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Sample records for presurgical focus localization

  1. Electrical source imaging of interictal spikes using multiple sparse volumetric priors for presurgical epileptogenic focus localization.

    PubMed

    Strobbe, Gregor; Carrette, Evelien; López, José David; Montes Restrepo, Victoria; Van Roost, Dirk; Meurs, Alfred; Vonck, Kristl; Boon, Paul; Vandenberghe, Stefaan; van Mierlo, Pieter

    2016-01-01

    Electrical source imaging of interictal spikes observed in EEG recordings of patients with refractory epilepsy provides useful information to localize the epileptogenic focus during the presurgical evaluation. However, the selection of the time points or time epochs of the spikes in order to estimate the origin of the activity remains a challenge. In this study, we consider a Bayesian EEG source imaging technique for distributed sources, i.e. the multiple volumetric sparse priors (MSVP) approach. The approach allows to estimate the time courses of the intensity of the sources corresponding with a specific time epoch of the spike. Based on presurgical averaged interictal spikes in six patients who were successfully treated with surgery, we estimated the time courses of the source intensities for three different time epochs: (i) an epoch starting 50 ms before the spike peak and ending at 50% of the spike peak during the rising phase of the spike, (ii) an epoch starting 50 ms before the spike peak and ending at the spike peak and (iii) an epoch containing the full spike time period starting 50 ms before the spike peak and ending 230 ms after the spike peak. To identify the primary source of the spike activity, the source with the maximum energy from 50 ms before the spike peak till 50% of the spike peak was subsequently selected for each of the time windows. For comparison, the activity at the spike peaks and at 50% of the peaks was localized using the LORETA inversion technique and an ECD approach. Both patient-specific spherical forward models and patient-specific 5-layered finite difference models were considered to evaluate the influence of the forward model. Based on the resected zones in each of the patients, extracted from post-operative MR images, we compared the distances to the resection border of the estimated activity. Using the spherical models, the distances to the resection border for the MSVP approach and each of the different time epochs were in

  2. Electrical source imaging of interictal spikes using multiple sparse volumetric priors for presurgical epileptogenic focus localization

    PubMed Central

    Strobbe, Gregor; Carrette, Evelien; López, José David; Montes Restrepo, Victoria; Van Roost, Dirk; Meurs, Alfred; Vonck, Kristl; Boon, Paul; Vandenberghe, Stefaan; van Mierlo, Pieter

    2016-01-01

    Electrical source imaging of interictal spikes observed in EEG recordings of patients with refractory epilepsy provides useful information to localize the epileptogenic focus during the presurgical evaluation. However, the selection of the time points or time epochs of the spikes in order to estimate the origin of the activity remains a challenge. In this study, we consider a Bayesian EEG source imaging technique for distributed sources, i.e. the multiple volumetric sparse priors (MSVP) approach. The approach allows to estimate the time courses of the intensity of the sources corresponding with a specific time epoch of the spike. Based on presurgical averaged interictal spikes in six patients who were successfully treated with surgery, we estimated the time courses of the source intensities for three different time epochs: (i) an epoch starting 50 ms before the spike peak and ending at 50% of the spike peak during the rising phase of the spike, (ii) an epoch starting 50 ms before the spike peak and ending at the spike peak and (iii) an epoch containing the full spike time period starting 50 ms before the spike peak and ending 230 ms after the spike peak. To identify the primary source of the spike activity, the source with the maximum energy from 50 ms before the spike peak till 50% of the spike peak was subsequently selected for each of the time windows. For comparison, the activity at the spike peaks and at 50% of the peaks was localized using the LORETA inversion technique and an ECD approach. Both patient-specific spherical forward models and patient-specific 5-layered finite difference models were considered to evaluate the influence of the forward model. Based on the resected zones in each of the patients, extracted from post-operative MR images, we compared the distances to the resection border of the estimated activity. Using the spherical models, the distances to the resection border for the MSVP approach and each of the different time epochs were in

  3. Local Functional Connectivity as a Pre-Surgical Tool for Seizure Focus Identification in Non-Lesion, Focal Epilepsy

    PubMed Central

    Weaver, K. E.; Chaovalitwongse, W. A.; Novotny, E. J.; Poliakov, A.; Grabowski, T. G.; Ojemann, J. G.

    2013-01-01

    Successful resection of cortical tissue engendering seizure activity is efficacious for the treatment of refractory, focal epilepsy. The pre-operative localization of the seizure focus is therefore critical to yielding positive, post-operative outcomes. In a small proportion of focal epilepsy patients presenting with normal MRI, identification of the seizure focus is significantly more challenging. We examined the capacity of resting state functional MRI (rsfMRI) to identify the seizure focus in a group of four non-lesion, focal (NLF) epilepsy individuals. We predicted that computing patterns of local functional connectivity in and around the epileptogenic zone combined with a specific reference to the corresponding region within the contralateral hemisphere would reliably predict the location of the seizure focus. We first averaged voxel-wise regional homogeneity (ReHo) across regions of interest (ROIs) from a standardized, probabilistic atlas for each NLF subject as well as 16 age- and gender-matched controls. To examine contralateral effects, we computed a ratio of the mean pair-wise correlations of all voxels within a ROI with the corresponding contralateral region (IntraRegional Connectivity – IRC). For each subject, ROIs were ranked (from lowest to highest) on ReHo, IRC, and the mean of the two values. At the group level, we observed a significant decrease in the rank for ROI harboring the seizure focus for the ReHo rankings as well as for the mean rank. At the individual level, the seizure focus ReHo rank was within bottom 10% lowest ranked ROIs for all four NLF epilepsy patients and three out of the four for the IRC rankings. However, when the two ranks were combined (averaging across ReHo and IRC ranks and scalars), the seizure focus ROI was either the lowest or second lowest ranked ROI for three out of the four epilepsy subjects. This suggests that rsfMRI may serve as an adjunct pre-surgical tool, facilitating the identification of the seizure focus in

  4. Ictal source localization in presurgical patients with refractory epilepsy.

    PubMed

    Boon, Paul; D'Havé, Michel; Vanrumste, Bart; Van Hoey, Gert; Vonck, Kristl; Van Walleghem, Phyllis; Caemaert, Jacques; Achten, Eric; De Reuck, Jacques

    2002-10-01

    Source localization of epileptic foci using ictal spatiotemporal dipole modeling (ISDM) yields reliable anatomic information in presurgical candidates. It requires substantial resources from EEG and neuroimaging laboratories. The profile and number of patients who may benefit from it are currently unknown. The purpose of this study is to demonstrate the clinical usefulness of source localization in a prospectively analyzed series. One hundred patients (51 male and 49 female patients) with mean age of 31 years (range, 2 to 63 years) and mean duration of refractory epilepsy of 20 years (range, 1 to 49 years) were enrolled consecutively in a presurgical protocol. Ictal EEG was available in 93 patients. ISDM was performed when suitable ictal EEG files were available. The clinical applicability of ISDM was examined in three patients groups: 37 patients in whom ictal EEG recording and MRI were congruent (group I), 30 patients in whom results were not completely congruent but not incongruent (group II), and 26 patients in whom the results were incongruent (group III). ISDM could be performed in 31 of 100 patients: 11 in group I, 8 in group II, and 12 in group III. ISDM influenced decision making in none of the patients in group I, in 4 of 8 patients in group II, and in 10 of 12 patients in group III. Typically, the results of ISDM directed avoiding intracranial EEG recordings in what appeared to be unsuitable candidates for resection by clearly confirming the incongruency between ictal EEG and MRI findings. In this series of 100 presurgical candidates, ictal source localization could be performed in 31% of patients. In 14% of patients, it proved to be a key element in the surgical decision process. PMID:12477991

  5. Determination of epileptic focus side in mesial temporal lobe epilepsy using long-term noninvasive fNIRS/EEG monitoring for presurgical evaluation

    PubMed Central

    Rizki, Edmi Edison; Uga, Minako; Dan, Ippeita; Dan, Haruka; Tsuzuki, Daisuke; Yokota, Hidenori; Oguro, Keiji; Watanabe, Eiju

    2015-01-01

    Abstract. Noninvasive localization of an epileptogenic zone is a fundamental step for presurgical evaluation of epileptic patients. Here, we applied long-term simultaneous functional near-infrared spectroscopy (fNIRS)/electroencephalogram (EEG) monitoring for focus diagnosis in patients with mesial temporal lobe epilepsy (MTLE). Six MTLE patients underwent long-term (8–16 h per day for 4 days) fNIRS/EEG monitoring for the occurrence of spontaneous seizures. Four spontaneous seizures were successfully recorded out of the six patients. To determine oxy-Hb amplitude, the period-average values of oxy-Hb across 20 s from the EEG- or clinically defined epileptic onset were calculated for both hemispheres from the simultaneously recorded fNIRS data. The average oxy-Hb values for the temporal lobe at the earlier EEG- or clinically defined epileptic onsets were greater for the epileptic side than for the contralateral side after EEG activity suppression, spike train, and clinical seizure in all four cases. The true laterality was determined based on the relief of seizures by selective amygdalo-hippocampectomy. Thus, oxy-Hb amplitude could be a reliable measure for determining the epileptic focus side. Long-term simultaneous fNIRS/EEG measurement serves as an effective tool for recording spontaneous seizures. Cerebral hemodynamic measurement by fNIRS would serve as a valuable supplementary noninvasive measurement method for presurgical evaluation of MTLE. PMID:26158007

  6. Focus on Local Reaction.

    ERIC Educational Resources Information Center

    Howe, Rod

    1999-01-01

    Discusses how the student newspaper "The Lance" (at Westside High School in Omaha, Nebraska) covered the shootings at Columbine High School. Notes that the staff localized the event and brought the student body into the story. (RS)

  7. Indication of pre-surgical radiochemotherapy enhances psychosocial morbidity among patients with resectable locally advanced rectal cancer.

