practical usefulness, may be being underemployed. (Author) 47 refs

  4. Pre- and intraoperative volume determination of craniopharyngioma cysts

    Georgi, P.; Strauss, L.; Sturm, V.; Ostertag, H.; Sinn, H.; Rommel, T.

    1980-08-01

    Exact cystic volume measurement is a prerequisite to proper /sup 90/Y dosage in the therapy of intracavitary monocystic craniopharyngiomas. The method of intraoperative volume measurement by a radionuclide dilution technique is compared to results abtained by preoperative using computer tomography. Both methods gave congruous results. It is pointed out that gamma camera scintigrams are essential for the early detection of complications.

  5. Probing the Cosmic X-Ray and MeV Gamma-Ray Background Radiation through the Anisotropy

    Inoue, Yoshiyuki [Stanford Univ., CA (United States). Kavli Inst. for Particle Astrophysics and Cosmology; SLAC National Accelerator Lab., Menlo Park, CA (United States); Murase, Kohta [Inst. for Advanced Study, Princeton, NJ (United States). School of Natural Sciences; Madejski, Grzegorz M. [Stanford Univ., CA (United States). Kavli Inst. for Particle Astrophysics and Cosmology; SLAC National Accelerator Lab., Menlo Park, CA (United States); Uchiyama, Yasunobu [Stanford Univ., CA (United States). Kavli Inst. for Particle Astrophysics and Cosmology; SLAC National Accelerator Lab., Menlo Park, CA (United States); Rikkyo Univ., Tokyo (Japan). Dept. of Physics

    2013-09-24

    While the cosmic soft X-ray background is very likely to originate from individual Seyfert galaxies, the origin of the cosmic hard X-ray and MeV gamma-ray background is not fully understood. It is expected that Seyferts including Compton thick population may explain the cosmic hard X-ray background. At MeV energy range, Seyferts having non-thermal electrons in coronae above accretion disks or MeV blazars may explain the background radiation. We propose that future measurements of the angular power spectra of anisotropy of the cosmic X-ray and MeV gamma-ray backgrounds will be key to deciphering these backgrounds and the evolution of active galactic nuclei (AGNs). As AGNs trace the cosmic large-scale structure, spatial clustering of AGNs exists. We show that e-ROSITA will clearly detect the correlation signal of unresolved Seyferts at 0.5-2 keV and 2-10 keV bands and will be able to measure the bias parameter of AGNs at both bands. Once the future hard X-ray all sky satellites achieve the sensitivity better than 10-12 erg/cm2/s-1 at 10-30 keV or 30-50 keV - although this is beyond the sensitivities of current hard X-ray all sky monitors - angular power spectra will allow us to independently investigate the fraction of Compton-thick AGNs in all Seyferts. We also find that the expected angular power spectra of Seyferts and blazars in the MeV range are different by about an order of magnitude, where the Poisson term, so-called shot noise, is dominant. Current and future MeV instruments will clearly disentangle the origin of the MeV gamma-ray background through the angular power spectrum.

  6. Probing the cosmic x-ray and MeV gamma ray background radiation through the anisotropy

    Inoue, Yoshiyuki [Stanford Univ., CA (United States); Murase, Kohta [Inst. for Advanced Study, Princeton, NJ (United States); Madejski, Grzegorz M. [Stanford Univ., CA (United States); Uchiyama, Yasunobu [Stanford Univ., CA (United States); Rikkyo Univ., Tokyo (Japan)

    2013-09-24

    While the cosmic soft X-ray background is very likely to originate from individual Seyfert galaxies, the origin of the cosmic hard X-ray and MeV gamma-ray background is not fully understood. It is expected that Seyferts including Compton thick population may explain the cosmic hard X-ray background. At MeV energy range, Seyferts having non-thermal electrons in coronae above accretion disks or MeV blazars may explain the background radiation. We propose that future measurements of the angular power spectra of anisotropy of the cosmic X-ray and MeV gamma-ray backgrounds will be key to deciphering these backgrounds and the evolution of active galactic nuclei (AGNs). As AGNs trace the cosmic large-scale structure, spatial clustering of AGNs exists. We show that e-ROSITA will clearly detect the correlation signal of unresolved Seyferts at 0.5-2 keV and 2-10 keV bands and will be able to measure the bias parameter of AGNs at both bands. Once future hard X-ray all sky satellites achieve a sensitivity better than 10–12 erg cm–2 s–1 at 10-30 keV or 30-50 keV—although this is beyond the sensitivities of current hard X-ray all sky monitors—angular power spectra will allow us to independently investigate the fraction of Compton-thick AGNs in all Seyferts. We also find that the expected angular power spectra of Seyferts and blazars in the MeV range are different by about an order of magnitude, where the Poisson term, so-called shot noise, is dominant. Current and future MeV instruments will clearly disentangle the origin of the MeV gamma-ray background through the angular power spectrum.

  7. Optically neuronavigated ultrasonography in an intraoperative magnetic resonance imaging environment.

    Katisko, Jani P A; Koivukangas, John P

    2007-04-01

    To develop a clinically useful method that shows the corresponding planes of intraoperative two-dimensional ultrasonography and intraoperative magnetic resonance imaging (MRI) scans determined with an optical neuronavigator from an intraoperative three-dimensional MRI scan data set, and to determine the qualitative and the quantitative spatial correspondence between the ultrasonography and MRI scans. An ultrasound probe was interlinked with an ergonomic and MRI scan-compatible ultrasonography probe tracker to the optical neuronavigator used in a low-field intraoperative MRI scan environment for brain surgery. Spatial correspondence measurements were performed using a custom-made ultrasonography/MRI scan phantom. In this work, instruments to combine intraoperatively collected ultrasonography and MRI scan data with an optical localization method in a magnetic environment were developed. The ultrasonography transducer tracker played an important role. Furthermore, a phantom for ultrasonography and MRI scanning was produced. This is the first report, to our knowledge, regarding the possibility of combining the two most important intraoperative imaging modalities used in neurosurgery, ultrasonography and MRI scanning, to guide brain tumor surgery. The method was feasible and, as shown in an illustrative surgical case, has direct clinical impact on image-guided brain surgery. The spatial deviation between the ultrasonography and the MRI scans was, on average, 1.90 +/- 1.30 mm at depths of 0 to 120 mm from the ultrasonography probe. The overall result of this work is a unique method to guide the neurosurgical operation with neuronavigated ultrasonography imaging in an intraoperative MRI scanning environment. The relevance of the method is emphasized in minimally invasive neurosurgery.

  8. [Sentinel node detection using optonuclear probe (gamma and fluorescence) after green indocyanine and radio-isotope injections].

    Poumellec, M-A; Dejode, M; Figl, A; Darcourt, J; Haudebourg, J; Sabah, Y; Voury, A; Martaens, A; Barranger, E

    2016-04-01

    Assess the biopsy's feasibility of the sentinel lymph node biopsy (SLNB) using optonuclear probe after of indocyanine green (ICG) and radio-isotope (RI) injections. Twenty-one patients with a localized breast cancer and unsuspicious axillary nodes underwent a SLNB after both injections of ICG and radio-isotope. One or more SLN were identified on the 21 patients (identification rate of 100%). The median number SLN was 2 (1-3). Twenty SLN were both radio-actives and fluorescents (54.1%), 11 fluorescent only (29.7%) and 6 were only radio-actives (16.2%). Seven patients had a metastatic SLN (8 SLN overall). Among them, only one had a micrometastasic SLN, 5 others had a macrometastatic SLN and one patient had two macrometastatic SLNs. Among the 8 metastatic SLN, 5 were both fluorescent and radioactive, 2 were only fluorescent and 1 was only radioactive. Detection SLN using optonuclear probe after indocyanine green and radio-isotope injections is effective and could be, after validation by randomized trial, a reliable alternative to the blue dye injection for teams who consider that combined detection as the reference. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. A hand-held beta imaging probe for FDG.

    Singh, Bipin; Stack, Brendan C; Thacker, Samta; Gaysinskiy, Valeriy; Bartel, Twyla; Lowe, Val; Cool, Steven; Entine, Gerald; Nagarkar, Vivek

    2013-04-01

    Advances in radiopharmaceuticals and clinical understanding have escalated the use of intraoperative gamma probes in surgery. However, most probes on the market are non-imaging gamma probes that suffer from the lack of ancillary information of the surveyed tissue area. We have developed a novel, hand-held digital Imaging Beta Probe™ (IBP™) to be used in surgery in conjunction with beta-emitting radiopharmaceuticals such as (18)FDG, (131)I and (32)P for real-time imaging of a surveyed area with higher spatial resolution and sensitivity and greater convenience than existing instruments. We describe the design and validation of a hand-held beta probe intended to be used as a visual mapping device to locate and confirm excision of (18)FDG-avid primary tumors and metastases in an animal model. We have demonstrated a device which can generate beta images from (18)FDG avid lesions in an animal model. It is feasible to image beta irradiation in animal models of cancer given (18)FDG. This technology may be applied to clinical mapping of tumors and/or their metastases in the operating room. Visual image depiction of malignancy may aid the surgeon in localization and excision of lesions of interest.

  10. Use of the gamma probe and of 99mTc-DMSA (V) in the identification of the neck recurrence of medullary carcinoma thyroid

    Melo, Rosana Leite de; Kowalski, Luiz P.; Ubrich, Fabio F.; Lima, Eduardo N. Pereira; Torres, Ivone C.G.

    2003-01-01

    Medullary carcinoma of the thyroid, a malignant neoplasm of para follicular C cells, represent about 5-10% of thyroid tumors. The symptoms are related to local invasion and hormonal secretion. The clinical course is variable, from indolent cases to extremely aggressive. Many radionuclide imaging have been described to locate metastasis of medullary cancer. Tl-201 and Tc-99m (V)DMS A showed to be useful in the evaluation o persistent elevated serum calcitonin levels. On the other hand, the use of the 131 I-Mibg, that is the isotope more used, has not been demonstrating efficiency in identifying metastasis. Our objective is to report a case of a patient with medullary thyroid carcinoma in which the follow-up use DMS A(V) demonstrated a recurrence no identified for other methods. A 34-year-old man had a diagnosis of medullary thyroid carcinoma and has submitted a total thyroidectomy and neck lymph node dissection. He presented elevated serum calcitonin levels and DMS A(V) scintigraphy demonstrated focal area of pathologic uptake at the medline of the neck, but the surgical exploration was negative. He persisted with high calcitonin levels and it was used a new DMS A(V). On this occasion he was submitted to the radio-guided surgery that located the recurrence and it was confirmed with anatomo-pathologic exam. This case allowed to demonstrate that the use of radionuclide associated to the gamma-probe is promising, allowing a precise surgical approach. (author)

  11. The ultrastructure of tumor cells in patients with rectal cancer after pre-operative irradiation and intra-operative cryotherapy

    Vyinnik, Yu.O.; Kotenko, O.Je.; Nevzorov, V.P.; Chyibyisov, L.P.

    2000-01-01

    Electronic microscopy of the tumor cells was performed to confirm the efficacy of combined pre-operative gamma-therapy and intraoperative cryotherapy (CT). Pre-operative irradiation at the dose of 20 Gy accompanied by intra-operative cryotherapy caused the changes in the ultrastructure, the depth and degree of which allow to consider them destructive and irreversible

  12. Intraoperative Localisation of Impalpable Breast Lesions Utilising the ROLLIS Technique Following Peritumoral 99mTc-colloid Sentinel Node Lymphoscintigraphy.

    Hung, Te-Jui; Burrage, John; Bourke, Anita; Taylor, Donna

    2017-08-24

    Ultrasound or stereotactic guided hook-wire localisation has been the standard-of-care for the pre-surgical localisation of impalpable breast lesions, which account for approximately a third of all breast cancer. Radioguided occult lesion localisation using I-125 seeds (ROLLIS) is a relatively new technique for guiding surgical excision of impalpable breast lesions, and is a promising alternative to the traditional hook-wire method. When combined with Tc-99m labelled colloid for sentinel node mapping in clinically indicated cases, there has been uncertainty regarding whether the downscatter of Tc-99m into the I-125 energy spectrum could adversely affect the intra-operative detection of the I-125 seed, especially pertaining to a peritumoral injection. To evaluate the percentage contribution of downscattered activity from Tc-99m into the I-125 energy spectrum in simulated intra-operative resections of an I-125 seed following different sentinel node injection techniques. Two scenarios were simulated using breast phantoms with lean chicken breast. The first scenario, with a 2cm distance between the Tc-99m injection site and the I-125 seed, simulated a periareolar ipsiquadrant injection with the subdermal or intradermal technique. The second scenario simulated a peritumoral injection technique with the Tc-99m bolus and an I-125 seed at the same site. Count rates were acquired with a hand-held gamma probe, and the percentage contribution of downscattered Tc-99m gamma photons to the I-125 energy window was calculated. In scenarios one and two, downscattered Tc-99m activity contributed 0.5% and 33% respectively to the detected count rate in the I-125 energy window. In both scenarios, the I-125 seed was successfully localised and removed using the gamma probe. There is no significant contribution of downscattered activity associated with a peritumoral injection of Tc-99m to adversely affect the accurate intra-operative localisation of an I- 125 seed. Copyright© Bentham

  13. [Intraoperative floppy iris syndrome].

    Mazal, Z

    2007-04-01

    In the year 2005, Chang and Cambell described unusual reaction of the iris during the cataract surgery in patients treated with tamsulosine. This was named as IFIS, an acronym for the Intraoperative Floppy Iris Syndrome. In its advanced stage, the syndrome is characterized by insufficient mydfiasis before the surgery, narrowing of the pupil during the surgery, its impossible dilatation during the surgery by means of stretching, unusual elasticity of the pupilar margin, surging and fluttering iris with tendency to prolapse. The same manifestations we observed in our patients and we confirm the direct connection with tamsulosine hydrochloride treatment. Tamsulosine is the antagonist of alpha 1A adrenergic receptors whose are present, except in the smooth musculature of the prostate gland and the urinary bladder, in the iris dilator as well. At the same time we observed this syndrome rarely in some patients not using tamsulosine. In most cases, these patients were treated with antipsychotic drugs.

  14. Gamma probe-assisted brain tumor microsurgical resection: a new technique Ressecção microcirúrgica de tumor cerebral assistida por detector gama: uma nova técnica

    Osvaldo Vilela Filho

    2002-12-01

    Full Text Available OBJECTIVES: The pioneering performance of gamma probe-assisted surgery (GPAS for brain tumors, aiming not only an improvement of tumor detection, but mainly assurance of its complete removal and the study of the usual distribution of the 99mTc-MIBI in the brain SPECT of normal individuals. METHOD: Patient's informed consent and demonstration of the tumor by the preoperative MIBI SPECT were the inclusion criteria adopted for GPAS, which was performed in one patient with a right parietal lobe metastatic tumor. The radiotracer (99mTc-MIBI was injected in a peripheral vein 5 hours before the operation. A tumor to-normal tissue count ratio equal to or greater than 2/1 was considered indicative of tumor. MIBI SPECT was performed in five normal individuals in a pilot study. RESULTS: The gamma probe greatly facilitated intraoperative tumor detection (tumor to-normal brain count ratio was 5/1 and indicated a small piece of residual tumor after what was thought to be a complete tumor removal, allowing its resection, which, otherwise, would have been left behind. Postoperative CT confirmed complete tumor resection. The MIBI SPECT in normal individuals showed an increased uptake by the hypophisis, choroid plexus, skull, scalp and salivary glands and absence of uptake by the normal brain tissue. There were no complications. CONCLUSION: GPAS proved to be, in this single case, a safe and reliable technique to improve brain tumor detection and to confirm the presence or absence of residual tumor.OBJETIVOS: A realização pioneira de cirurgia assistida por detector gama (CADG para tumores cerebrais, objetivando-se não apenas a identificação do tumor, mas, sobretudo, assegurar-se quanto à sua completa ressecção e estudar a distribuição usual do 99mTc-MIBI no SPECT cerebral de indivíduos normais. MÉTODO: O consentimento informado do paciente e a demonstração do tumor pelo SPECT pré-operatório com MIBI foram os critérios de inclusão adotados para a

  15. Intraoperative use of ultrasonography by small subcortical lesions

    Kondoff, Sl.; Gabrovski, St.; Krustev, E.; Poptodorov, G.; Gabrovski, N.; Uzunov, K.

    2004-01-01

    The aim of this study is to present the possibilities for use of intraoperative ultrasound (US) diagnostics as a method of image guided surgical navigation in neurosurgery. During an US scan of normal and pathologically changed tissues as well as volume taking lesion images are received in real time intraoperative display allowing dynamic control of the surgical radicalism and at the same time minimal invasiveness to the neural structures. Intraoperative ultrasound with real-time display characteristics finds a very wide application: subcortical and deeply localized tumour lesions, haematomas, large and giant aneurysms, arteriovenous (AV) malformations, spinal tumours and cysts. The real time dynamic scan is based on the B-mod. This method is founded on the US characteristic of reflecting in a different manner at the borderline of two mediums with different density as well as tissues with various physical and chemical characteristics. The reflection is partially absorbed depending on the acoustic impedance of the biologic field. We use a LOGIC200PRO unit with two probes I-type and T-type having a 'wedge of space' - 35 mm and working frequencies of 6 MHz and 7 MHz appropriate for visualizing lesions at a depth of 25 to 60 mm.The advantages of the Intraoperative US diagnostics are: non-invasiveness; real time display - i.e. presents the imminent intraoperative changes; it is a good alternative to other image-guided technologies; accessible price of the US unit

  16. Targeted intraoperative radiotherapy in oncology

    Keshtgar, Mohammed; Wenz, Frederik

    2014-01-01

    Targeted intraoperative radiotherapy is a major advance in the management of cancer patients. With an emphasis on practical aspects, this book offers an ideal introduction to this innovative  technology for clinicians.

  17. Feasibility of a wireless gammar probe in radioguided surgery

    Park, Hye Min; Kim, Jeong Ho; Park, Chan Jong; Joo, Koan Sik [Dept. of Physics, University of Myongji, Seoul (Korea, Republic of)

    2016-04-15

    Nuclear medicine is divided into two major domains: diagnosis and therapy. Nuclear medicine diagnostic procedures are used for determining and evaluating the physiological, chemical, endocrinal, and metabolic conditions of organs or tissues. Tumors can be diagnosed based on the images provided by the associated machinery; after diagnosis, sometimes these tumors can be surgically removed. Currently, to help guide the surgeon to the exact location of the tumor site, the use of intraoperative probes has steadily gained popularity. These probes allow the physician to locate the tumor on the basis of the higher uptake of the preoperatively injected radio pharmaceutical within the site, as compared to the surrounding tissue. Direct detection offers very good energy resolution, but the detection efficiency is low; on the other hand, indirect detection presents high efficiency and low energy resolution. For this reason, the use of both detectors is recommended for obtaining an accurate localization of the diagnostic and therapeutic fields. In the literature, there are several works that aim to develop a suitable probe that presents such characteristics (i.e., good resolution, high detection efficiency, as well as the capacity for miniaturization). In this study, a wireless gamma probe is designed for the detection of tumors of the tissue surface using a silicon photomultiplier (SiPM) and a cerium-doped gadolinium aluminum gallium garnet (Ce:GAGG) scintillator. Our experiments demonstrate the feasibility of wireless diagnostics, as well as the suitable energy resolution and spatial resolution. The system developed based on the results of this study is expected to perform intraoperative or diagnostic evaluations of residual lesions (or the absence thereof) and its quantitative distribution in the affected area, thus contributing to wireless diagnostics and screening systems.

  18. Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature

    Travis Arlene

    2005-09-01

    Full Text Available Abstract Background There are no studies that have directly investigated the incremental reduction in sensory morbidity that lymphoscintigraphy images (LS and triangulated body marking or other skin marking techniques provide during sentinel lymph node biopsy (SLNB compared to using only the probe without LS and skin marking or using only dye. However, an indirect assessment of this potential for additional sensory morbidity reduction is possible by extracting morbidity data from studies comparing the morbidity of SLNB to that of axillary lymph node dissection. Methods A literature search yielded 13 articles that had data on sensory morbidity at specific time points on pain, numbness or paresthesia from SLNB that used radiotracer and probe or used only dye as a primary method of finding the sentinel node (SN. Of these, 10 utilized LS, while 3 did not utilize LS. By matching the data in studies not employing LS to the studies that did, comparisons regarding the percentage of patients experiencing pain, numbness/paresthesia after SLNB could be reasonably attempted at a cutoff of 9 months. Results In the 7 studies reporting on pain after 9 months (> 9 months that used LS (1347 patients, 13.8% of patients reported these symptoms, while in the one study that did not use LS (143 patients, 28.7% of patients reported these symptoms at > 9 months (P 9 months that used LS (601 patients, 12.5% of patients reported these symptoms, while in the 3 studies that did not use LS (229 patients, 23.1% of patients reported these symptoms at > 9 months (P = 0.0002. Similar trends were also noted for all these symptoms at ≤ 9 months. Conclusion Because of variations in techniques and time of assessing morbidity, direct comparisons between studies are difficult. Nevertheless at a minimum, a clear trend is present: having the LS images and skin markings to assist during SLNB appears to yield more favorable morbidity outcomes for the patients compared to performing

  19. Potential role of a new hand-held miniature gamma camera in performing minimally invasive parathyroidectomy

    Ortega, Joaquin; Lledo, Salvador [University of Valencia, Clinic University Hospital, Department of Surgery, Valencia (Spain); Ferrer-Rebolleda, Jose [Clinic University Hospital, Department of Nuclear Medicine, Valencia (Spain); Cassinello, Norberto [Clinic University Hospital, Unit of Endocrinologic and Bariatric Surgery, Valencia (Spain)

    2007-02-15

    Sestamibi scans have increased the use of minimally invasive parathyroidectomy (MIP) to treat primary hyperparathyroidism (PHPT) when caused by a parathyroid single adenoma. The greatest concern for surgeons remains the proper identification of pathological glands in a limited surgical field. We have studied the usefulness of a new hand-held miniature gamma camera (MGC) when used intraoperatively to locate parathyroid adenomas. To our knowledge this is the first report published on this subject in the scientific literature. Five patients with PHPT secondary to a single adenoma, positively diagnosed by preoperative sestamibi scans, underwent a MIP. A gamma probe for radioguided surgery and the new hand-held MGC were used consecutively to locate the pathological glands. This new MGC has a module composed of a high-resolution interchangeable collimator and a CsI(Na) scintillating crystal. It has dimensions of around 15 cm x 8 cm x 9 cm and weighs 1 kg. The intraoperative assay of PTH (ioPTH) was used to confirm the complete resection of pathological tissue. All cases were operated on successfully by a MIP. The ioPTH confirmed the excision of all pathological tissues. The MGC proved its usefulness in all patients, even in a difficult case in which the first attempt with the gamma probe failed. In all cases it offered real-time accurate intraoperative images. The hand-held MGC is a useful instrument in MIP for PHPT. It may be used to complement the standard tools used to date, or may even replace them, at least in selected cases of single adenomas. (orig.)

  20. Potential role of a new hand-held miniature gamma camera in performing minimally invasive parathyroidectomy

    Ortega, Joaquin; Lledo, Salvador; Ferrer-Rebolleda, Jose; Cassinello, Norberto

    2007-01-01

    Sestamibi scans have increased the use of minimally invasive parathyroidectomy (MIP) to treat primary hyperparathyroidism (PHPT) when caused by a parathyroid single adenoma. The greatest concern for surgeons remains the proper identification of pathological glands in a limited surgical field. We have studied the usefulness of a new hand-held miniature gamma camera (MGC) when used intraoperatively to locate parathyroid adenomas. To our knowledge this is the first report published on this subject in the scientific literature. Five patients with PHPT secondary to a single adenoma, positively diagnosed by preoperative sestamibi scans, underwent a MIP. A gamma probe for radioguided surgery and the new hand-held MGC were used consecutively to locate the pathological glands. This new MGC has a module composed of a high-resolution interchangeable collimator and a CsI(Na) scintillating crystal. It has dimensions of around 15 cm x 8 cm x 9 cm and weighs 1 kg. The intraoperative assay of PTH (ioPTH) was used to confirm the complete resection of pathological tissue. All cases were operated on successfully by a MIP. The ioPTH confirmed the excision of all pathological tissues. The MGC proved its usefulness in all patients, even in a difficult case in which the first attempt with the gamma probe failed. In all cases it offered real-time accurate intraoperative images. The hand-held MGC is a useful instrument in MIP for PHPT. It may be used to complement the standard tools used to date, or may even replace them, at least in selected cases of single adenomas. (orig.)

  1. Reactor gamma spectrometry: status

    Gold, R.; Kaiser, B.J.

    1979-01-01

    Current work is described for Compton Recoil Gamma-Ray Spectrometry including developments in experimental technique as well as recent reactor spectrometry measurements. The current status of the method is described concerning gamma spectromoetry probe design and response characteristics. Emphasis is given to gamma spectrometry work in US LWR and BR programs. Gamma spectrometry in BR environments are outlined by focussing on start-up plans for the Fast Test Reactor (FTR). Gamma spectrometry results are presented for a LWR pressure vessel mockup in the Poolside Critical Assembly (PCA) at Oak Ridge National Laboratory

  2. A hand-held imaging probe for radio-guided surgery: physical performance and preliminary clinical experience

    Pitre, S.; Menard, L.; Charon, Y.; Solal, M.; Garbay, J.R.

    2003-01-01

    Improvements in the specificity of radiopharmaceutical compounds have been paralleled by an upsurge of interest in developing small detectors to assist surgeons in localizing tumour tissue during surgery. This study reports the main technical features and physical characteristics of a new hand-held gamma camera dedicated to accurate and real-time intra-operative imaging. First clinical experience is also reported. The POCI (Per-operative Compact Imager) camera consists of a head module composed of a high-resolution interchangeable lead collimator and a CsI(Na) crystal plate optically coupled to an intensified position-sensitive diode. The current prototype has a 40-mm diameter field of view, an outer diameter of 9.5 cm, a length of 9 cm and a weight of 1.2 kg. Overall detector imaging characteristics were evaluated by technetium-99m phantom measurements. Three patients with breast cancer previously scheduled to undergo sentinel lymph node detection were selected for the preliminary clinical experience. Preoperative images of the lymphatic basin obtained using the POCI camera were compared with conventional transcutaneous explorations using a non-imaging gamma probe. The full-width at half-maximum (FWHM) spatial resolution was investigated in both air and scattering medium; when the phantom was placed in contact with the collimator, the POCI camera exhibited a 3.2 mm FWHM. The corresponding sensitivity was 290 cps/MBq. The preliminary clinical results showed that POCI was able to predict the number and location of all SLNs. In one case, two deep radioactive nodes missed by the gamma probe were detected on the intra-operative images. This very initial experience demonstrates that the physical performance of the POCI camera is adequate for radio-guided surgery. These results are sufficiently encouraging to prompt further evaluation studies designed to determine the specific and optimal clinical role of intra-operative imaging devices

  3. Intraoperative transfusion practices in Europe

    Meier, J; Filipescu, D; Kozek-Langenecker, S

    2016-01-01

    BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (p......RBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. METHODS: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month...... period in 2013. RESULTS: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone...

  4. Neurosurgery contact handheld probe based on sapphire shaped crystal

    Shikunova, I. A.; Stryukov, D. O.; Rossolenko, S. N.; Kiselev, A. M.; Kurlov, V. N.

    2017-01-01

    A handheld contact probe based on sapphire shaped crystal is developed for intraoperative spectrally-resolved optical diagnostics, laser coagulation and aspiration of malignant brain tissue. The technology was integrated into the neurosurgical workflow for intraoperative real-time identification and removing of invasive brain cancer.

  5. Intraoperative radiotherapy - Current status

    Gunderson, Leonard L.; Willett, Christopher G.; Harrison, Louis B.

    1997-01-01

    Purpose/Objective: Intraoperative irradiation (IORT) in its broadest sense refers to the delivery of irradiation at the time of an operation. This refresher course will discuss the use of both electrons (IOERT) and high dose rate brachytherapy (IOHDR) in conjunction with surgical exploration and resection ± external irradiation/chemotherapy. Both IORT methods have evolved with similar philosophies as an attempt to achieve higher effective doses of irradiation while dose limiting structures are surgically displaced. The rationale for each is supported by excellent local control ± survival results achieved with brachytherapy alone or as a boost to external irradiation in organ preservation efforts in traditional sites (head and neck, breast, gynecologic) wherein a boost dose could be delivered to smaller volumes than could usually be accomplished with external irradiation alone. IOERT has been a tool in modern radiotherapy in Japan since the 1960's and in the U.S. since the mid 1970's. Results from randomized and nonrandomized trials will be presented in the refresher course with major emphasis on GI sites (gastric, pancreas, colorectal) since the data is more mature. While the largest clinical experience with IOERT (± external irradiation/chemotherapy, maximal resection) has been with gastrointestinal cancers in adults, moderate experience has also been obtained with locally advanced retroperitoneal sarcomas and recurrent genitourinary and gynecologic cancers. With primary colorectal cancers that are unresectable for cure or for locally recurrent colorectal cancers, both local control and long-term survival appear to be improved with the aggressive combinations including IOERT when compared to results achieved with conventional treatment. When residual disease exists after resection of gastric cancers, IOERT ± external radiation has achieved optimistic survival results in trials in Japan, the U.S., Spain and China. With locally unresectable pancreatic cancer, an

  6. Intraoperative ultrasound in colorectal surgery.

    Greif, Franklin; Aranovich, David; Hananel, Nissim; Knizhnik, Mikhail; Belenky, Alexander

    2009-09-01

    To assess the accuracy of intraoperative ultrasound (IOUS) as a localizing technique for colorectal resections, and its impact on surgical management. Twenty-five patients (15 men and 10 women; mean age, 74.4 years) with early cancers (p T1), or polyps, not amenable to endoscopic removal were selected. IOUS was used as a sole method of intraoperative localization. Its performance was evaluated through review of preoperative colonoscopy reports, intraoperative findings, histopathology reports, and clinical follow-up. The lesions were situated in the cecum (n = 5), ascending colon (n = 3), transverse colon (n = 4), descending colon (n = 7), and rectum (n = 6). IOUS technique allowed correct localization in 24 of 25 patients, visualization of the bowel wall, and its penetration by malignant tumors. In rectal lesions, IOUS showed clearly the tumor and its margin, which facilitated performance sphincter-sparing procedure. In patients with small polyps and early cancers of colon and rectum, IOUS may be effectively used as a sole method of intraoperative localization and provide additional information that may alter decision making with regard to surgical technique. (c) 2009 Wiley Periodicals, Inc.

  7. Measurement of angular correlations in Drell-Yan lepton pairs to probe $Z/\\gamma*$ boson transverse momentum at $\\sqrt{s}$=7 TeV with the ATLAS detector

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Hayden, Daniel; Hays, Chris; Hayward, Helen; Haywood, Stephen; Head, Simon; Hedberg, Vincent; Heelan, Louise; Heim, Sarah; Heinemann, Beate; Heisterkamp, Simon; Helary, Louis; Heller, Claudio; Heller, Matthieu; Hellman, Sten; Hellmich, Dennis; Helsens, Clement; Henderson, Robert; Henke, Michael; Henrichs, Anna; Henriques Correia, Ana Maria; Henrot-Versille, Sophie; Hensel, Carsten; Medina Hernandez, Carlos; Hernández Jiménez, Yesenia; Herrberg, Ruth; Herten, Gregor; Hertenberger, Ralf; Hervas, Luis; Hesketh, Gavin Grant; Hessey, Nigel; Hickling, Robert; Higón-Rodriguez, Emilio; Hill, John; Hiller, Karl Heinz; Hillert, Sonja; Hillier, Stephen; Hinchliffe, Ian; Hines, Elizabeth; Hirose, Minoru; Hirsch, Florian; Hirschbuehl, Dominic; Hobbs, John; Hod, Noam; Hodgkinson, Mark; Hodgson, Paul; Hoecker, Andreas; Hoeferkamp, Martin; Hoffman, Julia; Hoffmann, Dirk; Hohlfeld, Marc; Holder, Martin; Holmgren, Sven-Olof; Holy, Tomas; Holzbauer, Jenny; Hong, Tae Min; Hooft van Huysduynen, Loek; Horner, Stephan; Hostachy, Jean-Yves; Hou, Suen; Hoummada, Abdeslam; Howard, Jacob; Howarth, James; Hristova, Ivana; Hrivnac, Julius; Hryn'ova, Tetiana; Hsu, Pai-hsien Jennifer; Hsu, Shih-Chieh; Hu, Diedi; Hubacek, Zdenek; Hubaut, Fabrice; Huegging, Fabian; Huettmann, Antje; Huffman, Todd Brian; Hughes, Emlyn; Hughes, Gareth; Huhtinen, Mika; Hurwitz, Martina; Huseynov, Nazim; Huston, Joey; Huth, John; Iacobucci, Giuseppe; Iakovidis, Georgios; Ibbotson, Michael; Ibragimov, Iskander; Iconomidou-Fayard, Lydia; Idarraga, John; Iengo, Paolo; Igonkina, Olga; Ikegami, Yoichi; Ikeno, Masahiro; Iliadis, Dimitrios; Ilic, Nikolina; Ince, Tayfun; Ioannou, Pavlos; Iodice, Mauro; Iordanidou, Kalliopi; Ippolito, Valerio; Irles Quiles, Adrian; Isaksson, Charlie; Ishino, Masaya; Ishitsuka, Masaki; Ishmukhametov, Renat; Issever, Cigdem; Istin, Serhat; Ivashin, Anton; Iwanski, Wieslaw; Iwasaki, Hiroyuki; Izen, Joseph; Izzo, Vincenzo; Jackson, Brett; Jackson, John; Jackson, Paul; Jaekel, Martin; Jain, Vivek; Jakobs, Karl; Jakobsen, Sune; Jakoubek, Tomas; Jakubek, Jan; Jamin, David Olivier; Jana, Dilip; Jansen, Eric; Jansen, Hendrik; Janssen, Jens; Jantsch, Andreas; Janus, Michel; Jared, Richard; Jarlskog, Göran; Jeanty, Laura; Jen-La Plante, Imai; Jeng, Geng-yuan; Jennens, David; Jenni, Peter; Loevschall-Jensen, Ask Emil; Jež, Pavel; Jézéquel, Stéphane; Jha, Manoj Kumar; Ji, Haoshuang; Ji, Weina; Jia, Jiangyong; Jiang, Yi; Jimenez Belenguer, Marcos; Jin, Shan; Jinnouchi, Osamu; Joergensen, Morten Dam; Joffe, David; Johansen, Marianne; Johansson, Erik; Johansson, Per; Johnert, Sebastian; Johns, Kenneth; Jon-And, Kerstin; Jones, Graham; Jones, Roger; Jones, Tim; Joram, Christian; Jorge, Pedro; Joshi, Kiran Daniel; Jovicevic, Jelena; Jovin, Tatjana; Ju, Xiangyang; Jung, Christian; Jungst, Ralph Markus; Juranek, Vojtech; Jussel, Patrick; Juste Rozas, Aurelio; Kabana, Sonja; Kaci, Mohammed; Kaczmarska, Anna; Kadlecik, Peter; Kado, Marumi; Kagan, Harris; Kagan, Michael; Kajomovitz, Enrique; Kalinin, Sergey; Kalinovskaya, Lidia; Kama, Sami; Kanaya, Naoko; Kaneda, Michiru; Kaneti, Steven; Kanno, Takayuki; Kantserov, Vadim; Kanzaki, Junichi; Kaplan, Benjamin; Kapliy, Anton; Kar, Deepak; Karagounis, Michael; Karakostas, Konstantinos; Karnevskiy, Mikhail; Kartvelishvili, Vakhtang; Karyukhin, Andrey; Kashif, Lashkar; Kasieczka, Gregor; Kass, Richard; Kastanas, Alex; Kataoka, Mayuko; Kataoka, Yousuke; Katzy, Judith; Kaushik, Venkatesh; Kawagoe, Kiyotomo; Kawamoto, Tatsuo; Kawamura, Gen; Kazama, Shingo; Kazanin, Vassili; Kazarinov, Makhail; Keeler, Richard; Keener, Paul; Kehoe, Robert; Keil, Markus; Kekelidze, George; Keller, John; Kenyon, Mike; Keoshkerian, Houry; Kepka, Oldrich; Kerschen, Nicolas; Kerševan, Borut Paul; Kersten, Susanne; Kessoku, Kohei; Keung, Justin; Khalil-zada, Farkhad; Khandanyan, Hovhannes; Khanov, Alexander; Kharchenko, Dmitri; Khodinov, Alexander; Khomich, Andrei; Khoo, Teng Jian; Khoriauli, Gia; Khoroshilov, Andrey; Khovanskiy, Valery; Khramov, Evgeniy; Khubua, Jemal; Kim, Hyeon Jin; Kim, Shinhong; Kimura, Naoki; Kind, Oliver; King, Barry; King, Matthew; King, Robert Steven Beaufoy; Kirk, Julie; Kiryunin, Andrey; Kishimoto, Tomoe; Kisielewska, Danuta; Kitamura, Takumi; Kittelmann, Thomas; Kiuchi, Kenji; Kladiva, Eduard; Klein, Max; Klein, Uta; Kleinknecht, Konrad; Klemetti, Miika; Klier, Amit; Klimek, Pawel; Klimentov, Alexei; Klingenberg, Reiner; Klinger, Joel Alexander; Klinkby, Esben; Klioutchnikova, Tatiana; Klok, Peter; Klous, Sander; Kluge, Eike-Erik; Kluge, Thomas; Kluit, Peter; Kluth, Stefan; Kneringer, Emmerich; Knoops, Edith; Knue, Andrea; Ko, Byeong Rok; Kobayashi, Tomio; Kobel, Michael; Kocian, Martin; Kodys, Peter; Köneke, Karsten; König, Adriaan; Koenig, Sebastian; Köpke, Lutz; Koetsveld, Folkert; Koevesarki, Peter; Koffas, Thomas; Koffeman, Els; Kogan, Lucy Anne; Kohlmann, Simon; Kohn, Fabian; Kohout, Zdenek; Kohriki, Takashi; Koi, Tatsumi; Kolachev, Guennady; Kolanoski, Hermann; Kolesnikov, Vladimir; Koletsou, Iro; Koll, James; Komar, Aston; Komori, Yuto; Kondo, Takahiko; Kono, Takanori; Kononov, Anatoly; Konoplich, Rostislav; Konstantinidis, Nikolaos; Kopeliansky, Revital; Koperny, Stefan; Kopp, Anna Katharina; Korcyl, Krzysztof; Kordas, Kostantinos; Korn, Andreas; Korol, Aleksandr; Korolkov, Ilya; Korolkova, Elena; Korotkov, Vladislav; Kortner, Oliver; Kortner, Sandra; Kostyukhin, Vadim; Kotov, Sergey; Kotov, Vladislav; Kotwal, Ashutosh; Kourkoumelis, Christine; Kouskoura, Vasiliki; Koutsman, Alex; Kowalewski, Robert Victor; Kowalski, Tadeusz; Kozanecki, Witold; Kozhin, Anatoly; Kral, Vlastimil; Kramarenko, Viktor; Kramberger, Gregor; Krasny, Mieczyslaw Witold; Krasznahorkay, Attila; Kraus, Jana; Kravchenko, Anton; Kreiss, Sven; Krejci, Frantisek; Kretzschmar, Jan; Kreutzfeldt, Kristof; Krieger, Nina; Krieger, Peter; Kroeninger, Kevin; Kroha, Hubert; Kroll, Joe; Kroseberg, Juergen; Krstic, Jelena; Kruchonak, Uladzimir; Krüger, Hans; Kruker, Tobias; Krumnack, Nils; Krumshteyn, Zinovii; Kruse, Mark; Kubota, Takashi; Kuday, Sinan; Kuehn, Susanne; Kugel, Andreas; Kuhl, Thorsten; Kukhtin, Victor; Kulchitsky, Yuri; Kuleshov, Sergey; Kuna, Marine; Kunkle, Joshua; Kupco, Alexander; Kurashige, Hisaya; Kurata, Masakazu; Kurochkin, Yurii; Kus, Vlastimil; Kuwertz, Emma Sian; Kuze, Masahiro; Kvita, Jiri; Kwee, Regina; La Rosa, Alessandro; La Rotonda, Laura; Labarga, Luis; Lablak, Said; Lacasta, Carlos; Lacava, Francesco; Lacey, James; Lacker, Heiko; Lacour, Didier; Lacuesta, Vicente Ramón; Ladygin, Evgueni; Lafaye, Remi; Laforge, Bertrand; Lagouri, Theodota; Lai, Stanley; Laisne, Emmanuel; Lambourne, Luke; Lampen, Caleb; Lampl, Walter; Lancon, Eric; Landgraf, Ulrich; Landon, Murrough; Lang, Valerie Susanne; Lange, Clemens; Lankford, Andrew; Lanni, Francesco; Lantzsch, Kerstin; Lanza, Agostino; Laplace, Sandrine; Lapoire, Cecile; Laporte, Jean-Francois; Lari, Tommaso; Larner, Aimee; Lassnig, Mario; Laurelli, Paolo; Lavorini, Vincenzo; Lavrijsen, Wim; Laycock, Paul; Le Dortz, Olivier; Le Guirriec, Emmanuel; Le Menedeu, Eve; LeCompte, Thomas; Ledroit-Guillon, Fabienne Agnes Marie; Lee, Hurng-Chun; Lee, Jason; Lee, Shih-Chang; Lee, Lawrence; Lefebvre, Michel; Legendre, Marie; Legger, Federica; Leggett, Charles; Lehmacher, Marc; Lehmann Miotto, Giovanna; Leister, Andrew Gerard; Leite, Marco Aurelio Lisboa; Leitner, Rupert; Lellouch, Daniel; Lemmer, Boris; Lendermann, Victor; Leney, Katharine; Lenz, Tatiana; Lenzen, Georg; Lenzi, Bruno; Leonhardt, Kathrin; Leontsinis, Stefanos; Lepold, Florian; Leroy, Claude; Lessard, Jean-Raphael; Lester, Christopher; Lester, Christopher Michael; Levêque, Jessica; Levin, Daniel; Levinson, Lorne; Lewis, Adrian; Lewis, George; Leyko, Agnieszka; Leyton, Michael; Li, Bing; Li, Bo; Li, Haifeng; Li, Ho Ling; Li, Shu; Li, Xuefei; Liang, Zhijun; Liao, Hongbo; Liberti, Barbara; Lichard, Peter; Lie, Ki; Liebig, Wolfgang; Limbach, Christian; Limosani, Antonio; Limper, Maaike; Lin, Simon; Linde, Frank; Linnemann, James; Lipeles, Elliot; Lipniacka, Anna; Liss, Tony; Lissauer, David; Lister, Alison; Litke, Alan; Liu, Dong; Liu, Jianbei; Liu, Lulu; Liu, Minghui; Liu, Yanwen; Livan, Michele; Livermore, Sarah; Lleres, Annick; Llorente Merino, Javier; Lloyd, Stephen; Lobodzinska, Ewelina; Loch, Peter; Lockman, William; Loddenkoetter, Thomas; Loebinger, Fred; Loginov, Andrey; Loh, Chang Wei; Lohse, Thomas; Lohwasser, Kristin; Lokajicek, Milos; Lombardo, Vincenzo Paolo; Long, Robin Eamonn; Lopes, Lourenco; Lopez Mateos, David; Lorenz, Jeanette; Lorenzo Martinez, Narei; Losada, Marta; Loscutoff, Peter; Lo Sterzo, Francesco; Losty, Michael; Lou, XinChou; Lounis, Abdenour; Loureiro, Karina; Love, Jeremy; Love, Peter; Lowe, Andrew; Lu, Feng; Lubatti, Henry; Luci, Claudio; Lucotte, Arnaud; Ludwig, Dörthe; Ludwig, Inga; Ludwig, Jens; Luehring, Frederick; Luijckx, Guy; Lukas, Wolfgang; Luminari, Lamberto; Lund, Esben; Lund-Jensen, Bengt; Lundberg, Björn; Lundberg, Johan; Lundberg, Olof; Lundquist, Johan; Lungwitz, Matthias; Lynn, David; Lytken, Else; Ma, Hong; Ma, Lian Liang; Maccarrone, Giovanni; Macchiolo, Anna; Maček, Boštjan; Machado Miguens, Joana; Macina, Daniela; Mackeprang, Rasmus; Madaras, Ronald; Maddocks, Harvey Jonathan; Mader, Wolfgang; Maeno, Tadashi; Mättig, Peter; Mättig, Stefan; Magnoni, Luca; Magradze, Erekle; Mahboubi, Kambiz; Mahlstedt, Joern; Mahmoud, Sara; Mahout, Gilles; Maiani, Camilla; Maidantchik, Carmen; Maio, Amélia; Majewski, Stephanie; Makida, Yasuhiro; Makovec, Nikola; Mal, Prolay; Malaescu, Bogdan; Malecki, Pawel; Malecki, Piotr; Maleev, Victor; Malek, Fairouz; Mallik, Usha; Malon, David; Malone, Caitlin; Maltezos, Stavros; Malyshev, Vladimir; Malyukov, Sergei; Mamuzic, Judita; Manabe, Atsushi; Mandelli, Luciano; Mandić, Igor; Mandrysch, Rocco; Maneira, José; Manfredini, Alessandro; Manhaes de Andrade Filho, Luciano; Manjarres Ramos, Joany Andreina; Mann, Alexander; Manning, Peter; Manousakis-Katsikakis, Arkadios; Mansoulie, Bruno; Mantifel, Rodger; Mapelli, Alessandro; Mapelli, Livio; March, Luis; Marchand, Jean-Francois; Marchese, Fabrizio; Marchiori, Giovanni; Marcisovsky, Michal; Marino, Christopher; Marroquim, Fernando; Marshall, Zach; Marti, Lukas Fritz; Marti-Garcia, Salvador; Martin, Brian; Martin, Brian Thomas; Martin, Jean-Pierre; Martin, Tim; Martin, Victoria Jane; Martin dit Latour, Bertrand; Martin-Haugh, Stewart; Martinez, Homero; Martinez, Mario; Martinez Outschoorn, Verena; Martyniuk, Alex; Marx, Marilyn; Marzano, Francesco; Marzin, Antoine; Masetti, Lucia; Mashimo, Tetsuro; Mashinistov, Ruslan; Masik, Jiri; Maslennikov, Alexey; Massa, Ignazio; Massaro, Graziano; Massol, Nicolas; Mastrandrea, Paolo; Mastroberardino, Anna; Masubuchi, Tatsuya; Matsunaga, Hiroyuki; Matsushita, Takashi; Mattravers, Carly; Maurer, Julien; Maxfield, Stephen; Maximov, Dmitriy; Mazini, Rachid; Mazur, Michael; Mazzaferro, Luca; Mazzanti, Marcello; Mc Donald, Jeffrey; Mc Kee, Shawn Patrick; McCarn, Allison; McCarthy, Robert; McCarthy, Tom; McCubbin, Norman; McFarlane, Kenneth; Mcfayden, Josh; Mchedlidze, Gvantsa; Mclaughlan, Tom; McMahon, Steve; McPherson, Robert; Meade, Andrew; Mechnich, Joerg; Mechtel, Markus; Medinnis, Mike; Meehan, Samuel; Meera-Lebbai, Razzak; Meguro, Tatsuma; Mehlhase, Sascha; Mehta, Andrew; Meier, Karlheinz; Meirose, Bernhard; Melachrinos, Constantinos; Mellado Garcia, Bruce Rafael; Meloni, Federico; Mendoza Navas, Luis; Meng, Zhaoxia; Mengarelli, Alberto; Menke, Sven; Meoni, Evelin; Mercurio, Kevin Michael; Mermod, Philippe; Merola, Leonardo; Meroni, Chiara; Merritt, Frank; Merritt, Hayes; Messina, Andrea; Metcalfe, Jessica; Mete, Alaettin Serhan; Meyer, Carsten; Meyer, Christopher; Meyer, Jean-Pierre; Meyer, Jochen; Meyer, Joerg; Michal, Sebastien; Micu, Liliana; Middleton, Robin; Migas, Sylwia; Mijović, Liza; Mikenberg, Giora; Mikestikova, Marcela; Mikuž, Marko; Miller, David; Miller, Robert; Mills, Bill; Mills, Corrinne; Milov, Alexander; Milstead, David; Milstein, Dmitry; Minaenko, Andrey; Miñano Moya, Mercedes; Minashvili, Irakli; Mincer, Allen; Mindur, Bartosz; Mineev, Mikhail; Ming, Yao; Mir, Lluisa-Maria; Mirabelli, Giovanni; Mitrevski, Jovan; Mitsou, Vasiliki A; Mitsui, Shingo; Miyagawa, Paul; Mjörnmark, Jan-Ulf; Moa, Torbjoern; Moeller, Victoria; Mönig, Klaus; Möser, Nicolas; Mohapatra, Soumya; Mohr, Wolfgang; Moles-Valls, Regina; Molfetas, Angelos; Monk, James; Monnier, Emmanuel; Montejo Berlingen, Javier; Monticelli, Fernando; Monzani, Simone; Moore, Roger; Moorhead, Gareth; Mora Herrera, Clemencia; Moraes, Arthur; Morange, Nicolas; Morel, Julien; Morello, Gianfranco; Moreno, Deywis; Moreno Llácer, María; Morettini, Paolo; Morgenstern, Marcus; Morii, Masahiro; Morley, Anthony Keith; Mornacchi, Giuseppe; Morris, John; Morvaj, Ljiljana; Moser, Hans-Guenther; Mosidze, Maia; Moss, Josh; Mount, Richard; Mountricha, Eleni; Mouraviev, Sergei; Moyse, Edward; Mueller, Felix; Mueller, James; Mueller, Klemens; Müller, Thomas; Mueller, Timo; Muenstermann, Daniel; Munwes, Yonathan; Murray, Bill; Mussche, Ido; Musto, Elisa; Myagkov, Alexey; Myska, Miroslav; Nackenhorst, Olaf; Nadal, Jordi; Nagai, Koichi; Nagai, Ryo; Nagai, Yoshikazu; Nagano, Kunihiro; Nagarkar, Advait; Nagasaka, Yasushi; Nagel, Martin; Nairz, Armin Michael; Nakahama, Yu; Nakamura, Koji; Nakamura, Tomoaki; Nakano, Itsuo; Nanava, Gizo; Napier, Austin; Narayan, Rohin; Nash, Michael; Nattermann, Till; Naumann, Thomas; Navarro, Gabriela; Neal, Homer; Nechaeva, Polina; Neep, Thomas James; Negri, Andrea; Negri, Guido; Negrini, Matteo; Nektarijevic, Snezana; Nelson, Andrew; Nelson, Timothy Knight; Nemecek, Stanislav; Nemethy, Peter; Nepomuceno, Andre Asevedo; Nessi, Marzio; Neubauer, Mark; Neumann, Manuel; Neusiedl, Andrea; Neves, Ricardo; Nevski, Pavel; Newcomer, Mitchel; Newman, Paul; Nguyen Thi Hong, Van; Nickerson, Richard; Nicolaidou, Rosy; Nicquevert, Bertrand; Niedercorn, Francois; Nielsen, Jason; Nikiforou, Nikiforos; Nikiforov, Andriy; Nikolaenko, Vladimir; Nikolic-Audit, Irena; Nikolics, Katalin; Nikolopoulos, Konstantinos; Nilsen, Henrik; Nilsson, Paul; Ninomiya, Yoichi; Nisati, Aleandro; Nisius, Richard; Nobe, Takuya; Nodulman, Lawrence; Nomachi, Masaharu; Nomidis, Ioannis; Norberg, Scarlet; Nordberg, Markus; Novakova, Jana; Nozaki, Mitsuaki; Nozka, Libor; Nuncio-Quiroz, Adriana-Elizabeth; Nunes Hanninger, Guilherme; Nunnemann, Thomas; Nurse, Emily; O'Brien, Brendan Joseph; O'Neil, Dugan; O'Shea, Val; Oakes, Louise Beth; Oakham, Gerald; Oberlack, Horst; Ocariz, Jose; Ochi, Atsuhiko; Oda, Susumu; Odaka, Shigeru; Odier, Jerome; Ogren, Harold; Oh, Alexander; Oh, Seog; Ohm, Christian; Ohshima, Takayoshi; Okamura, Wataru; Okawa, Hideki; Okumura, Yasuyuki; Okuyama, Toyonobu; Olariu, Albert; Olchevski, Alexander; Olivares Pino, Sebastian Andres; Oliveira, Miguel Alfonso; Oliveira Damazio, Denis; Oliver Garcia, Elena; Olivito, Dominick; Olszewski, Andrzej; Olszowska, Jolanta; Onofre, António; Onyisi, Peter; Oram, Christopher; Oreglia, Mark; Oren, Yona; Orestano, Domizia; Orlando, Nicola; Oropeza Barrera, Cristina; Orr, Robert; Osculati, Bianca; Ospanov, Rustem; Osuna, Carlos; Otero y Garzon, Gustavo; Ottersbach, John; Ouchrif, Mohamed; Ouellette, Eric; Ould-Saada, Farid; Ouraou, Ahmimed; Ouyang, Qun; Ovcharova, Ana; Owen, Mark; Owen, Simon; Ozcan, Veysi Erkcan; Ozturk, Nurcan; Pacheco Pages, Andres; Padilla Aranda, Cristobal; Pagan Griso, Simone; Paganis, Efstathios; Pahl, Christoph; Paige, Frank; Pais, Preema; Pajchel, Katarina; Palacino, Gabriel; Paleari, Chiara; Palestini, Sandro; Pallin, Dominique; Palma, Alberto; Palmer, Jody; Pan, Yibin; Panagiotopoulou, Evgenia; Panduro Vazquez, William; Pani, Priscilla; Panikashvili, Natalia; Panitkin, Sergey; Pantea, Dan; Papadelis, Aras; Papadopoulou, Theodora; Paramonov, Alexander; Paredes Hernandez, Daniela; Park, Woochun; Parker, Michael Andrew; Parodi, Fabrizio; Parsons, John; Parzefall, Ulrich; Pashapour, Shabnaz; Pasqualucci, Enrico; Passaggio, Stefano; Passeri, Antonio; Pastore, Fernanda; Pastore, Francesca; Pásztor, Gabriella; Pataraia, Sophio; Patel, Nikhul; Pater, Joleen; Patricelli, Sergio; Pauly, Thilo; Pedraza Lopez, Sebastian; Pedraza Morales, Maria Isabel; Peleganchuk, Sergey; Pelikan, Daniel; Peng, Haiping; Penning, Bjoern; Penson, Alexander; Penwell, John; Perantoni, Marcelo; Perez, Kerstin; Perez Cavalcanti, Tiago; Perez Codina, Estel; Pérez García-Estañ, María Teresa; Perez Reale, Valeria; Perini, Laura; Pernegger, Heinz; Perrino, Roberto; Perrodo, Pascal; Peshekhonov, Vladimir; Peters, Krisztian; Petersen, Brian; Petersen, Jorgen; Petersen, Troels; Petit, Elisabeth; Petridis, Andreas; Petridou, Chariclia; Petrolo, Emilio; Petrucci, Fabrizio; Petschull, Dennis; Petteni, Michele; Pezoa, Raquel; Phan, Anna; Phillips, Peter William; Piacquadio, Giacinto; Picazio, Attilio; Piccaro, Elisa; Piccinini, Maurizio; Piec, Sebastian Marcin; Piegaia, Ricardo; Pignotti, David; Pilcher, James; Pilkington, Andrew; Pina, João Antonio; Pinamonti, Michele; Pinder, Alex; Pinfold, James; Pingel, Almut; Pinto, Belmiro; Pizio, Caterina; Pleier, Marc-Andre; Plotnikova, Elena; Poblaguev, Andrei; Poddar, Sahill; Podlyski, Fabrice; Poggioli, Luc; Pohl, David-leon; Pohl, Martin; Polesello, Giacomo; Policicchio, Antonio; Polifka, Richard; Polini, Alessandro; Poll, James; Polychronakos, Venetios; Pomeroy, Daniel; Pommès, Kathy; Pontecorvo, Ludovico; Pope, Bernard; Popeneciu, Gabriel Alexandru; Popovic, Dragan; Poppleton, Alan; Portell Bueso, Xavier; Pospelov, Guennady; Pospisil, Stanislav; Potrap, Igor; Potter, Christina; Potter, Christopher; Poulard, Gilbert; Poveda, Joaquin; Pozdnyakov, Valery; Prabhu, Robindra; Pralavorio, Pascal; Pranko, Aliaksandr; Prasad, Srivas; Pravahan, Rishiraj; Prell, Soeren; Pretzl, Klaus Peter; Price, Darren; Price, Joe; Price, Lawrence; Prieur, Damien; Primavera, Margherita; Prokofiev, Kirill; Prokoshin, Fedor; Protopopescu, Serban; Proudfoot, James; Prudent, Xavier; Przybycien, Mariusz; Przysiezniak, Helenka; Psoroulas, Serena; Ptacek, Elizabeth; Pueschel, Elisa; Puldon, David; Purdham, John; Purohit, Milind; Puzo, Patrick; Pylypchenko, Yuriy; Qian, Jianming; Quadt, Arnulf; Quarrie, David; Quayle, William; Raas, Marcel; Radeka, Veljko; Radescu, Voica; Radloff, Peter; Ragusa, Francesco; Rahal, Ghita; Rahimi, Amir; Rahm, David; Rajagopalan, Srinivasan; Rammensee, Michael; Rammes, Marcus; Randle-Conde, Aidan Sean; Randrianarivony, Koloina; Rao, Kanury; Rauscher, Felix; Rave, Tobias Christian; Raymond, Michel; Read, Alexander Lincoln; Rebuzzi, Daniela; Redelbach, Andreas; Redlinger, George; Reece, Ryan; Reeves, Kendall; Reinsch, Andreas; Reisinger, Ingo; Rembser, Christoph; Ren, Zhongliang; Renaud, Adrien; Rescigno, Marco; Resconi, Silvia; Resende, Bernardo; Reznicek, Pavel; Rezvani, Reyhaneh; Richter, Robert; Richter-Was, Elzbieta; Ridel, Melissa; Rijssenbeek, Michael; Rimoldi, Adele; Rinaldi, Lorenzo; Rios, Ryan Randy; Ritsch, Elmar; Riu, Imma; Rivoltella, Giancesare; Rizatdinova, Flera; Rizvi, Eram; Robertson, Steven; Robichaud-Veronneau, Andree; Robinson, Dave; Robinson, James; Robson, Aidan; Rocha de Lima, Jose Guilherme; Roda, Chiara; Roda Dos Santos, Denis; Roe, Adam; Roe, Shaun; Røhne, Ole; Rolli, Simona; Romaniouk, Anatoli; Romano, Marino; Romeo, Gaston; Romero Adam, Elena; Rompotis, Nikolaos; Roos, Lydia; Ros, Eduardo; Rosati, Stefano; Rosbach, Kilian; Rose, Anthony; Rose, Matthew; Rosenbaum, Gabriel; Rosendahl, Peter Lundgaard; Rosenthal, Oliver; Rosselet, Laurent; Rossetti, Valerio; Rossi, Elvira; Rossi, Leonardo Paolo; Rotaru, Marina; Roth, Itamar; Rothberg, Joseph; Rousseau, David; Royon, Christophe; Rozanov, Alexandre; Rozen, Yoram; Ruan, Xifeng; Rubbo, Francesco; Rubinskiy, Igor; Ruckstuhl, Nicole; Rud, Viacheslav; Rudolph, Christian; Rühr, Frederik; Ruiz-Martinez, Aranzazu; Rumyantsev, Leonid; Rurikova, Zuzana; Rusakovich, Nikolai; Ruschke, Alexander; Rutherfoord, John; Ruthmann, Nils; Ruzicka, Pavel; Ryabov, Yury; Rybar, Martin; Rybkin, Grigori; Ryder, Nick; Saavedra, Aldo; Sadeh, Iftach; Sadrozinski, Hartmut; Sadykov, Renat; Safai Tehrani, Francesco; Sakamoto, Hiroshi; Salamanna, Giuseppe; Salamon, Andrea; Saleem, Muhammad; Salek, David; Salihagic, Denis; Salnikov, Andrei; Salt, José; Salvachua Ferrando, Belén; Salvatore, Daniela; Salvatore, Pasquale Fabrizio; Salvucci, Antonio; Salzburger, Andreas; Sampsonidis, Dimitrios; Samset, Björn Hallvard; Sanchez, Arturo; Sanchez Martinez, Victoria; Sandaker, Heidi; Sander, Heinz Georg; Sanders, Michiel; Sandhoff, Marisa; Sandoval, Tanya; Sandoval, Carlos; Sandstroem, Rikard; Sankey, Dave; Sansoni, Andrea; Santamarina Rios, Cibran; Santoni, Claudio; Santonico, Rinaldo; Santos, Helena; Santoyo Castillo, Itzebelt; Saraiva, João; Sarangi, Tapas; Sarkisyan-Grinbaum, Edward; Sarrazin, Bjorn; Sarri, Francesca; Sartisohn, Georg; Sasaki, Osamu; Sasaki, Yuichi; Sasao, Noboru; Satsounkevitch, Igor; Sauvage, Gilles; Sauvan, Emmanuel; Sauvan, Jean-Baptiste; Savard, Pierre; Savinov, Vladimir; Savu, Dan Octavian; Sawyer, Lee; Saxon, David; Saxon, James; Sbarra, Carla; Sbrizzi, Antonio; Scannicchio, Diana; Scarcella, Mark; Schaarschmidt, Jana; Schacht, Peter; Schaefer, Douglas; Schäfer, Uli; Schaelicke, Andreas; Schaepe, Steffen; Schaetzel, Sebastian; Schaffer, Arthur; Schaile, Dorothee; Schamberger, R. Dean; Scharf, Veit; Schegelsky, Valery; Scheirich, Daniel; Schernau, Michael; Scherzer, Max; Schiavi, Carlo; Schieck, Jochen; Schioppa, Marco; Schlenker, Stefan; Schmidt, Evelyn; Schmieden, Kristof; Schmitt, Christian; Schmitt, Sebastian; Schneider, Basil; Schnellbach, Yan Jie; Schnoor, Ulrike; Schoeffel, Laurent; Schoening, Andre; Schorlemmer, Andre Lukas; Schott, Matthias; Schouten, Doug; Schovancova, Jaroslava; Schram, Malachi; Schroeder, Christian; Schroer, Nicolai; Schultens, Martin Johannes; Schultes, Joachim; Schultz-Coulon, Hans-Christian; Schulz, Holger; Schumacher, Markus; Schumm, Bruce; Schune, Philippe; Schwartzman, Ariel; Schwegler, Philipp; Schwemling, Philippe; Schwienhorst, Reinhard; Schwindling, Jerome; Schwindt, Thomas; Schwoerer, Maud; Sciacca, Gianfranco; Scifo, Estelle; Sciolla, Gabriella; Scott, Bill; Searcy, Jacob; Sedov, George; Sedykh, Evgeny; Seidel, Sally; Seiden, Abraham; Seifert, Frank; Seixas, José; Sekhniaidze, Givi; Sekula, Stephen; Selbach, Karoline Elfriede; Seliverstov, Dmitry; Sellden, Bjoern; Sellers, Graham; Seman, Michal; Semprini-Cesari, Nicola; Serfon, Cedric; Serin, Laurent; Serkin, Leonid; Serre, Thomas; Seuster, Rolf; Severini, Horst; Sfyrla, Anna; Shabalina, Elizaveta; Shamim, Mansoora; Shan, Lianyou; Shank, James; Shao, Qi Tao; Shapiro, Marjorie; Shatalov, Pavel; Shaw, Kate; Sherman, Daniel; Sherwood, Peter; Shimizu, Shima; Shimojima, Makoto; Shin, Taeksu; Shiyakova, Mariya; Shmeleva, Alevtina; Shochet, Mel; Short, Daniel; Shrestha, Suyog; Shulga, Evgeny; Shupe, Michael; Sicho, Petr; Sidoti, Antonio; Siegert, Frank; Sijacki, Djordje; Silbert, Ohad; Silva, José; Silver, Yiftah; Silverstein, Daniel; Silverstein, Samuel; Simak, Vladislav; Simard, Olivier; Simic, Ljiljana; Simion, Stefan; Simioni, Eduard; Simmons, Brinick; Simoniello, Rosa; Simonyan, Margar; Sinervo, Pekka; Sinev, Nikolai; Sipica, Valentin; Siragusa, Giovanni; Sircar, Anirvan; Sisakyan, Alexei; Sivoklokov, Serguei; Sjölin, Jörgen; Sjursen, Therese; Skinnari, Louise Anastasia; Skottowe, Hugh Philip; Skovpen, Kirill; Skubic, Patrick; Slater, Mark; Slavicek, Tomas; Sliwa, Krzysztof; Smakhtin, Vladimir; Smart, Ben; Smestad, Lillian; Smirnov, Sergei; Smirnov, Yury; Smirnova, Lidia; Smirnova, Oxana; Smith, Ben Campbell; Smith, Kenway; Smizanska, Maria; Smolek, Karel; Snesarev, Andrei; Snow, Steve; Snow, Joel; Snyder, Scott; Sobie, Randall; Sodomka, Jaromir; Soffer, Abner; Solans, Carlos; Solar, Michael; Solc, Jaroslav; Soldatov, Evgeny; Soldevila, Urmila; Solfaroli Camillocci, Elena; Solodkov, Alexander; Solovyanov, Oleg; Solovyev, Victor; Soni, Nitesh; Sood, Alexander; Sopko, Vit; Sopko, Bruno; Sosebee, Mark; Soualah, Rachik; Soueid, Paul; Soukharev, Andrey; South, David; Spagnolo, Stefania; Spanò, Francesco; Spighi, Roberto; Spigo, Giancarlo; Spiwoks, Ralf; Spousta, Martin; Spreitzer, Teresa; Spurlock, Barry; St Denis, Richard Dante; Stahlman, Jonathan; Stamen, Rainer; Stanecka, Ewa; Stanek, Robert; Stanescu, Cristian; Stanescu-Bellu, Madalina; Stanitzki, Marcel Michael; Stapnes, Steinar; Starchenko, Evgeny; Stark, Jan; Staroba, Pavel; Starovoitov, Pavel; Staszewski, Rafal; Staude, Arnold; Stavina, Pavel; Steele, Genevieve; Steinbach, Peter; Steinberg, Peter; Stekl, Ivan; Stelzer, Bernd; Stelzer, Harald Joerg; Stelzer-Chilton, Oliver; Stenzel, Hasko; Stern, Sebastian; Stewart, Graeme; Stillings, Jan Andre; Stockton, Mark; Stoebe, Michael; Stoerig, Kathrin; Stoicea, Gabriel; Stonjek, Stefan; Strachota, Pavel; Stradling, Alden; Straessner, Arno; Strandberg, Jonas; Strandberg, Sara; Strandlie, Are; Strang, Michael; Strauss, Emanuel; Strauss, Michael; Strizenec, Pavol; Ströhmer, Raimund; Strom, David; Strong, John; Stroynowski, Ryszard; Stugu, Bjarne; Stumer, Iuliu; Stupak, John; Sturm, Philipp; Styles, Nicholas Adam; Soh, Dart-yin; Su, Dong; Subramania, Halasya Siva; Subramaniam, Rajivalochan; Succurro, Antonella; Sugaya, Yorihito; Suhr, Chad; Suk, Michal; Sulin, Vladimir; Sultansoy, Saleh; Sumida, Toshi; Sun, Xiaohu; Sundermann, Jan Erik; Suruliz, Kerim; Susinno, Giancarlo; Sutton, Mark; Suzuki, Yu; Suzuki, Yuta; Svatos, Michal; Swedish, Stephen; Sykora, Ivan; Sykora, Tomas; Sánchez, Javier; Ta, Duc; Tackmann, Kerstin; Taffard, Anyes; Tafirout, Reda; Taiblum, Nimrod; Takahashi, Yuta; Takai, Helio; Takashima, Ryuichi; Takeda, Hiroshi; Takeshita, Tohru; Takubo, Yosuke; Talby, Mossadek; Talyshev, Alexey; Tamsett, Matthew; Tan, Kong Guan; Tanaka, Junichi; Tanaka, Reisaburo; Tanaka, Satoshi; Tanaka, Shuji; Tanasijczuk, Andres Jorge; Tani, Kazutoshi; Tannoury, Nancy; Tapprogge, Stefan; Tardif, Dominique; Tarem, Shlomit; Tarrade, Fabien; Tartarelli, Giuseppe Francesco; Tas, Petr; Tasevsky, Marek; Tassi, Enrico; Tayalati, Yahya; Taylor, Christopher; Taylor, Frank; Taylor, Geoffrey; Taylor, Wendy; Teinturier, Marthe; Teischinger, Florian Alfred; Teixeira Dias Castanheira, Matilde; Teixeira-Dias, Pedro; Temming, Kim Katrin; Ten Kate, Herman; Teng, Ping-Kun; Terada, Susumu; Terashi, Koji; Terron, Juan; Testa, Marianna; Teuscher, Richard; Therhaag, Jan; Theveneaux-Pelzer, Timothée; Thoma, Sascha; Thomas, Juergen; Thompson, Emily; Thompson, Paul; Thompson, Peter; Thompson, Stan; Thomsen, Lotte Ansgaard; Thomson, Evelyn; Thomson, Mark; Thong, Wai Meng; Thun, Rudolf; Tian, Feng; Tibbetts, Mark James; Tic, Tomáš; Tikhomirov, Vladimir; Tikhonov, Yury; Timoshenko, Sergey; Tiouchichine, Elodie; Tipton, Paul; Tisserant, Sylvain; Todorov, Theodore; Todorova-Nova, Sharka; Toggerson, Brokk; Tojo, Junji; Tokár, Stanislav; Tokushuku, Katsuo; Tollefson, Kirsten; Tomoto, Makoto; Tompkins, Lauren; Toms, Konstantin; Tonoyan, Arshak; Topfel, Cyril; Topilin, Nikolai; Torrence, Eric; Torres, Heberth; Torró Pastor, Emma; Toth, Jozsef; Touchard, Francois; Tovey, Daniel; Trefzger, Thomas; Tremblet, Louis; Tricoli, Alesandro; Trigger, Isabel Marian; Trincaz-Duvoid, Sophie; Tripiana, Martin; Triplett, Nathan; Trischuk, William; Trocmé, Benjamin; Troncon, Clara; Trottier-McDonald, Michel; True, Patrick; Trzebinski, Maciej; Trzupek, Adam; Tsarouchas, Charilaos; Tseng, Jeffrey; Tsiakiris, Menelaos; Tsiareshka, Pavel; Tsionou, Dimitra; Tsipolitis, Georgios; Tsiskaridze, Shota; Tsiskaridze, Vakhtang; Tskhadadze, Edisher; Tsukerman, Ilya; Tsulaia, Vakhtang; Tsung, Jieh-Wen; Tsuno, Soshi; Tsybychev, Dmitri; Tua, Alan; Tudorache, Alexandra; Tudorache, Valentina; Tuggle, Joseph; Turala, Michal; Turecek, Daniel; Turk Cakir, Ilkay; Turra, Ruggero; Tuts, Michael; Tykhonov, Andrii; Tylmad, Maja; Tyndel, Mike; Tzanakos, George; Uchida, Kirika; Ueda, Ikuo; Ueno, Ryuichi; Ughetto, Michael; Ugland, Maren; Uhlenbrock, Mathias; Ukegawa, Fumihiko; Unal, Guillaume; Undrus, Alexander; Unel, Gokhan; Unno, Yoshinobu; Urbaniec, Dustin; Urquijo, Phillip; Usai, Giulio; Vacavant, Laurent; Vacek, Vaclav; Vachon, Brigitte; Vahsen, Sven; Valentinetti, Sara; Valero, Alberto; Valery, Loic; Valkar, Stefan; Valladolid Gallego, Eva; Vallecorsa, Sofia; Valls Ferrer, Juan Antonio; Van Berg, Richard; Van Der Deijl, Pieter; van der Geer, Rogier; van der Graaf, Harry; Van Der Leeuw, Robin; van der Poel, Egge; van der Ster, Daniel; van Eldik, Niels; van Gemmeren, Peter; Van Nieuwkoop, Jacobus; van Vulpen, Ivo; Vanadia, Marco; Vandelli, Wainer; Vaniachine, Alexandre; Vankov, Peter; Vannucci, Francois; Vari, Riccardo; Varnes, Erich; Varol, Tulin; Varouchas, Dimitris; Vartapetian, Armen; Varvell, Kevin; Vassilakopoulos, Vassilios; Vazeille, Francois; Vazquez Schroeder, Tamara; Vegni, Guido; Veillet, Jean-Jacques; Veloso, Filipe; Veness, Raymond; Veneziano, Stefano; Ventura, Andrea; Ventura, Daniel; Venturi, Manuela; Venturi, Nicola; Vercesi, Valerio; Verducci, Monica; Verkerke, Wouter; Vermeulen, Jos; Vest, Anja; Vetterli, Michel; Vichou, Irene; Vickey, Trevor; Vickey Boeriu, Oana Elena; Viehhauser, Georg; Viel, Simon; Villa, Mauro; Villaplana Perez, Miguel; Vilucchi, Elisabetta; Vincter, Manuella; Vinek, Elisabeth; Vinogradov, Vladimir; Virchaux, Marc; Virzi, Joseph; Vitells, Ofer; Viti, Michele; Vivarelli, Iacopo; Vives Vaque, Francesc; Vlachos, Sotirios; Vladoiu, Dan; Vlasak, Michal; Vogel, Adrian; Vokac, Petr; Volpi, Guido; Volpi, Matteo; Volpini, Giovanni; von der Schmitt, Hans; von Radziewski, Holger; von Toerne, Eckhard; Vorobel, Vit; Vorwerk, Volker; Vos, Marcel; Voss, Rudiger; Vossebeld, Joost; Vranjes, Nenad; Vranjes Milosavljevic, Marija; Vrba, Vaclav; Vreeswijk, Marcel; Vu Anh, Tuan; Vuillermet, Raphael; Vukotic, Ilija; Wagner, Wolfgang; Wagner, Peter; Wahlen, Helmut; Wahrmund, Sebastian; Wakabayashi, Jun; Walch, Shannon; Walder, James; Walker, Rodney; Walkowiak, Wolfgang; Wall, Richard; Waller, Peter; Walsh, Brian; Wang, Chiho; Wang, Haichen; Wang, Hulin; Wang, Jike; Wang, Jin; Wang, Rui; Wang, Song-Ming; Wang, Tan; Warburton, Andreas; Ward, Patricia; Wardrope, David Robert; Warsinsky, Markus; Washbrook, Andrew; Wasicki, Christoph; Watanabe, Ippei; Watkins, Peter; Watson, Alan; Watson, Ian; Watson, Miriam; Watts, Gordon; Watts, Stephen; Waugh, Anthony; Waugh, Ben; Weber, Michele; Webster, Jordan S; Weidberg, Anthony; Weigell, Philipp; Weingarten, Jens; Weiser, Christian; Wells, Phillippa; Wenaus, Torre; Wendland, Dennis; Weng, Zhili; Wengler, Thorsten; Wenig, Siegfried; Wermes, Norbert; Werner, Matthias; Werner, Per; Werth, Michael; Wessels, Martin; Wetter, Jeffrey; Weydert, Carole; Whalen, Kathleen; White, Andrew; White, Martin; White, Sebastian; Whitehead, Samuel Robert; Whiteson, Daniel; Whittington, Denver; Wicke, Daniel; Wickens, Fred; Wiedenmann, Werner; Wielers, Monika; Wienemann, Peter; Wiglesworth, Craig; Wiik-Fuchs, Liv Antje Mari; Wijeratne, Peter Alexander; Wildauer, Andreas; Wildt, Martin Andre; Wilhelm, Ivan; Wilkens, Henric George; Will, Jonas Zacharias; Williams, Eric; Williams, Hugh; Williams, Sarah; Willis, William; Willocq, Stephane; Wilson, John; Wilson, Michael Galante; Wilson, Alan; Wingerter-Seez, Isabelle; Winkelmann, Stefan; Winklmeier, Frank; Wittgen, Matthias; Wollstadt, Simon Jakob; Wolter, Marcin Wladyslaw; Wolters, Helmut; Wong, Wei-Cheng; Wooden, Gemma; Wosiek, Barbara; Wotschack, Jorg; Woudstra, Martin; Wozniak, Krzysztof; Wraight, Kenneth; Wright, Michael; Wrona, Bozydar; Wu, Sau Lan; Wu, Xin; Wu, Yusheng; Wulf, Evan; Wynne, Benjamin; Xella, Stefania; Xiao, Meng; Xie, Song; Xu, Chao; Xu, Da; Xu, Lailin; Yabsley, Bruce; Yacoob, Sahal; Yamada, Miho; Yamaguchi, Hiroshi; Yamamoto, Akira; Yamamoto, Kyoko; Yamamoto, Shimpei; Yamamura, Taiki; Yamanaka, Takashi; Yamauchi, Katsuya; Yamazaki, Takayuki; Yamazaki, Yuji; Yan, Zhen; Yang, Haijun; Yang, Hongtao; Yang, Un-Ki; Yang, Yi; Yang, Zhaoyu; Yanush, Serguei; Yao, Liwen; Yasu, Yoshiji; Yatsenko, Elena; Ye, Jingbo; Ye, Shuwei; Yen, Andy L; Yilmaz, Metin; Yoosoofmiya, Reza; Yorita, Kohei; Yoshida, Rikutaro; Yoshihara, Keisuke; Young, Charles; Young, Christopher John; Youssef, Saul; Yu, Dantong; Yu, David Ren-Hwa; Yu, Jaehoon; Yu, Jie; Yuan, Li; Yurkewicz, Adam; Zabinski, Bartlomiej; Zaidan, Remi; Zaitsev, Alexander; Zanello, Lucia; Zanzi, Daniele; Zaytsev, Alexander; Zeitnitz, Christian; Zeman, Martin; Zemla, Andrzej; Zenin, Oleg; Ženiš, Tibor; Zinonos, Zinonas; Zerwas, Dirk; Zevi della Porta, Giovanni; Zhang, Dongliang; Zhang, Huaqiao; Zhang, Jinlong; Zhang, Xueyao; Zhang, Zhiqing; Zhao, Long; Zhao, Zhengguo; Zhemchugov, Alexey; Zhong, Jiahang; Zhou, Bing; Zhou, Ning; Zhou, Yue; Zhu, Cheng Guang; Zhu, Hongbo; Zhu, Junjie; Zhu, Yingchun; Zhuang, Xuai; Zhuravlov, Vadym; Zibell, Andre; Zieminska, Daria; Zimin, Nikolai; Zimmermann, Robert; Zimmermann, Simone; Zimmermann, Stephanie; Ziolkowski, Michael; Zitoun, Robert; Živković, Lidija; Zmouchko, Viatcheslav; Zobernig, Georg; Zoccoli, Antonio; zur Nedden, Martin; Zutshi, Vishnu; Zwalinski, Lukasz

