Current Issue : July - September Volume : 2015 Issue Number : 3 Articles : 4 Articles
Purpose Percutaneous needle insertion procedures are commonly\nused for diagnostic and therapeutic purposes. Although\ncurrent technology allows accurate localization of lesions,\nthey cannot yet be precisely targeted. Lung cancer is the most\ncommon cause of cancer-related death, and early detection\nreduces the mortality rate. Therefore, suspicious lesions are\ntested for diagnosis by performing needle biopsy.\nMethods In this paper, we have presented a novel computed\ntomography (CT)-compatible needle insertion device (NID).\nThe NID is used to steer a flexible needle (?0.55 mm) with\na bevel at the tip in biological tissue. CT images and an electromagnetic\n(EM) tracking system are used in two separate\nscenarios to track the needle tip in three-dimensional space\nduring the procedure. Our system uses a control algorithm to steer the needle through a combination of insertion and\nminimal number of rotations.\nResults Noise analysis of CT images has demonstrated the\ncompatibility of the device. The results for three experimental\ncases (case 1: open-loop control, case 2: closed-loop\ncontrol using EM tracking system and case 3: closed-loop\ncontrol using CT images) are presented. Each experimental\ncase is performed five times, and average targeting errors are\n2.86�±1.14, 1.11�±0.14 and 1.94�±0.63mm for case 1, case\n2 and case 3, respectively.\nConclusions The achieved results show that our device is\nCT-compatible and it is able to steer a bevel-tipped needle\ntoward a target. We are able to use intermittent CT images\nand EM tracking data to control the needle path in a closedloop\nmanner. These results are promising and suggest that\nit is possible to accurately target the lesions in real clinical\nprocedures in the future....
Introduction: Despite improvements in pre-hospital and post-arrest critical care, sudden cardiac arrest (CA) remains\none of the leading causes of death. Improving circulation during cardiopulmonary resuscitation (CPR) may improve\nsurvival rates and long-term clinical outcomes after CA.\nMethods: In a porcine model, we compared standard CPR (sCPR; n =10) with CPR using an intravascular cardiac\nassist device without additional chest compressions (iCPR; n =10) following 10 minutes of electrically induced\nventricular fibrillation (VF). In a separate crossover experiment, 10 additional pigs were subjected to 10 minutes of\nVF and 6 minutes of sCPR; the iCPR device was then implanted if a return of spontaneous circulation (ROSC) was\nnot achieved using sCPR. Animals were evaluated in respect to intra- and post-arrest hemodynamics, survival, functional\noutcome and cerebral and myocardial lesions following CPR. We hypothesized that iCPR would result in more frequent\nROSC and better functional recovery than sCPR.\nResults: iCPR produced a mean flow of 1.36 �± 0.02 L/min, leading to significantly higher coronary perfusion\npressure (CPP) values during the early period of CPR (22 �± 10 mmHg vs. 9 �± 5 mmHg, P ?0.01, 1 minute after start of\nCPR; 20 �± 11 mmHg vs. 10 �± 7 mmHg, P =0.03, 2 minutes after start of CPR), resulting in high ROSC rates (100% in iCPR\nvs. 50% in sCPR animals; P =0.03). iCPR animals showed significantly lower serum S100 levels at 10 and 30 minutes\nfollowing ROSC (3.5 �± 0.6 ng/ml vs. 7.4 �± 3.0 ng/ml 30 minutes after ROSC; P ?0.01), as well as superior clinical outcomes\nbased on overall performance categories (2.9 �± 1.0 vs. 4.6 �± 0.8 on day 1; P ?0.01). In crossover experiments, 80% of\nanimals required treatment with iCPR after failed sCPR. Notably, ROSC was still achieved in six of the remaining eight\nanimals (75%) after a total of 22.8 �± 5.1 minutes of ischemia.\nConclusions: In a model of prolonged cardiac arrest, the use of iCPR instead of sCPR improved CPP and doubled ROSC\nrates, translating into improved clinical outcomes....