    PubMed

    Bencova, V; Krajcovicova, I; Svec, J

    2016-01-01

    Patients with cancer experience stress-determined psychosocial comorbidities and behavioural alterations. Patients expectation to be cured by the first line surgery and their emotional status can be negatively influenced by the decision to include neoadjuvant long-course radiotherapy prior to surgical intervention. From the patient's perspective such treatment algorithmindicates incurability of the disease. The aim of this study was to analyse the extent and dynamics of stress and related psychosocial disturbances among patients with resectable rectal cancer to whom the neoadjuvant radiochemotherapy before surgery has been indicated.Three standardised assessment tools evaluating psychosocial morbidity of rectal cancer patients have been implemented: The EORTC QLQ C30-3, the EORTC QLQ CR29 module and the HADS questionnaires previously tested for internal consistency were answered by patients before and after long-course radiotherapy and after surgery and the scores of clinical and psychosocial values were evaluated by means of the EORTC and HADS manuals. The most profound psychosocial distress was experienced by patients after the decision to apply neoadjuvant radiotherapy and concomitant chemotherapy before surgical intervention. The involvement of pre-surgical radiotherapy into the treatment algorithm increased emotional disturbances (anxiety, feelings of hopelessness) and negatively influenced patient's treatment adherence and positive expectations from the healing process. The negative psychosocial consequences appeared to be more enhanced in female patients. Despite provided information about advances of neoadjuvant radiotherapy onto success of surgical intervention, the emotional and cognitive disorders improved only slightly. The results clearly indicate that addressed communication and targeted psychosocial support has to find place before pre-surgical radiochemotherapy and as a standard part through the trajectory of the entire multimodal rectal cancer

  8. Localization of Epileptogenic Zone on Pre-surgical Intracranial EEG Recordings: Toward a Validation of Quantitative Signal Analysis Approaches.

    PubMed

    Andrzejak, Ralph G; David, Olivier; Gnatkovsky, Vadym; Wendling, Fabrice; Bartolomei, Fabrice; Francione, Stefano; Kahane, Philippe; Schindler, Kaspar; de Curtis, Marco

    2015-11-01

    In patients diagnosed with pharmaco-resistant epilepsy, cerebral areas responsible for seizure generation can be defined by performing implantation of intracranial electrodes. The identification of the epileptogenic zone (EZ) is based on visual inspection of the intracranial electroencephalogram (IEEG) performed by highly qualified neurophysiologists. New computer-based quantitative EEG analyses have been developed in collaboration with the signal analysis community to expedite EZ detection. The aim of the present report is to compare different signal analysis approaches developed in four different European laboratories working in close collaboration with four European Epilepsy Centers. Computer-based signal analysis methods were retrospectively applied to IEEG recordings performed in four patients undergoing pre-surgical exploration of pharmaco-resistant epilepsy. The four methods elaborated by the different teams to identify the EZ are based either on frequency analysis, on nonlinear signal analysis, on connectivity measures or on statistical parametric mapping of epileptogenicity indices. All methods converge on the identification of EZ in patients that present with fast activity at seizure onset. When traditional visual inspection was not successful in detecting EZ on IEEG, the different signal analysis methods produced highly discordant results. Quantitative analysis of IEEG recordings complement clinical evaluation by contributing to the study of epileptogenic networks during seizures. We demonstrate that the degree of sensitivity of different computer-based methods to detect the EZ in respect to visual EEG inspection depends on the specific seizure pattern. PMID:24929558

  9. EEG Source Imaging in Partial Epilepsy in Comparison with Presurgical Evaluation and Magnetoencephalography

    PubMed Central

    Park, Chae Jung; Seo, Ji Hye; Kim, Daeyoung; Abibullaev, Berdakh; Kwon, Hyukchan; Lee, Yong-Ho; Kim, Min-Young; An, Kyung-min; Kim, Kiwoong; Kim, Jeong Sik; Joo, Eun Yeon

    2015-01-01

    Background and Purpose The aim of this study was to determine the usefulness of three-dimensional (3D) scalp EEG source imaging (ESI) in partial epilepsy in comparison with the results of presurgical evaluation, magnetoencephalography (MEG), and electrocorticography (ECoG). Methods The epilepsy syndrome of 27 partial epilepsy patients was determined by presurgical evaluations. EEG recordings were made using 70 scalp electrodes, and the 3D coordinates of the electrodes were digitized. ESI images of individual and averaged spikes were analyzed by Curry software with a boundary element method. MEG and ECoG were performed in 23 and 9 patients, respectively. Results ESI and MEG source imaging (MSI) results were well concordant with the results of presurgical evaluations (in 96.3% and 100% cases for ESI and MSI, respectively) at the lobar level. However, there were no spikes in the MEG recordings of three patients. The ESI results were well concordant with MSI results in 90.0% of cases. Compared to ECoG, the ESI results tended to be localized deeper than the cortex, whereas the MSI results were generally localized on the cortical surface. ESI was well concordant with ECoG in 8 of 9 (88.9%) cases, and MSI was also well concordant with ECoG in 4 of 5 (80.0%) cases. The EEG single dipoles in one patient with mesial temporal lobe epilepsy were tightly clustered with the averaged dipole when a 3 Hz high-pass filter was used. Conclusions The ESI results were well concordant with the results of the presurgical evaluation, MSI, and ECoG. The ESI analysis was found to be useful for localizing the seizure focus and is recommended for the presurgical evaluation of intractable epilepsy patients. PMID:25749824

  10. Environmental Flux and Locally Focused College Writing

    ERIC Educational Resources Information Center

    Shepley, Nathan

    2014-01-01

    This article reviews insights from place-based education and ecological models of writing to show how these theories can work together to shape locally focused composition pedagogies. From place-based education, the researcher takes an emphasis on physical specificity, and from ecological models of writing, the researcher takes an emphasis on…

  11. Think Globally, Act Locally (Focus on Teaching).

    ERIC Educational Resources Information Center

    Vesper, Joan F.

    1994-01-01

    Describes a project, carried out jointly between a business communication class and a local chamber of commerce, that brings students into partnership with international merchants in the local community. (SR)

  12. Presurgical multimodality neuroimaging analysis for complex partial seizures

    NASA Astrophysics Data System (ADS)

    Wong, Stephen T. C.; Hoo, Kent S., Jr.; Knowlton, Robert C.; Laxer, Kenneth D.; Hawkins, Randall A.; Rowley, Howard A.; Weiner, Michael W.

    1998-07-01

    Surgical treatment of patients suffering from complex partial seizures requires the localization of the epileptogenic zone for surgical resection. Currently, clinicians utilize electroencephalography (EEG), psychological tests, and various neuroimaging modalities together to determine the location of this zone. We investigate the use of positron emission tomography (PET), magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS) in the presurgical workup and analysis of patients with complex partial seizures. The results of imaging studies of 25 patients are compared for lateralization accuracy and relative concordance.

  13. Presurgical Pulmonary Evaluation in Renal Transplant Patients

    PubMed Central

    Sahni, Sonu; Molmenti, Ernesto; Bhaskaran, Madhu C.; Ali, Nicole; Basu, Amit; Talwar, Arunabh

    2014-01-01

    Patients with chronic renal failure (CRF) due to various mechanisms are prone to significant pulmonary comorbidities. With the improvements in renal replacement therapy (RRT), patients with CRF are now expected to live longer, and thus may develop complications in the lung from these processes. The preferred treatment of CRF is kidney transplantation and patients who are selected to undergo transplant must have a thorough preoperative pulmonary evaluation to assess pulmonary status and to determine risk of postoperative pulmonary complications. A MEDLINE®/PubMed® search was performed to identify all articles outlining the course of pre-surgical pulmonary evaluation with an emphasis on patients with CRF who have been selected for renal transplant. Literature review concluded that in addition to generic pre-surgical evaluation, renal transplant patients must also undergo a full cardiopulmonary and sleep evaluation to investigate possible existing pulmonary pathologies. Presence of any risk factor should then be aggressively managed or treated prior to surgery. PMID:25599047

  14. Role of Electroencephalography in Presurgical Evaluation of Temporal Lobe Epilepsy

    PubMed Central

    Raghavendra, Seetharam; Nooraine, Javeria; Mirsattari, Seyed M.