    2013-03-13

    A measurement of angular correlations in Drell-Yan lepton pairs via the phistar observable is presented. This variable probes the same physics as the $Z/\\gamma^*$ boson transverse momentum with a better experimental resolution. The $Z/\\gamma^* \\to e^+e^-$ and $Z/\\gamma^* \\to \\mu^+\\mu^-$ decays produced in proton--proton collisions at a centre-of-mass energy of $\\sqrt{s}$ = 7 TeV are used. The data were collected with the ATLAS detector at the LHC and correspond to an integrated luminosity of 4.6 fb$^{-1}$. Normalised differential cross sections as a function of $\\phi^*_\\eta$ are measured separately for electron and muon decay channels. These channels are then combined for improved accuracy. The cross section is also measured double differentially as a function of $\\phi^*_\\eta$ for three independent bins of the Z boson rapidity. The results are compared to QCD calculations and to predictions from different Monte Carlo event generators. The data are reasonably well described, in all measured Z boson rapidity re...

  8. Detection of GRB 060927 at z = 5.47: Implications for the Use of Gamma-Ray Bursts as Probes of the End of the Dark Ages

    Ruiz-Velasco, A.E.; Swan, H.; Troja, E.; Malesani, D.; Fynbo, J.P.U.; Starling, R.L.C.; Xu, D.; Aharonian, F.; Akerlof, C.; Andersen, M.I.; Ashley, M.C.B.; Barthelmy, S.D.; Bersier, D.F.; Cerón, J.M.; Castro-Tirado, A.J.; Gehrels, N.; Gögüs, E.; Gorosabel, J.; Guidorzi, C.; Güver, T.; Hjorth, J.; Horns, D.; Huang, K.Y.; Jakobsson, P.; Jensen, B.L.; Kiziloglu, Ü.; Kouveliotou, C.; Krimm, H.A.; Ledoux, C.; Levan, A.J.; Marsh, T.; McKay, T.; Melandri, A.; Milvang-Jensen, B.; Mundell, C.G.; O'Brien, P.T.; Özel, M.; Phillips, A.; Quimby, R.; Rowell, G.; Rujopakarn, W.; Rykoff, E.S.; Schaefer, B.E.; Sollerman, J.; Tanvir, N.R.; Thöne, C.C.; Urata, Y.; Vestrand, W.T.; Vreeswijk, P.M.; Watson, D.; Wheeler, J.C.; Wijers, R.A.M.J.; Wren, J.; Yost, S.A.; Yuan, F.; Zhai, M.; Zheng, W.K.

    2007-01-01

    We report on follow-up observations of the gamma-ray burst GRB 060927 using the robotic ROTSE-IIIa telescope and a suite of larger aperture ground-based telescopes. An optical afterglow was detected 20 s after the burst, the earliest rest-frame detection of optical emission from any GRB.

  9. Gamma-ray burst afterglows as probes of environment and blast wave physics. II. The distribution of p and structure of the circumburst medium

    Starling, R.L.C.; van der Horst, A.J.; Rol, E.; Wijers, R.A.M.J.; Kouveliotou, C.; Wiersema, K.; Curran, P.A.; Weltevrede, P.

    2008-01-01

    We constrain blast wave parameters and the circumburst media of a subsample of 10 BeppoSAX gamma-ray bursts (GRBs). For this sample we derive the values of the injected electron energy distribution index, p, and the density structure index of the circumburst medium, k, from simultaneous spectral

  10. Intraoperative Sentinel Lymph Node Evaluation

    Shaw, Richard; Christensen, Anders; Java, Kapil

    2016-01-01

    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic......-ready" intraoperative diagnostic test (one step nucleic acid amplification-OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50......% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result...

  11. Characterization of the detectability of an intraoperative minigammacamera; Caracterizacion de la detectabilidad de una minigammacamara intraoperatoria

    Sanchez Jimenez, J.; Nunez Martinez, L. M. R.; Morillas Ruiz, J.; Pizarro Trigo, F.; Crespo Mesa, S.; Ros Lorda, M.A.

    2011-07-01

    Screening of the sentinel node is a technique which is widely used in Nuclear Medicine Services for its ability to reduce the morbidity associated lymphadenectomy. This intervention is particularly important that accurate detection of the probe uptake, The aim of this study is to evaluate all the factors that influence the detection image by introducing the contributions of intraoperative minigammacamera systems. (Author)

  12. Mobile Probing and Probes

    Duvaa, Uffe; Ørngreen, Rikke; Weinkouff Mathiasen, Anne-Gitte

    2013-01-01

    Mobile probing is a method, developed for learning about digital work situations, as an approach to discover new grounds. The method can be used when there is a need to know more about users and their work with certain tasks, but where users at the same time are distributed (in time and space......). Mobile probing was inspired by the cultural probe method, and was influenced by qualitative interview and inquiry approaches. The method has been used in two subsequent projects, involving school children (young adults at 15-17 years old) and employees (adults) in a consultancy company. Findings point...... to mobile probing being a flexible method for uncovering the unknowns, as a way of getting rich data to the analysis and design phases. On the other hand it is difficult to engage users to give in depth explanations, which seem easier in synchronous dialogs (whether online or face2face). The development...

  13. Mobile Probing and Probes

    Duvaa, Uffe; Ørngreen, Rikke; Weinkouff, Anne-Gitte

    2012-01-01

    Mobile probing is a method, which has been developed for learning about digital work situations, as an approach to discover new grounds. The method can be used when there is a need to know more about users and their work with certain tasks, but where users at the same time are distributed (in time...... and space). Mobile probing was inspired by the cultural probe method, and was influenced by qualitative interview and inquiry approaches. The method has been used in two subsequent projects, involving school children (young adults at 15-17 years old) and employees (adults) in a consultancy company. Findings...... point to mobile probing being a flexible method for uncovering the unknowns, as a way of getting rich data to the analysis and design phases. On the other hand it is difficult to engage users to give in depth explanations, which seem easier in synchronous dialogs (whether online or face2face...

  14. Hyperfine interactions in MnAs studied by perturbed angular correlations of $\\gamma$-rays using the probe $^{77}$Br $\\rightarrow ^{77}$Se and first principles calculations for MnAs and other Mn pnictides

    Gonçalves, J N; Correia, J G; Lopes, A M L

    2011-01-01

    The MnAs compound shows a first-order transition at T$_{c}$≈ 42$^{\\circ}$C, and a second-order transition at T$_{t}$ ≈120$^{\\circ}$C. The first-order transition, with structural (hexagonal-orthorhombic), magnetic (FM-PM) and electrical conductivity changes, is associated to magnetocaloric, magnetoelastic, and magnetoresistance effects. We report a study in a large temperature range from −196$^{\\circ}$C up to 140$^{\\circ}$C, using the $\\gamma\\!-\\!\\gamma$ perturbed angular correlations method with the radioactive probe $^{77}$Br→$^{77}$Se, produced at the ISOLDE-CERN facility. The electric field gradients and magnetic hyperfine fields are determined across the first- and second-order phase transitions encompassing the pure and mixed phase regimes in cooling and heating cycles. The temperature irreversibility of the 1st order phase transition is seen locally, at the nanoscopic scale sensitivity of the hyperfine field, by its hysteresis, detailing and complementing information obtained with macroscopic me...

  15. Intraoperative Hypoglossal Nerve Mapping During Carotid Endarterectomy: Technical Note.

    Kojima, Atsuhiro; Saga, Isako; Ishikawa, Mami

    2018-05-01

    Hypoglossal nerve deficit is a possible complication caused by carotid endarterectomy (CEA). The accidental injury of the hypoglossal nerve during surgery is one of the major reasons for permanent hypoglossal nerve palsy. In this study, we investigated the usefulness of intraoperative mapping of the hypoglossal nerve to identify this nerve during CEA. Five consecutive patients who underwent CEA for the treatment of symptomatic or asymptomatic carotid artery stenosis were studied. A hand-held probe was used to detect the hypoglossal nerve in the operative field, and the tongue motor evoked potentials (MEPs) were recorded. The tongue MEPs were obtained in all the patients. The invisible hypoglossal nerve was successfully identified without any difficulty when the internal carotid artery was exposed. Intraoperative mapping was particularly useful for identifying the hypoglossal nerve when the hypoglossal nerve passed beneath the posterior belly of the digastric muscle. In 1 of 2 cases, MEP was also elicited when the ansa cervicalis was stimulated, although the resulting amplitude was much smaller than that obtained by direct stimulation of the hypoglossal nerve. Postoperatively, none of the patients presented with hypoglossal nerve palsy. Intraoperative hypoglossal nerve mapping enabled us to locate the invisible hypoglossal nerve during the exposure of the internal carotid artery accurately without retracting the posterior belly of the digastric muscle and other tissues in the vicinity of the internal carotid artery. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Can we trust intraoperative culture results in nonunions?

    Palmer, Michael P; Altman, Daniel T; Altman, Gregory T; Sewecke, Jeffrey J; Ehrlich, Garth D; Hu, Fen Z; Nistico, Laura; Melton-Kreft, Rachel; Gause, Trent M; Costerton, John W

    2014-07-01

    To identify the presence of bacterial biofilms in nonunions comparing molecular techniques (multiplex polymerase chain reaction and mass spectrometry, fluorescent in situ hybridization) with routine intraoperative cultures. Thirty-four patients with nonunions were scheduled for surgery and enrolled in this ongoing prospective study. Intraoperative specimens were collected from removed implants, surrounding tissue membrane, and local soft tissue followed by standard culture analysis, Ibis's second generation molecular diagnostics (Ibis Biosystems), and bacterial 16S rRNA-based fluorescence in situ hybridization (FISH). Confocal microscopy was used to visualize the tissue specimens reacted with the FISH probes, which were chosen based on the Ibis analysis. Thirty-four patient encounters were analyzed. Eight were diagnosed as infected nonunions by positive intraoperative culture results. Ibis confirmed the presence of bacteria in all 8 samples. Ibis identified bacteria in a total of 30 of 34 encounters, and these data were confirmed by FISH. Twenty-two of 30 Ibis-positive samples were culture-negative. Four samples were negative by all methods of analysis. No samples were positive by culture, but negative by molecular techniques. Our preliminary data indicate that molecular diagnostics are more sensitive for identifying bacteria than cultures in cases of bony nonunion. This is likely because of the inability of cultures to detect biofilms and bacteria previously exposed to antibiotic therapy. Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.

  17. System for gamma-gamma formation density logging while drilling

    Paske, W.C.

    1991-01-01

    The patent relates to a system for logging subterranean formations for the determination of formation density by using gamma radiation. Gamma ray source and detection means are disposed within a housing adapted for positioning within a borehole for the emission and detection of gamma rays propagating through earth formations and borehole drilling fluid. The gamma ray detection means comprises first and second gamma radiation sensors geometrically disposed within the housing, the same longitudinal distance from the gamma ray source and diametrically opposed in a common plane. A formation matrix density output signal is produced in proportion to the output signal from each of the gamma ray sensors and in conjunction with certain constants established by the geometrical configuration of the sensors relative to the gamma ray source and the borehole diameter. Formation density is determined without regard to the radial position of the logging probe within the borehole in a measuring while drilling mode. 6 figs

  18. Sentinel lymph node mapping using SPECT/CT and gamma probe in endometrial cancer: an analysis of parameters affecting detection rate

    Sahbai, Samine; La Fougere, Christian; Dittmann, Helmut [University Hospital Tuebingen, Nuclear Medicine and Clinical Molecular Imaging, Tuebingen (Germany); Taran, Florin-Andrei; Wallwiener, Diethelm; Brucker, Sara [University Hospital Tuebingen, Gynecology and Obstetrics, Tuebingen (Germany); Staebler, Annette [University Hospital Tuebingen, Pathology, Tuebingen (Germany)

    2017-08-15

    SPECT/CT after pericervical injection of technetium-99 m-nanocolloid was shown to be suitable for sentinel lymph node (SLN) mapping in endometrial cancer (EC). The aim of this study was to analyze factors affecting successful SLN detection by means of SPECT/CT such as imaging findings, patient characteristics and tumor biology in a large cohort of patients. One hundred and forty-five consecutive patients suffering from EC who received pre-surgical SLN mapping at our institution between 2011 and 2016 were included in this analysis. SPECT/CT data of abdomen and pelvis (mean 4:20 ± 1:20 h p.i.) were acquired after pericervical injection of technetium-99 m-nanocolloid (mean 230 ± 45 MBq) in all patients. Surgical staging was performed on the day after. Acquisition parameters, patient characteristics, SPECT/CT findings as well as histopathological results were collected. A total of 282 SLNs were identified by means of SPECT/CT. Overall, preoperative and intraoperative SLN detection rates were 86%, 76% and 74% respectively. The most important factor associated with failure to detect SLNs was the presence of high bone marrow on SPECT/CT (p = 0.005). Peritoneal/abdominal radioactivity was also associated with missed SLN detection in SPECT/CT (p = 0.02). However, the presence of liver/spleen uptake on its own was not predictive for detection failure. Low numbers of detected SLNs in SPECT/CT were slightly related with older age and lower injected activity. No significant influence was found for the parameters of tumor histology and stage, lymph node involvement and the time gap between injection and imaging. Venous drainage as indicated by bone marrow uptake is the most important factor associated with scintigraphic SLN detection failure. Moreover, high peritoneal and abdominal activity was also associated with detection failure. Thus, meticulous application of the radiotracer is crucial in EC. (orig.)

  19. Intraoperative nuclear guidance in benign hyperparathyroidism and parathyroid cancer

    Bonjer, H.J.; Bruining, H.A.; Pols, H.A.P.; Herder, W.W. de; Eijck, C.H.J.; Breeman, W.A.P.; Krenning, E.P.

    1997-01-01

    The success of parathyroid surgery is determined by the identification and removal of all hyperactive parathyroid tissue. Ectopic location of parathyroid tumours and fibrosis due to previous operations can cause failure of parathyroidectomy. Parathyroid tumours accumulate and retain 2-methoxyisobutylisonitrile (MIBI) labelled with technetium-99m. This study assesses the value of intra-operative localization of parathyroid tumours using a hand-held gamma detector in patients with hyperparathyroidism and parathyroid cancer. Twenty patients undergoing their first operations for hyperparathyroidism, 15 patients undergoing reoperations for either persistent or recurrent hyperparathyroidism and two patients with parathyroid cancer were studied. Radioactivity in the neck and the mediastinum was recorded by a gamma detector after administration of 370 MBq 99m Tc-MIBI. Surgical findings and postoperative serum levels of calcium were documented. The sensitivity of the gamma detector in identifying parathyroid tumours was 90.5% in first parathyroidectomies, 88.9% in reoperations for either persistent or recurrent hyperparathyroidism and 100% in parathyroid cancer. One false-positive result was due to a thyroid nodule. Hypercalcaemia ceased in all but one patient postoperatively. It is concluded that employment of the gamma detector is to be advocated in first parathyroidectomies when a parathyroid tumour cannot be discovered, in reoperations for either persistent or recurrent hyperparathyroidism and in surgery for parathyroid cancer. (orig.)

  20. Intraoperative confocal microscopy in the visualization of 5-aminolevulinic acid fluorescence in low-grade gliomas.

    Sanai, Nader; Snyder, Laura A; Honea, Norissa J; Coons, Stephen W; Eschbacher, Jennifer M; Smith, Kris A; Spetzler, Robert F

    2011-10-01

    Greater extent of resection (EOR) for patients with low-grade glioma (LGG) corresponds with improved clinical outcome, yet remains a central challenge to the neurosurgical oncologist. Although 5-aminolevulinic acid (5-ALA)-induced tumor fluorescence is a strategy that can improve EOR in gliomas, only glioblastomas routinely fluoresce following 5-ALA administration. Intraoperative confocal microscopy adapts conventional confocal technology to a handheld probe that provides real-time fluorescent imaging at up to 1000× magnification. The authors report a combined approach in which intraoperative confocal microscopy is used to visualize 5-ALA tumor fluorescence in LGGs during the course of microsurgical resection. Following 5-ALA administration, patients with newly diagnosed LGG underwent microsurgical resection. Intraoperative confocal microscopy was conducted at the following points: 1) initial encounter with the tumor; 2) the midpoint of tumor resection; and 3) the presumed brain-tumor interface. Histopathological analysis of these sites correlated tumor infiltration with intraoperative cellular tumor fluorescence. Ten consecutive patients with WHO Grades I and II gliomas underwent microsurgical resection with 5-ALA and intraoperative confocal microscopy. Macroscopic tumor fluorescence was not evident in any patient. However, in each case, intraoperative confocal microscopy identified tumor fluorescence at a cellular level, a finding that corresponded to tumor infiltration on matched histological analyses. Intraoperative confocal microscopy can visualize cellular 5-ALA-induced tumor fluorescence within LGGs and at the brain-tumor interface. To assess the clinical value of 5-ALA for high-grade gliomas in conjunction with neuronavigation, and for LGGs in combination with intraoperative confocal microscopy and neuronavigation, a Phase IIIa randomized placebo-controlled trial (BALANCE) is underway at the authors' institution.

  1. Minimalism through intraoperative functional mapping.

    Berger, M S

    1996-01-01

    Intraoperative stimulation mapping may be used to avoid unnecessary risk to functional regions subserving language and sensori-motor pathways. Based on the data presented here, language localization is variable in the entire population, with only certainty existing for the inferior frontal region responsible for motor speech. Anatomical landmarks such as the anterior temporal tip for temporal lobe language sites and the posterior aspect of the lateral sphenoid wing for the frontal lobe language zones are unreliable in avoiding postoperative aphasias. Thus, individual mapping to identify essential language sites has the greatest likelihood of avoiding permanent deficits in naming, reading, and motor speech. In a similar approach, motor and sensory pathways from the cortex and underlying white matter may be reliably stimulated and mapped in both awake and asleep patients. Although these techniques require an additional operative time and equipment nominally priced, the result is often gratifying, as postoperative morbidity has been greatly reduced in the process of incorporating these surgical strategies. The patients quality of life is improved in terms of seizure control, with or without antiepileptic drugs. This avoids having to perform a second costly operative procedure, which is routinely done when extraoperative stimulation and recording is done via subdural grids. In addition, an aggressive tumor resection at the initial operation lengthens the time to tumor recurrence and often obviates the need for a subsequent reoperation. Thus, intraoperative functional mapping may be best alluded to as a surgical technique that results in "minimalism in the long term".

  2. Probing the very-high-energy gamma-ray spectral curvature in the blazar PG 1553+113 with the MAGIC telescopes

    Aleksić, J.; Antonelli, L A; Antoranz, P; Babic, A; Bangale, P; Barrio, J A; González, J Becerra; Bednarek, W; Bernardini, E; Biasuzzi, B; Biland, A; Blanch, O; Bonnefoy, S; Bonnoli, G; Borracci, F; Bretz, T; Carmona, E; Carosi, A; Colin, P; Colombo, E; Contreras, J.L; Cortina, J; Covino, S; Da Vela, P; Dazzi, F; De Angelis, A; De Caneva, G; De Lotto, B; Wilhelmi, E de Oña; Mendez, C Delgado; Prester, D Dominis; Dorner, D; Doro, M; Einecke, S; Eisenacher, D; Elsaesser, D; Fidalgo, D; Fonseca, M.V; Font, L; Frantzen, K; Fruck, C; Galindo, D; López, R J García; Garczarczyk, M; Terrats, D Garrido; Gaug, M; Godinović, N; Muñoz, A González; Gozzini, S R; Hadasch, D; Hanabata, Y; Hayashida, M; Herrera, J; Hose, J; Hrupec, D; Idec, W; Kadenius, V; Kellermann, H; Knoetig, M L; Kodani, K; Konno, Y; Krause, J; Kubo, H; Kushida, J; La Barbera, A; Lelas, D; Lewandowska, N; Lindfors, E; Lombardi, S; Longo, F; López, M; López-Coto, R; López-Oramas, A; Lorenz, E; Lozano, I; Makariev, M; Mallot, K; Maneva, G; Mannheim, K; Maraschi, L; Marcote, B; Mariotti, M; Martínez, M; Mazin, D; Menzel, U; Miranda, J M; Mirzoyan, R; Moralejo, A; Munar-Adrover, P; Nakajima, D; Neustroev, V; Niedzwiecki, A; Nilsson, K; Nishijima, K; Noda, K; Orito, R; Overkemping, A; Paiano, S; Palatiello, M; Paneque, D; Paoletti, R; Paredes, J M; Paredes-Fortuny, X; Persic, M; Poutanen, J; Moroni, P G Prada; Prandini, E; Puljak, I; Reinthal, R; Rhode, W; Ribó, M; Rico, J; Garcia, J Rodriguez; Rügamer, S; Saito, T; Saito, K; Satalecka, K; Scalzotto, V; Scapin, V; Schultz, C; Schweizer, T; Sillanpää, A; Sitarek, J; Snidaric, I; Sobczynska, D; Spanier, F; Stamerra, A; Steinbring, T; Storz, J; Strzys, M; Takalo, L; Takami, H; Tavecchio, F; Temnikov, P; Terzić, T; Tescaro, D; Teshima, M; Thaele, J; Tibolla, O; Torres, D F; Toyama, T; Treves, A; Vogler, P; Will, M; Zanin, R; D'Ammando, F; Lähteenmäki, A; Tornikoski, M; Hovatta, T; Readhead, A C S; Max-Moerbeck, W; Richards, J.L

    2015-01-01

    PG 1553+113 is a very-high-energy (VHE, E>100 GeV) gamma-ray emitter classified as a BL Lac object. Its redshift is constrained by intergalactic absorption lines in the range 0.40.2). The observed curvature is compatible with the extragalactic background light (EBL) imprint predicted by the current generation of EBL models assuming a redshift z~0.4. New constraints on the redshift were derived from the VHE spectrum. These constraints are compatible with previous limits and suggest that the source is most likely located around the optical lower limit, z=0.4. Finally, we find that the synchrotron self-Compton (SSC) model gives a satisfactory description of the observed multi-wavelength spectral energy distribution during the flare.

  3. INTRAOPERATIVE PREDONATION CONTRIBUTES TO BLOOD SAVING

    SCHONBERGER, JPAM; BREDEE, JJ; TJIAN, D; EVERTS, PAM; WILDEVUUR, CRH

    1993-01-01

    The merits of reinfusing prebypass-removed autologous blood (intraoperative predonation) to salvage blood and improve postoperative hemostasis are still debated, specifically for patients at a higher risk for bleeding. To evaluate the effect of intraoperative predonation on the platelet count, blood

  4. Intraoperative digital angiography: Peripheral vascular applications

    Bell, K.; Reifsteck, J.E.; Binet, E.F.; Fleisher, H.J.

    1986-01-01

    Intraoperative digital angiography is the procedure of choice for the peripheral vascular surgeon who wishes to evaluate his results before terminating anesthesia. Two operating suites at the John L. McClellan Memorial Veterans Hospital are equipped with permanent ceiling-mounted Philips C-arm fluoroscopes and share an ADAC 4100 digital angiographic system. In the last 18 months, 40 peripheral vascular intraoperative digital angiographic procedures have been performed, in all but two cases using direct arterial puncture. In 65% of cases, the intraoperative study showed no significant abnormality. In 12.5%, minor abnormalities not requiring reoperation were seen. In 22.5% of cases, the intraoperative digital angiogram revealed a significant abnormality requiring immediate operative revision. None of the patients who underwent reoperation experienced postoperative sequelae. Intraoperative digital angiography is useful in identifying complications of peripheral vascular operations

  5. Intraoperative radiotherapy in breast cancer: literature review

    Alfaro Hidalgo, Sabrina A.

    2013-01-01

    A literature review was performed on intraoperative radiotherapy of breast cancer. The strength and attractiveness is established of techniques of partial irradiation in the treatment of breast cancer. The benefit is originated to restrict the area immediate of radiotherapy to the tumor bed or quadrant index and identifying the benefit of being applied during the radiotherapy while surgical lumpectomy. The impact of local recurrence has been established using intraoperative radiotherapy. The advantages of intraoperative radiotherapy was compared in the management of the conservative surgery in early stages of breast cancer with external radiotherapy. Different methods of intraoperative radiotherapy have been compared and individual impact on local recurrence ranges. Intraoperative radiotherapy has had many advantages: radiobiological, technical, clinical, psychological and economical in the handling of conservative surgery in early stages of breast cancer, compared with external radiotherapy [es

  6. Possibility of the use of radioimmunodetection for intraoperative control of neoplasms

    Wasilewska-Radwanska, M.; Hac, A.; Kulka, J.; Herman, K.; Chatal, J.-F.; Curtret, C.; Daniel, G.

    1999-01-01

    The aim of the study was the presentation of possibility of radioimmunodiagnostics with the use of portable gamma probe for localization of primary tumors and metastases which are small and deep localized. This method is referred to as RadioImmunoGuided Surgery and is being widely applied in developed countries. The article presented portable Modelo-2 gamma probe, produced by French Atomic Energy Commission, which could be applied in clinical practice in Poland. Examples of RIGS application were described

  7. Intraoperative radiotherapy for pancreatic carcinoma

    Nishimura, Akira; Iida, Koyo; Sato, Shigehiro; Sakata, Suo

    1986-01-01

    Twenty-eight patients with pancreatic carcinoma, 23 (82 %) of whom had Stage III or IV, received intraoperative radiotherapy (IOR) with curative or non-curative surgery. Electron beams (10 to 18 MeV) with doses of 20 to 40 Gy were delivered to the tumor. Eight of 26 patients with unresectable tumor had postoperative external irradiation of 10.5 to 50 Gy. Abdominal and back pain relief was achieved after IOR in 12 (71 %) and in 6 (60 %) of the 26 patients, respectively. Appetite was promoted in 11 patients. In the case of unresectable carcinoma, survival time tended to prolong in the 8 patients receiving both IOR and postoperative external irradiation. One patient developed perforation of the colon probably caused by IOR. (Namekawa, K.)

  8. Study, development and clinical evaluation of a per-operative {gamma} imager; Etude, developpement et evaluation clinique d`un imageur {gamma} per-operatoire

    Menard, Laurent [Inst. de Physique Nucleaire, Paris-11 Univ., 91 - Orsay (France)

    1999-01-19

    The precise localization and complete surgical ablation of tumors are one of the most important procedures in cancer treatment. In that context, the use, in operating room, of light hand-held detectors associated to radiopharmaceutical compounds for tumor labelling, plays a significant role in assisting surgeons in real-time detection of lesion. The POCI gamma imaging probe (Per-Operative Compact Imager), which is presented here, is precisely dedicated to improve the radio-guided operative cancer surgery efficiency by bringing a new tool discriminating between healthy and pathological tissues. To match the specifications of intra-operative detection, we chose to build our camera around an intensified position sensitive diode which appeared to be particularly suitable to achieve a high resolution small size imager. The optimal geometry of two gamma detection head modules, composed of parallel hole collimators and scintillation crystals, was then investigated by numerical simulations. From these technological solutions, a first prototype of POCI with a 24 mm diameter field of view has been developed. Its characterization has put forward a millimeter spatial resolution and a detection efficiency comparable to that of clinical gamma cameras and in agreement with the numerical predictions. Finally, in collaboration with Gustave Roussy, a first clinical evaluation of the POCI camera has been performed for sentinel ganglion pre-operative localization in patients afflicted by malignant melanomas or breast cancers. The preliminary results have already shown that the performances of POCI are compatible with intraoperative imaging purposes and suggest how this camera can boost the success rate of tumor removal surgeries for other cancerous diseases. (author) 100 refs., 67 figs., 11 tabs.

  9. Practicality of intraoperative teamwork assessments.

    Phitayakorn, Roy; Minehart, Rebecca; Pian-Smith, May C M; Hemingway, Maureen W; Milosh-Zinkus, Tanya; Oriol-Morway, Danika; Petrusa, Emil

    2014-07-01

    High-quality teamwork among operating room (OR) professionals is a key to efficient and safe practice. Quantification of teamwork facilitates feedback, assessment, and improvement. Several valid and reliable instruments are available for assessing separate OR disciplines and teams. We sought to determine the most feasible approach for routine documentation of teamwork in in-situ OR simulations. We compared rater agreement, hypothetical training costs, and feasibility ratings from five clinicians and two nonclinicians with instruments for assessment of separate OR groups and teams. Five teams of anesthesia or surgery residents and OR nurses (RN) or surgical technicians were videotaped in simulations of an epigastric hernia repair where the patient develops malignant hyperthermia. Two anesthesiologists, one OR clinical RN specialist, one educational psychologist, one simulation specialist, and one general surgeon discussed and then independently completed Anesthesiologists' Non-Technical Skills, Non-Technical Skills for Surgeons, Scrub Practitioners' List of Intraoperative Non-Technical Skills, and Observational Teamwork Assessment for Surgery forms to rate nontechnical performance of anesthesiologists, surgeons, nurses, technicians, and the whole team. Intraclass correlations of agreement ranged from 0.17-0.85. Clinicians' agreements were not different from nonclinicians'. Published rater training was 4 h for Anesthesiologists' Non-Technical Skills and Scrub Practitioners' List of Intraoperative Non-Technical Skills, 2.5 h for Non-Technical Skills for Surgeons, and 15.5 h for Observational Teamwork Assessment for Surgery. Estimated costs to train one rater to use all instruments ranged from $442 for a simulation specialist to $6006 for a general surgeon. Additional training is needed to achieve higher levels of agreement; however, costs may be prohibitive. The most cost-effective model for real-time OR teamwork assessment may be to use a simulation technician

  10. Gamma-Ray Burst Afterglows as Probes of Environment and Blast Wave Physics. II. The Distribution of rho and Structure of the Circumburst Medium

    Starling, R. L. C.; vanderHorst, A. J.; Rol, E.; Wijers, R. A. M. J.; Kouveliotou, C.; Wiersema, K.; Curran, P. A.; Weltervrede, P.

    2008-01-01

    We constrain blast wave parameters and the circumburst media ofa subsample of 10 BeppoSAX gamma-ray bursts (GRBs). For this sample we derive the values of the injected electron energy distribution index, p, and the density structure index of the circumburst medium, k, from simultaneous spectral fits to their X-ray, optical, and NIR afterglow data. The spectral fits have been done in count space and include the effects ofmetallicity, and are compared with the previously reported optical and X-ray temporal behavior. Using the blast wave model and some assumptions which include on-axis viewing and standard jet structure, constant blast wave energy, and no evolution of the microphysical parameters, we find a mean value ofp for the sample as a whole of 9.... oa -0.003.0" 2 a_ statistical analysis of the distribution demonstrates that the p-values in this sample are inconsistent with a single universal value forp at the 3 _ level or greater, which has significant implications for particle acceleration models. This approach provides us with a measured distribution ofcircumburst density structures rather than considering only the cases of k ----0 (homogeneous) and k - 2 (windlike). We find five GRBs for which k can be well constrained, and in four of these cases the circumburst medium is clearly windlike. The fifth source has a value of 0 medium.