The purpose of the study was to evaluate the\nefficacy and safety of wet chamber warming goggles\n(Blephasteam) in patients with meibomian gland\ndysfunction (MGD) unresponsive to warm compress\ntreatment. We consecutively enrolled 50 adult patients\nwith low-delivery, non-cicatricial, MGD, and we\ninstructed them to apply warm compresses twice a day\nfor 10 min for 3 weeks and to use Blephasteam\n(Laboratoires Thea, Clermont-Ferrand, France) twice a\nday for 10 min for the following 3 weeks. We considered\nââ?¬Ë?ââ?¬Ë?not-respondersââ?¬â?¢Ã¢â?¬â?¢ to warm compress treatment the\npatients who showed no clinically significant Ocular\nSurface Disease Index (OSDI) improvement after the\nfirst 3 weeks. Clinical and in vivo confocal outcome\nmeasures were assessed in the worst eye (lower BUT) at\nbaseline, after 3 weeks, and after 6 weeks. Eighteen/50\npatients were not-responders to warm compress treatment.\nThese patients, after 3 weeks of treatment with\nBlephasteam, showed significant improvement of\nOSDI score (36.4 Ã?± 15.8 vs 20.2 Ã?± 12.4; P\\0.05,\npaired samples t test), increased BUT (3.4 Ã?± 1.6 vs\n7.6 Ã?± 2.7;P\\0.05), and decreased acinar diameter and\narea (98.4 Ã?± 18.6 vs 64.5 Ã?± 14.4 and 8,037 Ã?± 1,411 vs\n5,532 Ã?± 1,172, respectively; P\\0.05). Neither warm\ncompresses nor Blephasteam determined adverse\nresponses. In conclusion, eyelid warming is the mainstay\nof the clinical treatment ofMGDand its poor results may\nbe often due to lack of compliance and standardization.\nBlephasteam wet chamber warming goggles are a\npromising alternative to classical warm compress treatment,\npotentially able to improve the effectiveness of the\nââ?¬Ë?ââ?¬Ë?warming approach.ââ?¬â?¢Ã¢â?¬â?¢...
Background: Patients who develop critical arrhythmia during left ventricular assist\ndevice (LVAD) perfusion have a low survival rate. For diagnosis of unexpected heart\nabnormalities, new heart-monitoring methods are required for patients supported\nby LVAD perfusion. Ventricular electrocardiography using electrodes implanted in\nthe ventricle to detect heart contractions is unsuitable if the heart is abnormal. Left\nventricular impedance (LVI) is useful for monitoring heart movement but does not\nshow abnormal action potential in the heart muscle.\nObjectives: To detect detailed abnormal heart conditions, we obtained ventricular\nelectrocardiograms (v-ECGs) and LVI simultaneously in porcine models connected\nto LVADs.\nMethods: In the porcine models, electrodes were set on the heart apex and\nascending aorta for real-time measurements of v-ECGs and LVI. As the carrier\ncurrent frequency of the LVI was adjusted to 30 kHz, it was easily derived from the\noriginal v-ECG signal by using a high-pass filter (cutoff: 10 kHz). In addition, v-ECGs\nwith a frequency band of 0.1 ââ?¬â?? 120 Hz were easily derived using a low-pass filter.\nSimultaneous v-ECG and LVI data were compared to detect heart volume changes\nduring the Q-T period when the heart contracted. A new real-time algorithm for\ncomparison of v-ECGs and LVI determined whether the porcine heartbeats were\nnormal or abnormal. Several abnormal heartbeats were detected using the LVADs\noperating in asynchronous mode, most of which were premature ventricle contractions\n(PVCs). To evaluate the accuracy of the new method, the results obtained were\ncompared to normal ECG data and cardiac output measured simultaneously using\ncommercial devices.\nResults: The new method provided more accurate detection of abnormal heart\nmovements. This method can be used for various heart diseases, even those in\nwhich the cardiac output is heavily affected by LVAD operation....
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