    2012-01-01

    Surgery remains a therapeutic option for patients with medically refractory epilepsy. Comprehensive presurgical evaluation includes electroencephalography (EEG) and video EEG in identifying patients who are likely to benefit from surgery. Here, we discuss in detail the utility of EEG in presurgical evaluation of patients with temporal lobe epilepsy along with illustrative cases. PMID:23198144

  15. The Role of Functional Neuroimaging in Pre-Surgical Epilepsy Evaluation

    PubMed Central

    Pittau, Francesca; Grouiller, Frédéric; Spinelli, Laurent; Seeck, Margitta; Michel, Christoph M.; Vulliemoz, Serge

    2014-01-01

    The prevalence of epilepsy is about 1% and one-third of cases do not respond to medical treatment. In an eligible subset of patients with drug-resistant epilepsy, surgical resection of the epileptogenic zone is the only treatment that can possibly cure the disease. Non-invasive techniques provide information for the localization of the epileptic focus in the majority of cases, whereas in others invasive procedures are required. In the last years, non-invasive neuroimaging techniques, such as simultaneous recording of functional magnetic resonance imaging and electroencephalogram (EEG-fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), electric and magnetic source imaging (MSI, ESI), spectroscopy (MRS), have proved their usefulness in defining the epileptic focus. The combination of these functional techniques can yield complementary information and their concordance is crucial for guiding clinical decision, namely the planning of invasive EEG recordings or respective surgery. The aim of this review is to present these non-invasive neuroimaging techniques, their potential combination, and their role in the pre-surgical evaluation of patients with pharmaco-resistant epilepsy. PMID:24715886

  16. Near-Field Source Localization by Using Focusing Technique

    NASA Astrophysics Data System (ADS)

    He, Hongyang; Wang, Yide; Saillard, Joseph

    2008-12-01

    We discuss two fast algorithms to localize multiple sources in near field. The symmetry-based method proposed by Zhi and Chia (2007) is first improved by implementing a search-free procedure for the reduction of computation cost. We present then a focusing-based method which does not require symmetric array configuration. By using focusing technique, the near-field signal model is transformed into a model possessing the same structure as in the far-field situation, which allows the bearing estimation with the well-studied far-field methods. With the estimated bearing, the range estimation of each source is consequently obtained by using 1D MUSIC method without parameter pairing. The performance of the improved symmetry-based method and the proposed focusing-based method is compared by Monte Carlo simulations and with Crammer-Rao bound as well. Unlike other near-field algorithms, these two approaches require neither high-computation cost nor high-order statistics.

  17. Focused ultrasound as a local therapy for liver cancer.

    PubMed

    Fischer, Krisztina; Gedroyc, Wladyslaw; Jolesz, Ferenc A

    2010-01-01

    Conventional surgical treatments of liver cancer are invasive (including minimally invasive) with a high incidence of new metastasis and poor success, even after multiple resections or ablations. These limitations motivated research into new, less invasive solutions for liver cancer treatment.Focused ultrasound surgery (FUS), or high-intensity focused ultrasound, has been recognized as a noninvasive technology for benign and malignant tumor treatment. Previously, FUS was guided with ultrasound that has limited target definition and monitoring capability of the ablation process. Combining magnetic resonance imaging (MRI) with multiple-element phased-array transducers to create MRI-guided focused ultrasound thermal therapy provides more accurate targeting and real-time temperature monitoring. This treatment is hindered by the ribcage that limits the acoustic windows to the liver and the respiratory motion of the liver. New advances in MRI and transducer design will likely resolve these limitations and make MRI-guided FUS a powerful tool in local liver cancer therapy. This article reviews this technology and advances that can expand its use for cancer treatment in general and liver cancer in particular. PMID:20404608

  18. Role of Neuroimaging in the Presurgical Evaluation of Epilepsy

    PubMed Central

    Lüders, Hans

    2008-01-01

    A significant minority of patients with focal epilepsy are candidates for resective epilepsy surgery. Structural and functional neuroimaging plays an important role in the presurgical evaluation of theses patients. The most frequent etiologies of pharmacoresistant epilepsy in the adult population are mesial temporal sclerosis, malformations of cortical development, cavernous angiomas, and low-grade neoplasms. High-resolution multiplanar magnetic resonance imaging (MRI) with sequences providing T1 and T2 contrast is the initial imaging study of choice to detect these epileptogenic lesions. The epilepsy MRI protocol can be individually tailored when considering the patient's clinical and electrophysiological data. Metabolic imaging techniques such as positron emission tomography (PET) and single photon emission tomography (SPECT) visualize metabolic alterations of the brain in the ictal and interictal states. These techniques may have localizing value in patients with a normal MRI scan. Functional MRI is helpful in non-invasively identifying areas of eloquent cortex. Developments in imaging technology and digital postprocessing may increase the yield for imaging studies to detect the epileptogenic lesion and to characterize its connectivity within the epileptic brain. PMID:19513318

  19. Chitosan in Mucoadhesive Drug Delivery: Focus on Local Vaginal Therapy

    PubMed Central

    Andersen, Toril; Bleher, Stefan; Flaten, Gøril Eide; Tho, Ingunn; Mattsson, Sofia; Škalko-Basnet, Nataša

    2015-01-01

    Mucoadhesive drug therapy destined for localized drug treatment is gaining increasing importance in today’s drug development. Chitosan, due to its known biodegradability, bioadhesiveness and excellent safety profile offers means to improve mucosal drug therapy. We have used chitosan as mucoadhesive polymer to develop liposomes able to ensure prolonged residence time at vaginal site. Two types of mucoadhesive liposomes, namely the chitosan-coated liposomes and chitosan-containing liposomes, where chitosan is both embedded and surface-available, were made of soy phosphatidylcholine with entrapped fluorescence markers of two molecular weights, FITC-dextran 4000 and 20,000, respectively. Both liposomal types were characterized for their size distribution, zeta potential, entrapment efficiency and the in vitro release profile, and compared to plain liposomes. The proof of chitosan being both surface-available as well as embedded into the liposomes in the chitosan-containing liposomes was found. The capability of the surface-available chitosan to interact with the model porcine mucin was confirmed for both chitosan-containing and chitosan-coated liposomes implying potential mucoadhesive behavior. Chitosan-containing liposomes were shown to be superior in respect to the simplicity of preparation, FITC-dextran load, mucoadhesiveness and in vitro release and are expected to ensure prolonged residence time on the vaginal mucosa providing localized sustained release of entrapped model substances. PMID:25574737

  20. Critical role of bevacizumab scheduling in combination with pre-surgical chemo-radiotherapy in MRI-defined high-risk locally advanced rectal cancer: results of the branch trial

    PubMed Central

    Avallone, Antonio; Pecori, Biagio; Bianco, Franco; Aloj, Luigi; Tatangelo, Fabiana; Romano, Carmela; Granata, Vincenza; Marone, Pietro; Leone, Alessandra; Botti, Gerardo; Petrillo, Antonella; Caracò, Corradina; Iaffaioli, Vincenzo R.; Muto, Paolo; Romano, Giovanni; Comella, Pasquale; Budillon, Alfredo; Delrio, Paolo

    2015-01-01

    Background We have previously shown that an intensified preoperative regimen including oxaliplatin plus raltitrexed and 5-fluorouracil/folinic acid (OXATOM/FUFA) during preoperative pelvic radiotherapy produced promising results in locally advanced rectal cancer (LARC). Preclinical evidence suggests that the scheduling of bevacizumab may be crucial to optimize its combination with chemo-radiotherapy. Patients and methods This non-randomized, non-comparative, phase II study was conducted in MRI-defined high-risk LARC. Patients received three biweekly cycles of OXATOM/FUFA during RT. Bevacizumab was given 2 weeks before the start of chemo-radiotherapy, and on the same day of chemotherapy for 3 cycles (concomitant-schedule A) or 4 days prior to the first and second cycle of chemotherapy (sequential-schedule B). Primary end point was pathological complete tumor regression (TRG1) rate. Results The accrual for the concomitant-schedule was early terminated because the number of TRG1 (2 out of 16 patients) was statistically inconsistent with the hypothesis of activity (30%) to be tested. Conversely, the endpoint was reached with the sequential-schedule and the final TRG1 rate among 46 enrolled patients was 50% (95% CI 35%–65%). Neutropenia was the most common grade ≥3 toxicity with both schedules, but it was less pronounced with the sequential than concomitant-schedule (30% vs. 44%). Postoperative complications occurred in 8/15 (53%) and 13/46 (28%) patients in schedule A and B, respectively. At 5 year follow-up the probability of PFS and OS was 80% (95%CI, 66%–89%) and 85% (95%CI, 69%–93%), respectively, for the sequential-schedule. Conclusions These results highlights the relevance of bevacizumab scheduling to optimize its combination with preoperative chemo-radiotherapy in the management of LARC. PMID:26320185