  11. Gamma-Ray Burst Afterglows as Probes of Environment and Blastwave Physics II: The Distribution of p and Structure of the Circumburst Medium

    Starling, R. L. C.; vanderHorst, A. J.; Rol, E.; Wijers, R. A. M. J.; Kouveliotou, C.; Wiersema, K.; Curran, P. A.; Weltevrede, P.

    2007-01-01

    We constrain blastwave parameters and the circumburst media of a subsample of BeppoSAX Gamma-Ray Bursts. For this sample we derive the values of the injected electron energy distribution index, p, and the density structure index of the circumburst medium, k, from simultaneous spectral fits to their X-ray, optical and nIR afterglow data. The spectral fits have been done in count space and include the effects of metallicity, and are compared with the previously reported optical and X-ray temporal behaviour. Assuming the fireball model, we can find a mean value of p for the sample as a whole of 2.035. A statistical analysis Of the distribution demonstrates that the p values in this sample are inconsistent with a single universal value for p at the 3sigma level or greater. This approach provides us with a measured distribution of circumburst density structures rather than considering only the cases of k = 0 (homogeneous) and k = 2 (wind-like). We find five GRBs for which k can be well constrained, and in four of these cases the circumburst medium is clearly wind-like. The fifth source has a value of 0 less than or equal to k less than or equal to 1, consistent with a homogeneous circumburst medium.

  12. TU-H-CAMPUS-TeP3-04: Probing the Dose Enhancement Due to a Clinically-Relevant Concentration of Gold Nanoparticles and Yb-169 Gamma Rays Using PRESAGE Dosimeters

    Cho, J [UT MD Anderson Cancer Center, Houston, TX (United States); Oklahoma State University, Stillwater, OK (United States); Alqathami, M; Cho, S [UT MD Anderson Cancer Center, Houston, TX (United States); Reynoso, F [UT MD Anderson Cancer Center, Houston, TX (United States); Washington University School of Medicine, St. Louis, MO (United States)

    2016-06-15

    Purpose: To probe physical evidences of the dose enhancement due to a low/clinically-relevant concentration of gold nanoparticles (GNPs) and Yb-169 gamma rays using PRESAGE dosimeters. Methods: A PRESAGE cuvette was placed at approximately 2 mm above the plane containing three novel Yb-169 brachytherapy seeds (3.2, 3.2, and 5.3 mCi each). Two types of PRESAGE dosimeters were used – plain PRESAGEs (controls) and PRESAGEs loaded with 0.02 wt. % of GNPs (GNP-PRESAGEs). Each PRESAGE dosimeter was irradiated with different time durations (0 to 24 hours) to deliver 0, 4, 8, 16 and 24 Gy of dose. For a reference/comparison, both types of PRESAGEs were also irradiated using 250 kVp x-rays with/without Er-filter to deliver 0, 3, 10, and 30 Gy of dose. Er-filter was used to emulate Yb-169 spectrum using 250 kVp x-rays. The absorption spectra of PRESAGEs were measured using a UV spectrophotometer and used to determine the corresponding optical densities (ODs). Results: GNP-PRESAGEs exposed to Yb-169 sources showed ∼65% increase in ODs compared with controls. When exposed to Er-filtered and unfiltered 250 kVp x-rays, they produced smaller increases in ODs, ∼41% and ∼37%, respectively. There was a linear relationship between ODs and delivered doses with a goodness-of-fit (R2) greater than 0.99. Conclusion: A notable increase in the ODs (∼65%) was observed for GNP-PRESAGEs irradiated by Yb-169 gamma rays. Considering the observed OD increases, it was highly likely that Yb-169 gamma rays were more effective than both Er-filtered and unfiltered 250 kVp x-rays, in terms of producing the dose enhancement. Due to several unknown factors (e.g., possible difference in the dose response of GNP-PRESAGEs vs. PRESAGEs), however, a further investigations is necessary to establish the feasibility of quantifying the exact amount of macroscopic or microscopic/local GNP-mediated dose enhancement using PRESAGE or similar volumetric dosimeters. Supported by DOD/PCRP grant W81XWH-12

  13. Intraoperative Ultrasound in Patients Undergoing Transsphenoidal Surgery for Pituitary Adenoma: Systematic Review [corrected].

    Marcus, Hani J; Vercauteren, Tom; Ourselin, Sebastien; Dorward, Neil L

    2017-10-01

    Transsphenoidal surgery is the gold standard for pituitary adenoma resection. However, despite advances in microsurgical and endoscopic techniques, some pituitary adenomas can be challenging to cure. We sought to determine whether, in patients undergoing transsphenoidal surgery for pituitary adenoma, intraoperative ultrasound is a safe and effective technologic adjunct. The PubMed database was searched between January 1996 and January 2016 to identify relevant publications that 1) featured patients undergoing transsphenoidal surgery for pituitary adenoma, 2) used intraoperative ultrasound, and 3) reported on safety or effectiveness. Reference lists were also checked, and expert opinions were sought to identify further publications. Ultimately, 10 studies were included, comprising 1 cohort study, 7 case series, and 2 case reports. One study reported their prototype probe malfunctioned, leading to false-positive results in 2 cases, and another study' prototype probe was too large to safely enter the sphenoid sinus in 2 cases. Otherwise, no safety issues directly related to use of intraoperative ultrasound were reported. In the only comparative study, remission occurred in 89.7% (61/68) of patients with Cushing disease in whom intraoperative ultrasound was used, compared with 83.8% (57/68) in whom it was not. All studies reported that surgeons anecdotally found intraoperative ultrasound helpful. Although there is limited and low-quality evidence available, the use of intraoperative ultrasound appears to be a safe and effective technologic adjunct to transsphenoidal surgery for pituitary adenoma. Advances in ultrasound technology may allow for more widespread use of such devices. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Intraoperative Ultrasound for Peripheral Nerve Applications.

    Willsey, Matthew; Wilson, Thomas J; Henning, Phillip Troy; Yang, Lynda J-S

    2017-10-01

    Offering real-time, high-resolution images via intraoperative ultrasound is advantageous for a variety of peripheral nerve applications. To highlight the advantages of ultrasound, its extraoperative uses are reviewed. The current intraoperative uses, including nerve localization, real-time evaluation of peripheral nerve tumors, and implantation of leads for peripheral nerve stimulation, are reviewed. Although intraoperative peripheral nerve localization has been performed previously using guide wires and surgical dyes, the authors' approach using ultrasound-guided instrument clamps helps guide surgical dissection to the target nerve, which could lead to more timely operations and shorter incisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Intraoperative radiotherapy for adenocarcinoma of the pancreas

    Yasue, Mitsunori; Yasui, Kenzo; Morimoto, Takeshi; Miyaishi, Seiichi; Morita, Kozo

    1986-01-01

    Thirty-six patients were given intraoperative radiotherapy for adenocarcinoma of the pancreas between April 1980 and March 1986. Twenty-six of those with well-advanced cancer underwent palliative intraoperative radiotherapy of their main primary lesions (1,500 to 3,000 rads). Fourteen of the 19 patients in this group who had intractable back pain before surgery achieved relief within one week after treatment. Of the remaining 10 patients who underwent pancreatectomy and received adjuvant intraoperative radiotherapy (2,000 to 3,000 rads), two remain clinically free of disease five years and six months and four years and six months after palliative distal pancreatectomy. (author)

  16. Probing the top-quark coupling to the photon through the cross-section measurement of $t\\bar{t}\\gamma$ production in $\\textit{pp}$ collisions with the ATLAS detector

    AUTHOR|(INSPIRE)INSPIRE-00443494

    The cross section of top-quark pair production in association with a photon is measured in proton–proton collisions at a centre-of-mass energy $\\sqrt{s}$ = 8 TeV with 20.2 fb$^{-1}$of data and at $\\sqrt{s}$ = 13 TeV with 36.1 fb$^{-1}$ of data. Both datasets are collected by the ATLAS detector at the Large Hadron Collider. The measurements provide a direct probe of the electromagnetic top-quark coupling. The $t\\bar{t}\\gamma$ events in the 8 (13) TeV analysis are selected by requiring a photon with a transverse momentum $p_{\\rm{T}}$ > 15 (20) GeV, one (two) isolated lepton(s) with large transverse momentum, large missing transverse momentum, and at least four (two) jets, where at least one of them is identified as originating from a $b$-quark. The inclusive and differential cross sections are measured in a fiducial region, defined to be close to the selection requirements. The inclusive fiducial cross sections at 8 TeV and 13 TeV are found to be 139 $\\pm$ 18 fb in the single-lepton channel, and 69.3 $\\pm$ 4....

  17. Intraoperative Radiotherapy for Breast Cancer

    Eleanor E. R. Harris

    2017-12-01

    Full Text Available Intraoperative radiotherapy (IORT for early stage breast cancer is a technique for partial breast irradiation. There are several technologies in clinical use to perform breast IORT. Regardless of technique, IORT generally refers to the delivery of a single dose of radiation to the periphery of the tumor bed in the immediate intraoperative time frame, although some protocols have performed IORT as a second procedure. There are two large prospective randomized trials establishing the safety and efficacy of breast IORT in early stage breast cancer patients with sufficient follow-up time on thousands of women. The advantages of IORT for partial breast irradiation include: direct visualization of the target tissue ensuring treatment of the high-risk tissue and eliminating the risk of marginal miss; the use of a single dose coordinated with the necessary surgical excision thereby reducing omission of radiation and the selection of mastectomy for women without access to a radiotherapy facility or unable to undergo several weeks of daily radiation; favorable toxicity profiles; patient convenience and cost savings; radiobiological and tumor microenvironment conditions which lead to enhanced tumor control. The main disadvantage of IORT is the lack of final pathologic information on the tumor size, histology, margins, and nodal status. When unexpected findings on final pathology such as positive margins or positive sentinel nodes predict a higher risk of local or regional recurrence, additional whole breast radiation may be indicated, thereby reducing some of the convenience and low-toxicity advantages of sole IORT. However, IORT as a tumor bed boost has also been studied and appears to be safe with acceptable toxicity. IORT has potential efficacy advantages related to overall survival related to reduced cardiopulmonary radiation doses. It may also be very useful in specific situations, such as prior to oncoplastic reconstruction to improve accuracy of

  18. Gamma-ray spectrometry applied to down-hole logging

    Dumesnil, P.; Umiastowsky, K.

    1983-11-01

    Gamma-ray spectrometry permits to improve the accuracy of natural gamma, gamma-gamma and neutron-gamma geophysical measurements. The probe developed at Centre d'Etudes Nucleaires de Saclay allows down-hole gamma-ray spectrometry. Among others, this probe can be applied to the uranium content determination by selective natural gamma method, down-hole determination of the ash content in the coal by gamma-gamma selective method and elemental analysis by neutron-gamma method. For the calibration and an exact interpretation of the measurements it is important to know the gamma-ray and neutron characteristics of the different kinds of rocks considered as probabilistic variables

  19. Intraoperative neurophysiological monitoring for the anaesthetist

    2012-11-15

    Nov 15, 2012 ... ... nerve tracts, and by understanding how anaesthetic agents affect the various ... of the physiologically sensitive nervous system and different ... Keywords: evoked potentials, intraoperative monitoring, brain mapping. Abstract.

  20. Use of the gamma probe and of 99mTc-DMSA (V) in the identification of the neck recurrence of medullary carcinoma thyroid; Uso do gama probe e do 99mTc-DMSA (V) na identificacao de recorrencias cervicais de carcinoma medular de tireoide

    Melo, Rosana Leite de; Kowalski, Luiz P.; Ubrich, Fabio F. [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Cirurgia de Cabeca e Pescoco e Otorrinolaringologia; Lima, Eduardo N. Pereira; Torres, Ivone C.G. [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Medicina Nuclear

    2003-03-01

    Medullary carcinoma of the thyroid, a malignant neoplasm of para follicular C cells, represent about 5-10% of thyroid tumors. The symptoms are related to local invasion and hormonal secretion. The clinical course is variable, from indolent cases to extremely aggressive. Many radionuclide imaging have been described to locate metastasis of medullary cancer. Tl-201 and Tc-99m (V)DMS A showed to be useful in the evaluation o persistent elevated serum calcitonin levels. On the other hand, the use of the 131 I-Mibg, that is the isotope more used, has not been demonstrating efficiency in identifying metastasis. Our objective is to report a case of a patient with medullary thyroid carcinoma in which the follow-up use DMS A(V) demonstrated a recurrence no identified for other methods. A 34-year-old man had a diagnosis of medullary thyroid carcinoma and has submitted a total thyroidectomy and neck lymph node dissection. He presented elevated serum calcitonin levels and DMS A(V) scintigraphy demonstrated focal area of pathologic uptake at the medline of the neck, but the surgical exploration was negative. He persisted with high calcitonin levels and it was used a new DMS A(V). On this occasion he was submitted to the radio-guided surgery that located the recurrence and it was confirmed with anatomo-pathologic exam. This case allowed to demonstrate that the use of radionuclide associated to the gamma-probe is promising, allowing a precise surgical approach. (author)

  1. [Selective intraoperative cholangiography in laparoscopic cholecystectomy].

    Pickuth, D; Leutloff, U

    1995-01-01

    Routine use of intraoperative cholangiography during laparoscopic cholecystectomy is still widely advocated and standard in many departments; however, it is controversial. We have developed a new diagnostic strategy for the detection of bile duct stones. The concept is based on an ultrasound examination and on screening for the presence of six risk indicators of choledocholithiasis. A total of 120 patients undergoing laparoscopic cholecystectomy were prospectively screened for the presence of these six risk indicators: history of jaundice, history of pancreatitis, hyperbilirubinemia, hyperamylasemia, dilated bile duct, and unclear ultrasound findings. The sensitivity of ultrasound and intraoperative cholangiography in diagnosing bile duct stones was also evaluated. For the detection of bile duct stones, the sensitivity was 77% for ultrasound and 100% for intraoperative cholangiography. Twenty percent of all patients had at least one risk indicator. The presence of a risk indicator correlated significantly with the presence of choledocholithiasis (P concept, we would have avoided 80% of intraoperative cholangiographies without missing a stone in the bile duct. This study lends further support to the view that routine use of intraoperative cholangiography is not necessary.

  2. Trends in Intraoperative Testing During Cochlear Implantation.

    Page, Joshua Cody; Cox, Matthew D; Hollowoa, Blake; Bonilla-Velez, Juliana; Trinidade, Aaron; Dornhoffer, John L

    2018-03-01

    No consensus guidelines exist regarding intraoperative testing during cochlear implantation and wide variation in practice habits exists. The objective of this observational study was to survey otologists/neurotologists to understand practice habits and overall opinion of usefulness of intraoperative testing. Cross-sectional survey. A web-based survey was sent to 194 practicing Otologists/Neurotologists. Questions included practice setting and experience, habits with respect to electrodes used, intraoperative testing modalities used, overall opinion of intraoperative testing, and practice habits in various scenarios. Thirty-nine of 194 (20%) completed the survey. For routine patients, ECAPs and EIs were most commonly used together (38%) while 33% do not perform testing at all. Eighty-nine percent note that testing "rarely" or "never" changes management. Fifty-one percent marked the most important reason for testing is the reassurance provided to the family and/or the surgeon. Intraoperative testing habits and opinions regarding testing during cochlear implantation vary widely among otologic surgeons. The majority of surgeons use testing but many think there is minimal benefit and that surgical decision-making is rarely impacted. The importance of testing may change as electrodes continue to evolve.

  3. Measuring probe for a nuclear reactor

    Overhoff, T.

    1976-01-01

    A coaxial cable is helically wound into two concentric coils, forming the one end of the probe. At the other end of the probe, the inner conductor's ends are wired to the outer conducter's two extremities by a conductor made of a material with low neutron and gamma interaction cross-section. The direct current produced by this self-powered detector is frequency filtered in order to separate the contributions of the neutron induced secondary-electrons from the photo-electrons, and from the thermally excited conduction electrons. Neutron and gamma fluxes, as well as temperature are therefore determined by using a single probe. (RW) [de

  4. Traversing incore probe device

    Yoshioka, Michiko.

    1985-01-01

    Purpose: To measure the neutron flux distribution in the reactor core always at a high accuracy. Constitution: A nuclear fission ionizing chamber type detector is disposed at the end of a cable for sending a detection signal of a traversing incore probe device and, further, a gamma-ray ionizing chamber type detector is connected in adjacent therewith and a selection circuit for selecting both of the detection signals and inputting them to a display device is disposed. Then, compensation for the neutron monitors is conducted by the gamma-ray ionizing chamber type detector during normal operation in which control rods are not driven and the positioning is carried out by the nuclear fission ionizing chamber type detector. Furthermore, both of the compensation for the neutron detector and the positioning are carried out by the nuclear fission ionizing chamber type detector upon starting where the control rods are driven. (Sekiya, K.)

  5. Intraoperative radiotherapy for cancer of the pancreas

    Manabe, Tadao; Nagai, Toshihiro; Tobe, Takayoshi; Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

    1985-01-01

    Seven patients treated by intraoperative radiotherapy for cancer of the pancreas were evaluated. Three patients undergoing pancreaticoduodenectomy for cancer of the head of the pancreas received a dose of 2,500--3,000 rad (6--10 MeV Betatron) intraoperatively with or without external beam irradiation at a dose of 2,520 rad (10 MeV lineac X-ray). One patient developed radiation pancreatitis and died 0.8 month after surgery. Autopsy revealed the degeneration of cancer cells in the involved superior mesenteric artery. One died of hepatic metastasis 8.5 months after surgery, however, recurrence was not found in the irradiation field. The other patient who had external beam irradiation combined with intraoperative radiotherapy is alive 7.5 months after surgery. Four patients with unresectable cancer of the body of the pancreas received a dose of 2,500--3,000 rad (13--18 MeV Betatron) intraoperatively with or without external beam irradiation at a dose of 1,500--5,520 rad (10 MeV lineac X-ray). One patient died of peritonitis carcinomatosa 3.0 months after surgery. One patient died of DIC 0.6 month after surgery. Two patients are alive 1.0 and 6.5 months after surgery. In these patients with intraoperative radiotherapy for unresectable cancer of the pancreas, remarkable effects on relief of pain and shrinkage of tumor were obtained. Further pursuit of intraoperative and external beam radiotherapies in combination with pancreatectomy should be indicated in an attempt to prolong survival of patient with cancer of the pancreas. (author)

  6. Probe Storage

    Gemelli, Marcellino; Abelmann, Leon; Engelen, Johannes Bernardus Charles; Khatib, M.G.; Koelmans, W.W.; Zaboronski, Olog; Campardo, Giovanni; Tiziani, Federico; Laculo, Massimo

    2011-01-01

    This chapter gives an overview of probe-based data storage research over the last three decades, encompassing all aspects of a probe recording system. Following the division found in all mechanically addressed storage systems, the different subsystems (media, read/write heads, positioning, data

  7. Cultural probes

    Madsen, Jacob Østergaard

    The aim of this study was thus to explore cultural probes (Gaver, Boucher et al. 2004), as a possible methodical approach, supporting knowledge production on situated and contextual aspects of occupation.......The aim of this study was thus to explore cultural probes (Gaver, Boucher et al. 2004), as a possible methodical approach, supporting knowledge production on situated and contextual aspects of occupation....

  8. Gamma Knife

    ... News Physician Resources Professions Site Index A-Z Gamma Knife Gamma Knife® is a radiation therapy that uses computerized ... If you're scheduled for radiation therapy using Gamma Knife®, a treatment team consisting of a radiation ...

  9. Nuclear borehole probes - theory and experiments

    Joergensen, J.L.; Korsbech, U.; Gynther Nielsen, K.; Oelgaard, P.L.

    1985-06-01

    The report gives a summary of the theoretical and expeimental work on borehole probes that has been performed since 1971 at The Department of Electrophysics, The Technical University of Denmark. The first part of the report concerns the use of a spectral natural gamma-ray probe (SNG-probe), which is used for measurements of the spectral distribution of the gamma-rays of the geological strata around a borehole. In general the spectrum is divided into three parts - the gamma-rays from potassium-40, from thorium-232 and daughters, and from uranium-238 and daughters. A set of curves showing the intensities of the gamm-radiation from K, Th, and U versus depth is called a SNG-log. If proper calibrated, the SNG-log gives the concentration of Th, U, and K in the formation surrounding the borehole. Initially the basis for an interpretation of SNG-logs is discussed. Then follows a description og some SNG-problems designed and built by The Department of Electrophysics, and a discussion of the calibration of SNG-probes. Some examples of SNG-logs are presented, and some general comments on the use of SNG-logs are given. The second part of the report concerns mainly the development of theoretical models for neutron-neutron probes, gamma-gamma probes, and pulsed-neutron probes. The purpose of this work has been to examine how well the models correlate with measured results and - where reasonable agreement is found - to use the models in studies of the factors that affect the probe responses in interpretation of experimental results and in probe design. (author)

  10. Intra-operative radiotherapy in oncology

    Gerard, J.P.; Braillon, G.; Sentenac, I.; Calvo, F.; Dubois, J.B.; Saint-Aubert, B.; Guillemin, C.; Roussel, A.

    1991-01-01

    This article is about a treatment used more and more frequently in the world, for some neoplasms: Intra-operative radiotherapy under electron beams. The main neoplasms concerned by this treatment are the stomach, pancreas, rectum, bladder, uterus cervix neoplasms and peritoneal sarcoma [fr

  11. Intraoperative neurophysiological monitoring for the anaesthetist ...

    Intraoperative neurophysiological monitoring (IONM) has become the gold standard for the monitoring of functional nervous tissue and mapping of eloquent brain tissue during neurosurgical procedures. The multimodal use of somatosensory-evoked potentials and motor-evoked potentials ensures adequate monitoring of ...

  12. Intraoperative and recovery room outcome | Edomwonyi | East ...

    Objectives: To identify and quantitate anaesthesia related complications in the intraoperative period and in the post anaesthesia recovery room. Design: A prospective study. Setting: University of Benin Teaching Hospital; a University - affiliated tertiary centre. Subjects: Patients scheduled for elective and emergency surgery ...

  13. Gamma-ray detector guidance of breast cancer therapy

    Ravi, Ananth

    2009-12-01

    Breast cancer is the most common form of cancer in women. Over 75% of breast cancer patients are eligible for breast conserving therapy. Breast conserving therapy involves a lumpectomy to excise the gross tumour, followed by adjuvant radiation therapy to eradicate residual microscopic disease. Recent advances in the understanding of breast cancer biology and recurrence have presented the opportunity to improve breast conserving therapy techniques. This thesis has explored the potential of gamma-ray detecting technology to improve guidance of both surgical and adjuvant radiation therapy aspects of breast conserving therapy. The task of accurately excising the gross tumour during breast conserving surgery (BCS) is challenging, due to the limited guidance currently available to surgeons. Radioimmuno guided surgery (RIGS) has been investigated to determine its potential to delineate the gross tumour intraoperatively. The effects of varying a set of user controllable parameters on the ability of RIGS to detect and delineate model breast tumours was determined. The parameters studied were: Radioisotope, blood activity concentration, collimator height and energy threshold. The most sensitive combination of parameters was determined to be an 111Indium labelled radiopharmaceutical with a gamma-ray detecting probe collimated to a height of 5 mm and an energy threshold at the Compton backscatter peak. Using these parameters it was found that, for the breast tumour model used, the minimum tumour-to-background ratio required to delineate the tumour edge accurately was 5.2+/-0.4 at a blood activity concentration of 5 kBq/ml. Permanent breast seed implantation (PBSI) is a form of accelerated partial breast irradiation that dramatically reduces the treatment burden of adjuvant radiation therapy on patients. Unfortunately, it is currently difficult to localize the implanted brachytherapy seeds, making it difficult to perform a correction in the event that seeds have been misplaced

  14. Complications of Intraoperative Transesophageal Echocardiography in Adult Cardiac Surgical Patients—Experience of Two Institutions in Taiwan

    Chi-Hsiang Huang

    2007-01-01

    Full Text Available There is some safety concern about transesophageal echocardiography (TEE when it is used routinely during cardiac operations. The purpose of this investigation was to study the incidence of intraoperative TEE-associated complications in adult cardiac surgical patients. The study population comprised 6255 consecutive adult cardiac surgical patients with intraoperative TEE examinations. TEE-associated complications occurred in 25 patients (0.4%. Most of these complications consisted of oropharyngeal mucosal bleeding (15/25, 60%. Esophageal perforation occurred in one patient. Two patients experienced upper gastrointestinal bleeding. Seven patients experienced dental injuries, and TEE probe insertion failed in 10 patients. We conclude that intraoperative TEE-associated complications in cardiac operations is very low; the complication rate we found was comparable to previously reported values. [J Formos Med Assoc 2007; 106(1:92-95

  15. INTRAOPERATIVE PHOTODYNAMIC THERAPY FOR METASTATIC PERITONEAL TUMORS

    E. A. Suleimanov

    2016-01-01

    Full Text Available This review is devoted to the cytoreductive treatment of malignant tumors of the abdominal organs. The actuality of the issue is determined both by increase of the incidence of abdominal cancer in Russia and in majority of developed countries and by high rate diagnosis on late stages of disease. The methods of treatment of peritoneal carcinomatosis, based on possible effects on the secondary peritoneal tumors after surgical cytoreduction to reduce the risk of local recurrence and disease progression are described. These methods of additional intraoperative specific antitumor action include intraoperative radiation therapy, hyperthermic intraperitoneal chemotherapy, intraoperative photodynamic therapy characterized by differences in difficulty of performance, mechanisms of effect on tumor and healthy tissues, efficiency. Benefits, opportunities and possibilities of application of intraoperative photodynamic therapy (IOPDT for secondary peritoneal tumors are described in details, the results of a number of domestic and foreign clinical studies are shown, the successful application of intraoperative photodynamic therapy in clinical oncology, which allows reducing the risk of secondary tumor lesions of the peritoneum significantly, is demonstrated. Photodynamic therapy – a method with high efficiency and almost no side effects and complications, based on the ability of photosensitizer to accumulate selectively and retain in the high proliferative tissues. The advantages of this type of treatment of patients with peritoneal carcinomatosis are a selective effect on the peritoneal carcinomatosis and on visually detected tumor tissue, high efficiency in patients with malignant tumors of the abdominal cavity and pelvis combined with surgical cytoreduction, minimal effect on normal organs and tissues of the patient, well tolerated procedure.

  16. Sentinel node biopsy and concomitant probe-guided tumor excision of nonpalpable breast cancer.

    van Rijk, Maartje C; Tanis, Pieter J; Nieweg, Omgo E; Loo, Claudette E; Olmos, Renato A Valdés; Oldenburg, Hester S A; Rutgers, Emiel J Th; Hoefnagel, Cornelis A; Kroon, Bin B R

    2007-02-01

    Preliminary data have shown encouraging results of a single intratumoral radiopharmaceutical injection that enables both sentinel node biopsy and probe-guided excision of the primary tumor in patients with nonpalpable breast cancer. The aim of the study was to evaluate this approach in a large group of patients. Lymphoscintigraphy was performed in 368 patients with nonpalpable breast cancer after intratumoral injection of (99m)Tc-nanocolloid (.2 mL, 123 MBq, 3.3 mCi) guided by ultrasound or stereotaxis. The sentinel node was pursued with the aid of vital blue dye (1.0 mL, intratumoral) and a gamma ray detection probe. In case of breast-conserving surgery, the probe was used to guide the excision. At least one sentinel node could be identified intraoperatively in 357 patients (97%), of whom 69 had involved nodes (19%). Age over 60 years was associated with less frequent nonaxillary lymphatic drainage and absence of internal mammary chain dissemination. Tumor-free margins were obtained in 262 (89%) of the 293 patients who underwent segmental excision. Re-excision of the primary tumor bed was performed in six patients (2%). During a median follow-up of 22 months, one breast recurrence and one axillary recurrence were observed. Lymphatic mapping and probe-guided tumor excision of nonpalpable breast cancer by intralesional administration of a single dose of (99m)Tc-nanocolloid and blue dye resulted in 97% identification of the sentinel node and in tumor-free margins in 89% of the patients who underwent breast-conserving surgery. Longer follow-up is needed to substantiate the accuracy and safety of this technique.

  17. 2-Azido-( sup 32 P)NAD+, a photoactivatable probe for G-protein structure: Evidence for holotransducin oligomers in which the ADP-ribosylated carboxyl terminus of alpha interacts with both alpha and gamma subunits

    Vaillancourt, R.R.; Dhanasekaran, N.; Johnson, G.L.; Ruoho, A.E. (Univ. of Wisconsin Medical School, Madison (USA))

    1990-05-01

    A radioactive and photoactivatable derivative of NAD+, 2-azido-(adenylate-32P)NAD+, has been synthesized and used with pertussis toxin to ADP-ribosylate Cys347 of the alpha subunit (alpha T) of GT, the retinal guanine nucleotide-binding protein. ADP-ribosylation of alpha T followed by light activation of the azide moiety of 2-azido-(adenylate-32P)ADP-ribose produced four crosslinked species involving the alpha and gamma subunits of the GT heterotrimer: an alpha trimer (alpha-alpha-alpha), and alpha-alpha-gamma crosslink, an alpha dimer (alpha-alpha), and an alpha-gamma crosslink. The alpha trimer, alpha-alpha-gamma complex, alpha dimer, and alpha-gamma complexes were immunoreactive with alpha T antibodies. The alpha-alpha-gamma and the alpha-gamma complexes were immunoreactive with antisera recognizing gamma subunits. No evidence was found for crosslinking of alpha T to beta T subunits. Hydrolysis of the thioglycosidic bond between Cys347 and 2-azido-(adenylate-32P)ADP-ribose using mercuric acetate resulted in the transfer of radiolabel from Cys347 of alpha T in the crosslinked oligomers to alpha monomers, indicative of intermolecular photocrosslinking, and to gamma monomers, indicative of either intermolecular crosslinked complexes (between heterotrimers) or intramolecular crosslinked complexes (within the heterotrimer). These results demonstrate that GT exists as an oligomer and that ADP-ribosylated Cys347, which is four residues from the alpha T-carboxyl terminus, is oriented toward and in close proximity to the gamma subunit.

  18. Mobile probes

    Ørngreen, Rikke; Jørgensen, Anna Neustrup; Noesgaard, Signe Schack

    2016-01-01

    A project investigating the effectiveness of a collection of online resources for teachers' professional development used mobile probes as a data collection method. Teachers received questions and tasks on their mobile in a dialogic manner while in their everyday context as opposed...... to in an interview. This method provided valuable insight into the contextual use, i.e. how did the online resource transfer to the work practice. However, the research team also found that mobile probes may provide the scaffolding necessary for individual and peer learning at a very local (intra-school) community...... level. This paper is an initial investigation of how the mobile probes process proved to engage teachers in their efforts to improve teaching. It also highlights some of the barriers emerging when applying mobile probes as a scaffold for learning....

  19. Optical probe

    Denis, J.; Decaudin, J.M.

    1984-01-01

    The probe includes optical means of refractive index n, refracting an incident light beam from a medium with a refractive index n1>n and reflecting an incident light beam from a medium with a refractive index n2 [fr

  20. Counting probe

    Matsumoto, Haruya; Kaya, Nobuyuki; Yuasa, Kazuhiro; Hayashi, Tomoaki

    1976-01-01

    Electron counting method has been devised and experimented for the purpose of measuring electron temperature and density, the most fundamental quantities to represent plasma conditions. Electron counting is a method to count the electrons in plasma directly by equipping a probe with the secondary electron multiplier. It has three advantages of adjustable sensitivity, high sensitivity of the secondary electron multiplier, and directional property. Sensitivity adjustment is performed by changing the size of collecting hole (pin hole) on the incident front of the multiplier. The probe is usable as a direct reading thermometer of electron temperature because it requires to collect very small amount of electrons, thus it doesn't disturb the surrounding plasma, and the narrow sweep width of the probe voltage is enough. Therefore it can measure anisotropy more sensitively than a Langmuir probe, and it can be used for very low density plasma. Though many problems remain on anisotropy, computer simulation has been carried out. Also it is planned to provide a Helmholtz coil in the vacuum chamber to eliminate the effect of earth magnetic field. In practical experiments, the measurement with a Langmuir probe and an emission probe mounted to the movable structure, the comparison with the results obtained in reverse magnetic field by using a Helmholtz coil, and the measurement of ionic sound wave are scheduled. (Wakatsuki, Y.)

  1. Intra-operative lymphatic mapping with Dextran Tc-99m and blue dye for sentinel node detection in patients with primary vulvar malignancies

    Morales, R.E.; Aguilar, C.R.; Cano, R.A.; Saavedra, P.; Santos, C.

    2004-01-01

    Full text: The purpose of this study was to determine the feasibility of sentinel lymph node detection using preoperative lymphoscintigraphy and intra-operative lymphatic mapping in patients with primary vulvar malignancies. Nine patients (29-84 years old) with primary vulvar malignancy were scheduled for sentinel node detection. Two patients had malignant melanoma of the vulva and seven had squamous cell carcinomas. Eight patients did not have a previous surgery of the primary tumour nor of the lymph nodes, one had an aspiration biopsy. Three hours before surgery 1-5 mCi of Tc-99m Dextran was injected intradermally in four points in the skin junction adjacent to the vulvar lesions. Static lymphoscintigraphy was performed using a planar GE gamma camera with a multipurpose low energy collimator, in anterior and lateral views. Images were displayed on a personal computer, through a Portable Imaging Processing software (PIP). In two cases a Siemens ECAM SPECT camera was used, due to necessity of having high-resolution images. Patten blue dye was injected in the junction between the skin and vulvar tumor, in the surgery room, after anaesthesia induction. Agamma probe (Navigator Gamma Guidance System) was used to detect the sentinel node. The activity in the sentinel node was measured in each case, before and after resection. Activity in the remaining tissue was also measured. Nodes were adequately placed in plastic bags and sent to pathology for H-E staining. Non-sentinel nodes were also resected and sent for pathology, except in two cases. Sentinel nodes (SN) were visualised on lymphoscintigraphy 1 to 5 minutes after injection of Tc-99m Dextran. In malignant melanoma drainage to the sentinel node was faster than for other tumours. There were five cases who had bilateral SN in inguinal regions, in other three cases, two SN were located on the same side, two in the inguinal region. In all cases the SN was identified corroborating to the skin mark and with enough

  2. Intraoperative high-field magnetic resonance imaging, multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas.

    Li, Fang-Ye; Chen, Xiao-Lei; Xu, Bai-Nan

    2016-09-01

    To determine the beneficial effects of intraoperative high-field magnetic resonance imaging (MRI), multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas. Twelve patients with 13 supratentorial cavernomas were prospectively enrolled and operated while using a 1.5 T intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. All cavernomas were deeply located in subcortical areas or involved critical areas. Intraoperative high-field MRIs were obtained for the intraoperative "visualization" of surrounding eloquent structures, "brain shift" corrections, and navigational plan updates. All cavernomas were successfully resected with guidance from intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. In 5 cases with supratentorial cavernomas, intraoperative "brain shift" severely deterred locating of the lesions; however, intraoperative MRI facilitated precise locating of these lesions. During long-term (>3 months) follow-up, some or all presenting signs and symptoms improved or resolved in 4 cases, but were unchanged in 7 patients. Intraoperative high-field MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring are helpful in surgeries for the treatment of small deeply seated subcortical cavernomas.

  3. Comparison of esophagogastric junction distensibility changes during POEM and Heller myotomy using intraoperative FLIP.

    Teitelbaum, Ezra N; Boris, Lubomyr; Arafat, Fahd O; Nicodème, Frédéric; Lin, Zhiyue; Kahrilas, Peter J; Pandolfino, John E; Soper, Nathaniel J; Hungness, Eric S

    2013-12-01

    Peroral endoscopic myotomy (POEM) is a novel endoscopic surgical procedure for the treatment of achalasia. The comparative effects of POEM and laparoscopic Heller myotomy (LHM) on esophagogastric junction (EGJ) physiology are unknown. A novel measurement catheter, the functional lumen imaging probe (FLIP), allows for intraoperative evaluation of EGJ compliance by measuring luminal geometry and pressure during volume-controlled distensions. Distensibility index (DI) (defined as the minimum cross-sectional area at the EGJ divided by pressure) was measured with FLIP intraoperatively in patients undergoing LHM and POEM. Separate measurements were taken after each operative step. During LHM, measurements were performed after: (1) induction of anesthesia, (2) insufflation of pneumoperitoneum, (3) hiatal dissection and esophageal mobilization, (4) myotomy, (5) partial fundoplication, and (6) deinsufflation. During POEM, they were performed after: (1) induction of anesthesia, (2) submucosal tunnel creation, and (3) myotomy. Eleven LHM and 14 POEM patients underwent intraoperative FLIP. Baseline DI was similar between groups. LHM resulted in an overall increase in mean DI (pre 1.4 vs. post 7.6 mm(2)/mmHg, using a 40-ml distension volume; p Myotomy caused an increase in DI. Partial fundoplication (6 Toupet, 5 Dor) caused a decrease in DI, and deinsufflation caused an increase in DI. POEM also resulted in an overall increase in mean DI (pre 1.4 vs. post 7.9 mm(2)/mmHg; p myotomy caused increases in DI. When overall changes were compared, there were no differences in the amount of DI increase between LHM and POEM. POEM and LHM result in a similar improvement in EGJ distensibility intraoperatively. Further study is needed to correlate intraoperative FLIP measurements with postoperative symptomatic and physiologic outcomes.

  4. The role of intraoperative ultrasound in small renal mass robotic enucleation

    Roberta Gunelli

    2016-12-01

    Full Text Available Introduction: As a result of the growing evidence on tumor radical resection in literature, simple enucleation has become one of the best techniques associated to robotic surgery in the treatment of renal neoplasia, as it guarantees minimal invasiveness and the maximum sparing of renal tissue, facilitating the use of reduced or zero ischemia techniques during resection. The use of a robotic ultrasound probe represents a useful tool to detect and define tumor location, especially in poorly exophytic small renal mass. Materials and methods: A total of 22 robotic enucleations were performed on < 3 cm renal neoplasias (PADUA score 18 Pz 6/7 e 4 Pz 8 using a 12-5 MHz robotic ultrasound probe (BK Drop-In 8826. Results: Once kidney had been isolated from the adipose capsule at the site of the neoplasia (2, the exact position of the lesion could be easily identified in all cases (22/22, even for mostly endophytic lesions, thanks to the insertion of the ultrasound probe through the assistant port. Images were produced and visualized by the surgeon using the TilePro feature of the DaVinci surgical system for producing a picture-in-picture image on the console screen. The margins of resection were then marked with cautery, thus allowing for speedy anatomical dissection. This reduced the time of ischemia to 8 min (6-13 and facilitated the enucleation technique when performed without clamping the renal peduncle (6/22. No complications due to the use of the ultrasound probe were observed. Conclusions: The use of an intraoperative robotic ultrasound probe has allowed for easier identification of small, mostly endophytic neoplasias, better anatomical approach, shorter ischemic time, reduced risk of pseudocapsule rupture during dissection, and easier enucleation in cases performed without clamping. It is noteworthy that the use of intraoperative ultrasound probe allows mental reconstruction of the tumor through an accurate 3D vision of the hidden field during

  5. The role of intraoperative ultrasound in small renal mass robotic enucleation.

    Gunelli, Roberta; Fiori, Massimo; Salaris, Cristiano; Salomone, Umberto; Urbinati, Marco; Vici, Alexia; Zenico, Teo; Bertocco, Mauro

    2016-12-30

    As a result of the growing evidence on tumor radical resection in literature, simple enucleation has become one of the best techniques associated to robotic surgery in the treatment of renal neoplasia, as it guarantees minimal invasiveness and the maximum sparing of renal tissue, facilitating the use of reduced or zero ischemia techniques during resection. The use of a robotic ultrasound probe represents a useful tool to detect and define tumor location, especially in poorly exophytic small renal mass. A total of 22 robotic enucleations were performed on < 3 cm renal neoplasias (PADUA score 18 Pz 6/7 e 4 Pz 8) using a 12-5 MHz robotic ultrasound probe (BK Drop-In 8826). Once kidney had been isolated from the adipose capsule at the site of the neoplasia (2), the exact position of the lesion could be easily identified in all cases (22/22), even for mostly endophytic lesions, thanks to the insertion of the ultrasound probe through the assistant port. Images were produced and visualized by the surgeon using the TilePro feature of the DaVinci surgical system for producing a picture-in-picture image on the console screen. The margins of resection were then marked with cautery, thus allowing for speedy anatomical dissection. This reduced the time of ischemia to 8 min (6-13) and facilitated the enucleation technique when performed without clamping the renal peduncle (6/22). No complications due to the use of the ultrasound probe were observed. The use of an intraoperative robotic ultrasound probe has allowed for easier identification of small, mostly endophytic neoplasias, better anatomical approach, shorter ischemic time, reduced risk of pseudocapsule rupture during dissection, and easier enucleation in cases performed without clamping. It is noteworthy that the use of intraoperative ultrasound probe allows mental reconstruction of the tumor through an accurate 3D vision of the hidden field during surgical dissection.

  6. Observation of galactic gamma radiation

    Paul, J.A.

    1982-09-01

    A complete and deep survey of the galactic high-energy gamma radiation is now available, thanks to the gamma-ray telescopes on board of the SAS-2 and COS-B spacecrafts. A comparison of the COS-B gamma-ray survey with a fully sampled CO survey together with an Hsub(I) survey is used to show that a simple model, in which uniformly distributed cosmic rays interact with the interstellar gas, can account for almost all the gamma-ray emission observed in the first galactic quadrant. At medium galactic latitudes, it is shown that a relationship exists between the gamma radiation and the interstellar absorption derived from galaxy counts. Therefore gamma rays from the local galactic environment can be used as a valuable probe of the content and structure of the local interstellar medium. The large scale features of the local interstellar gas are revealed, in particular wide concentrations of nearby molecular hydrogen. On a smaller scale, the detection of numerous localized gamma-ray sources focuses the attention on some particular phases of clusters of young and massive stars where diffuse processes of gamma-ray emission may also be at work

  7. DNA probes

    Castelino, J.

    1992-01-01

    The creation of DNA probes for detection of specific nucleotide segments differs from ligand detection in that it is a chemical rather than an immunological reaction. Complementary DNA or RNA is used in place of the antibody and is labelled with 32 P. So far, DNA probes have been successfully employed in the diagnosis of inherited disorders, infectious diseases, and for identification of human oncogenes. The latest approach to the diagnosis of communicable and parasitic infections is based on the use of deoxyribonucleic acid (DNA) probes. The genetic information of all cells is encoded by DNA and DNA probe approach to identification of pathogens is unique because the focus of the method is the nucleic acid content of the organism rather than the products that the nucleic acid encodes. Since every properly classified species has some unique nucleotide sequences that distinguish it from every other species, each organism's genetic composition is in essence a finger print that can be used for its identification. In addition to this specificity, DNA probes offer other advantages in that pathogens may be identified directly in clinical specimens

  8. DNA probes

    Castelino, J

    1993-12-31

    The creation of DNA probes for detection of specific nucleotide segments differs from ligand detection in that it is a chemical rather than an immunological reaction. Complementary DNA or RNA is used in place of the antibody and is labelled with {sup 32}P. So far, DNA probes have been successfully employed in the diagnosis of inherited disorders, infectious diseases, and for identification of human oncogenes. The latest approach to the diagnosis of communicable and parasitic infections is based on the use of deoxyribonucleic acid (DNA) probes. The genetic information of all cells is encoded by DNA and DNA probe approach to identification of pathogens is unique because the focus of the method is the nucleic acid content of the organism rather than the products that the nucleic acid encodes. Since every properly classified species has some unique nucleotide sequences that distinguish it from every other species, each organism`s genetic composition is in essence a finger print that can be used for its identification. In addition to this specificity, DNA probes offer other advantages in that pathogens may be identified directly in clinical specimens 10 figs, 2 tabs

  9. The Art of Intraoperative Glioma Identification

    Zoe Z Zhang

    2015-07-01

    Full Text Available A major dilemma in brain tumor surgery is the identification of tumor boundaries to maximize tumor excision and minimize postoperative neurological damage. Gliomas, especially low-grade tumors, and normal brain have a similar color and texture which poses a challenge to the neurosurgeon. Advances in glioma resection techniques combine the experience of the neurosurgeon and various advanced technologies. Intraoperative methods to delineate gliomas from normal tissue consist of 1 image-based navigation, 2 intraoperative sampling, 3 electrophysiological monitoring, and 4 enhanced visual tumor demarcation. The advantages and disadvantages of each technique are discussed. A combination of these methods is becoming widely accepted in routine glioma surgery. Gross total resection in conjunction with radiation, chemotherapy, or immune/gene therapy may increase the rates of cure in this devastating disease.

  10. Tolerance of bile duct to intraoperative irradiation

    Sindelar, W.F.; Tepper, J.; Travis, E.L.

    1982-01-01

    In order to determine the effects of intraoperative radiation therapy of the bile duct and surrounding tissues, seven adult dogs were subjected to laparotomy and intraoperative irradiation with 11 MeV electrons. Two animals were treated at each dose level of 2000, 3000, and 4500 rads. A single dog which received a laparotomy and sham irradiation served as a control. The irradiation field consisted of a 5 cm diameter circle encompassing the extrahepatic bile duct, portal vein, hepatic artery, and lateral duodenal wall. The animals were followed clinically for mor than 18 months after treatment, and autopsies were performed on dogs that died to assess radiation-induced complications or tissue damage. All dogs developed fibrosis and mural thickening of the common duct, which appeared by 6 weeks following irradiation and which was dose-related, being mild at low doses and more severe at high doses. Hepatic changes were seen as early as 6 weeks after irradiation, consisting of periportal inflammation and fibrosis. The hepatic changes appeared earliest at the highest doses. Frank biliary cirrhosis eventually developed at all dose levels. Duodenal fibrosis appeared in the irradiation portal, being most severe at the highest doses and in some animals resulting in duodenal obstruction. No changes were observed in irradiated portions of portal vein and hepatic artery at any dose level. It was concluded that intraoperative radiation therapy delivered to the region of the common duct leads to ductal fibrosis, partial biliary obstruction with secondary hepatic changes, and duodenal fibrosis if bowel wall is included in the field. Clinical use of intraoperative radiation therapy to the bile duct in humans may require routine use of biliary and duodenal bypass to prevent obstructive complications

  11. Experimental and clinical studies with intraoperative radiotherapy

    Sindelar, W.F.; Kinsella, T.; Tepper, J.; Travis, E.L.; Rosenberg, S.A.; Glatstein, E.

    1983-01-01

    Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinomas involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complications occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved

  12. Near-Infrared Intraoperative Chemiluminescence Imaging

    Büchel, Gabriel E.

    2016-08-03

    Intraoperative imaging technologies recently entered the operating room, and their implementation is revolutionizing how physicians plan, monitor, and perform surgical interventions. In this work, we present a novel surgical imaging reporter system: intraoperative chemiluminescence imaging (ICI). To this end, we have leveraged the ability of a chemiluminescent metal complex to generate near-infrared light upon exposure to an aqueous solution of Ce4+ in the presence of reducing tissue or blood components. An optical camera spatially resolves the resulting photon flux. We describe the construction and application of a prototype imaging setup, which achieves a detection limit as low as 6.9pmolcm-2 of the transition-metal-based ICI agent. As a proof of concept, we use ICI for the invivo detection of our transition metal tracer following both systemic and subdermal injections. The very high signal-to-noise ratios make ICI an interesting candidate for the development of new intraoperative imaging technologies. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Near-Infrared Intraoperative Chemiluminescence Imaging

    Bü chel, Gabriel E.; Carney, Brandon; Shaffer, Travis M.; Tang, Jun; Austin, Christine; Arora, Manish; Zeglis, Brian M.; Grimm, Jan; Eppinger, Jö rg; Reiner, Thomas

    2016-01-01

    Intraoperative imaging technologies recently entered the operating room, and their implementation is revolutionizing how physicians plan, monitor, and perform surgical interventions. In this work, we present a novel surgical imaging reporter system: intraoperative chemiluminescence imaging (ICI). To this end, we have leveraged the ability of a chemiluminescent metal complex to generate near-infrared light upon exposure to an aqueous solution of Ce4+ in the presence of reducing tissue or blood components. An optical camera spatially resolves the resulting photon flux. We describe the construction and application of a prototype imaging setup, which achieves a detection limit as low as 6.9pmolcm-2 of the transition-metal-based ICI agent. As a proof of concept, we use ICI for the invivo detection of our transition metal tracer following both systemic and subdermal injections. The very high signal-to-noise ratios make ICI an interesting candidate for the development of new intraoperative imaging technologies. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Intraoperative dynamic dosimetry for prostate implants

    Todor, D A [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Zaider, M [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Cohen, G N [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Worman, M F [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Zelefsky, M J [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States)

    2003-05-07

    This paper describes analytic tools in support of a paradigm shift in brachytherapy treatment planning for prostate cancer - a shift from standard pre-planning to intraoperative planning using dosimetric feedback based on the actual deposited seed positions within the prostate. The method proposed is guided by several desiderata: (a) bringing both planning and evaluation in the operating room (i.e. make post-implant evaluation superfluous) therefore making rectifications - if necessary - still achievable; (b) making planning and implant evaluation consistent by using the same imaging system (ultrasound); and (c) using only equipment commonly found in a hospital operating room. The intraoperative dosimetric evaluation is based on the fusion between ultrasound images and 3D seed coordinates reconstructed from fluoroscopic projections. Automatic seed detection and registration of the fluoroscopic and ultrasound information, two of the three key ingredients needed for the intraoperative dynamic dosimetry optimization (IDDO), are explained in detail. The third one, the reconstruction of 3D coordinates from projections, was reported in a previous article. The algorithms were validated using a custom-designed phantom with non-radioactive (dummy) seeds. Also, fluoroscopic images were taken at the conclusion of an actual permanent prostate implant and compared with data on the same patient obtained from radiographic-based post-implant evaluation. To offset the effect of organ motion the comparison was performed in terms of the proximity function of the two seed distributions. The agreement between the intra- and post-operative seed distributions was excellent.

  15. Multispectral open-air intraoperative fluorescence imaging.

    Behrooz, Ali; Waterman, Peter; Vasquez, Kristine O; Meganck, Jeff; Peterson, Jeffrey D; Faqir, Ilias; Kempner, Joshua

    2017-08-01

    Intraoperative fluorescence imaging informs decisions regarding surgical margins by detecting and localizing signals from fluorescent reporters, labeling targets such as malignant tissues. This guidance reduces the likelihood of undetected malignant tissue remaining after resection, eliminating the need for additional treatment or surgery. The primary challenges in performing open-air intraoperative fluorescence imaging come from the weak intensity of the fluorescence signal in the presence of strong surgical and ambient illumination, and the auto-fluorescence of non-target components, such as tissue, especially in the visible spectral window (400-650 nm). In this work, a multispectral open-air fluorescence imaging system is presented for translational image-guided intraoperative applications, which overcomes these challenges. The system is capable of imaging weak fluorescence signals with nanomolar sensitivity in the presence of surgical illumination. This is done using synchronized fluorescence excitation and image acquisition with real-time background subtraction. Additionally, the system uses a liquid crystal tunable filter for acquisition of multispectral images that are used to spectrally unmix target fluorescence from non-target auto-fluorescence. Results are validated by preclinical studies on murine models and translational canine oncology models.

  16. Intraoperative lung ultrasound: A clinicodynamic perspective

    Amit Kumar Mittal

    2016-01-01

    Full Text Available In the era of evidence-based medicine, ultrasonography has emerged as an important and indispensable tool in clinical practice in various specialties including critical care. Lung ultrasound (LUS has a wide potential in various surgical and clinical situations for timely and easy detection of an impending crisis such as pulmonary edema, endobronchial tube migration, pneumothorax, atelectasis, pleural effusion, and various other causes of desaturation before it clinically ensues to critical level. Although ultrasonography is frequently used in nerve blocks, airway handling, and vascular access, LUS for routine intraoperative monitoring and in crisis management still necessitates recognition. After reviewing the various articles regarding the use of LUS in critical care, we found, that LUS can be used in various intraoperative circumstances similar to Intensive Care Unit with some limitations. Except for few attempts in the intraoperative detection of pneumothorax, LUS is hardly used but has wider perspective for routine and crisis management in real-time. If anesthesiologists add LUS in their routine monitoring armamentarium, it can assist to move a step ahead in the dynamic management of critically ill and high-risk patients.

  17. Conductivity Probe

    2008-01-01

    The Thermal and Electrical Conductivity Probe (TECP) for NASA's Phoenix Mars Lander took measurements in Martian soil and in the air. The needles on the end of the instrument were inserted into the Martian soil, allowing TECP to measure the propagation of both thermal and electrical energy. TECP also measured the humidity in the surrounding air. The needles on the probe are 15 millimeters (0.6 inch) long. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  18. Probe specificity

    Laget, J.M.

    1986-11-01

    Specificity and complementarity of hadron and electron probes must be systematically developed to answer three questions currently asked in intermediate energy nuclear physics: what is nucleus structure at short distances, what is nature of short range correlations, what is three body force nature [fr

  19. Intraoperative floppy iris and prevalence of intraoperative complications: results from ophthalmic surgery outcomes database.

    Vollman, David E; Gonzalez-Gonzalez, Luis A; Chomsky, Amy; Daly, Mary K; Baze, Elizabeth; Lawrence, Mary

    2014-06-01

    To estimate the prevalence of untoward events during cataract surgery with the use of pupillary expansion devices and intraoperative floppy iris (IFIS). Retrospective analysis of 4923 cataract surgery cases from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project. Outcomes from 5 Veterans Affairs medical centers were analyzed, including use of alpha-blockers (both selective and nonselective), IFIS, intraoperative iris trauma, intraoperative iris prolapse, posterior capsular tear, anterior capsule tear, intraoperative vitreous prolapse, and use of pupillary expansion devices. P values were calculated using the χ(2) test. A total of 1254 patients (25.5%) took alpha-blockers preoperatively (selective, 587; nonselective, 627; both, 40). Of these 1254 patients, 428 patients (34.1%) had documented IFIS. However, 75.2% of patients with IFIS (428/569) had taken alpha-blockers preoperatively (P < .00001). A total of 430 patients (8.7%) had a pupillary expansion device used during their cataract surgery, of which 186 patients (43.4%) had IFIS (P < .0001). Eighty-six patients with IFIS had at least 1 intraoperative complication and 39 patients with IFIS had more than 1 intraoperative complication (P < .001). The use of either selective or nonselective alpha-antagonists preoperatively demonstrated a significant risk of IFIS. Nonselective alpha-antagonists caused IFIS at a higher prevalence than previously reported. This study did demonstrate statistically significant increased odds of surgical complications in patients with IFIS vs those without IFIS in all groups (those taking selective and nonselective alpha-antagonists and also those not taking medications). Published by Elsevier Inc.