  1. Presurgical epileptogenic network analysis: A way to enhance epilepsy surgery outcome.

    PubMed

    Dixit, Aparna Banerjee; Banerjee, Jyotirmoy; Tripathi, Manjari; Chandra, P Sarat

    2015-01-01

    Accurate localization of the "epileptogenic zone (EZ)" is an important issue in epilepsy surgery. The EZ is not discrete and focal; in fact, the epileptogenic networks can spread ictal activity to different regions of the brain. Changes in network characteristics and functional connectivity are shown to be associated with epilepsy. Seizures are thought to represent a hyper-synchronous state and presumable changes in synchronization between different brain regions underlie the mechanisms of seizure spread. Although presurgical evaluation of the epileptogenic network analysis can be carried out using existing investigative techniques like electroencephalogram (EEG), video-EEG, magnetic resonance imaging, single-photon emission computed tomography, and magnetoencephalography, advanced imaging techniques such as optical intrinsic spectroscopy, auto-fluorescence imaging, voltage sensitive dye imaging, and calcium imaging have the advantage of better spatiotemporal resolution over a large area of cortex. Understanding the wide-scale dynamic networks by analyzing the changes in the synchronization patterns using advanced imaging techniques will be instrumental in the presurgical analysis of the epileptogenic network and better localization of the EZs in the future. PMID:26448235

  2. Pre-Surgical Integration of fMRI and DTI of the Sensorimotor System in Transcortical Resection of a High-Grade Insular Astrocytoma

    PubMed Central

    Ekstrand, Chelsea L.; Mickleborough, Marla J. S.; Fourney, Daryl R.; Gould, Layla A.; Lorentz, Eric J.; Ellchuk, Tasha; Borowsky, Ron W.

    2016-01-01

    Herein we report on a patient with a WHO Grade III astrocytoma in the right insular region in close proximity to the internal capsule who underwent a right frontotemporal craniotomy. Total gross resection of insular gliomas remains surgically challenging based on the possibility of damage to the corticospinal tracts. However, maximizing the extent of resection has been shown to decrease future adverse outcomes. Thus, the goal of such surgeries should focus on maximizing extent of resection while minimizing possible adverse outcomes. In this case, pre-surgical planning included integration of functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), to localize motor and sensory pathways. Novel fMRI tasks were individually developed for the patient to maximize both somatosensory and motor activation simultaneously in areas in close proximity to the tumor. Information obtained was used to optimize resection trajectory and extent, facilitating gross total resection of the astrocytoma. Across all three motor-sensory tasks administered, fMRI revealed an area of interest just superior and lateral to the astrocytoma. Further, DTI analyses showed displacement of the corona radiata around the superior dorsal surface of the astrocytoma, extending in the direction of the activation found using fMRI. Taking into account these results, a transcortical superior temporal gyrus surgical approach was chosen in order to avoid the area of interest identified by fMRI and DTI. Total gross resection was achieved and minor post-surgical motor and sensory deficits were temporary. This case highlights the utility of comprehensive pre-surgical planning, including fMRI and DTI, to maximize surgical outcomes on a case-by-case basis. PMID:27013996

  3. A rapid method for the presurgical cleansing of hands.

    PubMed

    Decker, L A; Gross, A; Miller, F C; Read, J A; Cutright, D E; Devine, J

    1978-01-01

    A new rapid method of presurgical cleansing of the hands has been evaluated in a clinical setting. The effectiveness of a 90 second jet wash has been compared with a standard 10-minute presurgical scrub. Bacteriologic cultures were obtained from the fingertips of interns, residents, and staff of the Department of Obstetrics and Gynecology of the Walter Reed Army Medical Center before and after 90-second jet washings and 10-minute conventional scrubs. The results showed that the 90-second jet wash was more effective in degerming the hands than the 10-minute standard brush scrub. Other advantages of the new method, such as the amount of time saved, the standardization of cleansing, and reduced skin irritation are discussed. PMID:619330

  4. Presurgical nasoalveolar molding in unilateral cleft lip and palate

    PubMed Central

    Hegde, Rahul J.; Kharkar, Viraj R.; Kamath, Shamika

    2015-01-01

    Unilateral cleft lip and palate (UCLP) patients have an esthetic and functional compromise of the middle third of the face and nasal structures. To improve the esthetic result of lip repair, the concept of presurgical nasoalveolar molding (PNAM) was brought into conception. PNAM is an easy and passive method of bringing the alveolus and lips together by redirecting the forces of natural growth. This case report documents a 2-year follow-up of PNAM in UCLP. PMID:26681868

  5. Resting State Spontaneous Fluctuations in Brain Activity: A New Paradigm for Presurgical Planning using fMRI

    PubMed Central

    Shimony, Joshua S.; Zhang, Dongyang; Johnston, James M.; Fox, Michael D.; Roy, Abhik; Leuthardt, Eric C.

    2009-01-01

    Task evoked functional MRI (fMRI) has been used successfully in the study of brain function and clinically for pre-surgical localization of eloquent brain regions prior to the performance of brain surgery. This method requires patient cooperation and is not useful in patients with cognitive dysfunction or physical impairment. An alternative method that can overcome some of these disadvantages measures the intrinsic function of the brain using resting state fMRI. This method does not require any task performance and measures the spontaneous low frequency (<0.1 Hz) fluctuations of the fMRI signal over time. Resting state fMRI data can provide valuable pre-surgical information in many patients who cannot benefit from traditional task based fMRI. Our objective in the current review is to provide preliminary information, including advantages and remaining challenges, on the clinical utility of this technique for improving pre-surgical planning and individualized patient centered care. PMID:19345899

  6. Presurgical nasal moulding in a neonate with cleft lip

    PubMed Central

    Deshpande, Anshula; Shah, Dixit; Macwan, Chirag S

    2014-01-01

    The concept of presurgical nasoalveolar moulding (PNM) was developed to improve the aesthetic result of surgically corrected cleft lip. This paper presents the method of fabrication of PNM appliance and the case of a 30-day-old neonate with unilateral cleft lip in whom nasal moulding was performed. Treatment was initiated at 30 days and continued for 60 days after which the surgical correction of cleft lip was performed. Significant improvement in aesthetics and symmetry of the nose was achieved at the end of the treatment. PMID:24928928

  7. Presurgical Dentofacial Orthopedic Management of the Cleft Patient.

    PubMed

    Smith, Kevin S; Henry, Byron T; Scott, Michelle A

    2016-05-01

    Over the last decade, presurgical orthopedic molding for the patient with cleft lip and palate has become much more common; it is even reasonable to assume it may be the standard of care for those wide unilateral and bilateral clefts with substantial dentofacial deformities. In 2013, there was a comparative study of nasoalveolar molding methods, comparing the Grayson-NAM device and DynaCleft. The results showed the 2 to be equivocal with both methods significantly reducing the cleft width and improving the nasal asymmetry. PMID:27150304

  8. Combined EEG/MEG Can Outperform Single Modality EEG or MEG Source Reconstruction in Presurgical Epilepsy Diagnosis

    PubMed Central

    Aydin, Ümit; Vorwerk, Johannes; Dümpelmann, Matthias; Küpper, Philipp; Kugel, Harald; Heers, Marcel; Wellmer, Jörg; Kellinghaus, Christoph; Haueisen, Jens; Rampp, Stefan; Stefan, Hermann; Wolters, Carsten H.

    2015-01-01

    We investigated two important means for improving source reconstruction in presurgical epilepsy diagnosis. The first investigation is about the optimal choice of the number of epileptic spikes in averaging to (1) sufficiently reduce the noise bias for an accurate determination of the center of gravity of the epileptic activity and (2) still get an estimation of the extent of the irritative zone. The second study focuses on the differences in single modality EEG (80-electrodes) or MEG (275-gradiometers) and especially on the benefits of combined EEG/MEG (EMEG) source analysis. Both investigations were validated with simultaneous stereo-EEG (sEEG) (167-contacts) and low-density EEG (ldEEG) (21-electrodes). To account for the different sensitivity profiles of EEG and MEG, we constructed a six-compartment finite element head model with anisotropic white matter conductivity, and calibrated the skull conductivity via somatosensory evoked responses. Our results show that, unlike single modality EEG or MEG, combined EMEG uses the complementary information of both modalities and thereby allows accurate source reconstructions also at early instants in time (epileptic spike onset), i.e., time points with low SNR, which are not yet subject to propagation and thus supposed to be closer to the origin of the epileptic activity. EMEG is furthermore able to reveal the propagation pathway at later time points in agreement with sEEG, while EEG or MEG alone reconstructed only parts of it. Subaveraging provides important and accurate information about both the center of gravity and the extent of the epileptogenic tissue that neither single nor grand-averaged spike localizations can supply. PMID:25761059

  9. Combined EEG/MEG can outperform single modality EEG or MEG source reconstruction in presurgical epilepsy diagnosis.

    PubMed

    Aydin, Ümit; Vorwerk, Johannes; Dümpelmann, Matthias; Küpper, Philipp; Kugel, Harald; Heers, Marcel; Wellmer, Jörg; Kellinghaus, Christoph; Haueisen, Jens; Rampp, Stefan; Stefan, Hermann; Wolters, Carsten H