  20. Application of the similitude principle to gamma-gamma density measurements; Application du principe de similitude a la mesure gamma-gamma de densite

    Czubek, J A [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires. Departement d' Electronique Generale, Service d' Electronique Industrielle; Institut de Recherches Nucleaires, Dep. VI, Cracow (Poland)

    1966-07-01

    The work presented here deals with the problem of the application of the similitude principle to rock density measurements by the gamma-gamma method. A formula is presented which makes it possible to transform results of gamma-gamma measurements carried out on models in order to make them suitable for comparison with results obtained under actual field conditions. Both the space coordinates and the densities are transformed. This transformation makes it possible to obtain a calibration curve as a function of the density for a gamma-gamma probe using only a single model of given density. The influence has also been studied of the chemical composition on the results obtained from gamma-gamma measurements. A method has been developed for estimating the equivalent Z parameter of the medium; the possibility of completely eliminating the influence of the chemical composition of the medium on the measurement results has been studied. (author) [French] L'etude presentee ci-dessous traite le probleme de l'application du principe de similitude aux mesures de densite des roches par la methode gamma-gamma. Nous indiquons une formule qui permet de transformer les resultats des mesures gamma-gamma effectuees sur les modeles pour les comparer aux resultats obtenus dans les conditions reelles sur le terrain. On transforme les coordonnees spatiales ainsi que les densites. Cette transformation donne la possibilite d'obtenir une courbe d'etalonnage (en fonction de la densite) pour une sonde gamma-gamma en utilisant un seul modele de densite donnee. On a etudie aussi l'influence de la composition chimique sur les resultats obtenus des mesures gamma-gamma. On a etabli une methode d'estimation du parametre Z equivalent du milieu, ainsi que la possibilite d'eliminer completement l'influence de la composition chimique du milieu sur les resultats des mesures de densite. (auteur)

  1. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang

    2011-01-01

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 ± 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  2. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang [Tangdu Hospital of the Fourth Military Medicine University, Xi an (China)

    2011-10-15

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 {+-} 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  3. Intraoperative digital radiography for diagnosis of non-palpable breast lesions; Digitale intraoperative Praeparateradiographie bei diagnostischen Exzisionen nicht palpabler Laesionen der Brust

    Diekmann, F.; Grebe, S.; Hamm, B. [Humboldt-Univ., Berlin (Germany). Inst. fuer Radiologie; Bick, U. [Humboldt-Univ., Berlin (Germany). Inst. fuer Radiologie; Chicago Univ., IL (United States). Dept. of Radiology; Winzer, K.J. [Humboldt-Univ., Berlin (Germany). Klinik fuer Allgemein-, Viszeral-, Gefaess- und Thoraxchirurgie; Paepke, S. [Humboldt-Univ., Berlin (Germany). Abt. fuer Frauenheilkunde und Geburtshilfe

    2000-12-01

    , Prototyp) verglichen. Auswertekriterien waren dabei die Sichtbarkeit der pathologischen Laesion sowie die Zeitersparnis fuer den Chirurgen, Anaesthesisten und Radiologen. Ergebnisse: Mit der neuen Technik konnten alle markierten pathologischen Laesionen im Praeparat nachgewiesen werden, mit der herkoemmlichen Technik konnten ebenfalls 100% (36/36) der Laesionen nachgewiesen werden. Dabei kam es zu einer erheblichen Zeitersparnis fuer den Operateur und den Radiologen, die Operationszeit konnte gesenkt werden. So konnte die Zeit von der Entnahme der Probe bis zur Ergebnisuebermittlung von ca. 23 min auf ca. 13 min gesenkt werden. Die Praeparate waren in allen Faellen mit einer Aufnahme vollstaendig abbildbar. Schlussfolgerung: Durch die digitale intraoperative Praeparateradiographie kann eine erhebliche Reduktion der OP-Zeit in Abhaengigkeit von den oertlichen Verhaeltnissen des Krankenhauses erfolgen. Es kann mit sehr hoher Sicherheit eine Aussage ueber die Lokalisation des suspekten Areals innerhalb des Gewebes erfolgen. (orig.)

  4. Assessment of intraoperative 3D imaging alternatives for IOERT dose estimation

    Garcia-Vazquez, Veronica; Marinetto, Eugenio [Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid (Spain); Guerra, Pedro [Univ. Politecnica de Madrid (Spain). Dept. de Ingenieria Electronica; Centro de Investigacion Biomedica en Red en Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza (Spain); Valdivieso-Casique, Manlio Fabio [GMV SA, Madrid (Spain); Calvo, Felipe Angel [Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid (Spain); Hospital General Univ. Gregorio Maranon, Madrid (Spain). Dept. de Oncologia; Univ. Complutense de Madrid (Spain). Facultad de Medicina; Alvarado-Vazquez, Eduardo [Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid (Spain); Hospital General Univ. Gregorio Maranon, Madrid (Spain). Servicio de Oncologia Radioterapica; Sole, Claudio Vicente [Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid (Spain); Instituto de Radiomedicina, Santiago (Chile). Service of Radiation Oncology; Vosburgh, Kirby Gannett [Harvard Medical School, Brigham and Women' s Hospital, Boston, MA (United States). Department of Radiology; Desco, Manuel; Pascau, Javier [Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid (Spain); Univ. Carlos III de Madrid (Spain). Dept. de Bioingenieria e Ingenieria Aeroespacial; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Madrid (Spain)

    2017-10-01

    Intraoperative electron radiation therapy (IOERT) involves irradiation of an unresected tumour or a post-resection tumour bed. The dose distribution is calculated from a preoperative computed tomography (CT) study acquired using a CT simulator. However, differences between the actual IOERT field and that calculated from the preoperative study arise as a result of patient position, surgical access, tumour resection and the IOERT set-up. Intraoperative CT imaging may then enable a more accurate estimation of dose distribution. In this study, we evaluated three kilovoltage (kV) CT scanners with the ability to acquire intraoperative images. Our findings indicate that current IOERT plans may be improved using data based on actual anatomical conditions during radiation. The systems studied were two portable systems (''O-arm'', a cone-beam CT [CBCT] system, and ''BodyTom'', a multislice CT [MSCT] system) and one CBCT integrated in a conventional linear accelerator (LINAC) (''TrueBeam''). TrueBeam and BodyTom showed good results, as the gamma pass rates of their dose distributions compared to the gold standard (dose distributions calculated from images acquired with a CT simulator) were above 97% in most cases. The O-arm yielded a lower percentage of voxels fulfilling gamma criteria owing to its reduced field of view (which left it prone to truncation artefacts). Our results show that the images acquired using a portable CT or even a LINAC with on-board kV CBCT could be used to estimate the dose of IOERT and improve the possibility to evaluate and register the treatment administered to the patient.

  5. Assessment of intraoperative 3D imaging alternatives for IOERT dose estimation

    Garcia-Vazquez, Veronica; Marinetto, Eugenio; Guerra, Pedro; Valdivieso-Casique, Manlio Fabio; Calvo, Felipe Angel

    2017-01-01

    Intraoperative electron radiation therapy (IOERT) involves irradiation of an unresected tumour or a post-resection tumour bed. The dose distribution is calculated from a preoperative computed tomography (CT) study acquired using a CT simulator. However, differences between the actual IOERT field and that calculated from the preoperative study arise as a result of patient position, surgical access, tumour resection and the IOERT set-up. Intraoperative CT imaging may then enable a more accurate estimation of dose distribution. In this study, we evaluated three kilovoltage (kV) CT scanners with the ability to acquire intraoperative images. Our findings indicate that current IOERT plans may be improved using data based on actual anatomical conditions during radiation. The systems studied were two portable systems (''O-arm'', a cone-beam CT [CBCT] system, and ''BodyTom'', a multislice CT [MSCT] system) and one CBCT integrated in a conventional linear accelerator (LINAC) (''TrueBeam''). TrueBeam and BodyTom showed good results, as the gamma pass rates of their dose distributions compared to the gold standard (dose distributions calculated from images acquired with a CT simulator) were above 97% in most cases. The O-arm yielded a lower percentage of voxels fulfilling gamma criteria owing to its reduced field of view (which left it prone to truncation artefacts). Our results show that the images acquired using a portable CT or even a LINAC with on-board kV CBCT could be used to estimate the dose of IOERT and improve the possibility to evaluate and register the treatment administered to the patient.

  6. Probing Light Stops with Stoponium

    Batell, Brian

    2015-01-01

    We derive new limits on light stops from diboson resonance searches in the $\\gamma\\gamma$, $Z \\gamma$, $ZZ$, $WW$ and $hh$ channels from the first run of the LHC. If the two-body decays of the light stop are mildly suppressed or kinematically forbidden, stoponium bound states will form in $pp$ collisions and subsequently decay via the pair annihilation of the constituent stops to diboson final states, yielding striking resonance signatures. Remarkably, we find that stoponium searches are highly complementary to direct collider searches and indirect probes of light stops such as Higgs coupling measurements. Using an empirical quarkonia potential model and including the first two $S$-wave stoponium states, we find that in the decoupling limit $m_{\\widetilde t_1} \\lesssim 130$ GeV is excluded for any value of the stop mixing angle and heavy stop mass by the combination of the latest resonance searches and the indirect constraints. The $\\gamma \\gamma$ searches are the most complementary to the indirect constraint...

  7. Intraoperative mechanical ventilation: state of the art.

    Ball, Lorenzo; Costantino, Federico; Orefice, Giulia; Chandrapatham, Karthikka; Pelosi, Paolo

    2017-10-01

    Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review was to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass. While anesthesia and mechanical ventilation are becoming increasingly safe practices, the contribution to surgical mortality attributable to postoperative lung injury is not negligible: for these reasons, the prevention of PPCs, including the use of protective mechanical ventilation is mandatory. Mechanical ventilation should be optimized providing an adequate respiratory support while minimizing unwanted negative effects. Due to the high number of surgical procedures performed daily, the impact on patients' health and healthcare costs can be relevant, even when new strategies result in an apparently small improvement of outcome. A protective intraoperative ventilation should include a low tidal volume of 6-8 mL/kg of predicted body weight, plateau pressures ideally below 16 cmH2O, the lowest possible driving pressure, moderate-low PEEP levels except in obese patients, laparoscopy and long surgical procedures that might benefit of a slightly higher PEEP. The work of the anesthesiologist should start with a careful preoperative visit to assess the risk, and a close postoperative monitoring.

  8. Tolerance of retroperitoneal structures to intraoperative radiation

    Sindelar, W.F.; Tepper, J.; Travis, E.L.; Terrill, R.

    1982-01-01

    In conjunction with the clinical development of intraoperative radiotherapy, a study was undertaken in dogs to define the tolerance of normal anatomic structures in the retroperitoneum to radiation delivered during operation. Twenty adult dogs were subjected to laparotomy and intraoperative 11 MeV electron irradiation in single doses ranging from 0.to 5000 rad. Animals were followed regularly with clinical observation, blood count, serum chemistries, pyelography, and angiography. Animals were sacrificed and autopsied at regular intervals up to 12 months following treatment to assess radiation-induced complications or tissue damage. Irradiation field in all dogs consisted of a 4 X 15 cm rectangle extending in the retroperitoneum from the level of the renal vessels to the bifurcation of aorta and vena cava. The field included aorta, vena cava, inferior portion of left kidney, and distal portion of left ureter. No complications or histologic changes occurred in any animal given doses of 2000 rad, with a follow-up in excess of 18 months. A dose of 3000 rad was well tolerated, except for left ureteral occlusion in one animal. Mild vascular fibrosis was present inthe aorta and vena cava, and significant ureteral fibrosis developed by six months after doses of 4000 or 5000 rad. All animals that received 5000 rad died of radiation-related complications, including ureteral obstruction and rectal perforation. It was concluded that major vessels tolerate intraoperative irradiation well up to and including 3000 rad and that no clinically significant vascular problems develop after 4000 and 5000 rad, although some fibrosis does occur. The ureter and kidney appear to be the most radiosensitive structures inthe retroperitoneum, showing progressive changes at 300 rad or greater and showing the potential for serious complications after doses of 4000 rad or more

  9. Study on intraoperative radiotherapy of brain tumors

    Uozumi, Akimasa

    1990-01-01

    Effects of a single large dose radiation on the brain of dogs were investigated for the purpose of determining the optimal dose and radiation field in intraoperative radiotherapy. The right parietal lobe of dogs (three groups, four dogs in each) were radiated at the dose of 30, 40 and 50 Gy respectively at the depth of 1.5 cm by 11 Nev electron beam with field size of 2 cm. CT and histopathological study were performed 2, 6, 12 and 24 months after radiation. L-hemiparesis developed 14 months after radiation in the 30 Gy group and 8 months in the 40 Gy group, 6 months in the 50 Gy group. All animals in the 40 Gy and 50 Gy groups died before 15 months of radiation. CT showed delayed radiation necrosis in all groups. Brain swelling and ventricular displacement in the radiated hemisphere and contralateral ventricular dilatation were depicted on plain CT. Diffuse heterogeneous contrast enhancement (CE) was observed on CE-CT. CT revealed disappearance of radiation necrosis in the 30 Gy group 24 months of radiation, suggesting that radiation necrosis may be dependent on the term after radiation. Histological findings of radiation necrosis were similar in all animals, and the vascular change preceding the parechymal necrosis was not observed. This supports the theory that the vascular alternation dose not play a major role in the production of radiation necrosis. The necrotic area grossly reflected the isodose curve and was observed in the radiation field with 15 to 20 Gy at the depth of 3 to 4.5 cm. Thus, the intraoperative radiotherapy should be planned on the basis of two such factors as electron beam energy and the field size, and the area out of the target should not be radiated at the dose of more than 15 Gy. The author believes that the information would contribute to safer and more effective application of intraoperative radiotherapy on malignant brain tumors. (J.P.N.) 63 refs

  10. INTRAOPERATIVE PHOTODYNAMIC THERAPY FOR PERITONEAL MESOTHELIOMA

    A. D. Kaprin

    2017-01-01

    Full Text Available Abstract Results of application of a new technology of intraoperative photodynamic therapy (IOFDT in patients with peritoneal mesothelioma developed at P. Herzen Moscow Oncology Research Institute are presented. The study included 8 patients. 3 patients underwent surgery in various amount: 1 – limited peritonectomy in the volume of tumor foci resection and resection of a large omentum, 1 – limited peritonectomy in the volume of tumor foci resection and atypical resection of the right lobe of the liver, 1 – only resection of the large omentum due to the fact that the tumor was located only in a large omentum and no signs of lesions of the parietal peritoneum was revealed by intraoperative revision. Surgical intervention in these patients was concluded by IOPDT. The remaining 5 patients underwent only IOPDT. After the treatment, two patients underwent additional courses of laparoscopic IOPDT. Of the 8 patients enrolled in the study, 4 died from the underlying disease, 1 from cardiovascular disease with recurrence of the disease, 1 from cardiovascular disease without signs of recurrence, 2 were monitored for 6 months and 146 months (12 years. Thus, in the group of patients with peritoneal mesothelioma, the maximum observation period was 146.44 months, the median survival was 48.4 months, the total specific 1-year survival was 85.7±13.2%, the three-year survival was 68.5±18.6%, the 5-year survival was 45.7 ± 22.4 %. The average life expectancy after treatment of patients with repeated courses of laparoscopic IOPDT was 87 months, without repeated courses – 35.8 months. Thus, life expectancy was higher in patients with repeated courses of laparoscopic IOPDT. Small sample size caused to the rarity of this pathology does not allow for statistically significant conclusions. However, the results of the study indicate the prospects of multi-course intraoperative photodynamic therapy in patients with peritoneal mesothelioma.

  11. Spinal infection: Evaluation with MR imaging and intraoperative spinal US

    Donovan Post, M.J.; Montalvo, B.M.; Quencer, R.M.; Katz, B.H.; Green, B.A.; Elsmont, F.

    1987-01-01

    MR spine images and/or intraoperative US scans in 15 patients were reviewed retrospectively and correlated with clinical and pathologic data to determine the diagnostic value of these modalities in spinal infection. In osteomyelitis and retrospinal abscess MR imaging was definitive; in myelitis it was positive but nonspecific. In epidural abscess concomitant with meningitis, myelography with CT and intraoperative US were superior to MR imaging. Intraoperative US could be used to distinguish these processes and to monitor surgical decompression. The authors recommend that MR imaging be performed at the screening examination in cases of spinal infection, accompanied by intraoperative US in all surgical cases

  12. In vivo virtual intraoperative surgical photoacoustic microscopy

    Han, Seunghoon; Kim, Sehui; Kim, Jeehyun; Lee, Changho; Jeon, Mansik; Kim, Chulhong

    2013-01-01

    We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo

  13. Intraoperative radiation therapy for glioblastoma multiforme

    Matsutani, Masao; Tanaka, Yoshiaki; Matsuda, Tadayoshi

    1986-01-01

    Intraoperative radiation therapy (IOR) is quite applicable for radioresistant malignant gliomas, because of precise demarcations of the treatment volume under direct vision, minimum damage to surrounding normal tissues, and a high target absorbed dose of 1500 to 2000 rad. Fifteen patients with glioblatoma were treated with IOR, and the 2-year survival rate was 61.1 %. The result apparently indicate that areas adjacent to the margin of almost complete removal should be irradated with a sufficient dose to sterilize the remaining malignant remnants, and IOR is one of the logical treatment modalities for local control of malignant gliomas. (author)

  14. In vivo virtual intraoperative surgical photoacoustic microscopy

    Han, Seunghoon, E-mail: hsh860504@gmail.com; Kim, Sehui, E-mail: sehui0916@nate.com; Kim, Jeehyun, E-mail: jeehk@knu.ac.kr, E-mail: chulhong@postech.edu [School of Electrical Engineering and Computer Science, Kyungpook National University, Daegu 702-701 (Korea, Republic of); Lee, Changho, E-mail: ch31037@postech.edu; Jeon, Mansik, E-mail: msjeon@postech.edu [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Kim, Chulhong, E-mail: jeehk@knu.ac.kr, E-mail: chulhong@postech.edu [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, New York 14221 (United States)

    2013-11-11

    We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo.

  15. Versatile intraoperative MRI in neurosurgery and radiology.

    Yrjänä, S K; Katisko, J P; Ojala, R O; Tervonen, O; Schiffbauer, H; Koivukangas, J

    2002-03-01

    Several models for the application of intra-operative magnetic resonance imaging (IMRI) have recently been reported, most of them unique. Two fundamental issues need to be addressed: optimal use of the scanner to ensure a wide base for research, development and clinical application, and an organisational model that facilitates such use. While in our setting the IMRI project was initiated by the neurosurgeons, the need for wider use of the facilities was recognised since the beginning of the planning phase in 1996. An organisational model was developed that allowed for development of neurosurgical applications, radiological imaging, and radiological interventions and for the research and development work of the vendor. A resistive 0.23 T MR scanner was installed in a dedicated operating room environment. Unique to this scanner is the ability to turn off the magnet, allowing for normal OR activities and devices, and to turn on the magnet as needed with a relatively short six-minute ramp up time. A staged surgical technique was perfected, allowing for transfer of data to the neuronavigator outside the scanner during surgery. In neurosurgery, IMRI was used as one part of a neuronavigational system that included ultrasound imaging, intra-operative cortical stimulation during awake procedures, electrocorticography and two neuronavigators. 34 neurosurgical cases included 27 brain tumour resections, 5 brain tumour biopsies, 1 extirpation of an arterio-venous malformation, and 1 haematoma evacuation. The scanner could also be used for normal clinical imaging where obese patients, children, claustophobic patients and postoperative control examinations were the major groups. The radiologists performed 110 interventions, including bone and abdominal biopsies, nerve root infiltrations and local pain therapies, with the optical needle tracking system under continuous MRI guidance. The organisational model allowed frequent use of the facilities for both neurosurgery and radiology

  16. Gamma astronomy

    Cesarsky, C.; Cesarsky, J.P.

    1986-01-01

    This article overviews the gamma astronomy research. Sources already observed, and what causes to give to them; the galactic radiation and its interpretation; techniques already used and current projects [fr

  17. Gamma Spectroscopy

    Niemantsverdriet, J.W.; Butz, Tilman; Ertl, G.; Knözinger, H.; Schüth, F.

    2008-01-01

    No abstract. The sections in this article are 1 Introduction 2 Mössbauer Spectroscopy 3 Time-Differential Perturbed Angular Correlations (TDPAC) 4 Conclusions and Outlook Keywords: Mössbauer spectroscopy; gamma spectroscopy; perturbed angular correlation; TDPAC

  18. Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults

    Charles M. Giattino

    2017-05-01

    Full Text Available Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD. Delirium and POCD are each associated with decreased quality of life, early retirement, increased 1-year mortality, and long-term cognitive decline. Multiple investigators have thus suggested that anesthesia and surgery place severe stress on the aging brain, and that patients with less ability to withstand this stress will be at increased risk for developing postoperative delirium and POCD. Delirium and POCD risk are increased in patients with lower preoperative cognitive function, yet preoperative cognitive function is not routinely assessed, and no intraoperative physiological predictors have been found that correlate with lower preoperative cognitive function. Since general anesthesia causes alpha-band (8–12 Hz electroencephalogram (EEG power to decrease occipitally and increase frontally (known as “anteriorization”, and anesthetic-induced frontal alpha power is reduced in older adults, we hypothesized that lower intraoperative frontal alpha power might correlate with lower preoperative cognitive function. Here, we provide evidence that such a correlation exists, suggesting that lower intraoperative frontal alpha power could be used as a physiological marker to identify older adults with lower preoperative cognitive function. Lower intraoperative frontal alpha power could thus be used to target these at-risk patients for possible therapeutic interventions to help prevent postoperative delirium and POCD, or for increased postoperative monitoring and follow-up. More generally, these results suggest that understanding interindividual differences in how the brain responds to anesthetic drugs can be used as a probe of neurocognitive function (and dysfunction, and might be a useful measure of neurocognitive function in older adults.

  19. Brain tumors in eloquent areas: A European multicenter survey of intraoperative mapping techniques, intraoperative seizures occurrence, and antiepileptic drug prophylaxis.

    Spena, Giannantonio; Schucht, Philippe; Seidel, Kathleen; Rutten, Geert-Jan; Freyschlag, Christian Franz; D'Agata, Federico; Costi, Emanule; Zappa, Francesca; Fontanella, Marco; Fontaine, Denys; Almairac, Fabien; Cavallo, Michele; De Bonis, Pasquale; Conesa, Gerardo; Foroglou, Nicholas; Gil-Robles, Santiago; Mandonnet, Emanuel; Martino, Juan; Picht, Thomas; Viegas, Catarina; Wager, Michel; Pallud, Johan

    2017-04-01

    Intraoperative mapping and monitoring techniques for eloquent area tumors are routinely used world wide. Very few data are available regarding mapping and monitoring methods and preferences, intraoperative seizures occurrence and perioperative antiepileptic drug management. A questionnaire was sent to 20 European centers with experience in intraoperative mapping or neurophysiological monitoring for the treatment of eloquent area tumors. Fifteen centers returned the completed questionnaires. Data was available on 2098 patients. 863 patients (41.1%) were operated on through awake surgery and intraoperative mapping, while 1235 patients (58.8%) received asleep surgery and intraoperative electrophysiological monitoring or mapping. There was great heterogeneity between centers with some totally AW oriented (up to 100%) and other almost totally ASL oriented (up to 92%) (31% SD). For awake surgery, 79.9% centers preferred an asleep-awake-asleep anesthesia protocol. Only 53.3% of the centers used ECoG or transcutaneous EEG. The incidence of intraoperative seizures varied significantly between centers, ranging from 2.5% to 54% (p mapping technique and the risk of intraoperative seizures. Moreover, history of preoperative seizures can significantly increase the risk of intraoperative seizures (p mapping and monitoring protocols and the management of peri- and intraoperative seizures. This data can help identify specific aspects that need to be investigated in prospective and controlled studies.

  20. Intraoperative MRI in pediatric brain tumors

    Choudhri, Asim F. [Le Bonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Siddiqui, Adeel [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Klimo, Paul; Boop, Frederick A. [University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Semmes-Murphey Neurologic and Spine Institute, Memphis, TN (United States); St. Jude Children' s Hospital, Division of Neurosurgery, Department of Surgery, Memphis, TN (United States)

    2015-09-15

    Intraoperative magnetic resonance imaging (iMRI) has emerged as an important tool in guiding the surgical management of children with brain tumors. Recent advances have allowed utilization of high field strength systems, including 3-tesla MRI, resulting in diagnostic-quality scans that can be performed while the child is on the operating table. By providing information about the possible presence of residual tumor, it allows the neurosurgeon to both identify and resect any remaining tumor that is thought to be safely accessible. By fusing the newly obtained images with the surgical guidance software, the images have the added value of aiding in navigation to any residual tumor. This is important because parenchyma often shifts during surgery. It also gives the neurosurgeon insight into whether any immediate postoperative complications have occurred. If any complications have occurred, the child is already in the operating room and precious minutes lost in transport and communications are saved. In this article we review the three main approaches to an iMRI system design. We discuss the possible roles for iMRI during intraoperative planning and provide guidance to help radiologists and neurosurgeons alike in the collaborative management of these children. (orig.)

  1. Intraoperative MRI in pediatric brain tumors

    Choudhri, Asim F.; Siddiqui, Adeel; Klimo, Paul; Boop, Frederick A.

    2015-01-01

    Intraoperative magnetic resonance imaging (iMRI) has emerged as an important tool in guiding the surgical management of children with brain tumors. Recent advances have allowed utilization of high field strength systems, including 3-tesla MRI, resulting in diagnostic-quality scans that can be performed while the child is on the operating table. By providing information about the possible presence of residual tumor, it allows the neurosurgeon to both identify and resect any remaining tumor that is thought to be safely accessible. By fusing the newly obtained images with the surgical guidance software, the images have the added value of aiding in navigation to any residual tumor. This is important because parenchyma often shifts during surgery. It also gives the neurosurgeon insight into whether any immediate postoperative complications have occurred. If any complications have occurred, the child is already in the operating room and precious minutes lost in transport and communications are saved. In this article we review the three main approaches to an iMRI system design. We discuss the possible roles for iMRI during intraoperative planning and provide guidance to help radiologists and neurosurgeons alike in the collaborative management of these children. (orig.)

  2. [Threefold intraoperative electrophysiological monitoring of vestibular neurectomy].

    Hausler, R; Kasper, A

    1991-01-01

    A threefold intraoperative monitoring of facial nerve, auditory nerve and vestibular nerve function was performed in 14 cases of retrosigmoidal neurectomy. The facial nerve was monitoring with a pressure transducer placed against the cheek (Opalarm system). The auditory nerve was monitored with acoustically (click) evoked early potentials and the vestibular nerve was monitored with electrically evoked vestibular potentials obtained by direct stimulation (biphasic current pulses of 0.75-mA p-p, 100 us, 20/s) of the exposed vestibular nerve in the cerebellopontine angle before, during and after neurectomy. A characteristic vertex negative peak having a latency of approximately 2 ms and approximately 0.5 uV amplitude was obtained between a forehead and an ipsilateral ear lobe electrode (2 x 1,000 averaged responses over 10 ms) before the neurectomy. This response disappeared after selective vestibular nerve section proximal to the stimulation site. A diminished response amplitude was measured after incomplete nerve section. Simultaneous acoustic masking had no influence on the vestibular potential. The 14 operated patients became all free of vertiginous spells and drop-attacks except one patient who developed a contralateral Menière's. Facial nerve function remained normal in all. Hearing preservation was obtained in 12 patients (86%). The threefold intraoperative monitoring has turned out to be an additional safety factor for facial and auditory nerve preservation and, thanks to the recording of vestibular potentials, it increased the efficiency of vestibular neurectomy.

  3. Intraoperative irradiation in advanced cervical cancer

    Delgado, G.; Goldson, A.L.; Ashayeri, E.; Petrilli, E.S.

    1987-01-01

    Conventional treatment of cervical cancer, such as radical hysterectomy with lymphadenectomy or pelvic exenteration, is limited to the pelvis. Standard radio-therapeutic treatment is a combination of external-beam radiotherapy to the pelvis and intracavitary applications. However, there is a group of patients for whom external radiotherapy alone has limitations. This group consists primarily of patients with large pelvic lymph nodes containing metastatic cancer, metastatically involved paraaortic lymph nodes outside the usual pelvic radiation field, or large central tumors with parametrial involvement. In patients with cancer of the cervix, the incidence of metastasis to paraaortic lymph nodes is high. Attempts to treat paraaortic nodes with external radiotherapy have resulted in high complication rates because the treatment field includes the highly sensitive gastrointestinal tract. External radiation therapy after retroperitoneal exploration of lymph nodes does not seem to improve survival. In an attempt to circumvent the morbidity and mortality associated with conventional external-beam irradiation, the authors initiated a pilot study of intraoperative electron-beam irradiation of the paraaortic nodes and of the large metastatic lymph nodes in the pelvis. The intraoperative boost was followed by conventional fractionated external-beam irradiation. The theoretical advantages of this procedure include a higher radiation tumor dose without a concomitant increase in treatment morbidity and mortality

  4. BrachyView: Proof-of-principle of a novel in-body gamma camera for low dose-rate prostate brachytherapy

    Petasecca, M.; Loo, K. J.; Safavi-Naeini, M.; Han, Z.; Metcalfe, P. E.; Lerch, M. L. F.; Qi, Y.; Rosenfeld, A. B.; Meikle, S.; Pospisil, S.; Jakubek, J.; Bucci, J. A.; Zaider, M.

    2013-01-01

    Purpose: The conformity of the achieved dose distribution to the treatment plan strongly correlates with the accuracy of seed implantation in a prostate brachytherapy treatment procedure. Incorrect seed placement leads to both short and long term complications, including urethral and rectal toxicity. The authors present BrachyView, a novel concept of a fast intraoperative treatment planning system, to provide real-time seed placement information based on in-body gamma camera data. BrachyView combines the high spatial resolution of a pixellated silicon detector (Medipix2) with the volumetric information acquired by a transrectal ultrasound (TRUS). The two systems will be embedded in the same probe so as to provide anatomically correct seed positions for intraoperative planning and postimplant dosimetry. Dosimetric calculations are based on the TG-43 method using the real position of the seeds. The purpose of this paper is to demonstrate the feasibility of BrachyView using the Medipix2 pixel detector and a pinhole collimator to reconstruct the real-time 3D position of low dose-rate brachytherapy seeds in a phantom. Methods: BrachyView incorporates three Medipix2 detectors coupled to a multipinhole collimator. Three-dimensionally triangulated seed positions from multiple planar images are used to determine the seed placement in a PMMA prostate phantom in real time. MATLAB codes were used to test the reconstruction method and to optimize the device geometry. Results: The results presented in this paper show a 3D position reconstruction accuracy of the seed in the range of 0.5–3 mm for a 10–60 mm seed-to-detector distance interval (Z direction), respectively. The BrachyView system also demonstrates a spatial resolution of 0.25 mm in the XY plane for sources at 10 mm distance from Medipix2 detector plane, comparable to the theoretical value calculated for an equivalent gamma camera arrangement. The authors successfully demonstrated the capability of BrachyView for

  5. BrachyView: proof-of-principle of a novel in-body gamma camera for low dose-rate prostate brachytherapy.

    Petasecca, M; Loo, K J; Safavi-Naeini, M; Han, Z; Metcalfe, P E; Meikle, S; Pospisil, S; Jakubek, J; Bucci, J A; Zaider, M; Lerch, M L F; Qi, Y; Rosenfeld, A B

    2013-04-01

    The conformity of the achieved dose distribution to the treatment plan strongly correlates with the accuracy of seed implantation in a prostate brachytherapy treatment procedure. Incorrect seed placement leads to both short and long term complications, including urethral and rectal toxicity. The authors present BrachyView, a novel concept of a fast intraoperative treatment planning system, to provide real-time seed placement information based on in-body gamma camera data. BrachyView combines the high spatial resolution of a pixellated silicon detector (Medipix2) with the volumetric information acquired by a transrectal ultrasound (TRUS). The two systems will be embedded in the same probe so as to provide anatomically correct seed positions for intraoperative planning and postimplant dosimetry. Dosimetric calculations are based on the TG-43 method using the real position of the seeds. The purpose of this paper is to demonstrate the feasibility of BrachyView using the Medipix2 pixel detector and a pinhole collimator to reconstruct the real-time 3D position of low dose-rate brachytherapy seeds in a phantom. BrachyView incorporates three Medipix2 detectors coupled to a multipinhole collimator. Three-dimensionally triangulated seed positions from multiple planar images are used to determine the seed placement in a PMMA prostate phantom in real time. MATLAB codes were used to test the reconstruction method and to optimize the device geometry. The results presented in this paper show a 3D position reconstruction accuracy of the seed in the range of 0.5-3 mm for a 10-60 mm seed-to-detector distance interval (Z direction), respectively. The BrachyView system also demonstrates a spatial resolution of 0.25 mm in the XY plane for sources at 10 mm distance from Medipix2 detector plane, comparable to the theoretical value calculated for an equivalent gamma camera arrangement. The authors successfully demonstrated the capability of BrachyView for real-time imaging (using a 3 s

  6. Serial assessment of doxorubicin cardiomyopathy with the computerized scintillation probe

    Strashun, A.; Goldsmith, S.J.; Horowitz, S.F.

    1982-01-01

    Cardiac function was serially monitored in 55 patients receiving adriamycin chemotherapy over 18 months with quantitative radionuclide assessment by both a nonimaging computerized scintillation probe and gamma camera-computer imaging. Interval ejection fraction change was comparable with both techniques and predicted incipient cardiotoxicity. Probe data revealed ejection fraction decline was antedated by decline left ventricular emptying and filling rates

  7. The Resection Map : A proposal for intraoperative hepatectomy guidance

    Lamata, P.; Jalote-Parmar, A.; Lamata, F.; Declerck, J.

    2008-01-01

    Objective - To propose a new concept of an intra-operative 3D visualisation system to support hepatectomies. This system aims at improving the transfer of pre-operative planning into the intra-operative stage, both in laparoscopic and open approaches. Materials and methods - User (surgeon) centred

  8. IVVS probe mechanical concept design

    Rossi, Paolo, E-mail: paolo.rossi@enea.it; Neri, Carlo; De Collibus, Mario Ferri; Mugnaini, Giampiero; Pollastrone, Fabio; Crescenzi, Fabio

    2015-10-15

    Highlights: • ENEA designed, developed and tested a laser based In Vessel Viewing System (IVVS). • IVVS mechanical design has been revised from 2011 to 2013 to meet ITER requirements. • Main improvements are piezoceramic actuators and a step focus system. • Successful qualification activities validated the concept design for ITER environment. - Abstract: ENEA has been deeply involved in the design, development and testing of a laser based In Vessel Viewing System (IVVS) required for the inspection of ITER plasma-facing components. The IVVS probe shall be deployed into the vacuum vessel, providing high resolution images and metrology measurements to detect damages and possible erosion. ENEA already designed and manufactured an IVVS probe prototype based on a rad-hard concept and driven by commercial micro-step motors, which demonstrated satisfying viewing and metrology performances at room conditions. The probe sends a laser beam through a reflective rotating prism. By rotating the axes of the prism, the probe can scan all the environment points except those present in a shadow cone and the backscattered light signal is then processed to measure the intensity level (viewing) and the distance from the probe (metrology). During the last years, in order to meet all the ITER environmental conditions, such as high vacuum, gamma radiation lifetime dose up to 5 MGy, cumulative neutron fluence of about 2.3 × 10{sup 17} n/cm{sup 2}, temperature of 120 °C and magnetic field of 8 T, the probe mechanical design was significantly revised introducing a new actuating system based on piezo-ceramic actuators and improved with a new step focus system. The optical and mechanical schemes have been then modified and refined to meet also the geometrical constraints. The paper describes the mechanical concept design solutions adopted in order to fulfill IVVS probe functional performance requirements considering ITER working environment and geometrical constraints.

  9. Gamma camera

    Berninger, W.H.

    1975-01-01

    The light pulse output of a scintillator, on which incident collimated gamma rays impinge, is detected by an array of photoelectric tubes each having a convexly curved photocathode disposed in close proximity to the scintillator. Electronic circuitry connected to outputs of the phototubes develops the scintillation event position coordinate electrical signals with good linearity and with substantial independence of the spacing between the scintillator and photocathodes so that the phototubes can be positioned as close to the scintillator as is possible to obtain less distortion in the field of view and improved spatial resolution as compared to conventional planar photocathode gamma cameras

  10. Intraoperative nerve monitoring in laryngotracheal surgery.

    Bolufer, Sergio; Coves, María Dolores; Gálvez, Carlos; Villalona, Gustavo Adolfo

    Laryngotracheal surgery has an inherent risk of injury to the recurrent laryngeal nerves (RLN). These complications go from minor dysphonia to even bilateral vocal cord paralysis. The intraoperative neuromonitoring of the RLN was developed in the field of thyroid surgery, in order to preserve nerve and vocal cord function. However, tracheal surgery requires in-field intubation of the distal trachea, which limits the use of nerve monitoring using conventional endotracheal tube with surface electrodes. Given these challenges, we present an alternative method for nerve monitoring during laryngotracheal surgery through the insertion of electrodes within the endolaryngeal musculature by bilateral puncture. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Overview of intraoperative MRI in neurosurgery

    Shiino, Akihiko; Matsuda, Masayuki

    2002-01-01

    This review describes usefulness, prospect and present problems of intraoperative MRI in neurosurgery. MRI equipments for the surgery have to have a wide, open space and have those magnets of short cylindrical, biplanar (clam shell), dual air core superconducting solenoidal (double doughnut) and targeted FOV (field of view) type. Devices required for the surgery are specific and in author's facility, they are classified into 4 zones depending on the region of their use. Application of the surgery involves biopsy, drainage of cyst and abscess, hematoma evacuation, nerve block, thermotherapy (interstitial laser, RF ablation, focused untrasonic and cryosurgery), local drug therapy, chemoablation, vascular intervention and tumor extraction, of which actual procedures and pictures are presented together with, in particular, MR-guided thermotherapy, ablation therapy of brain tumors, endoscopic surgery and minimally invasive therapy of the spine. A navigation software, 3D SlicerTM system, is introduced for interventional imaging. Safety measures are emphasized for the operation. (K.H.)

  12. Overview of intraoperative MRI in neurosurgery

    Shiino, Akihiko; Matsuda, Masayuki [Shiga Univ. of Medical Science, Otsu (Japan)

    2002-01-01

    This review describes usefulness, prospect and present problems of intraoperative MRI in neurosurgery. MRI equipments for the surgery have to have a wide, open space and have those magnets of short cylindrical, biplanar (clam shell), dual air core superconducting solenoidal (double doughnut) and targeted FOV (field of view) type. Devices required for the surgery are specific and in author's facility, they are classified into 4 zones depending on the region of their use. Application of the surgery involves biopsy, drainage of cyst and abscess, hematoma evacuation, nerve block, thermotherapy (interstitial laser, RF ablation, focused untrasonic and cryosurgery), local drug therapy, chemoablation, vascular intervention and tumor extraction, of which actual procedures and pictures are presented together with, in particular, MR-guided thermotherapy, ablation therapy of brain tumors, endoscopic surgery and minimally invasive therapy of the spine. A navigation software, 3D SlicerTM system, is introduced for interventional imaging. Safety measures are emphasized for the operation. (K.H.)

  13. Intraoperative radiotherapy. Clinical experiences and results

    Calvo, F.A.; Santos, M. (Clinica Universitaria, Dept. of Oncology, Service of Radiotherapy, Pamplona (Spain)); Brady, L.W. (Hahnemann Univ., Dept. of Radiation Oncology, Philadelphia, PA (United States)) (eds.)

    1992-01-01

    This monograph reports on the largest clinical series to date in which intraoperative radiation therapy (IORT) has been used in mulitdisciplinary treatment programs for tumors of various sites and differing histological sybtype. It represents the product of 5 years' intensive work by physicians active at a leading European institution. The findings are supplemented by a thorough review of the data presented worldwide during the last two decades. The results in this book are meticulously presented and focus on the most important features of clinical research reports based on phase I-II studies (toxicity, local tumor control, and survival data). The tumor sites and histologies analyzed are: head and neck cancer, lung cancer, gastric cancer, pancreatic cancer, colorectal cancer, bladder cancer, gynecologic cancer, soft tissue sarcomas of the extremities, retroperitoneal and other central soft issue sarcomas, Ewing's sarcoma, osteosarcoma, and intracranial tumors. (orig./MG) With 60 figs.

  14. Intra-operative radiation treatment of cancers

    Dubois, J.B.; Joyeux, H.; Solassol, C.; Pujol, H.

    1986-01-01

    Intra-operative radiation treatment (I.O.R.T.) is concerning the treatment either of an unresectable tumor or of tumor bed after complete excision of a primary tumor and its first draining lymph nodes. We describe X-ray and electrons techniques and we discuss the delivered doses according to experimental and clinical data. According to the residual disease (macroscopic or microscopic), to the healthy tissues in the target volume, and the histological type, single doses from 20 Gy to 40 Gy can be delivered. Our preliminary results are reported: 25 patients with resectable tumors of the cardia, the stomach and the pancreas, 5 patients with pelvic recurrences of colon and rectum carcinomas. Therapeutic results of the I.O.R.T. providing from the literature are discussed. The I.O.R.T. indications are defined as palliative (unresectable tumors) and curative (irradiation of tumor bed after complete excision of the tumor) [fr

  15. Intraoperative radiotherapy for locally advanced refractory cancer

    Abe, Mitsuyuki; Takahashi, Masaji; Ono, Koji; Dodo, Yoshihiro; Hiraoka, Masahiro [Kyoto Univ. (Japan). Faculty of Medicine

    1983-05-01

    Clinical results of intraoperative radiotherapy (IOR) in carcinoma of the stomach and prostate, and malignant soft tissue tumors are reported. The 5-year survival rate was found to be increased by IOR in stages II-IV gastric cancer. From the analysis of the clinical results of prostatic cancer, a single dose of 3,500 rad was considered to be a potential curative dose for the tumor less than 3 cm in diameter. The local recurrence rate of patients with malignant soft tissue tumors who received a single dose ranging from 3,000 to 4,500 rad was 5.9 and the 5-year survival rate was 64.6 %.

  16. Brain mapping in tumors: intraoperative or extraoperative?

    Duffau, Hugues

    2013-12-01

    In nontumoral epilepsy surgery, the main goal for all preoperative investigation is to first determine the epileptogenic zone, and then to analyze its relation to eloquent cortex, in order to control seizures while avoiding adverse postoperative neurologic outcome. To this end, in addition to neuropsychological assessment, functional neuroimaging and scalp electroencephalography, extraoperative recording, and electrical mapping, especially using subdural strip- or grid-electrodes, has been reported extensively. Nonetheless, in tumoral epilepsy surgery, the rationale is different. Indeed, the first aim is rather to maximize the extent of tumor resection while minimizing postsurgical morbidity, in order to increase the median survival as well as to preserve quality of life. As a consequence, as frequently seen in infiltrating tumors such as gliomas, where these lesions not only grow but also migrate along white matter tracts, the resection should be performed according to functional boundaries both at cortical and subcortical levels. With this in mind, extraoperative mapping by strips/grids is often not sufficient in tumoral surgery, since in essence, it allows study of the cortex but cannot map subcortical pathways. Therefore, intraoperative electrostimulation mapping, especially in awake patients, is more appropriate in tumor surgery, because this technique allows real-time detection of areas crucial for cerebral functions--eloquent cortex and fibers--throughout the resection. In summary, rather than choosing one or the other of different mapping techniques, methodology should be adapted to each pathology, that is, extraoperative mapping in nontumoral epilepsy surgery and intraoperative mapping in tumoral surgery. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

  17. Best practices to optimize intraoperative photography.

    Gaujoux, Sébastien; Ceribelli, Cecilia; Goudard, Geoffrey; Khayat, Antoine; Leconte, Mahaut; Massault, Pierre-Philippe; Balagué, Julie; Dousset, Bertrand

    2016-04-01

    Intraoperative photography is used extensively for communication, research, or teaching. The objective of the present work was to define, using a standardized methodology and literature review, the best technical conditions for intraoperative photography. Using either a smartphone camera, a bridge camera, or a single-lens reflex (SLR) camera, photographs were taken under various standard conditions by a professional photographer. All images were independently assessed blinded to technical conditions to define the best shooting conditions and methods. For better photographs, an SLR camera with manual settings should be used. Photographs should be centered and taken vertically and orthogonal to the surgical field with a linear scale to avoid error in perspective. The shooting distance should be about 75 cm using an 80-100-mm focal lens. Flash should be avoided and scialytic low-powered light should be used without focus. The operative field should be clean, wet surfaces should be avoided, and metal instruments should be hidden to avoid reflections. For SLR camera, International Organization for Standardization speed should be as low as possible, autofocus area selection mode should be on single point AF, shutter speed should be above 1/100 second, and aperture should be as narrow as possible, above f/8. For smartphone, use high dynamic range setting if available, use of flash, digital filter, effect apps, and digital zoom is not recommended. If a few basic technical rules are known and applied, high-quality photographs can be taken by amateur photographers and fit the standards accepted in clinical practice, academic communication, and publications. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. [The use of intraoperative Doppler ultrasound in endoscopic transsphenoidal surgery].

    Sharipov, O I; Kutin, M A; Kalinin, P L; Fomichev, D V; Lukshin, V A; Kurnosov, A B

    2016-01-01

    Doppler ultrasound (DUS) has been widely used in neurosurgical practice to diagnose various cerebrovascular diseases. This technique is used in transsphenoidal surgery to identify the localization of intracranial arteries when making an approach or during tumor resection. To identify the cavernous segment of the internal carotid artery (ICA) and/or basilar artery during endoscopic transsphenoidal surgery, we used a combined device on the basis of a click line curette («Karl Storz») and a 16 MHz Doppler probe (Lassamed). The technique was used in 51 patients during both standard transsphenoidal surgery (23 cases) and transsphenoidal tumor resection through an extended approach (28 cases). Doppler ultrasound was used in different situations: to determine a trajectory of the endonasal transsphenoidal approach in the absence of the normal anatomical landmarks (16 cases), to define the limits of safe resection of a tumor located in the laterosellar region (7), and to implement an extended transsphenoidal endoscopic approach (28). Intraoperative Doppler ultrasound enabled identification of the cavernous segment of the internal carotid artery in 45 cases and the basilar artery in 2 cases; a blood vessel was not found in 4 cases. Injury to the cavernous segment of the internal carotid artery was observed only in 1 case. The use of the described combined device in transsphenoidal surgery turned Doppler ultrasound into an important and useful technique for visualization of the ICA within the tumor stroma as well as in the case of the changed skull base anatomy. Its use facilitates manipulations in a deep and narrow wound and enables inspection of the entire surface of the operative field in various planes, thereby surgery becomes safer due to the possibility of maximum investigation of the operative field.

  19. Intraoperative radiotherapy in primary rectal cancer; Intraoperative Radiotherapie des primaeren Rektumkarzinoms

    Mund, Christian

    2013-06-17

    According to the results of several studies intraoperative radiotherapy seems to influence local control for primary rectal cancer in UICC-Stage II / III positively, though recommendations in therapy cannot be given as studies of high evidence level do not exist. As IORT is rarely available and makes patient recruitment difficult, prospective randomised trials have not been carried out yet. This emphasizes the importance of non-randomised trials for an evaluation of IORT. A comparison of 21 patients with locally advanced rectal cancer who had been treated with intraoperative radiation therapy and 21 similar cases without an application of IORT could not show any significant improvements in prognosis (recurrences, metastases and disease-specific survival). Nevertheless the employment of intraoperative radiation showed a trend in improvement of local control. This hast been shown by several other studies before. Thus the application of IORT in patients with locally advanced rectal cancer is considered a useful part in multimodal treatment and should further be evaluated in specialized centres. In case-control studies 1:1-matching leads to a good comparability of groups and renders conclusions of high internal validity possible. To gain a sufficient power, this type of trials should however primarily be carried out by centres with a high number of cases.

  20. Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

    Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

    2017-12-01

    3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

  1. Gamma camera

    Tschunt, E.; Platz, W.; Baer, Ul; Heinz, L.

    1978-01-01

    A gamma camera has a plurality of exchangeable collimators, one of which is replaceably mounted in the ray inlet opening of the camera, while the others are placed on separate supports. Supports are swingably mounted upon a column one above the other

  2. Gamma camera

    Schlosser, P.A.; Steidley, J.W.

    1980-01-01

    The design of a collimation system for a gamma camera for use in nuclear medicine is described. When used with a 2-dimensional position sensitive radiation detector, the novel system can produce superior images than conventional cameras. The optimal thickness and positions of the collimators are derived mathematically. (U.K.)

  3. INTRAOPERATIVE RADIOFREQUENCY AND CRYOABLATION FOR ATRIAL FIBRILLATION IN PATIENTS WITH VALVULAR HEART DISEASE

    N. Maghamipour N. Safaie

    2007-05-01

    Full Text Available Patients with valvular heart disease and suffering atrial fibrillation of more than 12 months duration have a low probability of remaining in sinus rhythm after valve surgery alone. We performed intra-operative radiofrequency ablation or cryoablation as an alternative to surgical maze ІІІ procedure to create linear lesion lines for conversion of this arrhythmia to sinus rhythm. A total of 30 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant maze procedure with radiofrequency or cryo probes. These patients aged 48.10 ± 9.84 years in radiofrequency ablation group and 51.10 ± 13.93 years in cryoablation group. Both atrial ablation with radiofrequency probes, needed 26.15 ± 3.67 min extra ischemic time and ablation by mean of cryo-probes needed an extra ischemic time of 29.62 ± 4.27 min. There was one in hospital death postoperatively because of respiratory failure but no other complication. 6 months after the operation, among 30 patients with both atrial ablations, 25 patients were in sinus rhythm, no patient had junctional rhythm and 5 patients had persistent atrial fibrillation. At 12 months follow up, freedom from atrial fibrillation was 85% in radiofrequency group and 80% in cryo group. Doppler echocardiography in these patients demonstrated atrial contractility in 70% of the patients. Intraoperative radiofrequency or cryo-ablation of both atriums are effective and less invasive alternatives for the original maze procedure to eliminate the atrial fibrillation, and can be done in patients with valvular heart disease without increasing the risk of operation.

  4. The value of intraoperative sonography in low grade glioma surgery.

    Petridis, Athanasios K; Anokhin, Maxim; Vavruska, Jan; Mahvash, Mehran; Scholz, Martin

    2015-04-01

    There is a number of different methods to localize a glioma intraoperatively. Neuronavigation, intraoperative MRI, 5-aminolevulinic acid, as well as intraoperative sonography. Every method has its advantages and disadvantages. Low grade gliomas do not show a specific signal with 5-aminolevulinic acid and are difficult to distinguish macroscopically from normal tissue. In the present study we stress out the importance of intraoperative diagnostic ultrasound for localization of low grade gliomas. We retrospectively evaluated the charts and MRIs of 34 patients with low grade gliomas operated in our department from 2011 until December 2014. The efficacy of ultrasound as an intraoperative navigational tool was assessed. In 15 patients ultrasound was used and in 19 not. Only histologically proven low grades gliomas (astrocytomas grade II) were evaluated. In none of the patients where ultrasound (combined with neuronavigation) was used (N=15) to find the tumors, the target was missed, whereas the exclusive use of neuronavigation missed the target in 5 of 19 cases of small subcortical low grade gliomas. Intraoperative ultrasound is an excellent tool in localizing low grade gliomas intraoperatively. It is an inexpensive, real time neuronavigational tool, which overcomes brain shift. Even when identifying the tumors with ultrasound is very reliable, the extend of resection and the decision to remove any residual tumor with the help of ultrasound is at the moment unreliable. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. [Cost analysis of intraoperative neurophysiological monitoring (IOM)].

    Kombos, T; Suess, O; Brock, M

    2002-01-01

    A number of studies demonstrate that a significant reduction of postoperative neurological deficits can be achieved by applying intraoperative neurophysiological monitoring (IOM) methods. A cost analysis of IOM is imperative considering the strained financial situation in the public health services. The calculation model presented here comprises two cost components: material and personnel. The material costs comprise consumer goods and depreciation of capital goods. The computation base was 200 IOM cases per year. Consumer goods were calculated for each IOM procedure respectively. The following constellation served as a basis for calculating personnel costs: (a) a medical technician (salary level BAT Vc) for one hour per case; (b) a resident (BAT IIa) for the entire duration of the measurement, and (c) a senior resident (BAT Ia) only for supervision. An IOM device consisting of an 8-channel preamplifier, an electrical and acoustic stimulator and special software costs 66,467 euros on the average. With an annual depreciation of 20%, the costs are 13,293 euros per year. This amounts to 66.46 euros per case for the capital goods. For reusable materials a sum of 0.75 euro; per case was calculated. Disposable materials were calculate for each procedure respectively. Total costs of 228.02 euro; per case were,s a sum of 0.75 euros per case was calculated. Disposable materials were calculate for each procedure respectively. Total costs of 228.02 euros per case were, calculated for surgery on the peripheral nervous system. They amount to 196.40 euros per case for spinal interventions and to 347.63 euros per case for more complex spinal operations. Operations in the cerebellopontine angle and brain stem cost 376.63 euros and 397.33 euros per case respectively. IOM costs amount to 328.03 euros per case for surgical management of an intracranial aneurysm and to 537.15 euros per case for functional interventions. Expenses run up to 833.63 euros per case for operations near the

  6. Gamma-ray bursts at high redshift

    Wijers, R.A.M.J.

    1999-01-01

    Gamma-ray bursts are much brighter than supernovae, and could therefore possibly probe the Universe to high redshift. The presently established GRB redshifts range from 0.83 to 5, and quite possibly even beyond that. Since most proposed mechanisms for GRB link them closely to deaths of massive

  7. Gamma camera

    Reiss, K.H.; Kotschak, O.; Conrad, B.

    1976-01-01

    A gamma camera with a simplified setup as compared with the state of engineering is described permitting, apart from good localization, also energy discrimination. Behind the usual vacuum image amplifier a multiwire proportional chamber filled with trifluorine bromium methane is connected in series. Localizing of the signals is achieved by a delay line, energy determination by means of a pulse height discriminator. With the aid of drawings and circuit diagrams, the setup and mode of operation are explained. (ORU) [de

  8. Gamma irradiator

    Simonet, G.

    1986-09-01

    Fiability of devices set around reactors depends on material resistance under irradiation noticeably joints, insulators, which belongs to composition of technical, safety or physical incasurement devices. The irradiated fuel elements, during their desactivation in a pool, are an interesting gamma irradiation device to simulate damages created in a nuclear environment. The existing facility at Osiris allows to generate an homogeneous rate dose in an important volume. The control of the element distances to irradiation box allows to control this dose rate [fr

  9. Gamma teletopography

    Simonet, G.

    1987-06-01

    The mapping of gamma sources radiation emission in a nuclear plant is an important safety point. A remote gamma ray mapping process was developed in SPS/CEA/SACLAY. It uses the ''pinhole camera'' principle, precursor of photography. It mainly consists of a radiation proof box, with a small orifice, containing sensitive emulsions at the opposite. A first conventional photographic type emulsion photographs the area. A second photographic emulsion shows up the gamma radiations. The superim position of the two shots gives immediate informations of the precise location of each source of radiation in the observed area. To make easier the presentation and to improve the accuracy of the results for radiation levels mapping, the obtained films are digitally processed. The processing assigns a colours scale to the various levels of observed radiations. Taking account physical data and standard parameters, it gets possible to estimate the dose rate. The device is portable. Its compactness and fully independent nature make it suitable for use anywhere. It can be adapted to a remote automatic handling system, robot... so as to avoid all operator exposure when the local dose rate is too high [fr

  10. A non-docking intraoperative electron beam applicator system

    Palta, J.R.; Suntharalingam, N.

    1989-01-01

    A non-docking intraoperative radiation therapy electron beam applicator system for a linear accelerator has been designed to minimize the mechanical, electrical, and tumor visualization problems associated with a docking system. A number of technical innovations have been used in the design of this system. These include: (a) a new intraoperative radiation therapy cone design that gives a better dose uniformity in the treatment volume at all depths; (b) a collimation system which reduces the leakage radiation dose to tissues outside the intraoperative radiation therapy cone; (c) a non-docking system with a translational accuracy of 2 mm and a rotational accuracy of 0.5 degrees; and (d) a rigid clamping system for the cones. A comprehensive set of dosimetric characteristics of the intraoperative radiation therapy applicator system is presented

  11. Disparities between resident and attending surgeon perceptions of intraoperative teaching.

    Butvidas, Lynn D; Anderson, Cheryl I; Balogh, Daniel; Basson, Marc D

    2011-03-01

    This study aimed to assess attending surgeon and resident recall of good and poor intraoperative teaching experiences and how often these experiences occur at present. By web-based survey, we asked US surgeons and residents to describe their best and worst intraoperative teaching experiences during training and how often 26 common intraoperative teaching behaviors occur in their current environment. A total of 346 residents and 196 surgeons responded (51 programs; 26 states). Surgeons and residents consistently identified trainee autonomy, teacher confidence, and communication as positive, while recalling negatively contemptuous, arrogant, accusatory, or uncommunicative teachers. Residents described intraoperative teaching behaviors by faculty as substantially less frequent than faculty self-reports. Neither sex nor seniority explained these results, although women reported communicative behaviors more frequently than men. Although veteran surgeons and current trainees agree on what constitutes effective and ineffective teaching in the operating room, they disagree on how often these behaviors occur, leaving substantial room for improvement. Published by Elsevier Inc.

  12. Value of intraoperative radiotherapy in locally advanced rectal cancer

    Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, Joost J. M. E.; Graveland, Wilfried J.; Marinelli, Andreas W. K. S.; van der Sijp, Joost R.; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander M. M.; de Wilt, Johannes H. W.

    PURPOSE: This study was designed to analyze the results of a multimodality treatment using preoperative radiotherapy, followed by surgery and intraoperative radiotherapy in patients with primary locally advanced rectal cancer. METHODS: Between 1987 and 2002, 123 patients with initial unresectable

  13. Presurgical mapping with magnetic source imaging. Comparisons with intraoperative findings

    Roberts, T.P.L.; Ferrari, P.; Perry, D.; Rowley, H.A.; Berger, M.S.

    2000-01-01

    We compare noninvasive preoperative mapping with magnetic source imaging to intraoperative cortical stimulation mapping. These techniques were directly compared in 17 patients who underwent preoperative and postoperative somatosensory mapping of a total of 22 comparable anatomic sites (digits, face). Our findings are presented in the context of previous studies that used magnetic source imaging and functional magnetic resonance imaging as noninvasive surrogates of intraoperative mapping for the identification of sensorimotor and language-specific brain functional centers in patients with brain tumors. We found that magnetic source imaging results were reasonably concordant with intraoperative mapping findings in over 90% of cases, and that concordance could be defined as 'good' in 77% of cases. Magnetic source imaging therefore provides a viable, if coarse, identification of somatosensory areas and, consequently, can guide and reduce the time taken for intraoperative mapping procedures. (author)

  14. Intraoperative contamination influences wound discharge and periprosthetic infection

    Knobben, Bas A. S.; Engelsma, Yde; Neut, Danielle

    Intraoperative bacterial contamination increases risk for postoperative wound-healing problems and periprosthetic infection, but to what extent remains unclear. We asked whether bacterial contamination of the instruments and bone during primary prosthesis insertion was associated with prolonged

  15. Intraoperative management of ETT and LMA cufi pressures: a survey ...

    2008-07-16

    Jul 16, 2008 ... A study done by Stein et al. highlighted the inability of advanced life support ... Conclusion. There is increasing importance placed on quality assurance ... pressures – the worrying reality: a comparative audit of intra-operative.

  16. Association between intraoperative hypotension and myocardial injury after vascular surgery

    van Waes, JAR; Van Klei, Wilton A.; Wijeysundera, Duminda N.; Van Wolfswinkel, Leo; Lindsay, Thomas F.; Beattie, W. Scott

    2016-01-01

    Background: Postoperative myocardial injury occurs frequently after noncardiac surgery and is strongly associated with mortality. Intraoperative hypotension (IOH) is hypothesized to be a possible cause. The aim of this study was to determine the association between IOH and postoperative myocardial

  17. Intraoperative contamination influences wound discharge and periprosthetic infection

    Knobben, Bas A. S.; Engelsma, Yde; Neut, Danielle

    2006-01-01

    Intraoperative bacterial contamination increases risk for postoperative wound-healing problems and periprosthetic infection, but to what extent remains unclear. We asked whether bacterial contamination of the instruments and bone during primary prosthesis insertion was associated with prolonged

  18. Intraoperative transesophageal echocardiography in congenital heart diseases surgery

    Ozores Suarez, Francisco Javier; Perez de Ordaz, Luis Bravo

    2010-01-01

    The intraoperative transesophageal echocardiography is very used in pediatric cardiovascular surgery. The aim of present paper was to determine its impact on the surgery immediate results after a previous experience of authors with this type of procedure

  19. Sentinel lymph node biopsy: An audit of intraoperative assessment ...

    2015-07-02

    Jul 2, 2015 ... Sentinel lymph node biopsy: An audit of ... cytotechnology service ... To audit results from intraoperative assessment of sentinel lymph node ..... out, and turnaround time in gynecologic cytology quality assurance: Findings.

  20. Results of intraoperative radiotherapy for pancreatic cancers

    Okazaki, Atsushi; Shinozaki, Jun; Noda, Masanobu

    1991-01-01

    Reported are the results and observations of the authors who, from July 1986 through December 1989, have used electron beam intraoperative radiotherapy (IORT) on 20 patients with locally advanced pancreatic cancers, said number including 3 patients given a resection. In 14 of the 17 unresected patients, a chief symptom was pain, and 8 patients were given a celiac plexus block at the same time. The results and observations are given below. Life-threatening complications occurred in two patients, i.e., an insufficient pancreatojejunostomy, and a perforative peritonitis. In 12 of 13 evaluable patients, pain control was achieved for a mean period of 5 months, indicating that an IORT with celiac plexus block may be useful for palliation. In the resected patients, the mean survival time was 6 months, whereas in the unresected patients, the mean survival time was 7 months. The common cause of death in the unresected patients was a metastatic dissemination. Finally, in 3 of the 5 unresected patients, marked effects such as massive fibrosis were seen in the pancreatic tumor on autopsy. (author)

  1. Intraoperative radiation therapy for malignant glioma

    Sakai, Noboru; Yamada, Hiromu; Andoh, Takashi; Hirata, Toshifumi; Nishimura, Yasuaki; Miwa, Yoshiaki; Shimizu, Kotoyuki; Yanagawa, Shigeo [Gifu Univ. (Japan). Faculty of Medicine

    1991-11-01

    Intraoperative radiation therapy (IORT) was used as part of the initial therapy for malignant glioma in 32 of 73 patients with histologically verified anaplastic astrocytoma (grade III astrocytoma) and glioblastoma multiforme. The initial treatment for all cases was subtotal or total tumor resection combined with external irradiation and chemotherapy. IORT was performed 1 week after tumor resection, with doses of 10-50 Gy (mean 26.7 Gy) in one session. Fourteen of 32 cases had IORT two times because of tumor recurrence. The IORT patients had survival rates at 24 and 36 months after initial treatment of 57.1 and 33.5% (median survival 26.2 months). The other 41 patients had 23.6 and 13.1% survivals (median survival 20.7 months), which were significantly lower (p<0.01). Tumor recurrence within the original lesion site was suspected because of clinical condition, computed tomography, and magnetic resonance imaging studies in 65.6% of the IORT group (21 cases) 12 months after initial treatment. Twenty cases of death in the IORT group, including five autopsy cases, demonstrated regional tumor recurrence with a high incidence of intraventricular tumor invasion. The authors consider IORT is beneficial for selected malignant glioma patients, including tumor recurrence, because of prolonged survival. (author).

  2. Perspectives in Intraoperative Diagnostics of Human Gliomas

    O. Tyurikova

    2015-01-01

    Full Text Available Amongst large a variety of oncological diseases, malignant gliomas represent one of the most severe types of tumors. They are also the most common type of the brain tumors and account for over half of the astrocytic tumors. According to different sources, the average life expectancy of patients with various glioblastomas varies between 10 and 12 months and that of patients with anaplastic astrocytic tumors between 20 and 24 months. Therefore, studies of the physiology of transformed glial cells are critical for the development of treatment methods. Modern medical approaches offer complex procedures, including the microsurgical tumor removal, radiotherapy, and chemotherapy, supplemented with photodynamic therapy and immunotherapy. The most radical of them is surgical resection, which allows removing the largest part of the tumor, reduces the intracranial hypertension, and minimizes the degree of neurological deficit. However, complete removal of the tumor remains impossible. The main limitations are insufficient visualization of glioma boundaries, due to its infiltrative growth, and the necessity to preserve healthy tissue. This review is devoted to the description of advantages and disadvantages of modern intraoperative diagnostics of human gliomas and highlights potential perspectives for development of their treatment.

  3. Proximal Probes Facility

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  4. Probe Techniques. Introductory Remarks

    Emeleus, K. G. [School of Physics and Applied Mathematics, Queen' s University, Belfast (United Kingdom)

    1968-04-15

    In this brief introduction to the session on probes, the history of theii development is first touched on briefly. Reference is then made to the significance of the work to be described by Medicus, for conductivity and recombination calculations, and by Lam and Su, for a wide range of medium and higher pressure plasmas. Finally, a number of other probe topics are mentioned, including multiple probes; probes in electronegative plasmas; resonance probes; probes in noisy discharges; probes as oscillation detectors; use of probes where space-charge is not negligible. (author)

  5. Intraoperative Assessment of Tricuspid Valve Function After Conservative Repair

    Revuelta, J.M.; Gomez-Duran, C.; Garcia-Rinaldi, R.; Gallagher, M.W.

    1982-01-01

    It is desirable to repair coexistent tricuspid valve pathology at the time of mitral valve corrections. Conservative tricuspid repair may consist of commissurotomy, annuloplasty, or both. It is important that the repair be appropriate or tricuspid valve replacement may be necessary. A simple reproducible method of intraoperative testing for tricuspid valve insufficiency has been developed and used in 25 patients. Fifteen patients have been recatheterized, and the correlation between the intraoperative and postoperative findings has been consistent. PMID:15226931

  6. Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

    Lee, Su-Keon; Lee, Seung-Hwan; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

    2016-01-01

    Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondyloli...

  7. Intraoperative ultrasonography in detection of hepatic metastases from colorectal cancer

    Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

    1995-01-01

    PURPOSE: This study was designed to compare diagnostic accuracies of measuring liver enzymes, preoperative ultrasonography, surgical examination, and intraoperative ultrasonography for detection of liver metastases from colorectal cancer. METHODS: Blind, prospective comparisons of diagnostic...... examinations mentioned above were performed in 295 consecutive patients with colorectal cancer. An experienced ultrasonologist performed the preoperative examinations, and results were unknown to the other experienced ultrasonologist who performed the intraoperative examinations. The latter, also was unaware...

  8. Intraoperative magnetic resonance imaging to update interactive navigation in neurosurgery: method and preliminary experience.

    Wirtz, C R; Bonsanto, M M; Knauth, M; Tronnier, V M; Albert, F K; Staubert, A; Kunze, S

    1997-01-01

    We report on the first successful intraoperative update of interactive image guidance based on an intraoperatively acquired magnetic resonance imaging (MRI) date set. To date, intraoperative imaging methods such as ultrasound, computerized tomography (CT), or MRI have not been successfully used to update interactive navigation. We developed a method of imaging patients intraoperatively with the surgical field exposed in an MRI scanner (Magnetom Open; Siemens Corp., Erlangen, Germany). In 12 patients, intraoperatively acquired 3D data sets were used for successful recalibration of neuronavigation, accounting for any anatomical changes caused by surgical manipulations. The MKM Microscope (Zeiss Corp., Oberkochen, Germany) was used as navigational system. With implantable fiducial markers, an accuracy of 0.84 +/- 0.4 mm for intraoperative reregistration was achieved. Residual tumor detected on MRI was consequently resected using navigation with the intraoperative data. No adverse effects were observed from intraoperative imaging or the use of navigation with intraoperative images, demonstrating the feasibility of recalibrating navigation with intraoperative MRI.

  9. Intraoperative Secondary Insults During Orthopedic Surgery in Traumatic Brain Injury.

    Algarra, Nelson N; Lele, Abhijit V; Prathep, Sumidtra; Souter, Michael J; Vavilala, Monica S; Qiu, Qian; Sharma, Deepak

    2017-07-01

    Secondary insults worsen outcomes after traumatic brain injury (TBI). However, data on intraoperative secondary insults are sparse. The primary aim of this study was to examine the prevalence of intraoperative secondary insults during orthopedic surgery after moderate-severe TBI. We also examined the impact of intraoperative secondary insults on postoperative head computed tomographic scan, intracranial pressure (ICP), and escalation of care within 24 hours of surgery. We reviewed medical records of TBI patients 18 years and above with Glasgow Coma Scale score Secondary insults examined were: systemic hypotension (systolic blood pressurehypertension (ICP>20 mm Hg), cerebral hypotension (cerebral perfusion pressure40 mm Hg), hypocarbia (end-tidal CO2hypertension), hyperglycemia (glucose>200 mg/dL), hypoglycemia (glucose38°C). A total of 78 patients (41 [18 to 81] y, 68% male) met the inclusion criteria. The most common intraoperative secondary insults were systemic hypotension (60%), intracranial hypertension and cerebral hypotension (50% and 45%, respectively, in patients with ICP monitoring), hypercarbia (32%), and hypocarbia (29%). Intraoperative secondary insults were associated with worsening of head computed tomography, postoperative decrease of Glasgow Coma Scale score by ≥2, and escalation of care. After Bonferroni correction, association between cerebral hypotension and postoperative escalation of care remained significant (Psecondary insults were common during orthopedic surgery in patients with TBI and were associated with postoperative escalation of care. Strategies to minimize intraoperative secondary insults are needed.

  10. Intraoperative complications in pediatric neurosurgery: review of 1807 cases.

    van Lindert, Erik J; Arts, Sebastian; Blok, Laura M; Hendriks, Mark P; Tielens, Luc; van Bilsen, Martine; Delye, Hans

    2016-09-01

    OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.

  11. Intraoperative MRI to control the extent of brain tumor surgery

    Knauth, M.; Sartor, K.; Wirtz, C.R.; Tronnier, V.M.; Staubert, A.; Kunze, S.

    1998-01-01

    Intraoperative MRI definitely showed residual tumor in 6 of the 18 patients and resulted in ambiguous findings in 3 patients. In 7 patients surgery was continued. Early postoperative MRI showed residual tumor in 3 patients and resulted in uncertain findings in 2 patients. The rate of patients in whom complete removal of enhancing tumor could be achieved was 50% at the time of the intraoperative MR examination and 72% at the time of the early postoperative MR control. The difference in proportion of patients with 'complete tumor removal' between the groups who had been operated on using neuronavigation (NN) and intraoperative MRI (ioMRI) and those who had been operated on using only modern neurosurgical techniques except NN and ioMRI was statistically highly significant (Fisher exact test; P=0.008). Four different types of surgically induced contrast enhancement were observed. These phenomena carry different confounding potentials with residual tumor. Conclusion: Our preliminary experience with intraoperative MRI in patients with enhancing intraaxial tumors is encouraging. Combined use of neuronavigation and intraoperative MRI was able to increase the proportion of patients in whom complete removal of the enhancing parts of the tumor was achieved. Surgically induced enhancement requires careful analysis of the intraoperative MRI in order not to confuse it with residual tumor. (orig.) [de

  12. Selective serotonin reuptake inhibitors and intraoperative blood pressure.

    van Haelst, Ingrid M M; van Klei, Wilton A; Doodeman, Hieronymus J; Kalkman, Cor J; Egberts, Toine C G

    2012-02-01

    The influence of selective serotonin reuptake inhibitors (SSRIs) on blood pressure is poorly understood. We hypothesized that if SSRIs have an influence on blood pressure, this might become manifest in changes in intraoperative blood pressure. We aimed to study the association between perioperative use of SSRIs and changes in intraoperative blood pressure by measuring the occurrence of intraoperative hyper- and hypotension. We conducted a retrospective observational follow-up study among patients who underwent elective primary total hip arthroplasty. The index group included users of SSRIs. The reference group included a random sample (ratio 1:3) of nonusers of an antidepressant agent. The outcome was the occurrence of intraoperative hypo- and hypertensive episodes (number, mean and total duration, and area under the curve (AUC)). The outcome was adjusted for confounding factors using regression techniques. The index group included 20 users of an SSRI. The reference group included 60 nonusers. Users of SSRIs showed fewer intraoperative hypotensive episodes, a shorter mean and total duration, and a smaller AUC when compared to the reference group. After adjustment for confounders, SSRI use was associated with a significantly shorter total duration of hypotension: mean difference of -29.4 min (95% confidence interval (CI) -50.4 to -8.3). Two users of an SSRI and two patients in the reference group had a hypertensive episode. Continuation of treatment with SSRIs before surgery was associated with a briefer duration of intraoperative hypotension.

  13. Assessment of Macular Function during Vitrectomy: New Approach Using Intraoperative Focal Macular Electroretinograms.

    Celso Soiti Matsumoto

    Full Text Available To describe a new technique to record focal macular electroretinograms (FMERGs during vitrectomy to assess macular function.Intraoperative FMERGs (iFMERGs were recorded in ten patients (10 eyes who undergo vitrectomy. iFMERGs were elicited by focal macular stimulation. The stimulus light was directed to the macular area through a 25 gauge (25G glass fiber optic bundle. Background light was delivered through a dual chandelier-type light fiber probe. Focal macular responses elicited with combinations of stimulus and background luminances were analyzed.A stimulus luminance that was approximately 1.75 log units brighter than the background light was able to elicit focal macular responses that were not contaminated by stray light responses. Thus, a stimulus luminance of 160 cd/m2 delivered on a background of 3 cd/m2 elicited iFMEGs from only the stimulated area. This combination of stimulus and background luminances did not elicit a response when the stimulus was projected onto the optic nerve head. The iFMERGs elicited by a 10° stimulus with a duration of 100 ms and an interstimulus interval of 150 ms consisted of an a-, b-, and d-waves, the oscillatory potentials, and the photopic negative response (PhNR.Focal ERGs with all components can be recorded from the macula and other retinal areas during vitreous surgery. This new technique will allow surgeons to assess the function of focal areas of the retina intraoperatively.

  14. Intraoperative HDR brachytherapy for rectal cancer using a flexible intraoperative template: standard plans versus individual planning

    Kolkman-Deurloo, Inger-Karine K.; Nuyttens, Joost J.; Hanssens, Patrick E.J.; Levendag, Peter C.

    2004-01-01

    HDR intraoperative brachytherapy (IOBT) is applied to locally advanced rectal tumors using a 5 mm thick flexible intraoperative template (FIT). To reduce the procedure time, treatment planning is performed using standard plans that neglect the curvature of the FIT. We have calculated the individual treatment plan, based on the real geometry of the FIT, and the dose at clips placed during surgery. A mean treatment dose of 9.55±0.21 Gy was found for the individual plan, compared to the prescribed 10 Gy (P<0.0001). The mean central dose was 10.03±0.10 Gy in the standard plan and 9.20±0.32 Gy in the individual plan (P<0.0001). The mean dose at the corners of the FIT was 10.3 Gy in the standard plan and ranged between 10.3 and 10.5 Gy in the individual plan. In 63% of the clips, the dose was larger than 15.0 Gy, which is equivalent to a gap between the FIT and the target smaller than 5 mm. In 18% of the clips, the dose was smaller than 13.0 Gy indicating that locally the gap was larger than 5 mm. Clinical practice will have to prove if these small dose deviations influence the clinical outcome

  15. Intraoperative radiation therapy for malignant glioma

    Sakai, Noboru; Yamada, Hiromu; Andoh, Takashi; Takada, Mitsuaki; Hirata, Toshifumi; Funakoshi, Takashi; Doi, Hidetaka; Yanagawa, Shigeo [Gifu Univ. (Japan). Faculty of Medicine

    1989-04-01

    Intraoperative radiation therapy (IOR) is an ideal means of exterminating residual tumor after surgical resection. In this study, the clinical results of IOR using a Scanditronix Microtron MM-22 were evaluated in 14 patients with malignant glioma, five of whom had recurrent tumors. Between July, 1985 and October, 1986, 11 patients with glioblastoma multiforme (GB) were irradiated 18 times (mean, 1.6 times/case), and three with astrocytoma (Kernohan grade III) underwent IOR once each. The target-absorbed dose at 1 to 2 cm deeper than the tumor resection surface was 15 to 50 Gy. During irradiation, a cotton bolus was placed in the dead space after over 91% of the tumor had been resected. As a rule, external irradiation therapy was also given postoperatively at a dose of 30 to 52 Gy. One patient died of pneumonia and disseminated intravascular coagulation syndrome 1 month postoperatively. The 1- and 2-year survival rates of the ramaining 13 patients were 84.6% and 61.5%, respectively; among the 10 with GB, they were 80% and 50%. Generally, the smaller the tumor size, the better the results. There were no adverse effects, despite the dose 15 to 50 Gy applied temporally to the tumor bed. IOR was especially effective against small, localized tumors, but was not always beneficial in cases of large tumors, particularly those with a contralateral focus. The improved survival rate in this series demonstrates that IOR is significantly effective in the 'induction of remission' following surgical excision of malignant gliomas. (author).

  16. How do pediatric anesthesiologists define intraoperative hypotension?

    Nafiu, Olubukola O; Voepel-Lewis, Terri; Morris, Michelle; Chimbira, Wilson T; Malviya, Shobha; Reynolds, Paul I; Tremper, Kevin K

    2009-11-01

    Although blood pressure (BP) monitoring is a recommended standard of care by the ASA, and pediatric anesthesiologists routinely monitor the BP of their patients and when appropriate treat deviations from 'normal', there is no robust definition of hypotension in any of the pediatric anesthesia texts or journals. Consequently, what constitutes hypotension in pediatric anesthesia is currently unknown. We designed a questionnaire-based survey of pediatric anesthesiologists to determine the BP ranges and thresholds used to define intraoperative hypotension (IOH). Members of the Society of Pediatric Anesthesia (SPA) and the Association of Paediatric Anaesthetists (APA) of Great Britain and Ireland were contacted through e-mail to participate in this survey. We asked a few demographic questions and five questions about specific definitions of hypotension for different age groups of patients undergoing inguinal herniorraphy, a common pediatric surgical procedure. The overall response rate was 56% (483/860), of which 76% were SPA members. Majority of the respondents (72%) work in academic institutions, while 8.9% work in institutions with fewer than 1000 annual pediatric surgical caseload. About 76% of respondents indicated that a 20-30% reduction in baseline systolic blood pressure (SBP) indicates significant hypotension in children under anesthesia. Most responders (86.7%) indicated that they use mean arterial pressure or SBP (72%) to define IOH. The mean SBP values for hypotension quoted by SPA members was about 5-7% lower across all pediatric age groups compared to values quoted by APA members (P = 0.001 for all age groups). There is great variability in the BP parameters used and the threshold used for defining and treating IOH among pediatric anesthesiologists. The majority of respondents considered a 20-30% reduction from baseline in SBP as indicative of significant hypotension. Lack of a consensus definition for a common clinical condition like IOH could have

  17. Automated intraoperative calibration for prostate cancer brachytherapy

    Kuiran Chen, Thomas; Heffter, Tamas; Lasso, Andras; Pinter, Csaba; Abolmaesumi, Purang; Burdette, E. Clif; Fichtinger, Gabor

    2011-01-01

    Purpose: Prostate cancer brachytherapy relies on an accurate spatial registration between the implant needles and the TRUS image, called ''calibration''. The authors propose a new device and a fast, automatic method to calibrate the brachytherapy system in the operating room, with instant error feedback. Methods: A device was CAD-designed and precision-engineered, which mechanically couples a calibration phantom with an exact replica of the standard brachytherapy template. From real-time TRUS images acquired from the calibration device and processed by the calibration system, the coordinate transformation between the brachytherapy template and the TRUS images was computed automatically. The system instantly generated a report of the target reconstruction accuracy based on the current calibration outcome. Results: Four types of validation tests were conducted. First, 50 independent, real-time calibration trials yielded an average of 0.57 ± 0.13 mm line reconstruction error (LRE) relative to ground truth. Second, the averaged LRE was 0.37 ± 0.25 mm relative to ground truth in tests with six different commercial TRUS scanners operating at similar imaging settings. Furthermore, testing with five different commercial stepper systems yielded an average of 0.29 ± 0.16 mm LRE relative to ground truth. Finally, the system achieved an average of 0.56 ± 0.27 mm target registration error (TRE) relative to ground truth in needle insertion tests through the template in a water tank. Conclusions: The proposed automatic, intraoperative calibration system for prostate cancer brachytherapy has achieved high accuracy, precision, and robustness.

  18. Neurophysiologic intraoperative monitoring of the vestibulocochlear nerve.

    Simon, Mirela V

    2011-12-01

    Neurosurgical procedures involving the skull base and structures within can pose a significant risk of damage to the brain stem and cranial nerves. This can have life-threatening consequences and/or result in devastating neurologic deficits. Over the past decade, intraoperative neurophysiology has significantly evolved and currently offers a great tool for live monitoring of the integrity of nervous structures. Thus, dysfunction can be identified early and prompt modification of the surgical management or operating conditions, leads to avoidance of permanent structural damage.Along these lines, the vestibulocochlear nerve (CN VIII) and, to a greater extent, the auditory pathways as they pass through the brain stem are especially at risk during cerebelopontine angle (CPA), posterior/middle fossa, or brain stem surgery. CN VIII can be damaged by several mechanisms, from vascular compromise to mechanical injury by stretch, compression, dissection, and heat injury. Additionally, cochlea itself can be significantly damaged during temporal bone drilling, by noise, mechanical destruction, or infarction, and because of rupture, occlusion, or vasospasm of the internal auditory artery.CN VIII monitoring can be successfully achieved by live recording of the function of one of its parts, the cochlear or auditory nerve (AN), using the brain stem auditory evoked potentials (BAEPs), electrocochleography (ECochG), and compound nerve action potentials (CNAPs) of the cochlear nerve.This is a review of these techniques, their principle, applications, methodology, interpretation of the evoked responses, and their change from baseline, within the context of surgical and anesthesia environments, and finally the appropriate management of these changes.

  19. Gamma teletopography

    Simonet, G.

    1986-09-01

    To set the gamma activity cartography is an important element of safety in numerous cases: intervention in hot cell, search of a radioactive source, examination of radioactive waste circuit followed by a reprocessing definition of decontamination and decommissioning processes and for all other accidents. The device presented here is like a ''black box'' with an aperture and an emulsion photosensitive to the opposite; a classical film takes photography of the place; a X-ray type emulsion gives a spot more or less contrasted and extensive corresponding to each source. Images can be processed with a microprocessor [fr

  20. Monitoring system for isolated limb perfusion based on a portable gamma camera

    Orero, A.; Muxi, A.; Rubi, S.; Duch, J.; Vidal-Sicart, S.; Pons, F.; Roe, N.; Rull, R.; Pavon, N.; Pavia, J.

    2009-01-01

    Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-α) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-α and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is ±1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-α and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-α and melphalan has been indicated. (orig.)

  1. Monitoring system for isolated limb perfusion based on a portable gamma camera

    Orero, A.; Muxi, A.; Rubi, S.; Duch, J. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Vidal-Sicart, S.; Pons, F. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Inst. d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); Red Tematica de Investigacion Cooperativa en Cancer (RTICC), Barcelona (Spain); Roe, N. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain); Rull, R. [Servei de Cirurgia, Hospital Clinic, Barcelona (Spain); Pavon, N. [Inst. de Fisica Corpuscular, CSIC - UV, Valencia (Spain); Pavia, J. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Inst. d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain)

    2009-07-01

    Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-{alpha}) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-{alpha} and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is {+-}1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-{alpha} and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-{alpha} and melphalan has been indicated. (orig.)

  2. Intraoperative evaluation of renal blood flow during laparoscopic partial nephrectomy with a novel Doppler system.

    Mues, Adam C; Okhunov, Zhamshid; Badani, Ketan; Gupta, Mantu; Landman, Jaime

    2010-12-01

    Hemostasis remains a major challenge associated with laparoscopic renal surgery. We evaluated a cost-effective novel Doppler probe (DP) for assessment of vascular control during laparoscopic partial nephrectomy (LPN). We prospectively collected data during LPN procedures. We documented tumor location and size as well as subjective quality of the hilar dissection. The DP was compared with our standard intraoperative ultrasound system (SUS) for the ability to detect blood flow during hilar dissection and to determine parenchymal ischemia around the tumor after clamping of the renal vessels. Twenty patients underwent LPN by a single surgeon. The mean tumor size was 3.0 cm (range: 1.2-6.3 cm). The times to assess the kidney using the SUS and DP were 68.6 seconds (range: 20-155) and 44.5 seconds (range: 15-180), respectively. Evaluation prior to renal hilar clamping demonstrated the presence of blood flow in all 20 patients (100%) using the SUS and in 17 of 20 (85%) using the DP. Similarly, cessation of blood flow with clamping was documented in 100% of cases with SUS and 85% with DP. Persistent flow was detected by both SUS and DP in two patients requiring further dissection and reclamping. Then, both systems detected the absence of flow before tumor resection. With blood flow interruption confirmation, no patient had significant bleeding at the time of renal parenchymal transection. Intraoperative Doppler ultrasound technologies minimize the risk of significant bleeding during LPN. The DP is a small, simple, effective probe that can be used to assess blood flow interruption to the kidney during laparoscopic renal surgery.

  3. Gamma knife

    Kawamoto, Shunsuke; Takakura, Kintomo

    1991-01-01

    As to the gamma knife which is the radiation surgery device developed in Sweden a quarter century ago, its principle, structure, treatment techniques, already established clinical effect and the problems being left for hereafter are described. This treatment means supplements the operation under microscopes, and at present it takes the important position in neurosurgery, but hereafter, by the interdisciplinary cooperation of neurosurgery and clinical radiobiology, the more development can be expected. The method of irradiating the radiation of high dose selectively to a target region and breaking its tissue is called radiosurgery, and the device developed for this purpose is the gamma knife. First, it was applied to functional diseases, but good results were obtained by its application to auditory nerve and brain blood vessels, and it establishes the position as the safe treatment method of the morbid state in the deep part of brains, which is difficult to reach by operation. Accompanying the recent progress of the operation of skull base part, attention is paid to its application to various tumors in skull base. On the other hand, the radiosurgery combining a cyclotron or a linear accelerator with stereotaxic brain surgery is actively tried mainly to the deformation of brain blood vessels. (K.I.)

  4. A hybrid positron and OCT intraoperative probe for ovarian cancer detection and characterization

    Yang, Yi; Biswal, Nrusingh C.; Wang, Tianheng; Kumavor, Patrick; Karimeddini, Mozafareddin; Sanders, Melinda; Brewer, Molly; Zhu, Quing

    2011-03-01

    Ovarian cancer has the lowest survival rate of the gynecologic cancers with a 5-year survival of about 50% in the United States. With current screening and diagnostic abilities for ovarian cancers, most of the diagnosed patients are already with advanced stages and the majority of them will die of this deadly disease. In this paper, we report a multimodal imaging approach which combines optical coherence tomography (OCT) and positron detection for early ovarian cancer detection. The dual modality system has the capability of providing both functional and morphological images simultaneously. While the positron detection provides the metabolism activity of the ovary due to the uptake of radiotracer, the OCT provides the high resolution (25μm X 25μm X 12μm - longitudinal X lateral X axial in air) structural imaging at 20k A-lines per second. Total 18 ovaries obtained from 10 patients classified as normal, abnormal and malignant ovarian tissues were characterized ex vivo. Positron counts of 1.2-fold higher was found between abnormal and normal ovaries and 3~30-fold higher was found between malignant and normal ovaries. OCT imaging of malignant and abnormal ovaries revealed many detailed morphologic features that could be potentially valuable for detecting early malignant changes in the ovary.

  5. Gamma-Ray Pulsar Studies With GLAST

    Thompson, D.J.; /NASA, Goddard

    2011-11-23

    Some pulsars have their maximum observable energy output in the gamma-ray band, offering the possibility of using these high-energy photons as probes of the particle acceleration and interaction processes in pulsar magnetospheres. After an extended hiatus between satellite missions, the recently-launched AGILE mission and the upcoming Gamma-ray Large Area Space Telescope (GLAST) Large Area Telescope (LAT) will allow gamma-ray tests of the theoretical models developed based on past discoveries. With its greatly improved sensitivity, better angular resolution, and larger energy reach than older instruments, GLAST LAT should detect dozens to hundreds of new gamma-ray pulsars and measure luminosities, light curves, and phase-resolved spectra with unprecedented resolution. It will also have the potential to find radio-quiet pulsars like Geminga, using blind search techniques. Cooperation with radio and X-ray pulsar astronomers is an important aspect of the LAT team's planning for pulsar studies.

  6. Indocyanine green for intraoperative localization of ureter.

    Siddighi, Sam; Yune, Junchan Joshua; Hardesty, Jeffrey

    2014-10-01

    Intraurethral injection of indocyanine green (ICG; Akorn, Lake Forest, IL) and visualization under near-infrared (NIR) light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. Patients were scheduled to undergo robot-assisted laparoscopic sacrocolpopexy. Before the robotic surgery started, the tip of a 6-F ureteral catheter was inserted into the ureteral orifice. Twenty-five milligrams of ICG was dissolved in 10-mL of sterile water and injected through the open catheter. The same procedure was repeated on the opposite side. The ICG reversibly stained the inside lining of the ureter by binding to proteins on urothelial layer. During the course of robotic surgery, the NIR laser on the da Vinci Si surgical robot (Intuitive Surgical, Inc, Sunnyvale, CA) was used to excite ICG molecules, and infrared emission was captured by the da Vinci filtered lens system and electronically converted to green color. Thus, the ureter fluoresced green, which allowed its definitive identification throughout the entire case. In all cases of >10 patients, we were able to visualize bilateral ureters with this technology, even though there was some variation in brightness that depended on the depth of the ureter from the peritoneal surface. For example, in a morbidly obese patient, the ureters were not as bright green. There were no intraoperative or postoperative adverse effects attributable to ICG administration for up to 2 months of observation. In our experience, this novel method of intraurethral ICG injection was helpful to identify the entire course of ureter and allowed a safe approach to tissues that were adjacent to the urinary tract. The advantage of our technique is that it requires the insertion of just the tip of ureteral catheter. Despite our limited cohort of patients, our findings are consistent with previous reports of the excellent safety profile of intravenous and intrabiliary ICG

  7. A novel fully integrated handheld gamma camera

    Massari, R.; Ucci, A.; Campisi, C.; Scopinaro, F.; Soluri, A.

    2016-01-01

    In this paper, we present an innovative, fully integrated handheld gamma camera, namely designed to gather in the same device the gamma ray detector with the display and the embedded computing system. The low power consumption allows the prototype to be battery operated. To be useful in radioguided surgery, an intraoperative gamma camera must be very easy to handle since it must be moved to find a suitable view. Consequently, we have developed the first prototype of a fully integrated, compact and lightweight gamma camera for radiopharmaceuticals fast imaging. The device can operate without cables across the sterile field, so it may be easily used in the operating theater for radioguided surgery. The prototype proposed consists of a Silicon Photomultiplier (SiPM) array coupled with a proprietary scintillation structure based on CsI(Tl) crystals. To read the SiPM output signals, we have developed a very low power readout electronics and a dedicated analog to digital conversion system. One of the most critical aspects we faced designing the prototype was the low power consumption, which is mandatory to develop a battery operated device. We have applied this detection device in the lymphoscintigraphy technique (sentinel lymph node mapping) comparing the results obtained with those of a commercial gamma camera (Philips SKYLight). The results obtained confirm a rapid response of the device and an adequate spatial resolution for the use in the scintigraphic imaging. This work confirms the feasibility of a small gamma camera with an integrated display. This device is designed for radioguided surgery and small organ imaging, but it could be easily combined into surgical navigation systems.

  8. A novel fully integrated handheld gamma camera

    Massari, R.; Ucci, A.; Campisi, C. [Biostructure and Bioimaging Institute (IBB), National Research Council of Italy (CNR), Rome (Italy); Scopinaro, F. [University of Rome “La Sapienza”, S. Andrea Hospital, Rome (Italy); Soluri, A., E-mail: alessandro.soluri@ibb.cnr.it [Biostructure and Bioimaging Institute (IBB), National Research Council of Italy (CNR), Rome (Italy)

    2016-10-01

    In this paper, we present an innovative, fully integrated handheld gamma camera, namely designed to gather in the same device the gamma ray detector with the display and the embedded computing system. The low power consumption allows the prototype to be battery operated. To be useful in radioguided surgery, an intraoperative gamma camera must be very easy to handle since it must be moved to find a suitable view. Consequently, we have developed the first prototype of a fully integrated, compact and lightweight gamma camera for radiopharmaceuticals fast imaging. The device can operate without cables across the sterile field, so it may be easily used in the operating theater for radioguided surgery. The prototype proposed consists of a Silicon Photomultiplier (SiPM) array coupled with a proprietary scintillation structure based on CsI(Tl) crystals. To read the SiPM output signals, we have developed a very low power readout electronics and a dedicated analog to digital conversion system. One of the most critical aspects we faced designing the prototype was the low power consumption, which is mandatory to develop a battery operated device. We have applied this detection device in the lymphoscintigraphy technique (sentinel lymph node mapping) comparing the results obtained with those of a commercial gamma camera (Philips SKYLight). The results obtained confirm a rapid response of the device and an adequate spatial resolution for the use in the scintigraphic imaging. This work confirms the feasibility of a small gamma camera with an integrated display. This device is designed for radioguided surgery and small organ imaging, but it could be easily combined into surgical navigation systems.

  9. The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

    Stefan Linsler

    2016-01-01

    Full Text Available Objective: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT and magnetic resonance imaging (MRI. Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. Materials and Methods: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated. In this case, we performed an endonasal transsphenoidal approach for debulking the adenoma and for chiasma decompression. We used an MRI neuronavigation (Medtronic Stealth Air System which was registered via intraoperative CT scan (Siemens CT Somatom. Preexisting MRI studies (navigation protocol were fused with the intraoperative CT scans to enable three-dimensional navigation based on MR and CT imaging data. Intraoperatively, we did a further CT scan for resection control. Results: The intraoperative accuracy of the neuronavigation was excellent. There was an adjustment of <1 mm. The navigation was very helpful for orientation on the destroyed skull base in the sphenoid sinus. After opening the sellar region and tumor debulking, we did a CT scan for resection control because the extent of resection was not credible evaluable in this huge infiltrating adenoma. Thereby, we were able to demonstrate a sufficient decompression of the chiasma and complete resection of the medial part of the adenoma in the intraoperative CT images. Conclusions: The use of intraoperative CT/MRI-guided neuronavigation for transsphenoidal surgery is a time-effective, safe, and technically beneficial technique for special cases.

  10. Research about combination of Gamma Knife and cobalt-60 radiation therapy to treat hypophysoma

    Xing Yueming; Zhao Xinping; Song Xiang; Wu Wei; Huang Bai

    2003-01-01

    Objective: To probe the therapeutic effectiveness of combination of Gamma Knife and cobalt-60 radiotherapy. Methods: 80 Hypophysoma patients who have been randomly grouped into two groups. Combination of Gamma Knife and cobalt-60 radiotherapy group and single Gamma knife group. Results: The therapeutic effectiveness of combination of Gamma Knife and cobalt-60 radiation therapy group was higher than that of single Gamma Knife group. Conclusion: The hospital that treat Hypophysoma with single Gamma Knife should add cobalt-60 radiotherapy in order to increase the local Hypophysoma dose

  11. Selected versus routine use of intraoperative cholangiography during laparoscopic cholecystectomy.

    Pickuth, D

    1995-12-01

    Routine use of intraoperative cholangiography during laparoscopic cholecystectomy is still widely advocated and standard in many departments, however, this is discussed controversially. We have developed a new diagnostic strategy to detect bile duct stones. The concept is based on an ultrasound examination and on a screening for the presence of six risk indicators of choledocholithiasis. 120 consecutive patients undergoing laparoscopic cholecystectomy were prospectively screened for the presence of six risk indicators of choledocholithiasis: history of jaundice; history of pancreatitis; hyperbilirubinemia; hyperamylasemia; dilated bile duct; unclear ultrasound findings. The sensitivity of ultrasound and of intraoperative cholangiography in diagnosing bile duct stones was also evaluated. For the detection of bile duct stones, the sensitivity was 77% for ultrasound and 100% for intraoperative cholangiography. 20% of all patients had at least one risk indicator. The presence of a risk indicator correlated significantly with the presence of choledocholithiasis (p concept, we would have avoided 80% of intraoperative cholangiographies without missing a stone in the bile duct. This study lends further support to the view that the routine use of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy is not necessary.

  12. Role of scrape cytology in the intraoperative diagnosis of tumor

    Kolte Sachin

    2010-01-01

    Full Text Available Background : Rapid diagnosis of surgically removed specimens has created many controversies and a single completely reliable method has not yet been developed. Histopathology of a paraffin section remains the ultimate gold standard in tissue diagnosis. Frozen section is routinely used by the surgical pathology laboratories for intraoperative diagnosis. The use of either frozen section or cytological examination alone has an acceptable rate (93-97% of correct diagnosis, with regard to interpretation of benign versus malignant. Aim : To evaluate the utility of scrape cytology for the rapid diagnosis of surgically removed tumors and its utilisation for learning cytopathology. Materials and Methods : 75 surgically removed specimens from various organs and systems were studied. Scrapings were taken from each specimen before formalin fixation and stained by modified rapid Papanicolaou staining. Results : Of the 75 cases studied, 73 could be correctly differentiated into benign and malignant tumors, with an accuracy rate of 97.3%. Conclusions : Intraoperative scrape cytology is useful for intraoperative diagnosis of tumor, where facilities for frozen section are not available. The skill and expertise developed by routinely practicing intraoperative cytology can be applied to the interpretation of fine needle aspirate smears. Thus, apart from its diagnostic role, intraoperative cytology can become a very useful learning tool in the field of cytopathology.

  13. [Factors related to intraoperative retinal breaks in macular hole surgery].

    Kumagai, K; Ogino, N; Demizu, S; Atsumi, K; Kurihara, H; Iwaki, M; Ishigooka, H; Tachi, N

    2001-02-01

    To evaluate the factors of intraoperative retinal breaks in macular hole surgery. This study included 558 eyes of 506 patients who underwent idiopathic macular hole surgery by one surgeon. Multiple regression was performed using the variables of gender, age, affected eye, lens status, stage, duration of symptoms, hole size, axial length, and lattice degeneration. The rate of retinal breaks was higher in stage 3 (16.0%) than in stage 4 (8.2%) (p = 0.014). In eyes with lattice degeneration intraoperative retinal breaks occurred in about 40% of the cases. Major factors were as follows: lattice degeneration (r = 0.24, p lattice degeneration, and gender (r = -0.18, p = 0.035) in eyes of stage 4 without lattice degeneration. The factors of intraoperative retinal breaks in macular hole surgery were lattice degeneration in all eyes and stage 3 in eyes without lattice degeneration. The high incidence of intraoperative retinal breaks in stage 3 was mainly due to the occurrence of posterior vitreous detachment. Male gender was a significant factor associated with intraoperative retinal breaks.

  14. Intraoperative parathyroid hormone assay-cutting the Gordian knot

    Chandralekha Tampi

    2014-01-01

    Full Text Available Background: Hyperparathyroidism is treated by surgical excision of the hyperfunctioning parathyroid gland. In case of adenoma the single abnormal gland is removed, while in hyperplasias, a subtotal excision, that is, three-and-a-half of the four glands are removed. This therapeutic decision is made intraoperatively through frozen section evaluation and is sometimes problematic, due to a histological overlap between hyperplasia and the adenoma. The intraoperative parathyroid hormone (IOPTH assay, propogated in recent years, offers an elegant solution, with a high success rate, due to its ability to identify the removal of all hyperfunctioning parathyroid tissue. Aim: To study the feasibility of using IOPTH in our setting. Materials and Methods: Seven patients undergoing surgery for primary hyperparathyroidism had their IOPTH levels evaluated, along with the routine frozen and paraffin sections. Results: All seven patients showed more than a 50% intraoperative fall in serum PTH after excision of the abnormal gland. This was indicative of an adenoma and was confirmed by histopathological examination and normalization of serum calcium postoperatively. Conclusion: The intraoperative parathyroid hormone is a sensitive and specific guide to a complete removal of the abnormal parathyroid tissue. It can be incorporated without difficulty as an intraoperative guide and is superior to frozen section diagnosis in parathyroid surgery.

  15. Intraoperative adverse events associated with extremely preterm cesarean deliveries.

    Bertholdt, Charline; Menard, Sophie; Delorme, Pierre; Lamau, Marie-Charlotte; Goffinet, François; Le Ray, Camille

    2018-05-01

    At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries in two gestational age groups: 24-25 weeks and 26-27 weeks. This single-center retrospective cohort study included all women with cesarean deliveries performed before 28 +0 weeks from 2007 through 2015. It compared the frequency of intraoperative adverse events between two groups: those at 24-25 weeks of gestation and at 26-27 weeks. Intraoperative adverse events were a classical incision, transplacental incision, difficulty in fetal extraction (explicitly mentioned in the surgical report), postpartum hemorrhage (≥500 mL of blood loss), and injury to internal organs. A composite outcome including at least one of these events enabled us to analyze the risk factors for intraoperative adverse events with univariate and multivariable analysis. Stratified analyses by the indication for the cesarean were performed. We compared 74 cesarean deliveries at 24-25 weeks of gestation and 214 at 26-27 weeks. Intraoperative adverse events occurred at higher rates in the 24-25-week group (63.5 vs. 30.8%, p cesarean. These results should help obstetricians and women making decisions about cesarean deliveries at these extremely low gestational ages. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

  16. Intraoperative and early postoperative complications of manual sutureless cataract extraction.

    Iqbal, Yasir; Zia, Sohail; Baig Mirza, Aneeq Ullah

    2014-04-01

    To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. Case series. Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery (MSCS) by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences (SPSS) version 13.0 and the results were calculated in frequencies. Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases (3%) underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema.

  17. Gamma camera

    Tschunt, E.; Platz, W.; Baer, U.; Heinz, L.

    1978-01-01

    A gamma camera has a plurality of exchangeable collimators, one of which is mounted in the ray inlet opening of the camera, while the others are placed on separate supports. The supports are swingably mounted upon a column one above the other through about 90 0 to a collimator exchange position. Each of the separate supports is swingable to a vertically aligned position, with limiting of the swinging movement and positioning of the support at the desired exchange position. The collimators are carried on the supports by means of a series of vertically disposed coil springs. Projections on the camera are movable from above into grooves of the collimator at the exchange position, whereupon the collimator is turned so that it is securely prevented from falling out of the camera head

  18. Comparison of two types of scintillation probe for moisture density gauge

    Machaj, B.

    1974-01-01

    Investigations of pulse shape discrimination scintillation probe, and amplitude discrimination probe as a detector for moisutre density gauge have been carried out. It was found that sandwich scintillator consisting of NE-421 + NE-102A was the best for pulse shape discrimination probe for thermal neutrons and gamma radiation detection. Similarly LiJ(Eu) crystal was the best for amplitude discrimination probe. The amplitude discrimination probe with LiJ(Eu) comparing to pulse shape discrimination probe with sandwich scintillator, provides approximately two times higher thermal neutron detection efficiency and higher count rate stability. It is considered therefore more suitable as the detector for moisture density gauge. (author)

  19. Density and water content measurement with two dual detector probes

    Cariou, J.; Menard, J.

    1980-01-01

    The ''Laboratoires des Ponts et Chaussees'' have developed an electronic device for geological prospections. This system includes gamma-gamma and neutron-neutron probes for continuous measurement in borehole down to one hundred meters. It is used, as well to measure the density and the water content in the field of soil mechanic engineering. When the diameter is not constant all along the borehole the two probes have to use a dual detector procedure. When constant, a simple detector procedure is sufficient to obtain density and water content. Two examples show the possibilities of this apparatus, particularly to control the borehole diameter and the soil chemical composition [fr

  20. Mobile Game Probes

    Borup Lynggaard, Aviaja

    2006-01-01

    This paper will examine how probes can be useful for game designers in the preliminary phases of a design process. The work is based upon a case study concerning pervasive mobile phone games where Mobile Game Probes have emerged from the project. The new probes are aimed towards a specific target...... group and the goal is to specify the probes so they will cover the most relevant areas for our project. The Mobile Game Probes generated many interesting results and new issues occurred, since the probes came to be dynamic and favorable for the process in new ways....

  1. Intraoperative monitoring technician: a new member of the surgical team.

    Brown, Molly S; Brown, Debra S

    2011-02-01

    As surgery needs have increased, the traditional surgical team has expanded to include personnel from radiology and perfusion services. A new surgical team member, the intraoperative monitoring technician, is needed to perform intraoperative monitoring during procedures that carry a higher risk of central and peripheral nerve injury. Including the intraoperative monitoring technician on the surgical team can create challenges, including surgical delays and anesthesia care considerations. When the surgical team members, including the surgeon, anesthesia care provider, and circulating nurse, understand and facilitate this new staff member's responsibilities, the technician is able to perform monitoring functions that promote the smooth flow of the surgical procedure and positive patient outcomes. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  2. Intraoperative ultrasonography for presumed brain metastases: a case series study

    Helder Picarelli

    2012-10-01

    Full Text Available Brain metastases (BM are one of the most common intracranial tumors and surgical treatment can improve both the functional outcomes and patient survival, particularly when systemic disease is controlled. Image-guided BM resection using intraoperative exams, such as intraoperative ultrasound (IOUS, can lead to better surgical results. METHODS: To evaluate the use of IOUS for BM resection, 20 consecutives patients were operated using IOUS to locate tumors, identify their anatomical relationships and surgical cavity after resection. Technical difficulties, complications, recurrence and survival rates were noted. RESULTS: IOUS proved effective for locating, determining borders and defining the anatomical relationships of BM, as well as to identify incomplete tumor resection. No complications related to IOUS were seen. CONCLUSION: IOUS is a practical supporting method for the resection of BM, but further studies comparing this method with other intraoperative exams are needed to evaluate its actual contribution and reliability.

  3. Intraoperative magnetic resonance imaging for neurosurgery – An anaesthesiologist's challenge

    Rajashree U Gandhe

    2018-01-01

    Full Text Available Intraoperative magnetic resonance imaging (MRI-guided neurosurgery has gained popularity over the years globally. These surgeries require a dedicated operating room and MRI-compatible anaesthesia equipment. The anaesthesiologist providing care in this setup needs to be experienced and vigilant to ensure patient safety. Strict adherence to MRI safety checklists and regular personnel training would avoid potential accidents and life-threatening emergencies. Teamwork, good communication, preprocedure planning, and familiarity with the surroundings are very important for safe care and good outcomes. We performed a literature search in Google Scholar, PubMed and Cochrane databases for original and reviewed articles for the origins, development and applications of intraoperative MRI in neurosurgical procedures. Much of the research has emphasised on the surgical indications than the anaesthetic challenges faced during intraoperative MRI guided surgery. The purpose of this review is to discuss the anaesthetic concerns specific to this unique environment.

  4. Intraoperative cyclorotation and pupil centroid shift during LASIK and PRK.

    Narváez, Julio; Brucks, Matthew; Zimmerman, Grenith; Bekendam, Peter; Bacon, Gregory; Schmid, Kristin

    2012-05-01

    To determine the degree of cyclorotation and centroid shift in the x and y axis that occurs intraoperatively during LASIK and photorefractive keratectomy (PRK). Intraoperative cyclorotation and centroid shift were measured in 63 eyes from 34 patients with a mean age of 34 years (range: 20 to 56 years) undergoing either LASIK or PRK. Preoperatively, an iris image of each eye was obtained with the VISX WaveScan Wavefront System (Abbott Medical Optics Inc) with iris registration. A VISX Star S4 (Abbott Medical Optics Inc) laser was later used to measure cyclotorsion and pupil centroid shift at the beginning of the refractive procedure and after flap creation or epithelial removal. The mean change in intraoperative cyclorotation was 1.48±1.11° in LASIK eyes and 2.02±2.63° in PRK eyes. Cyclorotation direction changed by >2° in 21% of eyes after flap creation in LASIK and in 32% of eyes after epithelial removal in PRK. The respective mean intraoperative shift in the x axis and y axis was 0.13±0.15 mm and 0.17±0.14 mm, respectively, in LASIK eyes, and 0.09±0.07 mm and 0.10±0.13 mm, respectively, in PRK eyes. Intraoperative centroid shifts >100 μm in either the x axis or y axis occurred in 71% of LASIK eyes and 55% of PRK eyes. Significant changes in cyclotorsion and centroid shifts were noted prior to surgery as well as intraoperatively with both LASIK and PRK. It may be advantageous to engage iris registration immediately prior to ablation to provide a reference point representative of eye position at the initiation of laser delivery. Copyright 2012, SLACK Incorporated.