    2015-01-01

    We investigated two important means for improving source reconstruction in presurgical epilepsy diagnosis. The first investigation is about the optimal choice of the number of epileptic spikes in averaging to (1) sufficiently reduce the noise bias for an accurate determination of the center of gravity of the epileptic activity and (2) still get an estimation of the extent of the irritative zone. The second study focuses on the differences in single modality EEG (80-electrodes) or MEG (275-gradiometers) and especially on the benefits of combined EEG/MEG (EMEG) source analysis. Both investigations were validated with simultaneous stereo-EEG (sEEG) (167-contacts) and low-density EEG (ldEEG) (21-electrodes). To account for the different sensitivity profiles of EEG and MEG, we constructed a six-compartment finite element head model with anisotropic white matter conductivity, and calibrated the skull conductivity via somatosensory evoked responses. Our results show that, unlike single modality EEG or MEG, combined EMEG uses the complementary information of both modalities and thereby allows accurate source reconstructions also at early instants in time (epileptic spike onset), i.e., time points with low SNR, which are not yet subject to propagation and thus supposed to be closer to the origin of the epileptic activity. EMEG is furthermore able to reveal the propagation pathway at later time points in agreement with sEEG, while EEG or MEG alone reconstructed only parts of it. Subaveraging provides important and accurate information about both the center of gravity and the extent of the epileptogenic tissue that neither single nor grand-averaged spike localizations can supply. PMID:25761059

  10. Local search methods based on variable focusing for random K -satisfiability

    NASA Astrophysics Data System (ADS)

    Lemoy, Rémi; Alava, Mikko; Aurell, Erik

    2015-01-01

    We introduce variable focused local search algorithms for satisfiabiliity problems. Usual approaches focus uniformly on unsatisfied clauses. The methods described here work by focusing on random variables in unsatisfied clauses. Variants are considered where variables are selected uniformly and randomly or by introducing a bias towards picking variables participating in several unsatistified clauses. These are studied in the case of the random 3-SAT problem, together with an alternative energy definition, the number of variables in unsatisfied constraints. The variable-based focused Metropolis search (V-FMS) is found to be quite close in performance to the standard clause-based FMS at optimal noise. At infinite noise, instead, the threshold for the linearity of solution times with instance size is improved by picking preferably variables in several UNSAT clauses. Consequences for algorithmic design are discussed.

  11. Local search methods based on variable focusing for random K-satisfiability.

    PubMed

    Lemoy, Rémi; Alava, Mikko; Aurell, Erik

    2015-01-01

    We introduce variable focused local search algorithms for satisfiabiliity problems. Usual approaches focus uniformly on unsatisfied clauses. The methods described here work by focusing on random variables in unsatisfied clauses. Variants are considered where variables are selected uniformly and randomly or by introducing a bias towards picking variables participating in several unsatistified clauses. These are studied in the case of the random 3-SAT problem, together with an alternative energy definition, the number of variables in unsatisfied constraints. The variable-based focused Metropolis search (V-FMS) is found to be quite close in performance to the standard clause-based FMS at optimal noise. At infinite noise, instead, the threshold for the linearity of solution times with instance size is improved by picking preferably variables in several UNSAT clauses. Consequences for algorithmic design are discussed. PMID:25679737

  12. A Simulation Model for Local Harmonic Motion Monitoring of Focused Ultrasound Surgery

    SciTech Connect

    Heikkilae, Janne; Curiel, Laura; Hynynen, Kullervo

    2009-04-14

    A computational model for local harmonic motion (LHM) imaging-based monitoring of high-intensity focused ultrasound surgery (FUS) is presented. LMH technique is based on a focused ultrasound radiation force excitation, which induces local mechanical vibrations at the focal region. These pulse-echo imaged vibrations are then used to estimate the mechanical properties of the sonication region. LHM has been proven to be feasible for FUS monitoring because changes in the material properties during the coagulation affect the measured displacements. The presented model includes separate models to simulate acoustic fields, sonication induced temperature elevation and mechanical vibrations, and pulse-echo imaging of the induced motions. These simulation models are based on Rayleigh integral, finite element, and spatial impulse response methods. Simulated temperature rise and vibration amplitudes have been compared with in vivo rabbit experiments with noninvasive MRI thermometry.

  13. A Simulation Model for Local Harmonic Motion Monitoring of Focused Ultrasound Surgery

    NASA Astrophysics Data System (ADS)

    Heikkilä, Janne; Curiel, Laura; Hynynen, Kullervo

    2009-04-01

    A computational model for local harmonic motion (LHM) imaging-based monitoring of high-intensity focused ultrasound surgery (FUS) is presented. LMH technique is based on a focused ultrasound radiation force excitation, which induces local mechanical vibrations at the focal region. These pulse-echo imaged vibrations are then used to estimate the mechanical properties of the sonication region. LHM has been proven to be feasible for FUS monitoring because changes in the material properties during the coagulation affect the measured displacements. The presented model includes separate models to simulate acoustic fields, sonication induced temperature elevation and mechanical vibrations, and pulse-echo imaging of the induced motions. These simulation models are based on Rayleigh integral, finite element, and spatial impulse response methods. Simulated temperature rise and vibration amplitudes have been compared with in vivo rabbit experiments with noninvasive MRI thermometry.

  14. Development of a local vacuum system for focused ion beam machining

    NASA Astrophysics Data System (ADS)

    Masuzawa, Tsuneaki; Yoshida, Yoshikazu; Ikeda, Hiromichi; Oguchi, Keigo; Yamagishi, Hikaru; Wakabayashi, Yuji

    2009-07-01

    A local vacuum system for focused ion beam (FIB) processing, with a workpiece set in the air, has been developed. The local vacuum apparatus had a double-wall cylinder structure, used a differential exhaust, and each cylinder was connected to a vacuum exhaust pump. When the gap between the workpiece and the apparatus was 10 μm, the pressure of beam line in the machining head achieved 2.1×10-3 Pa. In addition, a visualization system was developed by visualizing the current flow out from a sample by FIB irradiation. With this system, it is possible to conduct focus adjustments of the FIB and shape recognition on a workpiece in the order of microns.

  15. [Pseudo color method for the infrared thermogram display of local breast focus tissue].

    PubMed

    Tang, Xian-Wu; Ding, Hai-Shu; Teng, Yi-Chao

    2009-03-01

    An infrared thermogram which reflects the human body surface temperature distribution can be obtained through detecting the infrared thermal radiation from each point on the human body surface. When a malignant tumor occurs in a breast, it will cause an increase in the prominent temperature in the breast surface focus region due to the abnormal blood transmission state of local focus tissue. Breast cancer can be detected through the visual analysis of the focus regions by physicians. In order to help physicians better find these focus regions, the present paper improved the traditional pseudo color display method by introducing visual effect factor and made the focus regions have a better display effect. The efficacy of this method was verified in the breast infrared thermograms of 47 breast cancer patients. The result from visual analysis of the focus region in infrared thermogram by this method can also be compared with the tissue blood transmission state from near infrared spectroscopy (NIRS) and other methods. It will be helpful to obtain more accurate diagnostic information. PMID:19455784

  16. High-Intensity Focused Ultrasound (HIFU) in Localized Prostate Cancer Treatment

    PubMed Central

    Alkhorayef, Mohammed; Mahmoud, Mustafa Z.; Alzimami, Khalid S.; Sulieman, Abdelmoneim; Fagiri, Maram A.

    2015-01-01

    Summary Background High-intensity focused ultrasound (HIFU) applies high-intensity focused ultrasound energy to locally heat and destroy diseased or damaged tissue through ablation. This study intended to review HIFU to explain the fundamentals of HIFU, evaluate the evidence concerning the role of HIFU in the treatment of prostate cancer (PC), review the technologies used to perform HIFU and the published clinical literature regarding the procedure as a primary treatment for PC. Material/Methods Studies addressing HIFU in localized PC were identified in a search of internet scientific databases. The analysis of outcomes was limited to journal articles written in English and published between 2000 and 2013. Results HIFU is a non-invasive approach that uses a precisely delivered ultrasound energy to achieve tumor cell necrosis without radiation or surgical excision. In current urological oncology, HIFU is used clinically in the treatment of PC. Clinical research on HIFU therapy for localized PC began in the 1990s, and the majority of PC patients were treated with the Ablatherm device. Conclusions HIFU treatment for localized PC can be considered as an alternative minimally invasive therapeutic modality for patients who are not candidates for radical prostatectomy. Patients with lower pre-HIFU PSA level and favourable pathologic Gleason score seem to present better oncologic outcomes. Future advances in technology and safety will undoubtedly expand the HIFU role in this indication as more of patient series are published, with a longer follow-up period. PMID:25806099

  17. NONINVASIVE MEASUREMENT OF LOCAL THERMAL DIFFUSIVITY USING BACKSCATTERED ULTRASOUND AND FOCUSED ULTRASOUND HEATING

    PubMed Central

    Anand, Ajay; Kaczkowski, Peter J.