  5. Glioma surgery using intraoperative tractography and MEP monitoring

    Maesawa, Satoshi; Nakahara, Norimoto; Watanabe, Tadashi; Fujii, Masazumi; Yoshida, Jun

    2009-01-01

    In surgery of gliomas in motor-eloquent locations, it is essential to maximize resection while minimizing motor deficits. We attempted to identify the cortico-spinal tract (CST) by intraoperative-diffusion tensor imaging (DTI) tractography, combined with electrophysiological mapping using direct subcortical stimulation during tumor resection. Our techniques and preliminary results are reported. Tumors were removed from twelve patients with gliomas in and around the CST using high-field intraoperative MRI and neuronavigation system (BrainSUITE). DTI-based tractography was implemented for navigation of CST pre-and intraoperatively. When the CST was close to the manipulating area, direct subcortical stimulation was performed, and motor evoked potential (MEP)-responses were examined. Locations of CST indicated by pre- and intraoperative tractography (pre- or intra-CST-tractography), and locations identified by subcortical stimulation were recorded, and those correlations were examined. Imaging and functional outcomes were reviewed. Total resections were achieved in 10 patients (83.4%). Two patients developed transient deterioration of motor function (16.6%), and permanent paresis was seen in one (8.3%). The distance from intra-CST-tractography to corresponding sites by subcortical stimulation was 4.5 mm in average (standard deviation (SD)=4.2), and significantly shorter than from pre-CST-tractography. That distance correlated significantly with the intensity of subcortical stimulation. We observed that intraoperative DTI-tractography demonstrated the location of the pyramidal tract more accurately than preoperative one. The combination of intraoperative tractgraphy and MEP monitoring enhanced the quality of surgery for gliomas in motor-eloquent area. (author)

  6. Pygopagus Conjoined Twins: A Neurophysiologic Intraoperative Monitoring Schema.

    Cromeens, Barrett P; McKinney, Jennifer L; Leonard, Jeffrey R; Governale, Lance S; Brown, Judy L; Henry, Christina M; Levitt, Marc A; Wood, Richard J; Besner, Gail E; Islam, Monica P

    2017-03-01

    Conjoined twins occur in up to 1 in 50,000 live births with approximately 18% joined in a pygopagus configuration at the buttocks. Twins with this configuration display symptoms and carry surgical risks during separation related to the extent of their connection which can include anorectal, genitourinary, vertebral, and neural structures. Neurophysiologic intraoperative monitoring for these cases has been discussed in the literature with variable utility. The authors present a case of pygopagus twins with fused spinal cords and imperforate anus where the use of neurophysiologic intraoperative monitoring significantly impacted surgical decision-making in division of these critical structures.

  7. Intraoperative ultrasound to facilitate removal of a submucosal foreign body.

    Smith, Matthew E; Riffat, Faruque; Berman, Laurence H; Jani, Piyush

    2014-01-01

    A 61-year-old man with a history of fish bone ingestion and poorly localized symptoms was seen. His clinical examination was unremarkable, but CT demonstrated a foreign body deeply embedded within his tongue. Intraoperative ultrasound (US) guidance facilitated identification of a bone, allowing a needle to be placed as a guide to dissection. Repeat US scanning through the incision permitted precisely targeted surgery. CT and US are the most effective imaging techniques for localizing fish bones. Intraoperative US can be used to accurately locate a submucosal fish bone in mobile tissue such as the tongue, and focused, image-guided dissection can reduce surgical tissue trauma. © 2014 Wiley Periodicals, Inc.

  8. Minimally Invasive Spinal Surgery with Intraoperative Image-Guided Navigation

    Terrence T. Kim

    2016-01-01

    Full Text Available We present our perioperative minimally invasive spine surgery technique using intraoperative computed tomography image-guided navigation for the treatment of various lumbar spine pathologies. We present an illustrative case of a patient undergoing minimally invasive percutaneous posterior spinal fusion assisted by the O-arm system with navigation. We discuss the literature and the advantages of the technique over fluoroscopic imaging methods: lower occupational radiation exposure for operative room personnel, reduced need for postoperative imaging, and decreased revision rates. Most importantly, we demonstrate that use of intraoperative cone beam CT image-guided navigation has been reported to increase accuracy.

  9. Intra-operative ultrasound hand-held strain imaging for the visualization of ablations produced in the liver with a toroidal HIFU transducer: first in vivo results

    Chenot, J; Melodelima, D; N' Djin, W A; Souchon, Remi; Rivoire, M; Chapelon, J Y, E-mail: jeremy.chenot@inserm.f [Inserm, U556, Lyon, F-69003 (France)

    2010-06-07

    The use of hand-held ultrasound strain imaging for the intra-operative real-time visualization of HIFU (high-intensity focused ultrasound) ablations produced in the liver by a toroidal transducer was investigated. A linear 12 MHz ultrasound imaging probe was used to obtain radiofrequency signals. Using a fast cross-correlation algorithm, strain images were calculated and displayed at 60 frames s{sup -1}, allowing the use of hand-held strain imaging intra-operatively. Fourteen HIFU lesions were produced in four pigs. Intra-operative strain imaging of HIFU ablations in the liver was feasible owing to the high frame rate. The correlation between dimensions measured on gross pathology and dimensions measured on B-mode images and on strain images were R = 0.72 and R = 0.94 respectively. The contrast between ablated and non-ablated tissue was significantly higher (p < 0.05) in the strain images (22 dB) than in the B-mode images (9 dB). Strain images allowed equivalent or improved definition of ablated regions when compared with B-mode images. Real-time intra-operative hand-held strain imaging seems to be a promising complement to conventional B-mode imaging for the guidance of HIFU ablations produced in the liver during an open procedure. These results support that hand-held strain imaging outperforms conventional B-mode ultrasound and could potentially be used for the assessment of thermal therapies.

  10. Dose estimative in operators during petroleum wells logging with nuclear wireless probes through computer modelling

    Souza, Edmilson Monteiro de; Silva, Ademir Xavier da; Lopes, Ricardo T.; Correa, Samanda Cristine Arruda; Rocha, Paula L.F.

    2011-01-01

    This paper evaluates the absorbed dose and the effective dose on operators during the petroleum well logging with nuclear wireless that uses gamma radiation sources. To obtain the data, a typical scenery of a logging procedure will be simulated with MCNPX Monte Carlo code. The simulated logging probe was the Density Gamma Probe - TRISOND produced by Robertson Geolloging. The absorbed dose values were estimated through the anthropomorphic simulator in male voxel MAX. The effective dose values were obtained using the ICRP 103

  11. Intravenous dexmedetomidine infusion in adult patients undergoing open nephrolithotomy: Effects on intraoperative hemodynamics and blood loss; a random

    Doaa A. Rashwan

    2015-10-01

    Conclusion: Dexmedetomidine infusion in patients undergoing open nephrolithotomy under general anesthesia was associated with intraoperative hemodynamic stability, which decreases intraoperative blood loss and the need for intraoperative blood transfusion.

  12. Gamma camera

    Conrad, B.; Heinzelmann, K.G.

    1975-01-01

    A gamma camera is described which obviates the distortion of locating signals generally caused by the varied light conductive capacities of the light conductors in that the flow of light through each light conductor may be varied by means of a shutter. A balancing of the flow of light through each of the individual light conductors, in effect, collective light conductors may be balanced on the basis of their light conductive capacities or properties, so as to preclude a distortion of the locating signals caused by the varied light conductive properties of the light conductors. Each light conductor has associated therewith two, relative to each other, independently adjustable shutters, of which one forms a closure member and the other an adjusting shutter. In this embodiment of the invention it is thus possible to block all of the light conductors leading to a photoelectric transducer, with the exception of those light conductors which are to be balanced. The balancing of the individual light conductors may then be obtained on the basis of the output signals of the photoelectric transducer. (auth)

  13. Gamma ray generator

    Firestone, Richard B; Reijonen, Jani

    2014-05-27

    An embodiment of a gamma ray generator includes a neutron generator and a moderator. The moderator is coupled to the neutron generator. The moderator includes a neutron capture material. In operation, the neutron generator produces neutrons and the neutron capture material captures at least some of the neutrons to produces gamma rays. An application of the gamma ray generator is as a source of gamma rays for calibration of gamma ray detectors.

  14. Intraoperative use of dextran is associated with cardiac complications after carotid endarterectomy

    Farber, Alik; Tan, Tze-Woei; Rybin, Denis; Kalish, Jeffrey A.; Hamburg, Naomi M.; Doros, Gheorghe; Goodney, Philip P.; Cronenwett, Jack L.

    2013-01-01

    Objective Although dextran has been theorized to diminish the risk of stroke associated with carotid endarterectomy (CEA), variation exists in its use. We evaluated outcomes of dextran use in patients undergoing CEA to clarify its utility. Methods We studied all primary CEAs performed by 89 surgeons within the Vascular Study Group of New England database (2003–2010). Patients were stratified by intraoperative dextran use. Outcomes included perioperative death, stroke, myocardial infarction (MI), and congestive heart failure (CHF). Group and propensity score matching was performed for risk-adjusted comparisons, and multivariable logistic and gamma regressions were used to examine associations between dextran use and outcomes. Results There were 6641 CEAs performed, with dextran used in 334 procedures (5%). Dextran-treated and untreated patients were similar in age (70 years) and symptomatic status (25%). Clinical differences between the cohorts were eliminated by statistical adjustment. In crude, group-matched, and propensity-matched analyses, the stroke/death rate was similar for the two cohorts (1.2%). Dextran-treated patients were more likely to suffer postoperative MI (crude: 2.4% vs 1.0%; P = .03; group-matched: 2.4% vs 0.6%; P = .01; propensity-matched: 2.4% vs 0.5%; P = .003) and CHF (2.1% vs 0.6%; P = .01; 2.1% vs 0.5%; P = .01; 2.1% vs 0.2%; P dextran was associated with a higher risk of postoperative MI (odds ratio, 3.52; 95% confidence interval, 1.62–7.64) and CHF (odds ratio, 5.71; 95% confidence interval, 2.35–13.89). Conclusions Dextran use was not associated with lower perioperative stroke but was associated with higher rates of MI and CHF. Taken together, our findings suggest limited clinical utility for routine use of intraoperative dextran during CEA. PMID:23337295

  15. Effects of intraoperative irradiation and intraoperative hyperthermia on canine sciatic nerve: neurologic and electrophysiologic study

    Vujaskovic, Zeljko; Gillette, Sharon M.; Powers, Barbara E.; Stukel, Therese A.; LaRue, Susan M.; Gillette, Edward L.; Borak, Thomas B.; Scott, Robert J.; Weiss, Julia; Colacchio, Thomas A.

    1996-01-01

    Purpose: Late radiation injury to peripheral nerve may be the limiting factor in the clinical application of intraoperative radiation therapy (IORT). The combination of IORT with intraoperative hyperthermia (IOHT) raises specific concerns regarding the effects on certain normal tissues such as peripheral nerve, which might be included in the treatment field. The objective of this study was to compare the effect of IORT alone to the effect of IORT combined with IOHT on peripheral nerve in normal beagle dogs. Methods and Materials: Young adult beagle dogs were randomized into five groups of three to five dogs each to receive IORT doses of 16, 20, 24, 28, or 32 Gy to 5 cm of surgically exposed right sciatic nerve using 6 MeV electrons and six groups of four to five dogs each received IORT doses of 0, 12, 16, 20, 24, or 28 Gy simultaneously with 44 deg. C of IOHT for 60 min. IOHT was performed using a water circulating hyperthermia device with a multichannel thermometry system on the surgically exposed sciatic nerve. Neurologic and electrophysiologic examinations were done before and monthly after treatment for 24 months. Electrophysiologic studies included electromyographic (EMG) examinations of motor function, as well as motor nerve conduction velocities studies. Results: Two years after treatment, the effective dose for 50% complication (ED 50 ) for limb paresis in dogs exposed to IORT only was 22 Gy. The ED 50 for paresis in dogs exposed to IORT combined with IOHT was 15 Gy. The thermal enhancement ratio (TER) was 1.5. Electrophysiologic studies showed more prominent changes such as EMG abnormalities, decrease in conduction velocity and amplitude of the action potential, and complete conduction block in dogs that received the combination of IORT and IOHT. The latency to development of peripheral neuropathies was shorter for dogs exposed to the combined treatment. Conclusion: The probability of developing peripheral neuropathies in a large animal model was higher

  16. The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism

    Yeliz Yilmaz

    2016-08-01

    Conclusion: Preoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss. Moreover, preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.

  17. Evaluation of the Gen-Probe DNA probe for the detection of legionellae in culture

    Edelstein, P.H.

    1986-01-01

    A commercial DNA probe kit designed to detect rRNA from legionellae was evaluated for its ability to correctly discriminate between legionellae and non-legionellae taken from culture plates. The probe kit, made by the Gen-Probe Corp. (San Diego, Calif.), was radiolabeled with 125 I, and probe bacterial RNA hybridization, detected in a simple one-tube system hybridization assay, was quantitated with a gamma counter. A total of 156 Legionella sp. strains were tested, of which 125 were Legionella pneumophila and the remainder were strains from 21 other Legionella spp. A total of 106 gram-negative non-legionellae, isolated from human respiratory tract (81%) and other body site (19%) specimens, were also tested; 14 genera and 28 species were represented. The probe easily distinguished all of the legionellae from the non-legionellae. The average legionellae/non-legionellae hybridization ratio was 42:1, and the lowest ratio was 2:1; a minor modification in the procedure increased the lowest ratio to 5:1. In addition to correctly identifying all Legionella species, the probe was able to separate some of the various species of Legionella. L. pneumophila strains hybridized more completely to the probe than did the other Legionella spp.; L. wadsworthii and L. oakridgensis hybridized only about 25% of the probe relative to L. pneumophila. Some strains of phenotypically identified L. pneumophila had much lower hybridization to the probe than other members of the species and may represent a new Legionella species. The simplicity of the technique and specificity of the probe make it a good candidate for confirming the identity of legionellae in culture

  18. INTRAOPERATIVE IRRADIATION OF THE CANINE PANCREAS - SHORT-TERM EFFECTS

    HEIJMANS, HJ; MEHTA, DM; KLEIBEUKER, JH; SLUITER, WJ; OLDHOFF, J; HOEKSTRA, HJ

    1993-01-01

    Intraoperative electron beam radiotherapy (IORT) is clinically used as a potential adjunctive treatment to surgery of locally advanced pancreatic and gastric cancer. The tolerance of the pancreas to IORT was studied in 15 adult beagles, divided in 3 groups of 5 beagles in which 25, 30 or 35 Gy IORT

  19. Intraoperative cell salvage in South Africa: Feasible, beneficial and ...

    More than one CS blood unit was available for transfusion in 66% of cases. No additional staff were required to operate the Cell Saver, which was successfully used by medical officers. Conclusions. This study showed that intraoperative CS use is feasible, has potential patient benefit by reducing blood bank blood ...

  20. Intraoperative Death During Cervical Spinal Surgery: A Retrospective Multicenter Study.

    Wang, Jeffrey C; Buser, Zorica; Fish, David E; Lord, Elizabeth L; Roe, Allison K; Chatterjee, Dhananjay; Gee, Erica L; Mayer, Erik N; Yanez, Marisa Y; McBride, Owen J; Cha, Peter I; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    A retrospective multicenter study. Routine cervical spine surgeries are typically associated with low complication rates, but serious complications can occur. Intraoperative death is a very rare complication and there is no literature on its incidence. The purpose of this study was to determine the intraoperative mortality rates and associated risk factors in patients undergoing cervical spine surgery. Twenty-one surgical centers from the AOSpine North America Clinical Research Network participated in the study. Medical records of patients who received cervical spine surgery from January 1, 2005, to December 31, 2011, were reviewed to identify occurrence of intraoperative death. A total of 258 patients across 21 centers met the inclusion criteria. Most of the surgeries were done using the anterior approach (53.9%), followed by posterior (39.1%) and circumferential (7%). Average patient age was 57.1 ± 13.2 years, and there were more male patients (54.7% male and 45.3% female). There was no case of intraoperative death. Death during cervical spine surgery is a very rare complication. In our multicenter study, there was a 0% mortality rate. Using an adequate surgical approach for patient diagnosis and comorbidities may be the reason how the occurrence of this catastrophic adverse event was prevented in our patient population.

  1. Intraoperative colonic irrigation in the management of left sided ...

    Objectives: To evaluate the safety and benefits of antegrade intraoperative colonic irrigation (lavage) and primary anastomosis, after colonic resection, in the treatment of left sided large bowel emergencies. Design: A prospective descriptive study. Setting: Jos University Teaching Hospital, Jos, Nigeria. Participants: Thirty ...

  2. Fusion of intraoperative force sensoring, surface reconstruction and biomechanical modeling

    Röhl, S.; Bodenstedt, S.; Küderle, C.; Suwelack, S.; Kenngott, H.; Müller-Stich, B. P.; Dillmann, R.; Speidel, S.

    2012-02-01

    Minimally invasive surgery is medically complex and can heavily benefit from computer assistance. One way to help the surgeon is to integrate preoperative planning data into the surgical workflow. This information can be represented as a customized preoperative model of the surgical site. To use it intraoperatively, it has to be updated during the intervention due to the constantly changing environment. Hence, intraoperative sensor data has to be acquired and registered with the preoperative model. Haptic information which could complement the visual sensor data is still not established. In addition, biomechanical modeling of the surgical site can help in reflecting the changes which cannot be captured by intraoperative sensors. We present a setting where a force sensor is integrated into a laparoscopic instrument. In a test scenario using a silicone liver phantom, we register the measured forces with a reconstructed surface model from stereo endoscopic images and a finite element model. The endoscope, the instrument and the liver phantom are tracked with a Polaris optical tracking system. By fusing this information, we can transfer the deformation onto the finite element model. The purpose of this setting is to demonstrate the principles needed and the methods developed for intraoperative sensor data fusion. One emphasis lies on the calibration of the force sensor with the instrument and first experiments with soft tissue. We also present our solution and first results concerning the integration of the force sensor as well as accuracy to the fusion of force measurements, surface reconstruction and biomechanical modeling.

  3. Appropriateness of Intra-Operative Blood Transfusion In Children at ...

    Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the ...

  4. The diagnostic dilemma of intraoperative hyperpyrexia in a malaria ...

    Keywords: Intraoperative fever, Malaria, Malignant hyperthermia. ... paludisme devront être examiné et soigné de paludisme s'il est indiqué d'une manière préopératoire même s'il est ... West African Journal of Medicine Vol.22(1) 2003: 98-100 ...

  5. Video-rate optical flow corrected intraoperative functional fluorescence imaging

    Koch, Maximilian; Glatz, Juergen; Ermolayev, Vladimir; de Vries, Elisabeth G. E.; van Dam, Gooitzen M.; Englmeier, Karl-Hans; Ntziachristos, Vasilis

    Intraoperative fluorescence molecular imaging based on targeted fluorescence agents is an emerging approach to improve surgical and endoscopic imaging and guidance. Short exposure times per frame and implementation at video rates are necessary to provide continuous feedback to the physician and

  6. Intraoperative seizures and seizures outcome in patients underwent awake craniotomy.

    Yuan, Yang; Peizhi, Zhou; Xiang, Wang; Yanhui, Liu; Ruofei, Liang; Shu, Jiang; Qing, Mao

    2016-11-25

    Awake craniotomies (AC) could reduce neurological deficits compared with patients under general anesthesia, however, intraoperative seizure is a major reason causing awake surgery failure. The purpose of the study was to give a comprehensive overview the published articles focused on seizure incidence in awake craniotomy. Bibliographic searches of the EMBASE, MEDLINE,were performed to identify articles and conference abstracts that investigated the intraoperative seizure frequency of patients underwent AC. Twenty-five studies were included in this meta-analysis. Among the 25 included studies, one was randomized controlled trials and 5 of them were comparable studies. The pooled data suggested the general intraoperative seizure(IOS) rate for patients with AC was 8%(fixed effect model), sub-group analysis identified IOS rate for glioma patients was 8% and low grade patients was 10%. The pooled data showed early seizure rates of AC patients was 11% and late seizure rates was 35%. This systematic review and meta-analysis shows that awake craniotomy is a safe technique with relatively low intraoperative seizure occurrence. However, few RCTs were available, and the acquisition of further evidence through high-quality RCTs is highly recommended.

  7. Intraoperative glucose management in children < 1 year or < 10 kg ...

    The intraoperative management of intravenous dextrose administration and blood glucose monitoring was at the discretion of the attending anaesthetists. Data collected included patient demographics, period of starvation, dose of dextrose administered and blood glucose measurements taken. Results: Nine infants had at ...

  8. Intraoperative Deaths at Ahmadu Bello University Teaching Hospital ...

    Nine cases of intraoperative deaths were recorded. Most of the deaths occurred among the gravely ill, inadequately prepared patients and patients whose operations were done in the late hours of the night. Conclusion: This tragedy is preventable by paying meticulous attention to details and careful patient selection and ...

  9. Comparative Study Of Intra-Operative Pelvimetry With Calipers And ...

    The pelvic measurement of patients who have had a caesarean section was done using Pelvic Calipers (intra-operative) and x-ray methods. In the former method, during Caesarean sections and after closure of the lower uterine segment incision, a pair of pelvic calipers was used to measure the true conjugate of the pelvis.

  10. Medical Error Avoidance in Intraoperative Neurophysiological Monitoring: The Communication Imperative.

    Skinner, Stan; Holdefer, Robert; McAuliffe, John J; Sala, Francesco

    2017-11-01

    Error avoidance in medicine follows similar rules that apply within the design and operation of other complex systems. The error-reduction concepts that best fit the conduct of testing during intraoperative neuromonitoring are forgiving design (reversibility of signal loss to avoid/prevent injury) and system redundancy (reduction of false reports by the multiplication of the error rate of tests independently assessing the same structure). However, error reduction in intraoperative neuromonitoring is complicated by the dichotomous roles (and biases) of the neurophysiologist (test recording and interpretation) and surgeon (intervention). This "interventional cascade" can be given as follows: test → interpretation → communication → intervention → outcome. Observational and controlled trials within operating rooms demonstrate that optimized communication, collaboration, and situational awareness result in fewer errors. Well-functioning operating room collaboration depends on familiarity and trust among colleagues. Checklists represent one method to initially enhance communication and avoid obvious errors. All intraoperative neuromonitoring supervisors should strive to use sufficient means to secure situational awareness and trusted communication/collaboration. Face-to-face audiovisual teleconnections may help repair deficiencies when a particular practice model disallows personal operating room availability. All supervising intraoperative neurophysiologists need to reject an insular or deferential or distant mindset.

  11. Intra-operative parathyroid hormone measurements – experience of ...

    Background. Surgery is the treatment of choice for symptomatic primary hyperparathyroidism. The majority of research concerning intra-operative parathyroid hormone (ioPTH) measurements is conducted in university hospitals. Whether ioPTH measurements are feasible and useful in predicting the presence of remaining ...

  12. Probe-diverse ptychography

    Peterson, I., E-mail: isaac.russellpeterson@rmit.edu.au [ARC Centre of Excellence for Coherent X-ray Science, the University of Melbourne, School of Physics, Victoria 3010 (Australia); Harder, R. [Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439 (United States); Robinson, I.K. [Research Complex at Harwell, Didcot, Oxfordshire OX11 0DE (United Kingdom); London Centre for Nanotechnology, University College London, London WC1H 0AH (United Kingdom)

    2016-12-15

    We propose an extension of ptychography where the target sample is scanned separately through several probes with distinct amplitude and phase profiles and a diffraction image is recorded for each probe and each sample translation. The resulting probe-diverse dataset is used to iteratively retrieve high-resolution images of the sample and all probes simultaneously. The method is shown to yield significant improvement in the reconstructed sample image compared to the image obtained using the standard single-probe ptychographic phase-retrieval scheme.

  13. Physics-based shape matching for intraoperative image guidance

    Suwelack, Stefan, E-mail: suwelack@kit.edu; Röhl, Sebastian; Bodenstedt, Sebastian; Reichard, Daniel; Dillmann, Rüdiger; Speidel, Stefanie [Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Adenauerring 2, Karlsruhe 76131 (Germany); Santos, Thiago dos; Maier-Hein, Lena [Computer-assisted Interventions, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Wagner, Martin; Wünscher, Josephine; Kenngott, Hannes; Müller, Beat P. [General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, Heidelberg 69120 (Germany)

    2014-11-01

    Purpose: Soft-tissue deformations can severely degrade the validity of preoperative planning data during computer assisted interventions. Intraoperative imaging such as stereo endoscopic, time-of-flight or, laser range scanner data can be used to compensate these movements. In this context, the intraoperative surface has to be matched to the preoperative model. The shape matching is especially challenging in the intraoperative setting due to noisy sensor data, only partially visible surfaces, ambiguous shape descriptors, and real-time requirements. Methods: A novel physics-based shape matching (PBSM) approach to register intraoperatively acquired surface meshes to preoperative planning data is proposed. The key idea of the method is to describe the nonrigid registration process as an electrostatic–elastic problem, where an elastic body (preoperative model) that is electrically charged slides into an oppositely charged rigid shape (intraoperative surface). It is shown that the corresponding energy functional can be efficiently solved using the finite element (FE) method. It is also demonstrated how PBSM can be combined with rigid registration schemes for robust nonrigid registration of arbitrarily aligned surfaces. Furthermore, it is shown how the approach can be combined with landmark based methods and outline its application to image guidance in laparoscopic interventions. Results: A profound analysis of the PBSM scheme based on in silico and phantom data is presented. Simulation studies on several liver models show that the approach is robust to the initial rigid registration and to parameter variations. The studies also reveal that the method achieves submillimeter registration accuracy (mean error between 0.32 and 0.46 mm). An unoptimized, single core implementation of the approach achieves near real-time performance (2 TPS, 7–19 s total registration time). It outperforms established methods in terms of speed and accuracy. Furthermore, it is shown that the

  14. Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

    Lee, Su-Keon; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

    2016-01-01

    Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. Methods Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°). Results Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). Conclusions Intraoperative lumbar lordosis on the OSI frame with a prone

  15. Traversing probe system

    Mashburn, D.N.; Stevens, R.H.; Woodall, H.C.

    1977-01-01

    This invention comprises a rotatable annular probe-positioner which carries at least one radially disposed sensing probe, such as a Pitot tube having a right-angled tip. The positioner can be coaxially and rotatably mounted within a compressor casing or the like and then actuated to orient the sensing probe as required to make measurements at selected stations in the annulus between the positioner and compressor casing. The positioner can be actuated to (a) selectively move the probe along its own axis, (b) adjust the yaw angle of the right-angled probe tip, and (c) revolve the probe about the axis common to the positioner and casing. A cam plate engages a cam-follower portion of the probe and normally rotates with the positioner. The positioner includes a first-motor-driven ring gear which effects slidable movement of the probe by rotating the positioner at a time when an external pneumatic cylinder is actuated to engage the cam plate and hold it stationary. When the pneumatic cylinder is not actuated, this ring gear can be driven to revolve the positioner and thus the probe to a desired circumferential location about the above-mentioned common axis. A second motor-driven ring gear included in the positioner can be driven to rotate the probe about its axis, thus adjusting the yaw angle of the probe tip. The positioner can be used in highly corrosive atmosphere, such as gaseous uranium hexafluoride. 10 claims, 6 figures

  16. Traversing probe system

    Mashburn, Douglas N.; Stevens, Richard H.; Woodall, Harold C.

    1977-01-01

    This invention comprises a rotatable annular probe-positioner which carries at least one radially disposed sensing probe, such as a Pitot tube having a right-angled tip. The positioner can be coaxially and rotatably mounted within a compressor casing or the like and then actuated to orient the sensing probe as required to make measurements at selected stations in the annulus between the positioner and compressor casing. The positioner can be actuated to (a) selectively move the probe along its own axis, (b) adjust the yaw angle of the right-angled probe tip, and (c) revolve the probe about the axis common to the positioner and casing. A cam plate engages a cam-follower portion of the probe and normally rotates with the positioner. The positioner includes a first-motor-driven ring gear which effects slidable movement of the probe by rotating the positioner at a time when an external pneumatic cylinder is actuated to engage the cam plate and hold it stationary. When the pneumatic cylinder is not actuated, this ring gear can be driven to revolve the positioner and thus the probe to a desired circumferential location about the above-mentioned common axis. A second motor-driven ring gear included in the positioner can be driven to rotate the probe about its axis, thus adjusting the yaw angle of the probe tip. The positioner can be used in highly corrosive atmosphere, such as gaseous uranium hexafluoride.

  17. Portal monitor incorporating smart probes

    Bartos, D.; Constantin, F.; Guta, T.

    2003-01-01

    Portal monitors are intended for detection of radioactive and special nuclear materials in vehicles, pedestrians, luggage, as well as for prevention of illegal traffic of radioactive sources. Monitors provide audio and visual alarms when radioactive and/or special nuclear materials are detected. They can be recommended to officers of customs, border guard and emergency services, civil defense, fire brigades, police and military departments or nuclear research or energetic facilities. The portal monitor developed by us consists in a portal frame, which sustains five intelligent probes having long plastic scintillator (0.5 liters each). The probes communicate, by serial transmission, with a Central Unit constructed on the basis of the 80552 microcontroller. This one manages the handshake, calculates the background, establishes the measuring time, starts and stops each measurement and makes all the other decisions. Sound signals and an infrared sensor monitor the passing through the portal and the measuring procedure. For each measurement the result is displayed on a LCD device contaminated/uncontaminated; for the contaminated case a loud and long sound signal is also issued. An RS 232 serial interface is provided in order to further developments or custom made devices. As a result, the portal monitor detects 1 μ Ci 137 Cs, spread all over a human body, in a 20 μR/h gamma background for a measuring time of 1.5 or 10 seconds giving a 99% confidence factor. (authors)

  18. Electrical resistivity probes

    Lee, Ki Ha; Becker, Alex; Faybishenko, Boris A.; Solbau, Ray D.

    2003-10-21

    A miniaturized electrical resistivity (ER) probe based on a known current-voltage (I-V) electrode structure, the Wenner array, is designed for local (point) measurement. A pair of voltage measuring electrodes are positioned between a pair of current carrying electrodes. The electrodes are typically about 1 cm long, separated by 1 cm, so the probe is only about 1 inch long. The electrodes are mounted to a rigid tube with electrical wires in the tube and a sand bag may be placed around the electrodes to protect the electrodes. The probes can be positioned in a borehole or on the surface. The electrodes make contact with the surrounding medium. In a dual mode system, individual probes of a plurality of spaced probes can be used to measure local resistance, i.e. point measurements, but the system can select different probes to make interval measurements between probes and between boreholes.

  19. Categorization of intraoperative ureteroscopy complications using modified Satava classification system.

    Tepeler, Abdulkadir; Resorlu, Berkan; Sahin, Tolga; Sarikaya, Selcuk; Bayindir, Mirze; Oguz, Ural; Armagan, Abdullah; Unsal, Ali

    2014-02-01

    To review our experience with ureteroscopy (URS) in the treatment of ureteral calculi and stratify intraoperative complications of URS according to the modified Satava classification system. We performed a retrospective analysis of 1,208 patients (672 males and 536 females), with a mean age of 43.1 years (range 1-78), who underwent ureteroscopic procedures for removal of ureteral stones. Intraoperative complications were recorded according to modified Satava classification system. Grade 1 complications included incidents without consequences for the patient; grade 2 complications, which are treated intraoperatively with endoscopic surgery (grade 2a) or required endoscopic re-treatment (grade 2b); and grade 3 complications included incidents requiring open or laparoscopic surgery. The stones were completely removed in 1,067 (88.3%) patients after primary procedure by either simple extraction or after fragmentation. The overall incidence of intraoperative complications was 12.6%. The most common complications were proximal stone migration (3.9%), mucosal injury (2.8%), bleeding (1.9%), inability to reach stone (1.8%), malfunctioning or breakage of instruments (0.8%), ureteral perforation (0.8%) and ureteral avulsion (0.16%). According to modified Satava classification system, there were 4.5% grade 1; 4.4% grade 2a; 3.2% grade 2b; and 0.57% grade 3 complications. We think that modified Satava classification is a quick and simple system for describing the severity of intraoperative URS complications and this grading system will facilitate a better comparison for the surgical outcomes obtained from different centers.

  20. Intraoperative and Early Postoperative Complications of Manual Sutureless Cataract Extraction

    Iqbal, Y.; Zia, S.; Mirza, A. B.

    2014-01-01

    Objective: To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. Study Design: Case series. Place and Duration of Study: Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. Methodology: Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery (MSCS) by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences (SPSS) version 13.0 and the results were calculated in frequencies. Results: Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases (3%) underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. Conclusion: Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema. (author)

  1. Effects of intraoperative irradiation (IORT) and intraoperative hyperthermia (IOHT) on canine sciatic nerve : Histopathological and morphometric studies

    Vujaskovic, Z; Powers, BE; Paardekoper, G; Gillette, SM; Gillette, EL; Colacchio, TA

    1999-01-01

    Purpose/Objective: Peripheral neuropathies have emerged as the major dose-limiting complication reported after intraoperative radiation therapy (IORT). The combination of IORT with hyperthermia may further increase the risk of peripheral nerve injury. The objective of this study was to evaluate

  2. 3D CMM strain-gauge triggering probe error characteristics modeling using fuzzy logic

    Achiche, Sofiane; Wozniak, A; Fan, Zhun

    2008-01-01

    FKBs based on two optimization paradigms are used for the reconstruction of the direction- dependent probe error w. The angles beta and gamma are used as input variables of the FKBs; they describe the spatial direction of probe triggering. The learning algorithm used to generate the FKBs is a real......The error values of CMMs depends on the probing direction; hence its spatial variation is a key part of the probe inaccuracy. This paper presents genetically-generated fuzzy knowledge bases (FKBs) to model the spatial error characteristics of a CMM module-changing probe. Two automatically generated...

  3. Intraoperative and external beam radiotherapy for pancreatic carcinoma; Intraoperative und perkutane Radiotherapie des Pankreaskarzinoms

    Eble, M.J. [Abt. Klinische Radiologie, Radiologische Universitaetsklinik Heidelberg (Germany); Maurer, U. [Klinikum der Stadt Mannheim (Germany). Inst. fuer Radiologie

    1996-05-01

    Therapeutic strategies in the treatment of pancreatic carcinoma are based on the high number of non-resectable cancers, the high relative radioresistance and the high distant metastases rate. Even in curatively resected carcinomas, a locally effective treatment modality is needed because of the risk of microscopical residual disease in the peripancreatic tissue. The efficacy of radiotherapy is dose dependent. Based on an analysis of published data a dose of more than 50 Gy is recommended, resulting in a high morbidity rate with external beam radiotherapy alone. The use of intraoperative radiotherapy allows locally restricted dose escalation without increased perioperative morbidity. In adjuvant and in primary treatment, local tumor control was improved (70-90%). With palliative intent, pain relief was obtained rapidly in over 60% of patients and led to improved patient performance. As a result of the high distant metastases rate, even in curatively resected carcinomas, the overall prognosis could not be significantly improved. Further dose escalation is limited by the increasing incidence of upper gastrointestinal bleeding (20-30%). (orig.) [Deutsch] Therapiestrategien beim Pankreaskarzinom werden bestimmt durch den hohen Anteil primaer nicht resektabler Karzinome, der hohen relativen Strahlenresistenz und der hohen Fernmetastasierungsrate. Selbst kurativ resezierte Karzinome erfordern durch ihre hohe lokale Tumorzellpersistenz eine lokal effektive adjuvante Behandlungsmassnahme. Die Effektivitaet einer Radiotherapie ist dosisabhaengig. Aus der Analyse publizierter Daten wird eine Dosis von >50 Gy, welche bei der alleinigen perkutanen Bestrahlung mit einer hohen Morbiditaet verbunden ist, empfohlen. Mit der intraoperativen Radiotherapie ist eine lokal begrenzte Dosiseskalation ohne erhoehte perioperative Morbiditaet moeglich. Sowohl in der adjuvanten als auch in der primaeren Behandlung kann die lokale Tumorkontrolle deutlich verbessert werden (70-90%). Unter

  4. Intraoperative /sup 99m/Tc bone imaging in the treatment of benign osteoblastic tumors

    Sty, J.; Simons, G.

    1982-01-01

    Benign bone tumors can be successfully treated by local resection with the use of intraoperative bone imaging. Intraoperative bone imaging provided accurate localization of an osteoid osteoma in a patella of a 16-year-old girl when standard radiographs failed to demonstrate the lesion. In a case of osteoblastoma of the sacrum in a 12-year old girl, intraoperative scanning was used repeatedly to guide completeness of resection. In these cases in which routine intraoperative radiographs would have failed, intraoperative scanning proved to be essential for success

  5. Intraoperative language localization in multilingual patients with gliomas.

    Bello, Lorenzo; Acerbi, Francesco; Giussani, Carlo; Baratta, Pietro; Taccone, Paolo; Songa, Valeria; Fava, Marica; Stocchetti, Nino; Papagno, Costanza; Gaini, Sergio M

    2006-07-01

    Intraoperative localization of speech is problematic in patients who are fluent in different languages. Previous studies have generated various results depending on the series of patients studied, the type of language, and the sensitivity of the tasks applied. It is not clear whether languages are mediated by multiple and separate cortical areas or shared by common areas. Globally considered, previous studies recommended performing a multiple intraoperative mapping for all the languages in which the patient is fluent. The aim of this work was to study the feasibility of performing an intraoperative multiple language mapping in a group of multilingual patients with a glioma undergoing awake craniotomy for tumor removal and to describe the intraoperative cortical and subcortical findings in the area of craniotomy, with the final goal to maximally preserve patients' functional language. Seven late, highly proficient multilingual patients with a left frontal glioma were submitted preoperatively to a battery of tests to evaluate oral language production, comprehension, and repetition. Each language was tested serially starting from the first acquired language. Items that were correctly named during these tests were used to build personalized blocks to be used intraoperatively. Language mapping was undertaken during awake craniotomies by the use of an Ojemann cortical stimulator during counting and oral naming tasks. Subcortical stimulation by using the same current threshold was applied during tumor resection, in a back and forth fashion, and the same tests. Cortical sites essential for oral naming were found in 87.5% of patients, those for the first acquired language in one to four sites, those for the other languages in one to three sites. Sites for each language were distinct and separate. Number and location of sites were not predictable, being randomly and widely distributed in the cortex around or less frequently over the tumor area. Subcortical stimulations found

  6. Cosmic gamma bursts

    Ehstulin, I.V.

    1980-01-01

    A brief consideration is being given to the history of cosmic gamma burst discovery and modern knowledge of their properties. The time dependence of gamma bursts is described and their possible sources are discussed

  7. Analytical applications of neutron capture gamma-rays

    Lindstrom, R.M.; Paul, R.L.; Anderson, D.L.; Paul, R.L.

    1997-01-01

    Field and industrial applications of neutron capture gamma-ray spectrometry with isotopic sources or neutron generators are economically important. Geochemical exploration in boreholes is done routinely with neutron probes. Coal and ores are assayed with analyzers adjacent to a conveyor belt in dozens of industrial facilities. The use of capture gamma rays for explosives detection has been described in the literature, both for scanning airline baggage and for characterizing obsolete munitions; a packaged system for the latter is available commercially. Generalizations are drawn from the history of the field, and predictions are made about the future usefulness of capture gamma rays. (author)

  8. Gamma ray astronomy

    Broomhead, Laurent.

    1980-01-01

    The nuclear gamma astronomy is presented, in particular the Gamma Ray Observatory, an enormous eight tonnes machine fitted with gamma telescopes, scheduled for launching around 1985. It is thereby hoped to study the natural nuclear reactions which occur when stars explode [fr

  9. Newer techniques for intravascular and intraoperative neurointerventional procedures

    Higashida, R.T.; Halbach, V.V.; Hieshima, G.B.; Yang, P.

    1987-01-01

    A videotape demonstrating newer techniques used in intravascular and intraoperative embolization procedures will be presented. The authors discuss the use of some of the newer embolic agents, real-time digital subtraction angiography, roadmapping techniques, and the use of microcatheters and steerable micro guide wires, which has greatly facilitated neurovascullar embolization procedures and enhanced patient safety. A number of actual intraoperative and intravascular cases will be shown demonstrating treatment of vascular malformations of the brain and spinal cord, carotid cavernous sinus fistulas, aneurysms and dural arteriovenous malformations. The indications for treatment, patient selection, technical preparation and newer methodologies and approaches to complex vascular lesions of the brain and spinal cord are discussed in detail

  10. Principles for Management of Intraoperative Acute Type A Aortic Dissection.

    Gukop, Philemon; Chandrasekaran, Vankatachalam

    2015-12-01

    Intraoperative Type A aortic dissection is a rare pathology with incidence of 0.06-0.32%. It is associated with a high mortality between 30-50%. Some associated risk factors, including hypertension, enlarged aorta, peripheral vascular disease, advanced age, atheroma, and high arterial pressure on cardiopulmonary bypass, have been identified. Modification of these risk factors could reduce the incidence of this event. Prompt diagnosis and management, with the aid of intraoperative trans-esophageal echocardiography and/or epi-aortic ultrasound has been shown to reduce the mortality to 17%. We illustrate the principles of management of this pathology with the case of a 62-year-old female who developed acute Type A aortic dissection while undergoing minimally invasive mitral valve repair.

  11. Transsphenoidal pituitary resection with intraoperative MR guidance: preliminary results

    Pergolizzi, Richard S., Jr.; Schwartz, Richard B.; Hsu, Liangge; Wong, Terence Z.; Black, Peter M.; Martin, Claudia; Jolesz, Ferenc A.

    1999-05-01

    The use of intraoperative MR image guidance has the potential to improve the precision, extent and safety of transsphenoidal pituitary resections. At Brigham and Women's Hospital, an open-bore configuration 0.5T MR system (SIGNA SP, GE Medical Systems, Milwaukee, WI) has been used to provide image guidance for nine transsphenoidal pituitary adenoma resections. The intraoperative MR system allowed the radiologist to direct the surgeon toward the sella turcica successfully while avoiding the cavernous sinus, optic chiasm and other sensitive structures. Imaging performed during the surgery monitored the extent of resection and allowed for removal of tumor beyond the surgeon's view in five cases. Dynamic MR imaging was used to distinguish residual tumor from normal gland and postoperative changes permitting more precise tumor localization. A heme-sensitive long TE gradient echo sequence was used to evaluate for the presence of hemorrhagic debris. All patients tolerated the procedure well without significant complications.

  12. Intraoperative Functional Mapping and Monitoring during Glioma Surgery

    SAITO, Taiichi; MURAGAKI, Yoshihiro; MARUYAMA, Takashi; TAMURA, Manabu; NITTA, Masayuki; OKADA, Yoshikazu

    2015-01-01

    Glioma surgery represents a significant advance with respect to improving resection rates using new surgical techniques, including intraoperative functional mapping, monitoring, and imaging. Functional mapping under awake craniotomy can be used to detect individual eloquent tissues of speech and/or motor functions in order to prevent unexpected deficits and promote extensive resection. In addition, monitoring the patient’s neurological findings during resection is also very useful for maximizing the removal rate and minimizing deficits by alarming that the touched area is close to eloquent regions and fibers. Assessing several types of evoked potentials, including motor evoked potentials (MEPs), sensory evoked potentials (SEPs) and visual evoked potentials (VEPs), is also helpful for performing surgical monitoring in patients under general anesthesia (GA). We herein review the utility of intraoperative mapping and monitoring the assessment of neurological findings, with a particular focus on speech and the motor function, in patients undergoing glioma surgery. PMID:25744346

  13. Response functions of NaI(Tl) detectors to terrestrial gamma radiation

    Gyurcsak, J.; Lenda, A.

    1978-01-01

    Computer programs, serving for calculation of detector efficiency and energy deposition spectrum for scintillation crystals irradiated by isotropic or half-isotropic gamma-ray fields were elaborated. The Monte-Carlo models used in calculations are valid for gamma-ray energies 2 π geometry by the 1.5'' x 2'' probe with experimental results is given. (author)

  14. Intraoperative injection of technetium-99m-dextran 500 for the identification of sentinel lymph node in breast cancer

    Delazeri, Gerson Jacob; Xavier, Nilton Leite; Menke, Carlos Henrique; Bittelbrunn, Ana Cristina; Spiro, Bernardo Leao; Mosmann, Marcos Pretto; Graudenz, Marcia Silveira

    2010-01-01

    Purpose: to determine the efficacy of intraoperative injection of Dextran-500- 99m -technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region. Methods: a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500- 99m -Tc filtered 0.22 μm in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18. Results: we identified the SLN in 100% of cases. The rate of SLN identification with the probe was 98% (73/74 cases). In one case (1.35%) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97±0.22 mCi. The average time to label the SLN was 10.7 minutes (±5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope. Conclusion: the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team. (author)

  15. A meta-analysis of intraoperative factors associated with ...

    ... 95% 1.9-26), new onset atrial fibrillation (OR 6.6, 95% CI 2.5-20), hypothermia (OR 2.2, 95% CI 1.1-5) and remote ischaemic preconditioning (OR 0.22, 95% CI 0.07-0.67). None of these studies controlled for blood transfusion. Conclusion: Both surgical and haemodynamic intraoperative events significantly increased the ...

  16. Intraoperative Assessment of Tricuspid Valve Function After Conservative Repair

    Revuelta, J.M.; Gomez-Duran, C.; Garcia-Rinaldi, R.; Gallagher, M.W.

    1982-01-01

    It is desirable to repair coexistent tricuspid valve pathology at the time of mitral valve corrections. Conservative tricuspid repair may consist of commissurotomy, annuloplasty, or both. It is important that the repair be appropriate or tricuspid valve replacement may be necessary. A simple reproducible method of intraoperative testing for tricuspid valve insufficiency has been developed and used in 25 patients. Fifteen patients have been recatheterized, and the correlation between the intra...

  17. Recurrent intraoperative silent ST depression responding to phenylephrine

    P M Singh

    2012-01-01

    Full Text Available Intraoperative myocardial ischemia is attributed to decreased myocardial oxygen supply. We present an unusual case of recurrent, symptomless inferior wall ischemia in an apparently healthy male with no history of coronary artery disease after a spinal block. The recurring episodes were linked to tachycardia and presented with significant ST depression in Lead II with reciprocal elevation in lead aVL. The episodes responded to phenylephrine and subsided without residual sequelae.

  18. Premedication with oral Dextromethorphan reduces intra-operative Morphine requirement

    R Talakoub

    2005-09-01

    Full Text Available Background: Intra-operative pain has adverse effects on hemodynamic parameters. Due to complications of opioids for pain relief, using non-opioids medication is preferred. The purpose of this study was to investigate the effect of oral dextrometorphan premedication on intra-operative Morphine requirement. Methods: After approval of the Ethics committee and informed consent, 40 adult patients who stand in American Society of Anesthesiologists Physical Status I and II, under general anesthesia for elective laparatomy were selected and classified in two equal groups randomly. In group A, oral dextromethorphan (60mg was administered at 10 PM and 6 AM preoperatively. In group B, placebo (dextrose was administered. After induction of general anesthesia and before skin incision, intravenous morphine (0.01 mg/kg was administered. During surgery, when systolic blood pressure or heart rate was increased more than 20% of the preoperative baseline, 0.01 mg/kg morphine was administered. At the end of surgery, the totally prescribed morphine (mg/kg and maximal increase in systolic, diastolic, mean arterial blood pressure and heart rate relative to the baseline values were calculated and statistically compared with student’s t-test. Results: The mean dose of administered morphine during surgery was significantly less in group A than group B (P<0.0001. Also, Maximal increase in systolic, diastolic and mean arterial blood pressure was significantly less in group A (p<0.003, p<0.004, p<0.0001, respectively. There was no significant difference in maximal heart rate increase between two groups (p<0.114. Conclusion: Oral dextromethorphan premedication may decrease intra-operative morphine requirement and reduce maximal increase in systolic and mean arterial blood pressure during surgery. Key words: Dextromethorphan, Morphine, Intra-operative, Premedication Hemodynamic

  19. Intraoperative tractography and neuronavigation of the pyramidal tract

    Nimsky, C.; Ganslandt, O.; Weigel, D.; Keller, B. von; Stadlbauer, A.; Akutsu, H.; Hammen, T.; Buchfelder, M.

    2008-01-01

    Diffusion tensor imaging (DTI) based fiber tracking was applied to visualize the course of the pyramidal tract in the surgical field by microscope-based navigation. In 70 patients with lesions adjacent to the pyramidal tract, DTI data were integrated in a navigational setup. Diffusion data (b=0) were rigidly registered with standard T1-weighted 3-D images. Fiber tracking was performed applying a tensor-deflection algorithm using a multiple volume of interest approach as seed regions for tracking. fMRI data identifying the motor gyrus were applied as selection criteria to define the fibers of interest. After tracking, a 3-D object was generated representing the pyramidal tract. In selected cases, the intraoperative image data (1.5 T intraoperative MRI) were used to update the navigation system. In all patients the pyramidal tract could be visualized in the operative field applying the heads-up display of the operating microscope. In 8 patients (11%) a new or aggravated postoperative paresis could be observed, which was transient in 5 of them; thus, only in 3 patients (4.2%) was there a new permanent neurological deficit. Intraoperative imaging depicted a shifting of the pyramidal tract which amounted up to 15 mm; even the direction of shifting was variable and could not be predicted before surgery, so that mathematical models trying to predict brain shift behaviour are of restricted value only. DTI fiber tracking data can be reliably integrated into navigational systems providing intraoperative visualization of the pyramidal tract. This technique allowed the resection of lesions adjacent to the pyramidal tract with low morbidity. (author)

  20. Dapsone Induced Methaemoglobinemia: Early Intraoperative Detection by Pulse Oximeter Desaturation

    Mahmood Rafiq

    2008-01-01

    Case signifies the importance of knowledge of any preoperative drug intake and its anaesthetic implications. Also patients on dapsone therapy especially children should be monitored for methaemoglobin levels. Since children with immune thrombocy-topenic purpura are being treated with dapsone these days and many of these patients would be planned for splenectomy, monitoring of preoperative methaemoglobin levels and methaemoglobinemia as a cause of intraoperative pulse oximeter desaturation should be kept in mind.

  1. Intraoperative radionuclide study and colonoscopy in gastrointestinal hemorrhage

    Navab, F.; Westbrook, K.C.; Slaton, G.; Boyd, C.M.

    1985-01-01

    Tc-99m labeled red cell imaging is used in the diagnosis and localization of gastrointestinal hemorrhage. A patient in whom a preoperative scan was positive in the right paraumbilical region is discussed. Intraoperative Tc-99m labeled red cell imaging was used in conjunction with colonoscopy, and the site of active bleeding was found in the proximal transverse colon, which had been displaced downward because of adhesions

  2. Intraoperative perception and sensation in laser in situ keratomileusis (LASIK).

    Srivannaboon, Sabong; Chansue, Ekktet

    2004-04-01

    To investigate intraoperative perception and sensation during Laser in situ Keratomileusis (LASIK). Sixty patients with uneventful LASIK were included. All procedures were performed by one surgeon with one technique. Any patient with intra-operative complications was excluded. The patients were asked to fill in the subjective evaluation form regarding their perception and sensation during the operation. Twenty-nine patients (48%) reported no pain and twenty-six patients (43%) reported no burning sensation during the surgery. Nineteen patients (32%) reported no light perception during the suction period of microkeratome. There was no correlation between duration of the suction and no light perception (R2 0.01). Thirty-four patients (56%) reported no trouble in maintaining visual fixation at the red light during the laser treatment. Ten patients (16%) reported they could clearly see the movement during the surgery and 5 out of 10 patients (50% of 16%) reported visual frightening. Fifty cases (84%) reported no visual frightening during the surgery after reassurance of the visual experience by the surgeon before the surgery. Patients undergoing LASIK may experience different visual perceptions. Reassurance of the intraoperative perception and sensation before the surgery can reduce the visual frightening.

  3. Intraoperative Cerebral Glioma Characterization with Contrast Enhanced Ultrasound

    Francesco Prada

    2014-01-01

    Full Text Available Background. Contrast enhanced ultrasound (CEUS is a dynamic and continuous modality providing real-time view of vascularization and flow distribution patterns of different organs and tumors. Nevertheless its intraoperative use for brain tumors visualization has been performed few times, and a thorough characterization of cerebral glioma had never been performed before. Aim. To perform the first characterization of cerebral glioma using CEUS and to possibly achieve an intraoperative differentiation of different gliomas. Methods. We performed CEUS in an off-label setting in 69 patients undergoing surgery for cerebral glioma. An intraoperative qualitative analysis was performed comparing iCEUS with B-mode imaging. A postprocedural semiquantitative analysis was then performed for each case, according to EFSUMB criteria. Results were related to histopathology. Results. We observed different CE patterns: LGG show a mild, dotted CE with diffuse appearance and slower, delayed arterial and venous phase. HGG have a high CE with a more nodular, nonhomogeneous appearance and fast perfusion patterns. Conclusion. Our study characterizes for the first time human brain glioma with CEUS, providing further insight regarding these tumors’ biology. CEUS is a fast, safe, dynamic, real-time, and economic tool that might be helpful during surgery in differentiating malignant and benign gliomas and refining surgical strategy.

  4. SEP Montage Variability Comparison during Intraoperative Neurophysiologic Monitoring.

    Hanson, Christine; Lolis, Athena Maria; Beric, Aleksandar

    2016-01-01

    Intraoperative monitoring is performed to provide real-time assessment of the neural structures that can be at risk during spinal surgery. Somatosensory evoked potentials (SEPs) are the most commonly used modality for intraoperative monitoring. SEP stability can be affected by many factors during the surgery. This study is a prospective review of SEP recordings obtained during intraoperative monitoring of instrumented spinal surgeries that were performed for chronic underlying neurologic and neuromuscular conditions, such as scoliosis, myelopathy, and spinal stenosis. We analyzed multiple montages at the baseline, and then followed their development throughout the procedure. Our intention was to examine the stability of the SEP recordings throughout the surgical procedure on multiple montages of cortical SEP recordings, with the goal of identifying the appropriate combination of the least number of montages that gives the highest yield of monitorable surgeries. Our study shows that it is necessary to have multiple montages for SEP recordings, as it reduces the number of non-monitorable cases, improves IOM reliability, and therefore could reduce false positives warnings to the surgeons. Out of all the typical montages available for use, our study has shown that the recording montage Cz-C4/Cz-C3 (Cz-Cc) is the most reliable and stable throughout the procedure and should be the preferred montage followed throughout the surgery.

  5. Hydrodynamic study of syringomyelia by MRI and intraoperative ultrasonography

    Moritake, Kouzo; Takaya, Mikio; Minamikawa, Jun; Ishikawa, Masatsune; Kikuchi, Haruhiko; Minami, Shunsuke

    1989-01-01

    Syringomyelic cavities were studied with magnetic resonance imaging (MRI) in eleven patients with special reference to the hemodynamic contribution to the pathogenesis of syringomyelia. They were also studied intraoperatively with ultrasonography (USG) in five patients. Syrinx cavities combined with lumbosacral lipomyelomeningocele or with spinal stenosis did not present a flow-void phenomenon reflecting pulsatile movements of syrinx fluid. On serial MRI study in those the patients, enlargement of the syrinx cavity was not observed. Syrinx cavities occupying the caudal part of the spinal cord did not develop either. These cases were not treated surgically but followed conservatively. On the other hand, the flow-void sign in the syrinx cavities was present on MRI in patients who also had Chiari type I or type II malformations. They were treated with a syringo-subarachnoid shunt. In these cases, intraoperative USG disclosed marked fluctuation of syrinx cavity size synchronous with the motions of pulmonary ventilation. In all of them, clinical signs and symptoms improved postoperatively to various degrees. These results suggest that both the flow-void sign in the syrinx cavity on MRI and marked fluctaution of cavity size on intraoperative USG are indications for the shunt operation and support William's revised theory (1987). Fluctuation of cystic cavity size synchronous with ventilation suggests that venous pressure in the spinal subarachnoid space contributes to the pathogenesis of syringomyelic cavities. Further analysis of the fluctuation of cystic cavities by video monitoring will provide further information on the etiology and other clinical problems of syringomyelia. (author)

  6. Intraoperative radiotherapy in combined treatment of sinonasal malignant tumors

    Novikov, V. A.; Gribova, O. V.; Vasiljev, R. V.; Choynzonov, E. L.; Shtin, V. I.; Shiianova, A. A.; Surkova, P. V.; Starceva, Zh. A.; Shilova, O. G.

    2017-09-01

    Obvious advantage of IORT (intraoperative radiotherapy) is that the radiation source is delivered directly to the bed of the tumor during surgery, thus avoiding the negative impact on the skin, subcutaneous tissue and reducing the risk of fibrosis. Sinonasal tumors—a convenient object for intraoperative radiotherapy application (surface location, relatively small size tumors, good operational access). The surface location and comparatively small size of neoplasms, good operational access provide an efficient and accurate transfer of the electron beam to the postoperative cavity to increase the irradiation dose in the areas of the most probable recurrence, which makes the tumors of this localization a convenient object for the use of the intraoperative radiation therapy. The treatment was conducted using a mobile compact betatron (MIB-6E), 10-12 Gy single dose. IORT session extends surgery period by 30 min. There were no pathological clinical and laboratory reactions on IORT in the early postoperative period. Carrying out the procedure is possible in various standard operating rooms. It does not require special security measures for the patients and the staff. IORT with the help of electron beam allows avoiding post-radiation reactions and achieving a 5-year—disease-free survival of 66% of the patients. IORT session is possible through a minimal incision during organ preservation surgeries. Evident economic feasibility provides the prospects of applying IORT in the clinical practice.

  7. Intraoperative ultrasonography of liver, bile ducts and pancreas

    Luciana Mendes de Oliveira Cerri

    Full Text Available The use of intraoperative ultrasonography (IOUS to evaluate liver, bile ducts and pancreatic disease, as compared to the results of preoperative ultrasonography and CT, is discussed. Forty-two patients who underwent abdominal surgery for suspected hepatobiliary and/or pancreatic disease were studied. The intraoperative study was carried out with a portable apparatus (Aloka 500, Japan, using 5.0 MHz and 7.5 MHz linear sterile transducers. The main indications for IOUS were the search for and/or evaluation of primary hepatic masses,hepatic abscesses or metastases, obstructive jaundice, or neuroendocrine tumors. In 15 cases (38.5 percent from the hepatobiliary group and in 7 cases (58.3 percent from the pancreatic group, a difference between preoperative and intraoperative findings was observed. The main difference was observed in relation to the number and size of hepatic and pancreatic lesions. The relationship between the lesions and the vascular structures was evaluated through IOUS. The method was also used to guide surgical procedures such as biopsies, the alcoholization of nodules, and the drainage of abscesses. IOUS plays an important role in detecting small hepatic and pancreatic nodules, in the assessment of anatomical relationships between the lesions and the vascular structures, and in the performance of interventionist procedures.

  8. Dacryocystorhinostomy without intubation with intraoperative mitomycin-c

    Rahman, A.; Channa, S.; Memon, M.S.; Niazi, J.H.

    2006-01-01

    To evaluate the success rate and complications of intraoperative Mitomycin-C in dacryocystorhinostomy surgery. This study included total 90 eyes of 90 patients fulfilling the inclusion criteria.The surgical procedure of external DCR done with intraoperative Mitomycin-C with a neurosurgical cottonoid soaked with 0.2mg/ml. Mitomycin C was applied to the anastomosed flaps and osteotomy site for 10 minutes, without Silicon tube intubation. Surgery was done under local as well as general anesthesia. Patients were followed for 6 months. Out of 90 patients included in this study, only 2 patients complained of persistent epiphora after 6 months follow-up and were labeled as failed DCR. Remaining 88 had either no tearing or significant improvement of tearing after 6 months follow up and patent lacrimal system by syringing without pressure. Success rate in this procedure was 97.77% (p-value< 0.001). This study showed very high rate of success. Only complication noted was excessive nasal bleeding which was easily controlled. Intraoperative Mitomycin-C application in external DCR is safe, effective, cheap adjunct that helps to achieve good results of DCR surgery. (author)

  9. Intraoperative panoramic image using alignment grid, is it accurate?

    Apivatthakakul, T; Duanghakrung, M; Luevitoonvechkit, S; Patumasutra, S

    2013-07-01

    Minimally invasive orthopedic trauma surgery relies heavily on intraoperative fluoroscopic images to evaluate the quality of fracture reduction and fixation. However, fluoroscopic images have a narrow field of view and often cannot visualize the entire long bone axis. To compare the coronal femoral alignment between conventional X-rays to that achieved with a new method of acquiring a panoramic intraoperative image. Twenty-four cadaveric femurs with simple diaphyseal fractures were fixed with an angulated broad DCP to create coronal plane malalignment. An intraoperative alignment grid was used to help stitch different fluoroscopic images together to produce a panoramic image. A conventional X-ray of the entire femur was then performed. The coronal plane angulation in the panoramic images was then compared to the conventional X-rays using a Wilcoxon signed rank test. The mean angle measured from the panoramic view was 173.9° (range 169.3°-178.0°) with median of 173.2°. The mean angle measured from the conventional X-ray was 173.4° (range 167.7°-178.7°) with a median angle of 173.5°. There was no significant difference between both methods of measurement (P = 0.48). Panoramic images produced by stitching fluoroscopic images together with help of an alignment grid demonstrated the same accuracy at evaluating the coronal plane alignment of femur fractures as conventional X-rays.

  10. Incidence of intraoperative hypothermia: adopting protocol for its prevention

    Al-Qahtani, Ali S.; Messahel, Farouk M.

    2003-01-01

    To determine the incidence of hypothermia during surgical procedures when adequate methods of preserving normothermia are applied .For this was a study in which patients ASA I-IV presented for surgery at the Armed Forces Hospital, Wadi Al- Dawasir, kingdom of Saudi Arabia ,during the period from July 2000 to February 2003 in whom body core temprature was between 35-37C ,were included. Ambient temperature of the operating room was thermostatically adjusted to record 26C and 24C if patents were < 10 year-old or above .Depending on type of surgery ;the patients were provided with space blankents and were lying on warm mattresses. Fluid or blood warmers and forced-air surface were used when needed for this. = Aggressive measures must be adopted to preserve normothermia as prevention of intraoperative hypothermia improves patients outcome .All patients shoud have their body temprature monitored during surgery .However application of available methods of keeping normothermia reduces the the incidence of intraoperative hypothermia but does not abolish it completely . Hypothermia patients should be closely moniterd during gradual rewarming preferably in the intensive care setting. A protocol for prevention of intraoperative hypothermia must be adopted by all operating theatres. (author)

  11. Intraoperative radiotherapy for the treatment of gastric cancer

    Satomura, Kisaku; Inamoto, Shun; Honda, Kazuo; Takahashi, Masaji [Kyoto Univ. (Japan). Faculty of Medicine

    1982-12-01

    Clinical results of intraoperative radiotherapy for gastric cancer were reported. One hundred and five cases of gastric cancer were treated by intraoperative radiotherapy. Whatever the stage of the patient was, 3-year survival rate was found to be better in the radiotherapy group than that of the control group (treated surgical resection only). Five year survival rate of the stages III and IV in the radiotherapy group was better than the control group. Unfavorable side effects were observed in 4 cases out of 105 cases. In one case, penetration of postoperative peptic ulcer into the irradiated aortic wall was found by autopsy. Two cases of bile duct stenosis and one case of ileus due to acutely developed peritonitis carcinomatosa were experienced. In conclusion, intraoperative radiotherapy immediately after surgical resection for the treatment of gastric cancer was found to be an effective method. The most effective application of the method appears to be to cases of stage II and III without liver metastasis and peritoneal disseminations (H/sub 0/P/sub 0/, M, A).

  12. Intraoperative CT with integrated navigation system in spinal neurosurgery

    Zausinger, S.; Heigl, T.; Scheder, B.; Schnell, O.; Tonn, J.C.; Uhl, E.; Morhard, D.

    2007-01-01

    For spinal surgery navigational system images are usually acquired before surgery with patients positioned supine. The aim of this study was to evaluate prospectively navigated procedures in spinal surgery with data acquisition by intraoperative computed tomography (iCT). CT data of 38 patients [thoracolumbar instability (n = 24), C1/2 instability (n = 6), cervicothoracic stabilization (n = 7), disk herniation (n = 1)] were acquired after positioning the patient in prone position. A sliding gantry 24 detector row CT was used for image acquisition. Data were imported to the frameless infrared-based neuronavigation station. A postprocedural CT was obtained to assess the extent of decompression and the accuracy of instrumentation. Intraoperative registration revealed computed accuracy 2 mm in 9/158 screws (5.6%), allowing immediate correction in five screws without any damage to vessels or nerves. There were three transient complications with clinical improvement in all patients. Intraoperative CT in combination with neuronavigation provides high accuracy of screw placement and thus safety for patients undergoing spinal stabilization. The procedure is rapid and easy to perform and - by replacing pre- and postoperative imaging-is not associated with additional exposure to radiation. (orig.)

  13. An audit of intraoperative frozen section in Johor.

    Khoo, J J

    2004-03-01

    A 4-year-review was carried out on intraoperative frozen section consultations in Sultanah Aminah Hospital, Johor Bahru. Two hundred and fifteen specimens were received from 79 patients in the period between January 1999 and December 2002. An average of 2.72 specimens per patient was received. The overall diagnostic accuracy was high, 97.56%. The diagnoses were deferred in 4.65% of the specimens. False positive diagnoses were made in 3 specimens (1.46%) and false negative diagnoses in 2 specimens (0.98%). This gave an error rate of 2.44%. The main cause of error was incorrect interpretation of the pathologic findings. In the present study, frozen sections showed good sensitivity (97.98%) and specificity (97.16%). Despite its limitations, frozen section is still generally considered to be an accurate mode of intraoperative consultation to assist the surgeon in deciding the best therapeutic approach for his patient at the operating table. The use of frozen section with proper indications was cost-effective as it helped lower the number of reoperations. An audit of intraoperative frozen section from time to time serves as part of an ongoing quality assurance program and should be recommended where the service is available.

  14. Gamma knife radiosurgery in movement disorders: Indications and limitations.

    Higuchi, Yoshinori; Matsuda, Shinji; Serizawa, Toru

    2017-01-01

    Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain. Applications of radiosurgery for intracranial diseases have increased with a focus on understanding radiobiology. Currently, the use of gamma knife radiosurgery to ablate deep brain structures is not widespread because visualization of the functional targets remains difficult despite the increased availability of advanced neuroimaging technology. Moreover, most existing reports have a small sample size or are retrospective. However, increased experience with intraoperative neurophysiological evaluations in radiofrequency thalamotomy and deep brain stimulation supports anatomical and neurophysiological approaches to the ventralis intermedius nucleus. Two recent prospective studies have promoted the clinical application of functional radiosurgery for movement disorders. For example, unilateral gamma knife thalamotomy is a potential alternative to radiofrequency thalamotomy and deep brain stimulation techniques for intractable tremor patients with contraindications for surgery. Despite the promising efficacy of gamma knife thalamotomy, however, these studies did not include sufficient follow-up to confirm long-term effects. Herein, we review the radiobiology literature, various techniques, and the treatment efficacy of gamma knife radiosurgery for patients with movement disorders. Future research should focus on randomized controlled studies and long-term effects. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  15. Labeled estrogens as mammary tumor probes

    Feenstra, A.

    1981-01-01

    In this thesis estrogens labeled with a gamma or positron emitting nuclide, called estrogen-receptor binding radiopharmaceuticals are investigated as mammary tumour probes. The requirements for estrogen-receptor binding radiopharmaceuticals are formulated and the literature on estrogens labeled for this purpose is reviewed. The potential of mercury-197/197m and of carbon-11 as label for estrogen-receptor binding radiopharmaceuticals is investigated. The synthesis of 197 Hg-labeled 4-mercury-estradiol and 2-mercury-estradiol and their properties in vitro and in vivo are described. It appears that though basically carbon-11 labeled compounds are very promising as mammary tumour probes, their achievable specific activity has to be increased. (Auth.)

  16. Probe tests microweld strength

    1965-01-01

    Probe is developed to test strength of soldered, brazed or microwelded joints. It consists of a spring which may be adjusted to the desired test pressure by means of a threaded probe head, and an indicator lamp. Device may be used for electronic equipment testing.

  17. Intraoperative Vascular Neuromonitoring in Patients with Subarachnoid Hemorrhage: A Pilot Study Using Combined Laser-Doppler Spectrophotometry.

    Schmitz, Emilija; Bischoff, Barbara; Wolf, Dennis; Schmitt, Hubert J; Eyupoglu, Ilker Y; Roessler, Karl; Buchfelder, Michael; Sommer, Björn

    2017-11-01

    Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurologic outcome. In this pilot study, we examined the value of a novel noninvasive real-time measurement technique for detecting changes in local microcirculation. We used the O2C (Oxygen to see) laser-Doppler spectrophotometry system in 14 patients with Hunt & Hess grade 2-5 SAH who underwent microsurgical cerebral aneurysm clipping. A subdural probe recorded capillary venous oxygenation (SO 2 ), relative hemoglobin concentration, blood cell velocity, and blood flow at a tissue depth of 7 mm. Data were recorded immediately before dural closure. We also recorded somatosensory evoked potentials (SEPs) with median and tibial nerve stimulation. Results were compared with neurologic performance, as measured on the modified Rankin Scale, at the day of discharge from the hospital and 12 months thereafter. Patient functional outcomes after discharge and 12 months were correlated with pathological decreased flow and increased SO 2 values. In 6 of 8 patients, microcirculatory monitoring parameters indicated ischemia during surgery, as shown by electrophysiological SEP changes and infarction detected on the postoperative computed tomography (CT) scan. Pathological SEP results correlated closely with infarct demarcation as seen on CT. Our results indicate the potential benefit of intraoperative combined laser-Doppler flowmetry and spectrophotometry for predicting postoperative clinical outcomes in this small patient sample. Larger-cohort testing is needed to verify our findings and show the possible merits of this novel method. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. GammaWorkshops Proceedings

    Ramebaeck, H.; Straelberg, E.; Klemola, S.; Nielsen, Sven P.; Palsson, S.E.

    2012-01-01

    Due to a sparse interaction during the last years between practioners in gamma ray spectrometry in the Nordic countries, a NKS activity was started in 2009. This GammaSem was focused on seminars relevant to gamma spectrometry. A follow up seminar was held in 2010. As an outcome of these activities it was suggested that the 2011 meeting should be focused on practical issues, e.g. different corrections needed in gamma spectrometric measurements. This three day's meeting, GammaWorkshops, was held in September at Risoe-DTU. Experts on different topics relevant for gamma spectrometric measurements were invited to the GammaWorkshops. The topics included efficiency transfer, true coincidence summing corrections, self-attenuation corrections, measurement of natural radionuclides (natural decay series), combined measurement uncertainty calculations, and detection limits. These topics covered both lectures and practical sessions. The practical sessions included demonstrations of tools for e.g. corrections and calculations of the above meantioned topics. (Author)

  19. Development of voltage sensitivity preamplifier to application in radioguided surgical probe

    Costa, Fabio Eduardo da; Rela, Paulo Roberto; Hamada, Margarida Mizue

    2005-01-01

    The methods of nuclear medicine are increasing used to complement standard diagnostic examinations. Some of these are radioguided detection of the sentinel lymph node (SN) and the radioguided localization of occult lesions. The SN technique is used in a small-size breast carcinoma and involves the identification, removal and immediate histological examination. Specifically, particles of colloidal human serum albumin are labelled with low activities of 99m Tc and are inoculated into the breast lesion or close in the case of SN biopsy. Subsequently, a hand-held gamma-ray detecting probe with reduced dimensions is used to locate the lesion or the SN as a hot spot and guide its surgical removal. Many techniques can be used for gamma-ray probes development. Gamma photons can be either directly detected via high atomic numbers semiconductors detectors or indirect detection, as scintillator crystal converts gamma photons into light photons. In all of them, the preamplifier is used as close as possible to the detector for obtaining a good energy resolution and due to the necessary small probe dimension, the preamplifier must have reduced size. The commercial preamplifiers are not small enough to be assembled inside the probe. It was developed a not usually preamplifier configuration for high-resolution spectroscopy energy, adequate in size to be set up in gamma-ray probes. This tension preamplifier can be split between the gamma-ray probe and the read out unit. Due to this configuration the effective size required inside the probe was reduced. The results and the probe assembling are showed in this work. (author)

  20. Intraoperative definition of bottom-of-sulcus dysplasia using intraoperative ultrasound and single depth electrode recording - A technical note.

    Miller, Dorothea; Carney, Patrick; Archer, John S; Fitt, Gregory J; Jackson, Graeme D; Bulluss, Kristian J

    2018-02-01

    Bottom of sulcus dysplasias (BOSDs) are localized focal cortical dysplasias (FCDs) centred on the bottom of a sulcus that can be highly epileptogenic, but difficult to delineate intraoperatively. We report on a patient with refractory epilepsy due to a BOSD, successfully resected with the aid of a multimodal surgical approach using neuronavigation based on MRI and PET, intraoperative ultrasound (iUS) and electrocorticography (ECoG) using depth electrodes. The lesion could be visualized on iUS showing an increase in echogenicity at the grey-white matter junction. IUS demonstrated the position of the depth electrode in relation to the lesion. Depth electrode recording showed almost continuous spiking. Thus, intraoperative imaging and electrophysiology helped confirm the exact location of the lesion. Post-resection ultrasound demonstrated the extent of the resection and depth electrode recording did not show any epileptiform activity. Thus, both techniques helped assess completeness of resection. The patient has been seizure free since surgery. Using a multimodal approach including iUS and ECoG is a helpful adjunct in surgery for BOSD and may improve seizure outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Experimental Status of b -> s(d) gamma Decays

    Di Lodovico, F

    2004-02-05

    Radiative penguin decays provide an indirect probe for physics beyond the Standard Model and contribute to the determination of the CKM matrix elements. Copious quantities of B mesons produced at the B-Factories permit precision measurements of radiative penguin decays. We review the experimental status of the radiative penguin processes b {yields} s(d){gamma}.

  2. Routine intraoperative transesophageal echocardiography for pediatric open heart surgery: Is it justifiable?

    Elgamal, Mohamed-Adel F.; Najm, Hani K.; Abid-Allah, M.; Omran, Ahmad S.

    2007-01-01

    The routine use of intraoperative transesophageal echocardiography (IO TEE) in children is still debatable. The aim of this study was to determine the safety, benefit and the possible risk of the routine use of IO TEE. It was performed in all children under the age of 14 years with a complex congenital heart defects undergoing open heart surgery, from July 2001 to December 2002. Simple lesions such as secundum atrial septal defects or simple perimembraneous ventricular septal defects (VSD) and neonates less than 2.7 kg were excluded. All children underwent a pre-repair and post-repair complete IO TEE study. There were 112 children, 65 males and 47 females. Ages ranged from 4 days to 156 month, a median of 9 months. A full study was not done in three neonates (3%) because the probe could not be inserted in one, and because of airway compression resulting in desaturation in another two. A pre-repair study confirmed the preoperative transthoracic echocardiographic findings in 105 children (95%). Diagnostic discrepancy or unexpected lesions not reported preoperative were found in six children (5%). Of the 109 children who had full post-repair studies, 67 (60%) showed optimum repair with no residual lesions and 26 (23%) showed trivial or mild residual lesions accepted by the team. Going back on pump to fix moderate or severe residual lesions occurred in 16 (14%) children. In all of these children, the decision for going back on pump was prompted by the IO TEE examination alone. Mild complications occurred in two children (2%). Based on our results, we recommend the routine use of IO TEE. It is safe, has a low complication rate, adds additional information and has a high impact on the diagnosis of residual lesions required in the operating room. However, careful monitoring of the ventilation and airway pressure, particularly during probe insertion and manipulation in small children, is very essential. (author)

  3. Expression of human gamma-globin genes in human erythroleukemia (K562) cells.

    Donovan-Peluso, M; Acuto, S; Swanson, M; Dobkin, C; Bank, A

    1987-12-15

    K562 cells express embryonic (epsilon) and fetal (gamma) globins and hemoglobins but not adult (beta) globin. To define the cis acting regulatory elements involved in the discrimination between gamma and beta genes, we have constructed chimeric genes composed of portions of gamma and beta and evaluated their expression in stable K562 transfectants. A gamma beta fusion gene containing gamma 5' sequences to the EcoRI site in exon 3 and beta sequences 3' is expressed at 10-40% that of the endogenous gamma level. In 50% of the lines, this fusion gene appropriately increases its expression in response to hemin, an inducer of endogenous globin gene expression in K562 cells. In contrast, a beta gamma fusion gene, containing beta sequences 5' to the EcoRI site in exon 3 and gamma sequences 3', is neither expressed nor correctly initiated. A beta gene containing gamma-intervening sequence (IVS) 2 accumulates an mRNA transcript when analyzed with a 3' beta probe. However, no correctly initiated beta mRNA is observed. A gamma gene with beta-IVS 2 is only inducible in one of six expressing clones. All the results are consistent with the presence of stage-specific trans acting factors in K562 cells that stimulate expression of gamma genes and suggest a significant role for gamma-IVS 2 in gamma gene expression.

  4. Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract.

    Hubalewska-Dydejczyk, A; Kulig, J; Szybinski, P; Mikolajczak, R; Pach, D; Sowa-Staszczak, A; Fröss-Baron, K; Huszno, B

    2007-10-01

    Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue "marked" by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [(99m)Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [(99m)Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [(99m)Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [(99m)Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology.

  5. Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract

    Hubalewska-Dydejczyk, A.; Kulig, J.; Szybinski, P.; Mikolajczak, R.; Pach, D.; Sowa-Staszczak, A.; Froess-Baron, K.; Huszno, B.

    2007-01-01

    Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue ''marked'' by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [ 99m Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [ 99m Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [ 99m Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [ 99m Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology. (orig.)

  6. Gamma Splines and Wavelets

    Hannu Olkkonen

    2013-01-01

    Full Text Available In this work we introduce a new family of splines termed as gamma splines for continuous signal approximation and multiresolution analysis. The gamma splines are born by -times convolution of the exponential by itself. We study the properties of the discrete gamma splines in signal interpolation and approximation. We prove that the gamma splines obey the two-scale equation based on the polyphase decomposition. to introduce the shift invariant gamma spline wavelet transform for tree structured subscale analysis of asymmetric signal waveforms and for systems with asymmetric impulse response. Especially we consider the applications in biomedical signal analysis (EEG, ECG, and EMG. Finally, we discuss the suitability of the gamma spline signal processing in embedded VLSI environment.

  7. Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy

    Bub-Se Na

    2017-10-01

    Full Text Available Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.

  8. Hard probes 2006 Asilomar

    2006-01-01

    "The second international conference on hard and electromagnetic probes of high-energy nuclear collisions was held June 9 to 16, 2006 at the Asilomar Conference grounds in Pacific Grove, California" (photo and 1/2 page)

  9. Neutrons as a probe

    Iizumi, Masashi

    1993-01-01

    As an introduction to the symposium a brief overview will be given about the features of neutrons as a probe. First it will be pointed out that the utilization of neutrons as a probe for investigating the structural and dynamical properties of condensed matters is a benign gift eventuated from the release of atomic energy initiated by Enrico Fermi exactly half century ago. Features of neutrons as a probe are discussed in accordance with the four basic physical properties of neutrons as an elementary particle; (1) no electric charge (the interaction with matter is nuclear), (2) the mass of neutron is 1 amu, (3) spin is 1/2 and (4) neutrons have magnetic dipole moment. Overview will be given on the uniqueness of neutrons as a probe and on the variety in the way they are used in the wide research area from the pure science to the industrial applications. (author)

  10. Diagnosing periprosthetic infection: false-positive intraoperative Gram stains.

    Oethinger, Margret; Warner, Debra K; Schindler, Susan A; Kobayashi, Hideo; Bauer, Thomas W

    2011-04-01

    Intraoperative Gram stains have a reported low sensitivity but high specificity when used to help diagnose periprosthetic infections. In early 2008, we recognized an unexpectedly high frequency of apparent false-positive Gram stains from revision arthroplasties. The purpose of this report is to describe the cause of these false-positive test results. We calculated the sensitivity and specificity of all intraoperative Gram stains submitted from revision arthroplasty cases during a 3-month interval using microbiologic cultures of the same samples as the gold standard. Methods of specimen harvesting, handling, transport, distribution, specimen processing including tissue grinding/macerating, Gram staining, and interpretation were studied. After a test modification, results of specimens were prospectively collected for a second 3-month interval, and the sensitivity and specificity of intraoperative Gram stains were calculated. The retrospective review of 269 Gram stains submitted from revision arthroplasties indicated historic sensitivity and specificity values of 23% and 92%, respectively. Systematic analysis of all steps of the procedure identified Gram-stained but nonviable bacteria in commercial broth reagents used as diluents for maceration of periprosthetic membranes before Gram staining and culture. Polymerase chain reaction and sequencing showed mixed bacterial DNA. Evaluation of 390 specimens after initiating standardized Millipore filtering of diluent fluid revealed a reduced number of positive Gram stains, yielding 9% sensitivity and 99% specificity. Clusters of false-positive Gram stains have been reported in other clinical conditions. They are apparently rare related to diagnosing periprosthetic infections but have severe consequences if used to guide treatment. Even occasional false-positive Gram stains should prompt review of laboratory methods. Our observations implicate dead bacteria in microbiologic reagents as potential sources of false-positive Gram

  11. Intraoperative HDR implant boost for breast cancer (preliminary results)

    Rodriguez, I.; Torre, M. de la; Gonzalez, E.; Bourel, V.

    1996-01-01

    Introduction: In spite of the fact that it is been discussed whether or not a boost is necessary for all conservative treated breast cancer patients, it is a generalized radiotherapy practice. Since september 1993 we developed a breast conservative protocol for early stage breast cancer (T1-T2) with intraoperative HDR implant boost. Side effects, cosmetic results and recurrence rates are reviewed. Method and Material: From September 1993 we treated 55 patients with intraoperative HDR implant boost to the lumpectomy site for clinical T1 or T2 invasive breast cancer, followed by external megavoltage radiotherapy to the entire breast. We used the Nucletron microselectron HDR remote afterloading system with flexible implant tubes. The geometric distribution of the tubes was performed according to the 'Paris' configuration. Each implant was evaluated by calculating the dose-volume natural histograms. The HDR fractionation schedule consists of three fractions of 4.5Gy each given at least 48 hs apart, and starting between 48-72hs from surgical procedure. The external radiotherapy to the entire breast started one week after the completion of brachytherapy, using conventional fractionation of 5 fractions per week, 1,8Gy per fraction up to 45-50Gy. Results: So far there is not any local recurrence, but medium follow up is only 18 months. We did not observe any acute damage and the cosmetic outcome was 60% excellent, 30% good and 10% acceptable. Two patients developed localized fibrosis, in both the implant involved the submamary fold. Conclusion: The intraoperative implant is the most accurate way to localize the lumpectomy site, to define the target volume, decrease the total treatment time and avoid a second anesthetic procedure without delaying the inpatient time or the initial wound healing process

  12. [Intraoperative choledochoscopy usefulness in the treatment of difficult biliary stones].

    Cuendis-Velázquez, A; Rojano-Rodríguez, M E; Morales-Chávez, C E; González Angulo-Rocha, A; Fernández-Castro, E; Aguirre-Olmedo, I; Torres-Ruiz, M F; Orellana-Parra, J C; Cárdenas-Lailson, L E

    2014-01-01

    Choledocholithiasis presents in 5-10% of the patients with biliary lithiasis. Numerous treatment algorithms have been considered for this disease, however, up to 10% of these therapeutic procedures may fail. Intraoperative choledochoscopy has become a useful tool in the treatment of patients with difficult-to-manage choledocholithiasis. To determine the usefulness of intraoperative choledochoscopy in the laparoendoscopic treatment of difficult stones that was carried out in our service. A cross-sectional study was conducted. The case records were reviewed of the patients that underwent intraoperative choledochoscopy during biliary tree exploration plus laparoscopic choledochoduodenal anastomosis within the time frame of March 1, 2011 and May 31, 2012, at the Hospital General Dr. Manuel Gea González. Transabdominal choledochoscopies were performed with active stone extraction when necessary, followed by peroral choledochoscopies through the recently formed bilioenteric anastomosis. The data were analyzed with descriptive statistics and measures of central tendency. The mean age was 71 years, 57% of the patients were women, and the ASA III score predominated. Active extraction of stones with 7 to 35mm diameters was carried out in 4 of the cases and the absence of stones in the biliary tract was corroborated in all the patients. The mean surgery duration was 18 minutes (range: 4 to 45min). Choledochoscopy is a safe and effective minimally invasive procedure for the definitive treatment of difficult stones. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  13. Pediatric awake craniotomy and intra-operative stimulation mapping.

    Balogun, James A; Khan, Osaama H; Taylor, Michael; Dirks, Peter; Der, Tara; Carter Snead Iii, O; Weiss, Shelly; Ochi, Ayako; Drake, James; Rutka, James T

    2014-11-01

    The indications for operating on lesions in or near areas of cortical eloquence balance the benefit of resection with the risk of permanent neurological deficit. In adults, awake craniotomy has become a versatile tool in tumor, epilepsy and functional neurosurgery, permitting intra-operative stimulation mapping particularly for language, sensory and motor cortical pathways. This allows for maximal tumor resection with considerable reduction in the risk of post-operative speech and motor deficits. We report our experience of awake craniotomy and cortical stimulation for epilepsy and supratentorial tumors located in and around eloquent areas in a pediatric population (n=10, five females). The presenting symptom was mainly seizures and all children had normal neurological examinations. Neuroimaging showed lesions in the left opercular (n=4) and precentral or peri-sylvian regions (n=6). Three right-sided and seven left-sided awake craniotomies were performed. Two patients had a history of prior craniotomy. All patients had intra-operative mapping for either speech or motor or both using cortical stimulation. The surgical goal for tumor patients was gross total resection, while for all epilepsy procedures, focal cortical resections were completed without any difficulty. None of the patients had permanent post-operative neurologic deficits. The patient with an epileptic focus over the speech area in the left frontal lobe had a mild word finding difficulty post-operatively but this improved progressively. Follow-up ranged from 6 to 27 months. Pediatric awake craniotomy with intra-operative mapping is a precise, safe and reliable method allowing for resection of lesions in eloquent areas. Further validations on larger number of patients will be needed to verify the utility of this technique in the pediatric population. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Alpha antagonists and intraoperative floppy iris syndrome: A spectrum

    Sharif A Issa

    2008-07-01

    Full Text Available Sharif A Issa, Omar H Hadid, Oliver Baylis, Margaret DayanDepartment of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UKBackground: To determine occurrence of features of intraoperative floppy iris syndrome (IFIS during cataract surgery in patients taking systemic alpha-antagonists (AA.Methods: We prospectively studied patients on AA and who underwent phacoemulsification. The following were recorded: pupil diameter preoperatively, iris flaccidity, iris prolapse and peroperative miosis.Results: We studied 40 eyes of 31 subjects. Mean age was 78 years. Overall, 14 eyes (13 patients showed signs of IFIS: 9/13 (69% eyes of patients on tamsulosin, 1/18 (6% eyes in the doxazosin group, 2/2 prazosin patients, 1/4 eyes in the indoramin group, and 1/2 eyes in two patients on a combination of doxazosin and tamsulosin. Most cases (92% had only one or two signs of IFIS. Bilateral cataract surgery was undertaken in 9 patients but only one patient (on tamsulosin had features of IFIS in both eyes, while 4 patients (2 on tamsulosin and 2 on other AA showed signs of IFIS in one eye only, and 4 patients did not show IFIS in either eye.Conclusion: Most AA were associated with IFIS, but it tends to present as a spectrum of signs rather than full triad originally described. Tamsulosin was most likely to be associated with IFIS; however, its intake does not necessarily mean that IFIS will occur. For patients on AA, the behavior of the iris intraoperatively in one eye is a poor predictor of the other eye. Surgeons should anticipate the occurrence of IFIS in any patient on AA.Keywords: alpha blocker, alpha antagonist, cataract surgery, intraoperative floppy iris syndrome, tamsulosin.

  15. Microdebrider tonsillectomy associated with more intraoperative blood loss than electrocautery.

    Stansifer, Kyle J; Szramowski, Molly G; Barazsu, Lindsay; Buchinsky, Farrel J

    2012-10-01

    To describe and compare the intraoperative blood loss in children who underwent tonsillectomy and/or adenoidectomy during a transition from using electrocautery to a microdebrider. Retrospective case series of a single pediatric otolaryngologist at an urban general hospital. Patients aged 2-20 years who had tonsillectomy, adenoidectomy, or adenotonsillectomy over a 12 month period were included. Tonsillectomy was performed by microdebrider or electrocautery and adenoidectomy was performed by microdebrider, curette, or suction electrocautery. Total intraoperative blood loss was measured and compared between surgical techniques. Of the 148 patients, 109 had tonsillectomy with or without adenoidectomy and 39 had adenoidectomy alone. The mean blood loss was 47 ml or 1.8 ± 1.6 ml/kg and the maximum blood loss was 11 ml/kg. Adenoid curette and adenoid microdebrider yielded similar blood loss but were associated with more bleeding than suction electrocautery (Pelectrocautery tonsillectomy (mean of 2.6 ± 2.2 ml/kg versus 1.2 ± 1.2 ml/kg, P=0.0002). Eighteen percent of adenotonsillectomy patients lost greater than 5% of calculated circulating blood volume (95% CI, 9.8-26). Linear regression models did not show an association between the amount of blood loss and patient age, clinical indication, or the surgeon's experience with the microdebrider (P>0.05). Microdebrider tonsillectomy is associated with more intraoperative bleeding than electrocautery tonsillectomy. Approximately twice as much blood was lost with the microdebrider, but the absolute increase was insignificant from a hemodynamic perspective. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Intraoperative neurophysiology of the conus medullaris and cauda equina.

    Kothbauer, Karl F; Deletis, Vedran

    2010-02-01

    Intraoperative neurophysiological techniques are becoming routine tools for neurosurgical practice. Procedures affecting the lumbosacral nervous system are frequent in adult and pediatric neurosurgery. This review provides an overview of the techniques utilized in cauda and conus operations. Two basic methodologies of intraoperative neurophysiological testing are utilized during surgery in the lumbosacral spinal canal. Mapping techniques help identify functional neural structures, namely, nerve roots and their respective spinal levels. Monitoring is referred to as the technology to continuously assess the functional integrity of pathways and reflex circuits. For mapping direct electrical stimulation of a structure within the surgical field and recording at a distant site, usually a muscle is the most commonly used setup. Sensory nerve roots or spinal cord areas can be mapped by stimulation of a distant sensory nerve or skin area and recording from a structure within the surgical field. Continuous monitoring of the motor system is done with motor evoked potentials. These are evoked by transcranial electrical stimulation and recorded from lower extremity and sphincter muscles. Presence or absence of muscle responses are the monitored parameters. To monitor the sensory pathways, sensory potentials evoked by tibial, peroneal, or pudendal nerve stimulation and recorded from the dorsal columns with a spinal electrode or as cortical responses from scalp electrodes are used. Amplitudes and latencies of these responses are measured for interpretation. The bulbocavernosus reflex, with stimulation of the pudendal nerve and recording from the external anal sphincter, is used for continuous monitoring of the reflex circuitry. The presence of absence of this response is the pertinent parameter monitored. Stimulation of individual dorsal nerve roots is used to identify those segments that generate spastic activity and which may be cut during selective dorsal rhizotomy

  17. Adjustable Pitot Probe

    Ashby, George C., Jr.; Robbins, W. Eugene; Horsley, Lewis A.

    1991-01-01

    Probe readily positionable in core of uniform flow in hypersonic wind tunnel. Formed of pair of mating cylindrical housings: transducer housing and pitot-tube housing. Pitot tube supported by adjustable wedge fairing attached to top of pitot-tube housing with semicircular foot. Probe adjusted both radially and circumferentially. In addition, pressure-sensing transducer cooled internally by water or other cooling fluid passing through annulus of cooling system.

  18. Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas.

    Mehta, Gautam U; Oldfield, Edward H

    2012-06-01

    Cerebrospinal fluid leakage is a major complication of transsphenoidal surgery. An intraoperative CSF leak, which occurs in up to 50% of pituitary tumor cases, is the only modifiable risk factor for postoperative leaks. Although several techniques have been described for surgical repair when an intraoperative leak is noted, none has been proposed to prevent an intraoperative CSF leak. The authors postulated that intraoperative CSF drainage would diminish tension on the arachnoid, decrease the rate of intraoperative CSF leakage during surgery for larger tumors, and reduce the need for surgical repair of CSF leaks. The results of 114 transsphenoidal operations for pituitary macroadenoma performed without intraoperative CSF drainage were compared with the findings from 44 cases in which a lumbar subarachnoid catheter was placed before surgery to drain CSF at the time of dural exposure and tumor removal. Cerebrospinal fluid drainage reduced the rate of intraoperative CSF leakage from 41% to 5% (p drainage reduced the need for operative repair (from 32% to 5%, p drainage during transsphenoidal surgery for macroadenomas reduces the rate of intraoperative CSF leaks. This preventative measure obviated the need for surgical repair of intraoperative CSF leaks using autologous fat graft placement, other operative techniques, postoperative lumbar drainage, and/or reoperation in most patients and is associated with minimal risks.

  19. Intraoperative computed tomography with integrated navigation system in spinal stabilizations.

    Zausinger, Stefan; Scheder, Ben; Uhl, Eberhard; Heigl, Thomas; Morhard, Dominik; Tonn, Joerg-Christian

    2009-12-15

    STUDY DESIGN.: A prospective interventional case-series study plus a retrospective analysis of historical patients for comparison of data. OBJECTIVE.: To evaluate workflow, feasibility, and clinical outcome of navigated stabilization procedures with data acquisition by intraoperative computed tomography. SUMMARY OF BACKGROUND DATA.: Routine fluoroscopy to assess pedicle screw placement is not consistently reliable. Our hypothesis was that image-guided spinal navigation using an intraoperative CT-scanner can improve the safety and precision of spinal stabilization surgery. METHODS.: CT data of 94 patients (thoracolumbar [n = 66], C1/2 [n = 12], cervicothoracic instability [n = 16]) were acquired after positioning the patient in the final surgical position. A sliding gantry 40-slice CT was used for image acquisition. Data were imported to a frameless infrared-based neuronavigation workstation. Intraoperative CT was obtained to assess the accuracy of instrumentation and, if necessary, the extent of decompression. All patients were clinically evaluated by Odom-criteria after surgery and after 3 months. RESULTS.: Computed accuracy of the navigation system reached /=2 mm without persistent neurologic or vascular damage in 20/414 screws (4.8%) leading to immediate correction of 10 screws (2.4%). Control-iCT changed the course of surgery in 8 cases (8.5% of all patients). The overall revision rate was 8.5% (4 wound revisions, 2 CSF fistulas, and 2 epidural hematomas). There was no reoperation due to implant malposition. According to Odom-criteria all patients experienced a clinical improvement. A retrospective analysis of 182 patients with navigated thoracolumbar transpedicular stabilizations in the preiCT era revealed an overall revision rate of 10.4% with 4.4% of patients requiring screw revision. CONCLUSION.: Intraoperative CT in combination with neuronavigation provides high accuracy of screw placement and thus safety for patients undergoing spinal stabilization

  20. Visualization strategies for major white matter tracts for intraoperative use

    Nimsky, C.; Ganslandt, O.; Buchfelder, M. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Neurosurgery; Erlangen-Nuernberg Univ., Erlangen (Germany). Neurocenter; Enders, F.; Merhof, D. [Erlangen-Nuernberg Univ., Erlangen (Germany). Neurocenter; Hammen, T. [Erlangen-Nuernberg Univ., Erlangen (Germany). Neurocenter; Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Neurology

    2006-03-15

    Streamline representation of major fiber tract systems along with high-resolution anatomical data provides a reliable orientation for the neurosurgeon. For intraoperative visualization of these data either on navigation screens near the surgical field or directly in the surgical field applying heads-up displays of operating microscopes, wrapping of all streamlines of interest to render an individual object representing the whole fiber bundle is the most suitable representation. Integration of fiber tract data into a neuronavigation setup allows removal of tumors adjacent to eloquent brain areas with low morbidity. (orig.)

  1. Visualization strategies for major white matter tracts for intraoperative use

    Nimsky, C.; Ganslandt, O.; Buchfelder, M.; Erlangen-Nuernberg Univ., Erlangen; Enders, F.; Merhof, D.; Hammen, T.; Erlangen-Nuernberg Univ., Erlangen

    2006-01-01

    Streamline representation of major fiber tract systems along with high-resolution anatomical data provides a reliable orientation for the neurosurgeon. For intraoperative visualization of these data either on navigation screens near the surgical field or directly in the surgical field applying heads-up displays of operating microscopes, wrapping of all streamlines of interest to render an individual object representing the whole fiber bundle is the most suitable representation. Integration of fiber tract data into a neuronavigation setup allows removal of tumors adjacent to eloquent brain areas with low morbidity. (orig.)

  2. Non-radiographic intraoperative fluorescent cholangiography is feasible

    Larsen, Søren Schytt; Schulze, Svend; Bisgaard, Thue

    2014-01-01

    INTRODUCTION: Intraoperative fluorescent cholangiography (IFC) with concomitant fluorescent angiography was recently developed for non-invasive identification of the anatomy during laparoscopic cholecystectomy. The objective of this study was to assess the time required for routine-use of IFC...... hepatic duct was identified by IFC in all patients. In 29 of the 35 patients (83%; 95% confidence interval: 71-96%), the cystic artery was visualised by fluorescent angiography. No adverse effects or complications were recorded. CONCLUSION: Routine-use of IFC with fluorescent angiography during...

  3. A CASE OF GRANISETRON ASSOCIATED INTRAOPERATIVE CARDIAC ARREST.

    Al Harbi, Mohammed; Al Rifai, Derar; Al Habeeb, Hassan; Wambi, Freddie; Geldhof, Georges; Dimitriou, Vassilios

    2016-02-01

    We report a case of intraoperative severe bradycardia that resulted in asystole and cardiac arrest shortly after (granisetron 1mg for postoperative nausea and vomiting prophylaxis, that occurred in a female patient who underwent an elective total thyroidectomy. After two cycles of cardiopulmonary resuscitation and defibrillation, spontaneous circulation and sinus rhythm returned successfully. Postoperatively, the patient was diagnosed with a drug-induced long QT syndrome. At the time of the event, granisetron was the only medication administered. Furthermore, there was no reason to suspect electrolyte abnormalities. We explore the association of the onset of severe sinus bradycardia with the intravenous administration of granisetron.

  4. Intraoperative radiotherapy of malignant pancreatic tumors - first results

    Thurnher, S.; Glaser, K.; Url, M.; Frommhold, H.; Bodner, E.

    1987-02-01

    Thirteen patients suffering from adenocarcinomas of the pancreas were submitted to an intraoperative fast electron 'boost' therapy with or without percutaneous photon irradiation. A duodeno-cephalo-pancreatectomy with subsequent irradiation of the tumor bed could be performed in three patients. Ten patients were inoperable because of advanced tumors and formation of metastases. The average survival is 6.5 months, at present six patients are alive without major troubles. An analgetic effect was obtained in ten patients. The first results are encouraging with respect to local control, the little acute and chronic morbidity, and palliation achieved in advances stages.

  5. Intraoperative radiotherapy of malignant pancreatic tumors - first results

    Thurnher, S.; Glaser, K.; Url, M.; Frommhold, H.; Bodner, E.; Innsbruck Univ.

    1987-01-01

    Thirteen patients suffering from adenocarcinomas of the pancreas were submitted to an intraoperative fast electron 'boost' therapy with or without percutaneous photon irradiation. A duodeno-cephalo-pancreatectomy with subsequent irradiation of the tumor bed could be performed in three patients. Ten patients were inoperable because of advanced tumors and formation of metastases. The average survival is 6.5 months, at present six patients are alive without major troubles. An analgetic effect was obtained in ten patients. The first results are encouraging with respect to local control, the little acute and chronic morbidity, and palliation achieved in advances stages. (orig.) [de

  6. Intraoperative neuropathology of glioma recurrence: cell detection and classification

    Abas, Fazly S.; Gokozan, Hamza N.; Goksel, Behiye; Otero, Jose J.; Gurcan, Metin N.

    2016-03-01

    Intraoperative neuropathology of glioma recurrence represents significant visual challenges to pathologists as they carry significant clinical implications. For example, rendering a diagnosis of recurrent glioma can help the surgeon decide to perform more aggressive resection if surgically appropriate. In addition, the success of recent clinical trials for intraoperative administration of therapies, such as inoculation with oncolytic viruses, may suggest that refinement of the intraoperative diagnosis during neurosurgery is an emerging need for pathologists. Typically, these diagnoses require rapid/STAT processing lasting only 20-30 minutes after receipt from neurosurgery. In this relatively short time frame, only dyes, such as hematoxylin and eosin (H and E), can be implemented. The visual challenge lies in the fact that these patients have undergone chemotherapy and radiation, both of which induce cytological atypia in astrocytes, and pathologists are unable to implement helpful biomarkers in their diagnoses. Therefore, there is a need to help pathologists differentiate between astrocytes that are cytologically atypical due to treatment versus infiltrating, recurrent, neoplastic astrocytes. This study focuses on classification of neoplastic versus non-neoplastic astrocytes with the long term goal of providing a better neuropathological computer-aided consultation via classification of cells into reactive gliosis versus recurrent glioma. We present a method to detect cells in H and E stained digitized slides of intraoperative cytologic preparations. The method uses a combination of the `value' component of the HSV color space and `b*' component of the CIE L*a*b* color space to create an enhanced image that suppresses the background while revealing cells on an image. A composite image is formed based on the morphological closing of the hue-luminance combined image. Geometrical and textural features extracted from Discrete Wavelet Frames and combined to classify

  7. Clinical experience with intraoperative radiotherapy for locally advanced colorectal cancer

    Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

    1988-01-01

    Intraoperative radiotherapy (IORT) was performed on 20 patients with colorectal cancer. IORT with a single dose of 20 to 40 Gy was delivered to the residual tumor, tumor bed, and/or lymphnode regions. Although most of the patients had advanced lesions, local control was achieved in 67 % of the patients when IORT was combined with tumor resection, and 4 patients survived more than 5 years. There were no serious complications, except for contracture or atrophy of the psoas muscle seen in 2 patients. IORT combined with external beam radiotherapy should be a useful adjuvant therapy to surgery for locally advanced colorectal cancer. (author)

  8. Intraoperative Anaphylaxis to Inj Ceftriaxone: Here We Go Again

    Amit G Bhagwat

    2008-01-01

    Full Text Available Anaphylactic reactions to intraoperative antibiotics are rare events and reactions after a negative intradermal skin testing are even rarer. We are reporting a case of grade V anaphylactic reaction to ceftriaxone, which occurred inspite of a negative skin testing preoperatively. Despite of the treatment along the established guidelines, patient suffered hypoxic brain damage ultimately having a fatal outcome 7 days later. This case highlights the limits of the screening test done preoperatively for antibiotic sensitivity and also the difficulty in resuscitating anaphylactic reac-tions when patient is on B blocker and under spinal anaesthesia.

  9. Gamma ray astronomy

    Fichtel, C.E.

    1975-01-01

    The first certain detection of celestial high energy gamma rays came from a satellite experiment flown on the third Orbiting Solar Observatory (OSO-111). A Gamma ray spark chamber telescope with substantively greater sensitivity and angular resolution (a few degrees) flown on the second Small Astronomy Satellite (SAS-II) has now provided a better picture of the gamma ray sky, and particularly the galactic plane and pulsars. This paper will summarize the present picture of gamma ray astronomy as it has developed at this conference from measurements made with experiments carried out on balloons, those remaining on the ground, and ones flown on satellites. (orig.) [de

  10. Study of a Laser-Produced Plasma by Langmuir Probes

    Chang, C. T.; Hasimi, M.; Pant, H. C.

    1977-01-01

    -emission peak and the main plasma from the target. The flow velocity, density and electron temperature of the plasma were determined. The expansion of the plasma was found to be adiabatic, yielding gamma =5/3. The spatial distribution of the plasma was observed to be strongly anisotropic.......The structure, the parameters and the expansion of the plasma produced by focusing a 7 J, 20 ns Nd-glass laser on stainless-steel and glass targets suspended in a high-vacuum chamber were investigated by Langmuir probes. It was observed that the probe signals consisted of a photoelectric...

  11. Comparison of attraction capabilities associated with high-speed, dual-pneumatic vitrectomy probes.

    Dugel, Pravin U; Abulon, Dina J K; Dimalanta, Ramon

    2015-05-01

    To measure membrane attraction capabilities of enhanced 27-gauge, enhanced 25-gauge, and 23-gauge vitrectomy probes under various parameters. A membrane-on-cantilever apparatus was used to measure membrane attraction for enhanced 27-, enhanced 25-, and 23-gauge UltraVit probes (n = 6 for each). The following parameters were evaluated: effects of cut rates and duty cycles on membrane attraction distances, and flow rates and vacuum levels required to attract a membrane at a fixed distance. The enhanced 27-gauge probe had the shortest attraction distance across all cutting speeds and duty cycles. To attract a membrane at a fixed distance, increasing vacuum was necessary with higher cutting rates and smaller probe gauges but flow rate remained relatively constant. The biased open duty cycle was associated with a longer attraction distance than 50/50 or biased closed modes. The shorter membrane attraction distance of the enhanced 27-gauge probe versus 23-gauge and enhanced 25-gauge probes may permit greater membrane dissection precision while providing improved access to small tissue planes. Equivalent fluid flow capabilities of the 27-gauge probe compared with the 23-gauge and 25-gauge probes may provide efficient aspiration. Surgeon selection of duty cycle modes may improve intraoperative fluid control and expand the cutter utility as a multifunctional tool.

  12. Swift: A gamma ray burst MIDEX

    Barthelmy, Scott

    2001-01-01

    Swift is a first of its kind multiwavelength transient observatory for gamma-ray burst astronomy. It has the optimum capabilities for the next breakthroughs in determining the origin of gamma-ray bursts and their afterglows as well as using bursts to probe the early Universe. Swift will also perform the first sensitive hard X-ray survey of the sky. The mission is being developed by an international collaboration and consists of three instruments, the Burst Alert Telescope (BAT), the X-ray Telescope (XRT), and the Ultraviolet and Optical Telescope (UVOT). The BAT, a wide-field gamma-ray detector, will detect ∼1 gamma-ray burst per day with a sensitivity 5 times that of BATSE. The sensitive narrow-field XRT and UVOT will be autonomously slewed to the burst location in 20 to 70 seconds to determine 0.3-5.0 arcsec positions and perform optical, UV, and X-ray spectrophotometry. On-board measurements of redshift will also be done for hundreds of bursts. Swift will incorporate superb, low-cost instruments using existing flight-spare hardware and designs. Strong education/public outreach and follow-up programs will help to engage the public and astronomical community. Swift has been selected by NASA for development and launch in late 2003

  13. Improvement of limb salvage procedure using intraoperative radiotherapy for osteosarcoma

    Hirano, Toru; Iwasaki, Katsuo; Kamishiro,; Toshiyuki,; Hayashi, Yasuyuki [Nagasaki Univ. (Japan). School of Medicine

    1992-10-01

    Clinical outcome of limb salvage procedure combined with intraoperative irradiation was investigated in 6 patients with osteosarcoma in the distal part of femur (n=4) and proximal part of tibia (n=2). They ranged in age from 12 to 54 years, with a mean of 22.5. First, a lesion was separated from the surrounding soft tissue with curatively wide margin. Osteotomy was performed at the portion of diaphysis. After irradiation field was setted up by lifting the lesion, and was exposed to doses ranging from 60 Gy to 85 Gy of intraoperative irradiation, soft tissue and fragile tumor tissue, excluding joint capsule and ligament, were removed as soon as possible. Finally, bone was jointed by means of inner fixation or bone grafting. They had a median follow-up of one year and four months after surgery. Although superficial wound infection and delayed wound adhesion were encountered as postoperative complications in one and two patients, respectively, these were all healed. None of the patients had local recurrence. The ability of salvaged limb was excellent in one, good in 3, and fair in 2 patients. Because both of the two patients with sarcoma in the proximal part of tibia had excellent and good limb ability, this procedure was considered useful especially for sarcoma in the proximal part of tibia. (N.K.).

  14. Integrating multimodal information for intraoperative assistance in neurosurgery

    Eisenmann U.

    2015-09-01

    Full Text Available Computer-assisted planning of complex neurosurgical interventions benefits from a variety of specific functions and tools. However, commercial planning- and neuronavigation systems are rather restrictive concerning the availability of innovative methods such as novel imaging modalities, fiber tracking algorithms or electrical dipole mapping. In this respect there is a demand for modular neurosurgical planning systems offering flexible interfaces for easy enhancement. Furthermore all relevant planning information should be available within neuron-avigation. In this work we present a planning system providing these capabilities and its suitability and application in a clinical setting. Our Multimodal Planning System (MOPS 3D offers a variety of tools such as definition of trajectories for minimally invasive surgery, segmentation of ROIs, integration of functional information from atlas maps or magnetoencephalography. It also supplies plugin interfaces for future extensions. For intraoperative application MOPS is coupled with the neuronavigation system Brainlab Vector Vision Cranial/ENT (VVC. We evaluated MOPS in the Department of Neurosurgery at the University Hospital Heidelberg. Surgical planning and navigation was performed in 5 frequently occurring clinical cases. The time necessary for planning was between 5 and 15 minutes including data import, segmentation and planning tasks. The additional information intraoperatively provided by MOPS 3D was highly appreciated by the neurosurgeons and the performance was satisfactory.