    2009-01-01

    Previously, noninvasive methods of estimating local tissue thermal and acoustic properties using backscattered ultrasound have been proposed in the literature. In this article, a noninvasive method of estimating local thermal diffusivity in situ during focused ultrasound heating using beamformed acoustic backscatter data and applying novel signal processing techniques is developed. A high intensity focused ultrasound (HIFU) transducer operating at subablative intensities is employed to create a brief local temperature rise of no more than 10°C. Beamformed radio-frequency (RF) data are collected during heating and cooling using a clinical ultrasound scanner. Measurements of the time-varying “acoustic strain”, that is, spatiotemporal variations in the RF echo shifts induced by the temperature related sound speed changes, are related to a solution of the heat transfer equation to estimate the thermal diffusivity in the heated zone. Numerical simulations and experiments performed in vitro in tissue mimicking phantoms and excised turkey breast muscle tissue demonstrate agreement between the ultrasound derived thermal diffusivity estimates and independent estimates made by a traditional hot-wire technique. The new noninvasive ultrasonic method has potential applications in thermal therapy planning and monitoring, physiological monitoring and as a means of noninvasive tissue characterization. PMID:18450361

  18. Noninvasive measurement of local thermal diffusivity using backscattered ultrasound and focused ultrasound heating.

    PubMed

    Anand, Ajay; Kaczkowski, Peter J

    2008-09-01

    Previously, noninvasive methods of estimating local tissue thermal and acoustic properties using backscattered ultrasound have been proposed in the literature. In this article, a noninvasive method of estimating local thermal diffusivity in situ during focused ultrasound heating using beamformed acoustic backscatter data and applying novel signal processing techniques is developed. A high intensity focused ultrasound (HIFU) transducer operating at subablative intensities is employed to create a brief local temperature rise of no more than 10 degrees C. Beamformed radio-frequency (RF) data are collected during heating and cooling using a clinical ultrasound scanner. Measurements of the time-varying "acoustic strain", that is, spatiotemporal variations in the RF echo shifts induced by the temperature related sound speed changes, are related to a solution of the heat transfer equation to estimate the thermal diffusivity in the heated zone. Numerical simulations and experiments performed in vitro in tissue mimicking phantoms and excised turkey breast muscle tissue demonstrate agreement between the ultrasound derived thermal diffusivity estimates and independent estimates made by a traditional hot-wire technique. The new noninvasive ultrasonic method has potential applications in thermal therapy planning and monitoring, physiological monitoring and as a means of noninvasive tissue characterization. PMID:18450361

  19. High Intensity Focused Ultrasound (HIFU) Focal Spot Localization Using Harmonic Motion Imaging (HMI)

    PubMed Central

    Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

    2015-01-01

    Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of High-Intensity Focused Ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the −3 dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R2 = 0.821 at p<0.002 in the 2D HMI system. We demonstrated the

  20. High intensity focused ultrasound (HIFU) focal spot localization using harmonic motion imaging (HMI)

    NASA Astrophysics Data System (ADS)

    Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

    2015-08-01

    Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of high-intensity focused ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic motion imaging for focused ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the  -3dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R2 = 0.821 at p  <  0.002 in the 2D HMI system. We demonstrated

  1. Computing network-based features from intracranial EEG time series data: Application to seizure focus localization.

    PubMed

    Hao, Stephanie; Subramanian, Sandya; Jordan, Austin; Santaniello, Sabato; Yaffe, Robert; Jouny, Christophe C; Bergey, Gregory K; Anderson, William S; Sarma, Sridevi V

    2014-01-01

    The surgical resection of the epileptogenic zone (EZ) is the only effective treatment for many drug-resistant epilepsy (DRE) patients, but the pre-surgical identification of the EZ is challenging. This study investigates whether the EZ exhibits a computationally identifiable signature during seizures. In particular, we compute statistics of the brain network from intracranial EEG (iEEG) recordings and track the evolution of network connectivity before, during, and after seizures. We define each node in the network as an electrode and weight each edge connecting a pair of nodes by the gamma band cross power of the corresponding iEEG signals. The eigenvector centrality (EVC) of each node is tracked over two seizures per patient and the electrodes are ranked according to the corresponding EVC value. We hypothesize that electrodes covering the EZ have a signature EVC rank evolution during seizure that differs from electrodes outside the EZ. We tested this hypothesis on multi-channel iEEG recordings from 2 DRE patients who had successful surgery (i.e., seizures were under control with or without medications) and 1 patient who had unsuccessful surgery. In the successful cases, we assumed that the resected region contained the EZ and found that the EVC rank evolution of the electrodes within the resected region had a distinct "arc" signature, i.e., the EZ ranks first rose together shortly after seizure onset and then fell later during seizure. PMID:25571317

  2. Grains unchained: local fluidization of a granular packing by focused ultrasound.

    PubMed

    Lidon, Pierre; Taberlet, Nicolas; Manneville, Sébastien

    2016-02-17

    We report experimental results on the dynamics of a granular packing submitted to high-intensity focused ultrasound. Acoustic radiation pressure is shown to remotely induce local rearrangements within a pile as well as global motion around the focal spot in an initially jammed system. We demonstrate that this fluidization process is intermittent for a range of acoustic pressures and hysteretic when the pressure is cycled. Such a first-order-like unjamming transition is reproduced in numerical simulations in which the acoustic pressure field is modeled by a localized external force. Further analysis of the simulated packings suggests that in the intermittent regime unjamming is not associated with any noticeable prior structural signature. A simple two-state model based on effective temperatures is proposed to account for these findings. PMID:26781268

  3. Localized conductive patterning via focused electron beam reduction of graphene oxide

    NASA Astrophysics Data System (ADS)

    Kim, Songkil; Kulkarni, Dhaval D.; Henry, Mathias; Zackowski, Paul; Jang, Seung Soon; Tsukruk, Vladimir V.; Fedorov, Andrei G.

    2015-03-01

    We report on a method for "direct-write" conductive patterning via reduction of graphene oxide (GO) sheets using focused electron beam induced deposition (FEBID) of carbon. FEBID treatment of the intrinsically dielectric graphene oxide between two metal terminals opens up the conduction channel, thus enabling a unique capability for nanoscale conductive domain patterning in GO. An increase in FEBID electron dose results in a significant increase of the domain electrical conductivity with improving linearity of drain-source current vs. voltage dependence, indicative of a change of graphene oxide electronic properties from insulating to semiconducting. Density functional theory calculations suggest a possible mechanism underlying this experimentally observed phenomenon, as localized reduction of graphene oxide layers via interactions with highly reactive intermediates of electron-beam-assisted dissociation of surface-adsorbed hydrocarbon molecules. These findings establish an unusual route for using FEBID as nanoscale lithography and patterning technique for engineering carbon-based nanomaterials and devices with locally tailored electronic properties.

  4. Localized conductive patterning via focused electron beam reduction of graphene oxide

    SciTech Connect

    Kim, Songkil; Henry, Mathias; Kulkarni, Dhaval D.; Zackowski, Paul; Jang, Seung Soon; Tsukruk, Vladimir V.; Fedorov, Andrei G.

    2015-03-30

    We report on a method for “direct-write” conductive patterning via reduction of graphene oxide (GO) sheets using focused electron beam induced deposition (FEBID) of carbon. FEBID treatment of the intrinsically dielectric graphene oxide between two metal terminals opens up the conduction channel, thus enabling a unique capability for nanoscale conductive domain patterning in GO. An increase in FEBID electron dose results in a significant increase of the domain electrical conductivity with improving linearity of drain-source current vs. voltage dependence, indicative of a change of graphene oxide electronic properties from insulating to semiconducting. Density functional theory calculations suggest a possible mechanism underlying this experimentally observed phenomenon, as localized reduction of graphene oxide layers via interactions with highly reactive intermediates of electron-beam-assisted dissociation of surface-adsorbed hydrocarbon molecules. These findings establish an unusual route for using FEBID as nanoscale lithography and patterning technique for engineering carbon-based nanomaterials and devices with locally tailored electronic properties.

  5. Site-selective local fluorination of graphene induced by focused ion beam irradiation

    PubMed Central

    Li, Hu; Daukiya, Lakshya; Haldar, Soumyajyoti; Lindblad, Andreas; Sanyal, Biplab; Eriksson, Olle; Aubel, Dominique; Hajjar-Garreau, Samar; Simon, Laurent; Leifer, Klaus

    2016-01-01

    The functionalization of graphene remains an important challenge for numerous applications expected by this fascinating material. To keep advantageous properties of graphene after modification or functionalization of its structure, local approaches are a promising road. A novel technique is reported here that allows precise site-selective fluorination of graphene. The basic idea of this approach consists in the local radicalization of graphene by focused ion beam (FIB) irradiation and simultaneous introduction of XeF2 gas. A systematic series of experiments were carried out to outline the relation between inserted defect creation and the fluorination process. Based on a subsequent X-ray photoelectron spectroscopy (XPS) analysis, a 6-fold increase of the fluorine concentration on graphene under simultaneous irradiation was observed when compared to fluorination under normal conditions. The fluorine atoms are predominately localized at the defects as indicated from scanning tunneling microscopy (STM). The experimental findings are confirmed by density functional theory which predicts a strong increase of the binding energy of fluorine atoms when bound to the defect sites. The developed technique allows for local fluorination of graphene without using resists and has potential to be a general enabler of site-selective functionalization of graphene using a wide range of gases. PMID:26822900

  6. Evidence of local effects in anomalous refraction and focusing properties of dodecagonal photonic quasicrystals

    NASA Astrophysics Data System (ADS)

    di Gennaro, Emiliano; Miletto, Carlo; Savo, Salvatore; Andreone, Antonello; Morello, Davide; Galdi, Vincenzo; Castaldi, Giuseppe; Pierro, Vincenzo

    2008-05-01

    We present the key results from a comprehensive study of the refraction and focusing properties of a two-dimensional dodecagonal photonic “quasicrystal” (PQC), which was carried out via both full-wave numerical simulations and microwave measurements on a slab made of alumina rods inserted in a parallel-plate waveguide. We observe an anomalous refraction and focusing in several frequency regions, which confirm some recently published results. However, our interpretation, which is based on numerical and experimental evidence, substantially differs from the one in terms of “effective negative refractive index” that was originally proposed. Instead, our study highlights the critical role played by short-range interactions associated with local order and symmetry.

  7. In Vivo application and localization of transcranial focused ultrasound using dual-mode ultrasound arrays.

    PubMed

    Haritonova, Alyona; Liu, Dalong; Ebbini, Emad S

    2015-12-01

    Focused ultrasound (FUS) has been proposed for a variety of transcranial applications, including neuromodulation, tumor ablation, and blood-brain barrier opening. A flurry of activity in recent years has generated encouraging results demonstrating its feasibility in these and other applications. To date, monitoring of FUS beams has been primarily accomplished using MR guidance, where both MR thermography and elastography have been used. The recent introduction of real-time dual-mode ultrasound array (DMUA) systems offers a new paradigm in transcranial focusing. In this paper, we present first experimental results of ultrasound-guided transcranial FUS (tFUS) application in a rodent brain, both ex vivo and in vivo. DMUA imaging is used for visualization of the treatment region for placement of the focal spot within the brain. This includes the detection and localization of pulsating blood vessels at or near the target point(s). In addition, DMUA imaging is used to monitor and localize the FUS-tissue interactions in real time. In particular, a concave (40 mm radius of curvature), 32-element, 3.5-MHz DMUA prototype was used for imaging and tFUS application in ex vivo and in vivo rat models. The ex vivo experiments were used to evaluate the point spread function of the transcranial DMUA imaging at various points within the brain. In addition, DMUA-based transcranial ultrasound thermography measurements were compared with thermocouple measurements of subtherapeutic tFUS heating in rat brain ex vivo. The ex vivo setting was also used to demonstrate the capability of DMUA to produce localized thermal lesions. The in vivo experiments were designed to demonstrate the ability of the DMUA to apply, monitor, and localize subtherapeutic tFUS patterns that could be beneficial in transient blood-brain barrier opening. The results show that although the DMUA focus is degraded due to the propagation through the skull, it still produces localized heating effects within a sub

  8. In Vivo Application and Localization of Transcranial Focused Ultrasound Using Dual-Mode Ultrasound Arrays

    PubMed Central

    Haritonova, Alyona; Liu, Dalong; Ebbini, Emad S.

    2015-01-01

    Focused ultrasound (FUS) has been proposed for a variety of transcranial applications, including neuromodulation, tumor ablation, and blood brain barrier opening. A flurry of activity in recent years has generated encouraging results demonstrating its feasibility in these and other applications. To date, monitoring of FUS beams have been primarily accomplished using MR guidance, where both MR thermography and elastography have been used. The recent introduction of real-time dual-mode ultrasound array (DMUA) systems offers a new paradigm in transcranial focusing. In this paper, we present first experimental results of ultrasound-guided transcranial FUS (tFUS) application in a rodent brain, both ex vivo and in vivo. DMUA imaging is used for visualization of the treatment region for placement of the focal spot within the brain. This includes the detection and localization of pulsating blood vessels at or near the target point(s). In addition, DMUA imaging is used to monitor and localize the FUS-tissue interactions in real-time. In particular, a concave (40-mm radius of curvature), 32-element, 3.5 MHz DMUA prototype was used for imaging and tFUS application in ex vivo and in vivo rat model. The ex vivo experiments were used to evaluate the point spread function (psf) of the transcranial DMUA imaging at various points within the brain. In addition, DMUA-based transcranial ultrasound thermography measurements were compared with thermocouple measurements of subtherapeutic tFUS heating in rat brain ex vivo. The ex vivo setting was also used to demonstrate the DMUA capability to produce localized thermal lesions. The in vivo experiments were designed to demonstrate the ability of the DMUA to apply, monitor, and localize subtherapeutic tFUS patterns that could be beneficial in transient blood brain barrier opening. The results show that, while the DMUA focus is degraded due to the propagation through the skull, it still produces localized heating effects within sub

  9. Local harmonic motion monitoring of focused ultrasound surgery--a simulation model.

    PubMed

    Heikkilä, Janne; Curiel, Laura; Hynynen, Kullervo

    2010-01-01

    In this paper, a computational model for localized harmonic motion (LHM) imaging-based monitoring of high-intensity focused ultrasound surgery (FUS) is presented. The LHM technique is based on a focused, time-varying ultrasound radiation force excitation, which induces local oscillatory motions at the focal region. These vibrations are tracked, using pulse-echo imaging, and then, used to estimate the mechanical properties of the sonication region. LHM is feasible for FUS monitoring because changes in the material properties during the coagulation process affect the measured displacements. The presented model includes separate models to simulate acoustic sonication fields, sonication-induced temperature elevation and mechanical motion, and pulse-echo imaging of the induced motions. These 3-D simulation models are based on Rayleigh-Sommerfield integral, finite element, and spatial impulse response methods. Simulated-tissue temperature elevation and mechanical motion were compared with previously published in vivo measurements. Finally, the simulation model was used to simulate coagulation and LHM monitoring, as would occur with multiple, neighbouring sonication locations covering a large tumor. PMID:19822463

  10. Global, local and focused geographic clustering for case-control data with residential histories

    PubMed Central

    Jacquez, Geoffrey M; Kaufmann, Andy; Meliker, Jaymie; Goovaerts, Pierre; AvRuskin, Gillian; Nriagu, Jerome

    2005-01-01

    Background This paper introduces a new approach for evaluating clustering in case-control data that accounts for residential histories. Although many statistics have been proposed for assessing local, focused and global clustering in health outcomes, few, if any, exist for evaluating clusters when individuals are mobile. Methods Local, global and focused tests for residential histories are developed based on sets of matrices of nearest neighbor relationships that reflect the changing topology of cases and controls. Exposure traces are defined that account for the latency between exposure and disease manifestation, and that use exposure windows whose duration may vary. Several of the methods so derived are applied to evaluate clustering of residential histories in a case-control study of bladder cancer in south eastern Michigan. These data are still being collected and the analysis is conducted for demonstration purposes only. Results Statistically significant clustering of residential histories of cases was found but is likely due to delayed reporting of cases by one of the hospitals participating in the study. Conclusion Data with residential histories are preferable when causative exposures and disease latencies occur on a long enough time span that human mobility matters. To analyze such data, methods are needed that take residential histories into account. PMID:15784151

  11. Focused Impedance Method (FIM) and Pigeon Hole Imaging (PHI) for localized measurements - a review

    NASA Astrophysics Data System (ADS)

    Siddique-e Rabbani, K.

    2010-04-01

    This paper summarises up to date development in Focused Impedance Method (FIM) initiated by us. It basically involves taking the sum of two orthogonal tetra-polar impedance measurements around a common central region, giving a localized enhanced sensitivity. Although the basic idea requires 8 electrodes, versions with 6- and 4-electrodes were subsequently conceived and developed. The focusing effect has been verified in 2D and 3D phantoms and through numerical analysis. Dynamic stomach emptying, and ventilation of localized lung regions have been studied successfully suggesting further applications in monitoring of gastric acid secretion, artificial respiration, bladder emptying, etc. Multi-frequency FIM may help identify some diseases and disorders including certain cancers. FIM, being much simpler and having less number of electrodes, appears to have the potential to replace EIT for applications involving large and shallow organs. An enhancement of 6-electrode FIM led to Pigeon Hole Imaging (PHI) in a square matrix through backprojection in two orthogonal directions, good for localising of one or two well separated objects.