  15. A case of lumbar pain after intraoperative radiotherapy

    Shimizu, Wakako; Ogino, Takashi; Murakami, Koji; Nawano, Shigeru; Moriyama, Noriyuki; Ryu, Munemasa; Kawano, Nariaki

    1996-01-01

    We report a case of abnormal magnetic resonance imaging (MRI) findings after intraoperative radiotherapy. A 53-year-old woman with cancer of the papilla of Vater was treated with pancreatoduodenectomy and 20 Gy of intraoperative radiotherapy by electron beam to the tumor bed. Three months later the patient complained of lumbar pain. A change of signal intensity on MRI was detected in the anterior half of the vertebral body within the irradiated field. The signal was of high intensity but was not enhanced by Gd-DTPA on T1-weighted images, was isointense on T2-weighted images and of low intensity with the fat-suppression method. The radiation dose to the lumbar spine and the surrounding soft tissue was calculated to be 16 Gy. Histologic changes in bone after irradiation may include depletion of bone marrow cells and fat degeneration. The MRI findings were compatible with these changes. The radiation dose that can be tolerated by soft tissue is lower than that tolerated by bone. Therefore, late radiation injury of the soft tissue might have been the cause of the patient's lumbar pain. (author)

  16. Improvement of limb salvage procedure using intraoperative radiotherapy for osteosarcoma

    Hirano, Toru; Iwasaki, Katsuo; Kamishiro; Toshiyuki; Hayashi, Yasuyuki

    1992-01-01

    Clinical outcome of limb salvage procedure combined with intraoperative irradiation was investigated in 6 patients with osteosarcoma in the distal part of femur (n=4) and proximal part of tibia (n=2). They ranged in age from 12 to 54 years, with a mean of 22.5. First, a lesion was separated from the surrounding soft tissue with curatively wide margin. Osteotomy was performed at the portion of diaphysis. After irradiation field was setted up by lifting the lesion, and was exposed to doses ranging from 60 Gy to 85 Gy of intraoperative irradiation, soft tissue and fragile tumor tissue, excluding joint capsule and ligament, were removed as soon as possible. Finally, bone was jointed by means of inner fixation or bone grafting. They had a median follow-up of one year and four months after surgery. Although superficial wound infection and delayed wound adhesion were encountered as postoperative complications in one and two patients, respectively, these were all healed. None of the patients had local recurrence. The ability of salvaged limb was excellent in one, good in 3, and fair in 2 patients. Because both of the two patients with sarcoma in the proximal part of tibia had excellent and good limb ability, this procedure was considered useful especially for sarcoma in the proximal part of tibia. (N.K.)

  17. Tumors in dogs exposed to experimental intraoperative radiotherapy

    Johnstone, Peter A.S.; Laskin, William B.; De Luca, Anne Marie; Barnes, Margaret; Kinsella, Timothy J.; Sindelar, William F.

    1996-01-01

    Purpose: The frequency of radiation-induced neoplasms was determined in dogs enrolled in the National Cancer Institute canine trials of intraoperative radiotherapy (IORT). Methods and Materials: Twelve protocols assessing normal tissue response to IORT involved 238 dogs in a 15-year trial. Eighty-one dogs were followed for > 24 months postoperatively and were assessed for tumor development; 59 of these animals received IORT. Results: Twelve tumors occurred in the 59 dogs receiving IORT. Nine were in the IORT portals and were considered to be radiation induced. No tumors occurred in 13 sham animals or in 9 animals treated with external beam radiotherapy alone. The frequency of radiation-induced malignancies in dogs receiving IORT was 15%, and was 25% in animals receiving ≥ 25 Gy IORT. Frequency of all tumors, including spontaneous lesions, was 20%. Conclusions: Intraoperative radiotherapy contributed to a high frequency of sarcoma induction in these dogs. Unknown to date in humans involved in clinical trials of IORT, this potential complication should be looked for as long-term survivors are followed

  18. Neurophysiological intraoperative monitoring during an optic nerve schwannoma removal.

    San-Juan, Daniel; Escanio Cortés, Manuel; Tena-Suck, Martha; Orozco Garduño, Adolfo Josué; López Pizano, Jesús Alejandro; Villanueva Domínguez, Jonathan; Fernández Gónzalez-Aragón, Maricarmen; Gómez-Amador, Juan Luis

    2017-10-01

    This paper reports the case of a patient with optic nerve schwannoma and the first use of neurophysiological intraoperative monitoring of visual evoked potentials during the removal of such tumor with no postoperative visual damage. Schwannomas are benign neoplasms of the peripheral nervous system arising from the neural crest-derived Schwann cells, these tumors are rarely located in the optic nerve and the treatment consists on surgical removal leading to high risk of damage to the visual pathway. Case report of a thirty-year-old woman with an optic nerve schwannoma. The patient underwent surgery for tumor removal on the left optic nerve through a left orbitozygomatic approach with intraoperative monitoring of left II and III cranial nerves. We used Nicolet Endeavour CR IOM (Carefusion, Middleton WI, USA) to performed visual evoked potentials stimulating binocularly with LED flash goggles with the patient´s eyes closed and direct epidural optic nerve stimulation delivering rostral to the tumor a rectangular current pulse. At follow up examinations 7 months later, the left eye visual acuity was 20/60; Ishihara score was 8/8 in both eyes; the right eye photomotor reflex was normal and left eye was mydriatic and arreflectic; optokinetic reflex and ocular conjugate movements were normal. In this case, the epidural direct electrical stimulation of optic nerve provided stable waveforms during optic nerve schwannoma resection without visual loss.

  19. Compact Intraoperative MRI: Stereotactic Accuracy and Future Directions.

    Markowitz, Daniel; Lin, Dishen; Salas, Sussan; Kohn, Nina; Schulder, Michael

    2017-01-01

    Intraoperative imaging must supply data that can be used for accurate stereotactic navigation. This information should be at least as accurate as that acquired from diagnostic imagers. The aim of this study was to compare the stereotactic accuracy of an updated compact intraoperative MRI (iMRI) device based on a 0.15-T magnet to standard surgical navigation on a 1.5-T diagnostic scan MRI and to navigation with an earlier model of the same system. The accuracy of each system was assessed using a water-filled phantom model of the brain. Data collected with the new system were compared to those obtained in a previous study assessing the older system. The accuracy of the new iMRI was measured against standard surgical navigation on a 1.5-T MRI using T1-weighted (W) images. The mean error with the iMRI using T1W images was lower than that based on images from the 1.5-T scan (1.24 vs. 2.43 mm). T2W images from the newer iMRI yielded a lower navigation error than those acquired with the prior model (1.28 vs. 3.15 mm). Improvements in magnet design can yield progressive increases in accuracy, validating the concept of compact, low-field iMRI. Avoiding the need for registration between image and surgical space increases navigation accuracy. © 2017 S. Karger AG, Basel.

  20. Stereoscopic Integrated Imaging Goggles for Multimodal Intraoperative Image Guidance.

    Christopher A Mela

    Full Text Available We have developed novel stereoscopic wearable multimodal intraoperative imaging and display systems entitled Integrated Imaging Goggles for guiding surgeries. The prototype systems offer real time stereoscopic fluorescence imaging and color reflectance imaging capacity, along with in vivo handheld microscopy and ultrasound imaging. With the Integrated Imaging Goggle, both wide-field fluorescence imaging and in vivo microscopy are provided. The real time ultrasound images can also be presented in the goggle display. Furthermore, real time goggle-to-goggle stereoscopic video sharing is demonstrated, which can greatly facilitate telemedicine. In this paper, the prototype systems are described, characterized and tested in surgeries in biological tissues ex vivo. We have found that the system can detect fluorescent targets with as low as 60 nM indocyanine green and can resolve structures down to 0.25 mm with large FOV stereoscopic imaging. The system has successfully guided simulated cancer surgeries in chicken. The Integrated Imaging Goggle is novel in 4 aspects: it is (a the first wearable stereoscopic wide-field intraoperative fluorescence imaging and display system, (b the first wearable system offering both large FOV and microscopic imaging simultaneously,

  1. A link between prompt optical and prompt gamma-ray emission in gamma-ray bursts.

    Vestrand, W T; Wozniak, P R; Wren, J A; Fenimore, E E; Sakamoto, T; White, R R; Casperson, D; Davis, H; Evans, S; Galassi, M; McGowan, K E; Schier, J A; Asa, J W; Barthelmy, S D; Cummings, J R; Gehrels, N; Hullinger, D; Krimm, H A; Markwardt, C B; McLean, K; Palmer, D; Parsons, A; Tueller, J

    2005-05-12

    The prompt optical emission that arrives with the gamma-rays from a cosmic gamma-ray burst (GRB) is a signature of the engine powering the burst, the properties of the ultra-relativistic ejecta of the explosion, and the ejecta's interactions with the surroundings. Until now, only GRB 990123 had been detected at optical wavelengths during the burst phase. Its prompt optical emission was variable and uncorrelated with the prompt gamma-ray emission, suggesting that the optical emission was generated by a reverse shock arising from the ejecta's collision with surrounding material. Here we report prompt optical emission from GRB 041219a. It is variable and correlated with the prompt gamma-rays, indicating a common origin for the optical light and the gamma-rays. Within the context of the standard fireball model of GRBs, we attribute this new optical component to internal shocks driven into the burst ejecta by variations of the inner engine. The correlated optical emission is a direct probe of the jet isolated from the medium. The timing of the uncorrelated optical emission is strongly dependent on the nature of the medium.

  2. Gamma tomography apparatus

    Span, F.J.

    1988-01-01

    The patent concerns a gamma tomography apparatus for medical diagnosis. The apparatus comprises a gamma scintillation camera head and a suspension system for supporting and positioning the camera head with respect for the patient. Both total body scanning and single photon emission tomography can be carried out with the apparatus. (U.K.)

  3. Gamma-sterilization

    Lindgren, E.

    1974-01-01

    The author makes a survey of his experience in sterilization and sterility control of medical products. At present three different methods are used, steamsterilization, gassterilizing and gammasterilizing. The investments and costs for gamma radiation is presented and a comparison of the costs for gamma- and gassterilization including sterility control is made. (M.S.)

  4. Gamma-ray sources

    Hermsen, W.

    1980-01-01

    Results are presented from an analysis of the celestial gamma-ray fine-scale structure based on over half of the data which may ultimately be available from the COS-B satellite. A catalogue consisting of 25 gamma-ray sources measured at energies above 100 MeV is presented. (Auth.)

  5. Gamma ray astronomy

    Hillier, R.

    1984-01-01

    The book reviews the development of gamma ray astronomy over the past twenty five years. A large section of the book is devoted to the problems of background radiation and the design of detectors. Gamma rays from the sun, the galactic disc, the galaxy, and extra galactic sources; are also discussed. (U.K.)

  6. Model for resonant plasma probe.

    Warne, Larry Kevin; Johnson, William Arthur; Hebner, Gregory Albert; Jorgenson, Roy E.; Coats, Rebecca Sue

    2007-04-01

    This report constructs simple circuit models for a hairpin shaped resonant plasma probe. Effects of the plasma sheath region surrounding the wires making up the probe are determined. Electromagnetic simulations of the probe are compared to the circuit model results. The perturbing effects of the disc cavity in which the probe operates are also found.

  7. Convective heat flow probe

    Dunn, James C.; Hardee, Harry C.; Striker, Richard P.

    1985-01-01

    A convective heat flow probe device is provided which measures heat flow and fluid flow magnitude in the formation surrounding a borehole. The probe comprises an elongate housing adapted to be lowered down into the borehole; a plurality of heaters extending along the probe for heating the formation surrounding the borehole; a plurality of temperature sensors arranged around the periphery of the probe for measuring the temperature of the surrounding formation after heating thereof by the heater elements. The temperature sensors and heater elements are mounted in a plurality of separate heater pads which are supported by the housing and which are adapted to be radially expanded into firm engagement with the walls of the borehole. The heat supplied by the heater elements and the temperatures measured by the temperature sensors are monitored and used in providing the desired measurements. The outer peripheral surfaces of the heater pads are configured as segments of a cylinder and form a full cylinder when taken together. A plurality of temperature sensors are located on each pad so as to extend along the length and across the width thereof, with a heating element being located in each pad beneath the temperature sensors. An expansion mechanism driven by a clamping motor provides expansion and retraction of the heater pads and expandable packer-type seals are provided along the probe above and below the heater pads.

  8. Langmuir probe study of plasma expansion in pulsed laser ablation

    Hansen, T.N.; Schou, Jørgen; Lunney, J.G.

    1999-01-01

    Langmuir probes were used to monitor the asymptotic expansion of the plasma produced by the laser ablation of a silver target in a vacuum. The measured angular and temporal distributions of the ion flux and electron temperature were found to be in good agreement with the self-similar isentropic...... and adiabatic solution of the gas dynamics equations describing the expansion. The value of the adiabatic index gamma was about 1.25, consistent with the ablation plume being a low temperature plasma....

  9. Theory of NMR probe design

    Schnall, M.D.

    1988-01-01

    The NMR probe is the intrinsic part of the NMR system which allows transmission of a stimulus to a sample and the reception of a resulting signal from a sample. NMR probes are used in both imaging and spectroscopy. Optimal probe design is important to the production of adequate signal/moise. It is important for anyone using NMR techniques to understand how NMR probes work and how to optimize probe design

  10. Intraoperative three-dimensional fluoroscopy after transpedicular positioning of Kirschner-wire versus conventional intraoperative biplanar fluoroscopic control: A retrospective study of 345 patients and 1880 pedicle screws

    Ghassan Kerry

    2014-01-01

    Full Text Available Study Design: Retrospective study. Objective: The aim was to find out whether intraoperative three-dimensional imaging after transpedicular positioning of Kirschner wire (K-wire in lumbar and thoracic posterior instrumentation procedures is of benefit to the patients and if this technique is accurately enough to make a postoperative screw position control through computer tomography (CT dispensable. Patients and Methods: Lumbar and thoracic posterior instrumentation procedures conducted at our department between 2002 and 2012 were retrospectively reviewed. The patients were divided into two groups: group A, including patients who underwent intraoperative three-dimensional scan after transpedicular positioning of the K-wire and group B, including patients who underwent only intraoperative biplanar fluoroscopy. An early postoperative CT of the instrumented section was done in all cases to assess the screw position. The rate of immediate intraoperative correction of the K-wires in cases of mal-positioning, as well as the rate of postoperative screw revisions, was measured. Results: In general, 345 patients (1880 screws were reviewed and divided into two groups; group A with 225 patients (1218 screws and group B with 120 patients (662 screws. One patient (0.44% (one screw [0.082%] of group A underwent postoperative screw correction while screw revisions were necessary in 14 patients (11.7% (28 screws [4.2%] of group B. Twenty-three patients (10.2% (28 K-wires [2.3%] of group A underwent intraoperative correction due to primary intraoperative detected K-wire mal-position. None of the corrected K-wires resulted in a corresponding neurological deficit. Conclusion: Three-dimensional imaging after transpedicular K-wire positioning leads to solid intraoperative identification of misplaced K-wires prior to screw placement and reduces screw revision rates compared with conventional fluoroscopic control. When no clinical deterioration emerges, a

  11. Gamma monitoring system 'Hyperion' at the research nuclear reactor RB

    Zigic, A.; Saponjic, Dj.; Arandelovic, V. . E-mail address of corresponding author: alex@vin.bg.ac.yu

    2005-01-01

    While performing experiments at the research reactor RB at Vinca institute it is mandatory to measure the intensity of gamma radiation at reactor RB since the reactor has no biological protection. the stationary distributed measurement system 'Hyperion' implemented at reactor RB, performs measurements and monitoring of gamma radiation at 10 specified measuring sites within and in the vicinity of the reactor RB in the required absorbed dose in air range of 50 nGy/h to 10 mGy/h. the 'Hyperion' monitoring system have three hierarchically organized layers. the basic layer consists of the network of 10 intelligent gm probes located at predetermined measuring sites. the medium layer represents the PC-based local control node where measured data from all intelligent probes are separately acquired, stored in the local database and processed for local visualization and printed measurements reports for network operator. the information on the status of the intelligent gm probes are also provided, enabling the verification of measured results at the local control node. the central control node represents the pc-based highest monitoring network layer connected to the local control node using already existing lan infrastructure. the central control node hosts the central database, provides full insight into instantaneous gamma radiation levels at all measuring sites, provides archives on daily bases for all monitored locations and printed reports on measurements for all measuring sites at any time of gamma radiation measurement. (author)

  12. Intra-operative blood transfusion among adult surgical patients in a ...

    This retrospective study was designed to audit the pattern of intra-operative whole blood transfusion among adult surgical patients over a two-year period. Data were collected on the rate of intra-operative transfusion, estimated blood loss, units of donor blood transfused, pattern of use of autologous blood and circumstances ...

  13. Is Intraoperative Diffusion tensor Imaging at 3.0T Comparable to Subcortical Corticospinal tract Mapping?

    Ostrý, S.; Belšan, T.; Otáhal, Jakub; Beneš, V.; Netuka, D.

    2013-01-01

    Roč. 73, č. 5 (2013), s. 797-807 ISSN 0148-396X Institutional support: RVO:67985823 Keywords : corticospinal tract * intraoperative tractography * intraoperative image distortion * motor -evoked potentials * subcortical mapping Subject RIV: FH - Neurology Impact factor: 3.031, year: 2013

  14. Intra-operative removal of chest tube in video-assisted thoracoscopic procedures

    Moustafa M. El-Badry

    2017-12-01

    Conclusions: Intra-operative removal of chest tube during VATS procedures was a safe technique in well selected patients with an intra-operative successful air-leak test with radiological and clinical follow-up. This technique provided lesser post-operative pain with shorter hospital stay.

  15. Study on intraoperative radiotherapy applying hyperthermia together with radiation sensitizers for progressive local carcinoma

    Abe, M; Takahashi, M; Ono, K; Hiraoka, M [Kyoto Univ. (Japan). Faculty of Medicine

    1980-08-01

    Intraoperative radiotherapy for gastric cancer, colonic cancer, pancreatic cancer, cancer of the biliary tract, prostatic carcinoma, cerebral tumor, tumor of soft tissues, and osteosarcoma and its clinical results were described. Basic and clinical studies on effects of both hyperthermia and radiation sensitizers to elevate radiation sensitivity were also described, because effects of intraoperative radiotherapy were raised by applying hyperthermia and hypoxic cell sensitizers.

  16. Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

    Woods, Michael; Birkholz, Denise; MacBarb, Regina; Capobianco, Robyn; Woods, Adam

    2014-01-01

    Study Design. Retrospective case series. Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct...

  17. Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China.

    Jie Yi

    Full Text Available Inadvertent intraoperative hypothermia (core temperature 2 h (OR = 2.60, 95% CI 2.09-3.24.The incidence of intraoperative hypothermia in China is high, and the rate of active warming of patients during operation is low. Hypothermia is associated with more postoperative shivering, increased ICU admissions, and longer postoperative hospital days.

  18. INTRAOPERATIVE MOTIVE FOR PERFORMING A LAPAROSCOPIC APPENDECTOMY ON A POSTOPERATIVE HISTOLOGICAL PROVEN NORMAL APPENDIX

    Slotboom, T.; Hamminga, J. T. H.; Hofker, H. S.; Heineman, E.; Haveman, J. W.

    2014-01-01

    Background: Diagnostic laparoscopy is the ultimate tool to evaluate the appendix. However, the intraoperative evaluation of the appendix is difficult, as the negative appendectomy rate remains 12%-18%. The aim of this study is to analyze the intraoperative motive for performing a laparoscopic

  19. Radioguided Parathyroidectomy with Portable Mini Gamma-Camera for the Treatment of Primary Hyperparathyroidism

    Claudio Casella

    2015-01-01

    Full Text Available Background. A proper localisation of pathological parathyroid glands is essential for a minimally invasive approach in the surgical treatment of primary hyperparathyroidism (PHP. The recent introduction of portable mini gamma-cameras (pMGCs enabled intraoperative scintigraphic scanning. The aim of our study is to evaluate the efficacy of this new method and compare it with the preoperative localisation surveys. Methods. 20 patients were studied; they were evaluated preoperatively by neck ultrasound and Tc-sestaMIBI-scintigraphy and intraoperatively with the pMGC IP Guardian 2. The results obtained from the three evaluations were compared. Results. The pMGC presented a sensitivity of 95%, a specificity of 98.89%, and a diagnostic accuracy of 98.18%, which were higher than those of preoperative ultrasound (sensitivity 55%; specificity 95%; diagnostic accuracy 87% and scintigraphy with Tc-sestaMIBI (sensitivity 73.68%; specificity 96.05%; diagnostic accuracy 91.58%. Conclusions. The pMGC can be used effectively as an intraoperative method to find the correct location of the pathological parathyroid glands. The pMGC is more reliable than the currently used preoperative and intraoperative localisation techniques.

  20. The Measuring of the Gamma Dose Rate in the Air at Location of the Sar-Mountain

    Adrovic, F.; Ninkovic, M.; Adrovic, S.

    1999-01-01

    The results of the measured values of gamma dose rate in the air at the location of Sar-mountain (Balkan Peninsula) using autonomous ADL-probe Gamma Tracer system. The difference between levels of the natural background radiation and natural environment has been pointed out at the different chosen measuring overall research of natural radioactivity at the location of Sar-mountain

  1. Intraoperative near-infrared fluorescent imaging during robotic operations.

    Macedo, Antonio Luiz de Vasconcellos; Schraibman, Vladimir

    2016-01-01

    The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results. Disadvantages are linked to contrast distribution in certain clinical scenarios. The intraoperative near-infrared fluorescent imaging is new and promising addition to robotic surgery. Several reports show the utility of this technology in several different procedures. The ideal dose, time and site for dye injection are not well defined. No high quality evidence-based comparative studies and long-term follow-up outcomes have been published so far. Initial results, however, are good and safe. RESUMO A identificação intraoperatória de certas estruturas anatômicas, por seu tamanho ou por elas serem ocultas à visão, pode ser desafiadora. O desenvolvimento da cirurgia minimamente invasiva trouxe dificuldades adicionais, pela falta da sensibilidade tátil completa. Diversas formas de detecção intraoperatória destas estruturas têm sido tentadas. Recentemente, a tecnologia de fluorescência infravermelha com verde de indocianina foi associada às plataformas robóticas. Além disso, essa tecnologia tem sido testada em uma variedade de cirurgias, e suas vantagens parecem estar ligadas a baixo custo, segurança e bons resultados. As desvantagens estão associadas à má distribuição do contraste em determinados cenários. A imagem intraoperatória por fluorescência infravermelha é uma nova e promissora adição à cirurgia robótica. Diversas séries mostram

  2. Intraoperative performance and postoperative outcomes of microcoaxial phacoemulsification. Observational study.

    Vasavada, Viraj; Vasavada, Vaishali; Raj, Shetal M; Vasavada, Abhay R

    2007-06-01

    To evaluate the intraoperative performance and postoperative outcomes after microcoaxial phacoemulsification. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. A prospective observational case series comprised 84 eyes with age-related uncomplicated cataract having microcoaxial phacoemulsification through a 2.2 mm clear corneal incision by a standard surgical technique. Phacoemulsification parameters (Infiniti Vision System, Alcon) were microburst width, 30 ms; preset power, 50%; vacuum, 650 mm Hg; aspiration flow rate, 25 cc/minute. A single-piece Alcon AcrySof intraocular lens was implanted with the C cartridge (Alcon) cartridge. The incision was measured at the end of surgery. Observations included surgical time (from commencement of sculpting to end of epinucleus removal), cumulative dissipated energy (CDE), wound burns, intraoperative complications, postoperative increase in mean central corneal thickness (CCT) at 1 day and 1 month, mean % decrease in endothelial cell density (ECD), absolute mean change in coefficient of variation (cv) 3 months, and uncorrected visual acuity (UCVA) at 1 day. Data were analyzed using a 1-sample t test with 95% confidence intervals (CIs). The mean follow up was 3 months +/- 0.3 (SD). The mean incision size at the end of surgery was 2.3 +/- .09 mm; mean surgical time, 4.5 +/- 1.5 minutes; and mean CDE, 2.3 +/- 2.2 seconds. No wound burns or other intraoperative complications occurred. The postoperative CCT increased by a mean of 16 microm at 1 day (95% CI, 8-25; P = .66;) and by a mean of 3.14 microm at 1 month (95% CI, 2.26-4.05; P = .92). The ECD decreased by a mean of 5.8% (95% CI, 6.8-3.5; P = .82) and the mean coefficient of variation, by 3.3 (95% CI, 4.5-2.0; P = .65). At 1 day, the UCVA was 20/20 in 29% of cases, 20/20 to 20/40 in 58%, and 20/40 to 20/50 in 12%. Microcoaxial phacoemulsification was safely and effectively performed, achieving consistent and satisfactory postoperative outcomes.

  3. Intraoperative electron beam radiation therapy (IOEBRT) for carcinoma of the exocrine pancreas

    Dobelbower, R.R. Jr.; Konski, A.A.; Merrick, H.W. III; Bronn, D.G.; Schifeling, D.; Kamen, C.

    1991-01-01

    The abdominal cavities of 50 patients were explored in a specially constructed intraoperative radiotherapy operating amphitheater at the Medical College of Ohio. Twenty-six patients were treated with intraoperative and postoperative precision high dose external beam therapy, 12 with intraoperative irradiation but no external beam therapy, and 12 with palliative surgery alone. All but two patients completed the postoperative external beam radiation therapy as initially prescribed. The median survival time for patients treated with palliative surgery alone was 4 months, and that for patients treated with intraoperative radiotherapy without external beam therapy was 3.5 months. Patients undergoing intraoperative irradiation and external beam radiation therapy had a median survival time of 10.5 months. Four patients died within 30 days of surgery and two patients died of gastrointestinal hemorrhage 5 months posttreatment

  4. Intra-operative radiotherapy of malignant tumors: Past, present and perspectives

    Mazeron, J.J.; Le Bourgeois, J.P.; Ganem, G.

    1986-01-01

    Intra-operative radiotherapy consists of electron or photon radiation which is used during the operative procedure. The treatment field is arranged very precisely after critical organs have been previously arranged out of the field. The target volume includes the remaining tumor which could not be removed surgically, and the surrounding tumor bed which is also felt to be high risk for recurrence. It is preferable to have as little tumor remaining as possible before the intra-operative treatment radiation is given. Intra-operative radiotherapy was developed less than a quarter century ago in Japon, and it was later used in U.S.A. The accumulated experience in Japan and U.S.A. is rewieved here. Intra-operative radiotherapy has only recently been introduced to France. The biology, physics and medical and technical problems of intra-operative therapy are discussed [fr

  5. GammaWorkshops Proceedings

    Ramebaeck, H. (ed.) (Swedish Defence Research Agency (Sweden)); Straalberg, E. (Institute for Energy Technology, Kjeller (Norway)); Klemola, S. (Radiation and Nuclear Safety Authority, STUK (Finland)); Nielsen, Sven P. (Technical Univ. of Denmark. Risoe National Lab. for Sustainable Energy, Roskilde (Denmark)); Palsson, S.E. (Icelandic Radiation Safety Authority (Iceland))

    2012-01-15

    Due to a sparse interaction during the last years between practioners in gamma ray spectrometry in the Nordic countries, a NKS activity was started in 2009. This GammaSem was focused on seminars relevant to gamma spectrometry. A follow up seminar was held in 2010. As an outcome of these activities it was suggested that the 2011 meeting should be focused on practical issues, e.g. different corrections needed in gamma spectrometric measurements. This three day's meeting, GammaWorkshops, was held in September at Risoe-DTU. Experts on different topics relevant for gamma spectrometric measurements were invited to the GammaWorkshops. The topics included efficiency transfer, true coincidence summing corrections, self-attenuation corrections, measurement of natural radionuclides (natural decay series), combined measurement uncertainty calculations, and detection limits. These topics covered both lectures and practical sessions. The practical sessions included demonstrations of tools for e.g. corrections and calculations of the above meantioned topics. (Author)

  6. The gamma function

    Artin, Emil

    2015-01-01

    This brief monograph on the gamma function was designed by the author to fill what he perceived as a gap in the literature of mathematics, which often treated the gamma function in a manner he described as both sketchy and overly complicated. Author Emil Artin, one of the twentieth century's leading mathematicians, wrote in his Preface to this book, ""I feel that this monograph will help to show that the gamma function can be thought of as one of the elementary functions, and that all of its basic properties can be established using elementary methods of the calculus."" Generations of teachers

  7. [Intraoperative detection of the sentinel lymph nodes in lung cancer].

    Akopov, A L; Papayan, G V; Chistyakov, I V

    2015-01-01

    An analysis of the scientific data was made. It was used the literature devoted to the intraoperative visualization of the sentinel lymph nodes in patients with lung cancer. Correct detection of such lymph nodes with following pathologic investigation allowed limiting the volume of lympho-dissection in a number of patients. There is the possibility of maximal in-depth study of the sentinel lymph nodes by purposeful application of most sensible pathologic and molecular methods for detection their micrometastatic lesions. At the same time the treatment strategy and prognosis could be determined. The authors present the results of an application of dye techniques, radioactive preparation and fluorescence imaging for sentinel lymph node detection. Advantages and disadvantages of the methods are shown in the article. There are validated the prospects of technical development, study of information value of new applications and the most perspective method of fluorescence indocyanine green visualization by lymph outflow.

  8. Intraoperative Assessment of Esophagogastric Junction Distensibility During Laparoscopic Heller Myotomy.

    DeHaan, Reece K; Frelich, Matthew J; Gould, Jon C

    2016-04-01

    We sought to characterize the changes in esophagogastric junction (EGJ) distensibility during Heller Myotomy with Dor fundoplication using the EndoFLIP device. Intraoperative distensibility measurements on 14 patients undergoing Heller myotomy with Dor fundoplication were conducted over an 18-month period. Minimum esophageal diameter, cross-sectional areas, and distensibility index were measured at 30 and 40 mL catheter volumes before myotomy, postmyotomy, and following Dor fundoplication. Distensibility index is defined as the narrowest cross-sectional area divided by the corresponding pressure expressed in mm/mm Hg. Heller myotomy was found to lead to significant changes in the distensibility characteristics of the EGJ. Minimum esophageal diameter and EGJ distensibility increased significantly with Heller myotomy.

  9. Videoscopic Heller Myotomy with Intraoperative Endoscopy Promotes Optimal Outcomes

    Bloomston, Mark; Brady, Patrick

    2002-01-01

    Background and Objectives: Minimally invasive surgical techniques are applicable to achalasia, but the optimum approach to intraoperative assessment of adequacy of myotomy remains unestablished. We set out to show that videoscopic Heller myotomy with concurrent endoscopy ensures adequacy of myotomy while limiting postoperative clinically apparent reflux. Methods: Seventy-eight consecutive patients with achalasia underwent videoscopic Heller myotomy with concomitant endoscopy between 1992 and 1998. Fundoplication was not routinely undertaken. Results: Preoperative symptoms consisted of dysphagia (100%), emesis/regurgitation (68%), heartburn (58%), and postprandial chest pain (49%). Following myotomy, significant improvement (P Heller myotomy guides the extent and adequacy of myotomy. By utilizing a focused dissection with preservation of the natural antireflux mechanisms around the gastroesophageal junction and limiting the extent of myotomy along the cardia, postoperative reflux symptoms are minimized. We advocate concomitant endoscopy during Heller myotomy to guide myotomy and submit that routine fundoplication is clinically unnecessary. PMID:12113416

  10. Is current clinical practice modified about intraoperative breast irradiation?

    Massa, Michela; Franchelli, Simonetta; Panizza, Renzo; Massa, Tiberio

    2016-04-01

    After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

  11. Non-radiographic intraoperative fluorescent cholangiography is feasible

    Larsen, Søren S; Schulze, Svend; Bisgaard, Thue

    2014-01-01

    INTRODUCTION: Intraoperative fluorescent cholangiography (IFC) with concomitant fluorescent angiography was recently developed for non-invasive identification of the anatomy during laparoscopic cholecystectomy. The objective of this study was to assess the time required for routine-use of IFC...... and to evaluate the success rate of the procedures. MATERIAL AND METHODS: A total of 35 patients scheduled for laparoscopic cholecystectomy and operated by the same surgeon were consecutively enrolled. A standardised protocol with IFC including angiography was performed during laparoscopic cholecystectomy...... hepatic duct was identified by IFC in all patients. In 29 of the 35 patients (83%; 95% confidence interval: 71-96%), the cystic artery was visualised by fluorescent angiography. No adverse effects or complications were recorded. CONCLUSION: Routine-use of IFC with fluorescent angiography during...

  12. Intra-operative hearing monitoring methods in middle ear surgeries

    Wei Ren

    2016-12-01

    Full Text Available Hearing loss is a condition affecting millions of people worldwide. Conductive hearing loss (CHL is mainly caused by middle ear diseases. The low frequency area is the pivotal part of speech frequencies and most frequently impaired in patients with CHL. Among various treatments of CHL, middle ear surgery is efficient to improve hearing. However, variable success rates and possible needs for prolonged revision surgery still frustrate both surgeons and patients. Nowadays, increasing numbers of researchers explore various methods to monitor the efficacy of ossicular reconstruction intraoperatively, including electrocochleography (ECochG, auditory brainstem response (ABR, auditory steady state response (ASSR, distortion product otoacoustic emissions (DPOAE, subjective whisper test, and optical coherence tomography (OCT. Here, we illustrate several methods used clinically by reviewing the literature.

  13. Upper gastrointestinal tract injuries by intraoperative radiotherapy for pancreatic cancer

    Tabata, I; Isawa, T; Satomi, T; Tazima, T [Tokyo Metropolitan Komagome Hospital (Japan)

    1981-08-01

    Twenty-one patients with unresectable carcinoma of the pancreas were treated by intraoperative irradiation with a large electron dose of 1500 - 3000 rads and upper gastrointestinal complications were encountered in five cases. All of those five cases were for carcinoma of the pancreatic head, and were seen for gastrointestinal tract injuries of the duodenum as follows, gastric ulcer in 2 cases, ulcer of the 1st duodenal portion in one case and ulcer with severe stenosis of the 2nd or 3rd duodenal portion in one case, respectively. Endoscopic features of these postirradiation gastrointestinal ulcers were characterized by deep, punched-out ulcers with grayish bases and sharp margins. Clinically these ulcers and stenosis were very difficult to treat, so by-pass operations were performed in two cases, resulting in prolonged survival.

  14. Intraoperative radiation in the canine para-aortic abdomen

    Hoopes, P.J.; Gillette, E.L.

    1984-01-01

    Twenty adult beagle dogs received intraoperatively delivered 6 MeV electrons to the para-aortic abdomen and bladder. The dogs were equally divided into 4 dose groups receiving 22 Gy, 30 Gy, 38.5 Gy and 47 Gy. The 5 cm x 8 cm radiation field included a variable portion of the left kidney, the left ureter, the abdominal aorta and vena cava, the base of the bladder and the left sciatic and femoral nerves. The lesions observed were fibroelastic proliferation of the aortic intima, severe renal atrophy and fibrosis, ureteral stenosis, bladder fibrosis and demyelinating peripheral neuropathies. Histologic, morphometric and dose response analyses are compared with responses of dogs receiving more conventional fractionated doses to a total of 60 Gy, 70 Gy or 80 Gy x-ray in 6 weeks

  15. Postprocessing algorithm for automated analysis of pelvic intraoperative neuromonitoring signals

    Wegner Celine

    2016-09-01

    Full Text Available Two dimensional pelvic intraoperative neuromonitoring (pIONM® is based on electric stimulation of autonomic nerves under observation of electromyography of internal anal sphincter (IAS and manometry of urinary bladder. The method provides nerve identification and verification of its’ functional integrity. Currently pIONM® is gaining increased attention in times where preservation of function is becoming more and more important. Ongoing technical and methodological developments in experimental and clinical settings require further analysis of the obtained signals. This work describes a postprocessing algorithm for pIONM® signals, developed for automated analysis of huge amount of recorded data. The analysis routine includes a graphical representation of the recorded signals in the time and frequency domain, as well as a quantitative evaluation by means of features calculated from the time and frequency domain. The produced plots are summarized automatically in a PowerPoint presentation. The calculated features are filled into a standardized Excel-sheet, ready for statistical analysis.

  16. How evolution of the nailing system improves results and reduces orthopedic complications: more than 2000 cases of trochanteric fractures treated with the Gamma Nail System.

    Pascarella, R; Fantasia, R; Maresca, A; Bettuzzi, C; Amendola, L; Violini, S; Cuoghi, F; Sangiovanni, P; Cerbasi, S; Boriani, S; Tigani, D S

    2016-04-01

    The incidence of trochanteric fractures has increased significantly during the last few decades, especially in elderly patients with osteoporosis. The dynamic/sliding hip screw and the cephalomedullary nail are the most commonly used fixation methods to treat trochanteric fractures. The improvements in the Gamma Nail System (GNS) associated with a correct surgical technique reduced the postoperative orthopedic complications. The purpose of this study was to compare the results of the different Gamma Nails. The present study is a retrospective analysis of 2144 patients treated with GNS between January 1997 and December 2011 for trochanteric fractures, classified according to AO classification method. The patients were divided into three groups according to the nailing system: 525 were treated with Standard Gamma Nail (SGN), 422 with Trochanteric Gamma Nail (TGN) and 1197 with Gamma3 Nail. The overall incidence of intra-operative complications was 1.21 %; the incidence of intra-operative complications for each group was 1.71 % for SGN group, 0.47 % for TGN group and 1.25 % for Gamma3 Nail group. The overall incidence of postoperative complications was 5.48 %, and the incidence for each group was 10.73 % for SGN group, 9.92 % for TGN group and 2.92 % for Gamma3 Nail group. The GNS is a safe device with a low rate of intra-operative complications. The evolution of this nail system reduces postoperative complications, thus improving the results at follow-up and confirming that the Gamma3 Nail is a safe and predictable device to fix trochanteric fracture.

  17. One-Probe Search

    Östlin, Anna; Pagh, Rasmus

    2002-01-01

    We consider dictionaries that perform lookups by probing a single word of memory, knowing only the size of the data structure. We describe a randomized dictionary where a lookup returns the correct answer with probability 1 - e, and otherwise returns don't know. The lookup procedure uses an expan...

  18. Probing the Solar System

    Wilkinson, John

    2013-01-01

    Humans have always had the vision to one day live on other planets. This vision existed even before the first person was put into orbit. Since the early space missions of putting humans into orbit around Earth, many advances have been made in space technology. We have now sent many space probes deep into the Solar system to explore the planets and…

  19. Probing the Solar Interior

    Home; Journals; Resonance – Journal of Science Education; Volume 3; Issue 3. Probing the Solar Interior Hearing the Heartbeats of the Sun. Ashok Ambastha. General ... Author Affiliations. Ashok Ambastha1. Joint In-Charge Udaipur Solar Observatory Physical Research laboratory P.O. Box No. 198 Udaipur 313 001, India ...

  20. Flexible position probe assembly

    Schmitz, J.J.

    1977-01-01

    The combination of a plurality of tubular transducer sections and a flexible supporting member extending through the tubular transducer sections forms a flexible elongated probe of a design suitable for monitoring the level of an element, such as a nuclear magnetically permeable control rod or liquid. 3 claims, 23 figures

  1. Tolerance of canine anastomoses to intraoperative radiation therapy

    Tepper, J.E.; Sindelar, W.; Travis, E.L.; Terrill, R.; Padikal, T.

    1983-01-01

    Radiation has been given intraoperatively to various abdominal structures in dogs, using a fixed horizontal 11 MeV electron beam at the Armed Forces Radiobiologic Research Institute. Animals were irradiated with single doses of 2000, 3000 and 4500 rad to a field which extended from the bifurcation of the aorta to the rib cage. All animals were irradiated during laparotomy under general anesthesia. Because the clinical use of intraoperative radiotherapy in cancer treatment will occasionally require irradiation of anastomosed large vessels and blind loops of bowel, the tolerance of aortic anastomoses and the suture lines of blind loops of jejunum to irradiation were studied. Responses in these experiments were scored at times up to one year after irradiation. In separate experiments both aortic and intestinal anastomoses were performed on each animal for evaluation of short term response. The dogs with aortic anastomoses showed adequate healing at all doses with no evidence of suture line weakening. On long-term follow-up one animal (2000 rad) had stenosis at the anastomosis and one animal (4500 rad) developed an arteriovenous fistula. Three of the animals that had an intestinal blind loop irradiated subsequently developed intussusception, with the irradiated loop acting as the lead point. One week after irradiation, bursting pressure of an intestinal blind loop was normal at 3000 rad, but markedly decreased at 4500 rad. No late complications were noted after the irradiation of the intestinal anastomosis. No late complicatons were observed after irradiation of intestinal anastomoses, but one needs to be cautious with regards to possible late stenosis at the site of an irradiated vascular anastomosis

  2. VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection

    Boutros Cherif

    2008-03-01

    Full Text Available Abstract Introduction Video-assisted thoracic surgery (VATS has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instruments, robotic applications, and increased patient acceptance and awareness. Several techniques have been described to localize peripheral pulmonary nodules, including pre-operative CT-guided tattooing with methylene blue, CT scan guided spiral/hook wire placement, and transthoracic ultrasound. As pulmonary surgeons well know, the lung and visceral pleura may appear featureless on top of a pulmonary nodule. Case description This paper presents a rapid, direct and inexpensive approach to peripheral lung lesion resection by marking the lung parenchyma on top of the nodule using direct methylene blue injection. Methods In two patients with peripherally located lung nodules (n = 3 scheduled for VATS, we used direct methylene blue injection for intraoperative localization of the pulmonary nodule. Our technique was the following: After finger palpation of the lung, a spinal 25 gauge needle was inserted through an existing port and 0.1 ml of methylene blue was used to tattoo the pleura perpendicular to the localized nodule. The methylene blue tattoo immediately marks the lung surface over the nodule. The surgeon avoids repeated finger palpation, while lining up stapler, graspers and camera, because of the visible tattoo. Our technique eliminates regrasping and repalpating the lung once again to identify a non marked lesion. Results Three lung nodules were resected in two patients. Once each lesion was palpated it was marked, and the area was resected with security of accurate localization. All lung nodules were resected in totality with normal lung parenchymal margins. Our technique added about one minute to the operative time. The two patients were discharged home on the second postoperative day, with no morbidity. Conclusion

  3. Intraoperative detection of glioma invasion beyond MRI enhancement with Raman spectroscopy in humans

    Jermyn, Michael; Mok, Kelvin; Mercier, Jeanne; Desroches, Joannie; Pichette, Julien; Saint-Arnaud, Karl; Guiot, Marie-Christine; Petrecca, Kevin; Leblond, Frédéric

    2015-03-01

    Cancer tissue is frequently impossible to distinguish from normal brain during surgery. Gliomas are a class of brain cancer which invade into the normal brain. If left unresected, these invasive cancer cells are the source of glioma recurrence. Moreover, these invasion areas do not show up on standard-of-care pre-operative Magnetic Resonance Imaging (MRI). This inability to fully visualize invasive brain cancers results in subtotal surgical resections, negatively impacting patient survival. To address this issue, we have demonstrated the efficacy of single-point in vivo Raman spectroscopy using a contact hand-held fiber optic probe for rapid detection of cancer invasion in 8 patients with low and high grade gliomas. Using a supervised machine learning algorithm to analyze the Raman spectra obtained in vivo, we were able to distinguish normal brain from the presence of cancer cells with sensitivity and specificity greater than 90%. Moreover, by correlating these results with pre-operative MRI we demonstrate the ability to detect low density cancer invasion up to 1.5cm beyond the cancer extent visible using MRI. This represents the potential for significant improvements in progression-free and overall patient survival, by identifying previously undetectable residual cancer cell populations and preventing the resection of normal brain tissue. While the importance of maximizing the volume of tumor resection is important for all grades of gliomas, the impact for low grade gliomas can be dramatic because surgery can even be curative. This convenient technology can rapidly classify cancer invasion in real-time, making it ideal for intraoperative use in brain tumor resection.

  4. Basics of Gamma Ray Detection

    Stinnett, Jacob [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Venkataraman, Ram [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-09-13

    The objective of this training is to explain the origin of x-rays and gamma rays, gamma ray interactions with matter, detectors and electronics used in gamma ray-spectrometry, and features of a gamma-ray spectrum for nuclear material that is safeguarded.

  5. ECG-gated scintillation probe measurement of left ventricular function

    Bacharach, S.L.; Green, M.V.; Borer, J.S.; Ostrow, H.G.; Redwood, D.R.; Johnston, G.S.

    1977-01-01

    A nonimaging, ECG-gated scintillation-probe system is described that permits real-time quantification, at high temporal resolution, of the time variation of left ventricular (LV) volume over a complete, average cardiac cycle. Linearity between counting rate and volume, probe positioning, and background correction were investigated for both cylindrically collimated (CC) and parallel-hole-collimated (PC) detectors. In 53 patient studies, results obtained with these probes were compared with results obtained from an ECG-gated gamma camera system (CS) with high temporal resolution. Time-activity curves obtained by all three devices were essentially identical in shape (for CC against CS, r = 0.93; for PC against CS, r = 0.98) and in intracycle timing. Left-ventricular ejection fractions obtained with the probes showed workable agreement with the camera: for CC against CS, r = 0.85 (N = 31); for PC against CS, r = 0.90 (N = 21). When LV background is removed as a source of error, the correlation between (PC) probe and camera is improved (r = 0.95, N = 21). This suggests that the portable probe system be used in circumstances where exact knowledge of LV background is minimally important--e.g., continuous bedside monitoring of changes in LV function

  6. Shift of the pyramidal tract during resection of the intraaxial brain tumors estimated by intraoperative diffusion-weighted imaging

    Ozawa, Norihiko; Muragaki, Yoshihiro; Nakamura, Ryoichi; Iseki, Hiroshi; Hori, Tomokatsu

    2009-01-01

    The present study evaluated the shift of the pyramidal tract during resection of 17 proximal intraaxial brain tumors. In each case intraoperative diffusion-weighted (iDW) magnetic resonance imaging with a motion-probing gradient applied in the anteroposterior direction was performed using a scanner with a 0.3 T vertical magnetic field. The position of the white matter bundles containing the pyramidal tract was estimated on the coronal images before and after resection of the neoplasm, and both quantitative and directional evaluation of its displacement was done. In all cases iDW imaging provided visualization of the structure of interest. The magnitude of the pyramidal tract displacement due to removal of the neoplasm varied from 0.5 to 8.7 mm (mean 4.4±2.5 mm) on the lesion side and from 0 to 3.6 mm (mean 1.3±1.1 mm) on the normal side (p<0.001). Tumor location in regards to the pyramidal tract was significantly associated with the direction of the pyramidal tract displacement (p<0.05). Outward shift occurred in 10 out of 13 cases of the lateral neoplasms, whereas in all 4 superomedial tumors inward shift was marked. In conclusion, the direction of the pyramidal tract displacement during resection of the proximal intraaxial brain tumors is mainly determined by position of the neoplasm, but can be unpredictable in some cases, which necessitates use of subcortical brain mapping and intraoperative imaging, particularly iDW imaging with updated neuronavigation. (author)

  7. GammaWorkshops Proceedings

    Strålberg, Elisabeth; Klemola, Seppo; Nielsen, Sven Poul

    to the GammaWorkshops. The topics included efficiency transfer, true coincidence summing corrections, self-attenuation corrections, measurement of natural radionuclides (natural decay series), combined measurement uncertainty calculations, and detection limits. These topics covered both lectures and practical...

  8. FTR europia gamma heating

    Ward, J.T. Jr.

    1975-01-01

    Calculated and experimental gamma heating rates of europia in the Engineering Mockup Critical Assembly (EMC) were correlated. A calculated to experimental (C/E) ratio of 1.086 was established in validating the theoretical approach and computational technique applied in the calculations. Gamma heat deposition rates in the FTR with Eu 2 O 3 control absorbers were determined from three-dimensional calculations. Maximum gamma heating was found to occur near the tip of a half-inserted row 5 control rod assembly--12.8 watts/gm of europia. Gamma heating profiles were established for a single half-inserted europia absorber assembly. Local heat peaking was found not to alter significantly heating rates computed in the FTR core model, where larger mesh interval sizes precluded examination of spatially-limited heating gradients. These computations provide the basis for thermal-hydraulic analyses to ascertain temperature profiles in the FTR under europia control

  9. Beta and Gamma Gradients

    Løvborg, Leif; Gaffney, C. F.; Clark, P. A.

    1985-01-01

    Experimental and/or theoretical estimates are presented concerning, (i) attenuation within the sample of beta and gamma radiation from the soil, (ii) the gamma dose within the sample due to its own radioactivity, and (iii) the soil gamma dose in the proximity of boundaries between regions...... of differing radioactivity. It is confirmed that removal of the outer 2 mm of sample is adequate to remove influence from soil beta dose and estimates are made of the error introduced by non-removal. Other evaluations include variation of the soil gamma dose near the ground surface and it appears...... that the present practice of avoiding samples above a depth of 0.3 m may be over-cautious...

  10. Gamma spectrometry today

    Hemingway, J.

    1990-01-01

    This paper reviews the important advances in gamma spectroscopy made in recent years. Improvements in detectors and other components and the addition of on-line computer control systems is discussed. (UK)

  11. EDITORIAL: Probing the nanoworld Probing the nanoworld

    Miles, Mervyn

    2009-10-01

    In nanotechnology, it is the unique properties arising from nanometre-scale structures that lead not only to their technological importance but also to a better understanding of the underlying science. Over the last twenty years, material properties at the nanoscale have been dominated by the properties of carbon in the form of the C60 molecule, single- and multi-wall carbon nanotubes, nanodiamonds, and recently graphene. During this period, research published in the journal Nanotechnology has revealed the amazing mechanical properties of such materials as well as their remarkable electronic properties with the promise of new devices. Furthermore, nanoparticles, nanotubes, nanorods, and nanowires from metals and dielectrics have been characterized for their electronic, mechanical, optical, chemical and catalytic properties. Scanning probe microscopy (SPM) has become the main characterization technique and atomic force microscopy (AFM) the most frequently used SPM. Over the past twenty years, SPM techniques that were previously experimental in nature have become routine. At the same time, investigations using AFM continue to yield impressive results that demonstrate the great potential of this powerful imaging tool, particularly in close to physiological conditions. In this special issue a collaboration of researchers in Europe report the use of AFM to provide high-resolution topographical images of individual carbon nanotubes immobilized on various biological membranes, including a nuclear membrane for the first time (Lamprecht C et al 2009 Nanotechnology 20 434001). Other SPM developments such as high-speed AFM appear to be making a transition from specialist laboratories to the mainstream, and perhaps the same may be said for non-contact AFM. Looking to the future, characterisation techniques involving SPM and spectroscopy, such as tip-enhanced Raman spectroscopy, could emerge as everyday methods. In all these advanced techniques, routinely available probes will

  12. Dynamic gamma knife radiosurgery

    Luan Shuang; Swanson, Nathan; Chen Zhe; Ma Lijun

    2009-01-01

    Gamma knife has been the treatment of choice for various brain tumors and functional disorders. Current gamma knife radiosurgery is planned in a 'ball-packing' approach and delivered in a 'step-and-shoot' manner, i.e. it aims to 'pack' the different sized spherical high-dose volumes (called 'shots') into a tumor volume. We have developed a dynamic scheme for gamma knife radiosurgery based on the concept of 'dose-painting' to take advantage of the new robotic patient positioning system on the latest Gamma Knife C(TM) and Perfexion(TM) units. In our scheme, the spherical high dose volume created by the gamma knife unit will be viewed as a 3D spherical 'paintbrush', and treatment planning reduces to finding the best route of this 'paintbrush' to 'paint' a 3D tumor volume. Under our dose-painting concept, gamma knife radiosurgery becomes dynamic, where the patient moves continuously under the robotic positioning system. We have implemented a fully automatic dynamic gamma knife radiosurgery treatment planning system, where the inverse planning problem is solved as a traveling salesman problem combined with constrained least-square optimizations. We have also carried out experimental studies of dynamic gamma knife radiosurgery and showed the following. (1) Dynamic gamma knife radiosurgery is ideally suited for fully automatic inverse planning, where high quality radiosurgery plans can be obtained in minutes of computation. (2) Dynamic radiosurgery plans are more conformal than step-and-shoot plans and can maintain a steep dose gradient (around 13% per mm) between the target tumor volume and the surrounding critical structures. (3) It is possible to prescribe multiple isodose lines with dynamic gamma knife radiosurgery, so that the treatment can cover the periphery of the target volume while escalating the dose for high tumor burden regions. (4) With dynamic gamma knife radiosurgery, one can obtain a family of plans representing a tradeoff between the delivery time and

  13. Dynamic gamma knife radiosurgery

    Luan Shuang; Swanson, Nathan; Chen Zhe [Department of Computer Science, University of New Mexico, Albuquerque, NM 87131 (United States); Ma Lijun [Department of Radiation Oncology, University of California San Francisco, San Francisco, CA 94143 (United States)], E-mail: sluan@cs.unm.edu, E-mail: nate@cs.unm.edu, E-mail: zchen@cs.unm.edu, E-mail: lijunma@radonc.ucsf.edu

    2009-03-21

    Gamma knife has been the treatment of choice for various brain tumors and functional disorders. Current gamma knife radiosurgery is planned in a 'ball-packing' approach and delivered in a 'step-and-shoot' manner, i.e. it aims to 'pack' the different sized spherical high-dose volumes (called 'shots') into a tumor volume. We have developed a dynamic scheme for gamma knife radiosurgery based on the concept of 'dose-painting' to take advantage of the new robotic patient positioning system on the latest Gamma Knife C(TM) and Perfexion(TM) units. In our scheme, the spherical high dose volume created by the gamma knife unit will be viewed as a 3D spherical 'paintbrush', and treatment planning reduces to finding the best route of this 'paintbrush' to 'paint' a 3D tumor volume. Under our dose-painting concept, gamma knife radiosurgery becomes dynamic, where the patient moves continuously under the robotic positioning system. We have implemented a fully automatic dynamic gamma knife radiosurgery treatment planning system, where the inverse planning problem is solved as a traveling salesman problem combined with constrained least-square optimizations. We have also carried out experimental studies of dynamic gamma knife radiosurgery and showed the following. (1) Dynamic gamma knife radiosurgery is ideally suited for fully automatic inverse planning, where high quality radiosurgery plans can be obtained in minutes of computation. (2) Dynamic radiosurgery plans are more conformal than step-and-shoot plans and can maintain a steep dose gradient (around 13% per mm) between the target tumor volume and the surrounding critical structures. (3) It is possible to prescribe multiple isodose lines with dynamic gamma knife radiosurgery, so that the treatment can cover the periphery of the target volume while escalating the dose for high tumor burden regions. (4) With dynamic gamma knife radiosurgery, one can

  14. IMEF gamma scanning system

    Baek, Sang Yeol; Park, Dae Kyu; Ahn, Sang Bok; Ju, Yong Sun; Jeon, Yong Bum

    1997-06-01

    The gamma scanning system which is installed in IMEF is the equipment obtaining the gamma ray spectrum from irradiated fuels. This equipment could afford the useful data relating spent fuels like as burn-up measurements. We describe