  12. Presurgical Rehearsals for Patients Considering "Awake" Deep Brain Stimulation.

    PubMed

    Falconer, Ramsey A; Rogers, Sean L; Brewer, Cristie M; Piscitani, Franco; Shenai, Mahesh B

    2016-01-01

    Simulated surgical environments are rapidly gaining adoption in training students, residents, and members of specialized surgical teams. However, minimal attention has been given to the use of simulated surgical environments to educate patients on surgical processes, particularly procedures that require the active participation of the patient. "Awake" neurosurgery provides a unique situation in which patients openly participate in their operation. We describe a case report, in which a 62-year-old male was referred for "awake" deep brain stimulation implantation, in relation to medically refractory Parkinson's disease. The patient had significant concerns regarding anxiety and claustrophobia, and toleration of the "awake" procedure. Consequently, we designed a simulated OR environment and process, to recreate the physical experience of the procedure, with minimal cost or risk. This experience was crucial in determining the care plan, as after this experience, the patient opted for an "asleep" alternative. Thus, in certain settings, presurgical rehearsals may have a dramatic impact in the overall course of care. PMID:27532036

  13. Probabilistic machine learning for the evaluation of presurgical language dominance.

    PubMed

    Gazit, Tomer; Andelman, Fani; Glikmann-Johnston, Yifat; Gonen, Tal; Solski, Aliya; Shapira-Lichter, Irit; Ovadia, Moran; Kipervasser, Svetlana; Neufeld, Miriam Y; Fried, Itzhak; Hendler, Talma; Perry, Daniella

    2016-08-01

    OBJECTIVE Providing a reliable assessment of language lateralization is an important task to be performed prior to neurosurgery in patients with epilepsy. Over the last decade, functional MRI (fMRI) has emerged as a useful noninvasive tool for language lateralization, supplementing or replacing traditional invasive methods. In standard practice, fMRI-based language lateralization is assessed qualitatively by visual inspection of fMRI maps at a specific chosen activation threshold. The purpose of this study was to develop and evaluate a new computational technique for providing the probability of each patient to be left, right, or bilateral dominant in language processing. METHODS In 76 patients with epilepsy, a language lateralization index was calculated using the verb-generation fMRI task over a wide range of activation thresholds (from a permissive threshold, analyzing all brain regions, to a harsh threshold, analyzing only the strongest activations). The data were classified using a probabilistic logistic regression method. RESULTS Concordant results between fMRI and Wada lateralization were observed in 89% of patients. Bilateral and right-dominant groups showed similar fMRI lateralization patterns differentiating them from the left-dominant group but still allowing classification in 82% of patients. CONCLUSIONS These findings present the utility of a semi-supervised probabilistic learning approach for presurgical language-dominance mapping, which may be extended to other cognitive domains such as memory and attention. PMID:26722848

  14. Improved highly accurate localized motion imaging for monitoring high-intensity focused ultrasound therapy

    NASA Astrophysics Data System (ADS)

    Qu, Xiaolei; Azuma, Takashi; Sugiyama, Ryusuke; Kanazawa, Kengo; Seki, Mika; Sasaki, Akira; Takeuchi, Hideki; Fujiwara, Keisuke; Itani, Kazunori; Tamano, Satoshi; Takagi, Shu; Sakuma, Ichiro; Matsumoto, Yoichiro

    2016-07-01

    Visualizing an area subjected to high-intensity focused ultrasound (HIFU) therapy is necessary for controlling the amount of HIFU exposure. One of the promising monitoring methods is localized motion imaging (LMI), which estimates coagulation length by detecting the change in stiffness. In this study, we improved the accuracy of our previous LMI by dynamic cross-correlation window (DCCW) and maximum vibration amount (MVA) methods. The DCCW method was used to increase the accuracy of estimating vibration amplitude, and the MVA method was employed to increase signal–noise ratio of the decrease ratio at the coagulated area. The qualitative comparison of results indicated that the two proposed methods could suppress the effect of noise. Regarding the results of the quantitative comparison, coagulation length was estimated with higher accuracy by the improved LMI method, and the root-mean-square error (RMSE) was reduced from 2.51 to 1.69 mm.

  15. High intensity focused ultrasound: A noninvasive therapy for locally advanced pancreatic cancer

    PubMed Central

    Wu, Feng

    2014-01-01

    The noninvasive ablation of pancreatic cancer with high intensity focused ultrasound (HIFU) energy is received increasingly widespread interest. With rapidly temperature rise to cytotoxic levels within the focal volume of ultrasound beams, HIFU can selectively ablate a targeted lesion of the pancreas without any damage to surrounding or overlying tissues. Preliminary studies suggest that this approach is technical safe and feasible, and can be used alone or in combination with systemic chemotherapy for the treatment of patients with locally advanced pancreatic cancer. It can effectively alleviate cancer-related abdominal pain, and may confer an additional survival benefit with few significant complications. This review provides a brief overview of HIFU, describes current clinical applications, summarizes characteristics of continuous and pulsed HIFU, and discusses future applications and challenges in the treatment of pancreatic cancer. PMID:25469016

  16. Real-time feedback control for high-intensity focused ultrasound system using localized motion imaging

    NASA Astrophysics Data System (ADS)

    Sugiyama, Ryusuke; Kanazawa, Kengo; Seki, Mika; Azuma, Takashi; Sasaki, Akira; Takeuchi, Hideki; Fujiwara, Keisuke; Itani, Kazunori; Tamano, Satoshi; Yoshinaka, Kiyoshi; Takagi, Shu; Matsumoto, Yoichiro

    2015-07-01

    High-intensity focused ultrasound (HIFU) is one of the noninvasive treatment for tumors. Visualizing the treated area inside the human body is necessary to control the HIFU exposure. Localized motion imaging (LMI) using ultrasound to induce and detect tissue deformation is one technique to detect a change in tissue stiffness caused by thermal coagulation. In experiments with porcine liver, LMI has shown to detect deformation with less than 20% accuracy. We have developed a prototype feedback control system using real-time LMI. In this system, coagulation size was measured every 1 s and controlled to correspond to a targeted size. The typical size error was reduced to 14% from 35%. LMI displacements in normal and coagulated tissues were sufficiently different to discriminate between coagulated areas and noncoagulated ones after HIFU sonication and to visualize treated areas after HIFU treatment.

  17. High intensity focused ultrasound: a noninvasive therapy for locally advanced pancreatic cancer.

    PubMed

    Wu, Feng

    2014-11-28

    The noninvasive ablation of pancreatic cancer with high intensity focused ultrasound (HIFU) energy is received increasingly widespread interest. With rapidly temperature rise to cytotoxic levels within the focal volume of ultrasound beams, HIFU can selectively ablate a targeted lesion of the pancreas without any damage to surrounding or overlying tissues. Preliminary studies suggest that this approach is technical safe and feasible, and can be used alone or in combination with systemic chemotherapy for the treatment of patients with locally advanced pancreatic cancer. It can effectively alleviate cancer-related abdominal pain, and may confer an additional survival benefit with few significant complications. This review provides a brief overview of HIFU, describes current clinical applications, summarizes characteristics of continuous and pulsed HIFU, and discusses future applications and challenges in the treatment of pancreatic cancer. PMID:25469016

  18. A scanned, focused, multiple transducer ultrasonic system for localized hyperthermia treatments. 1987.

    PubMed

    Hynynen, K; Roemer, R; Anhalt, D; Johnson, C; Xu, Z X; Swindell, W; Cetas, T

    2010-02-01

    A commercial diagnostic ultrasound scanner (Octoson) was modified for performing hyperthermia treatments. The temperature elevations were induced in tissues by four large, focused ultrasonic transducers whose common focal zone was scanned along a computer controlled path as determined from B-scan images. The system is described and the results of preliminary tests demonstrating some of its capabilities are given. Extensive tests with canine thighs and kidneys were performed. The blood flow to the kidneys was controllable, and thus tumours having different blood perfusion rates could be simulated. The results showed that the system is capable of inducing a local temperature maximum deep in tissues (up to 10 cm was tested) and that tissues with high perfusion rates could be heated. PMID:20100046

  19. Focus and enlarge the enhancement region of local electric field by overlapping Ag triangular nanoplates

    NASA Astrophysics Data System (ADS)

    Zhang, Chun-Hong; Zhu, Jian; Li, Jian-Jun; Zhao, Jun-Wu

    2016-01-01

    The local electric field enhancements of overlapping Ag triangular nanoplates are investigated using the discrete dipole approximate (DDA) method. The enhancement region of local electric field in the gap could be focused and enlarged by adjusting the thickness and the number of layers of the nanoplates. For the double-layer Ag triangular nanoplates, with the thickness increasing, the electric field enhancements transform from near the corners to the center of the gap gradually and the intensities get stronger. The largest "hot spot volume" appears as the thickness increases to 20 nm. The plasmonic coupling between the two nanoplates leads to the surface charges accumulating on the surfaces adjoining the gap. The variation of the surface charges due to the increase of the thickness should be responsible for this phenomenon. For the multilayer Ag triangular nanoplates, the enhancement region enlarges as the number of layers increases. And the "hot spot volume" could reach about 72% of the total volume of the middle gap when the number of layers is 6. The large volume of the intense electric field enhancements obtained in overlapping Ag triangular nanoplates provide potential for surface-enhanced Raman scattering (SERS) and surface enhancement fluorescence (SEF) applications. Figures s1-4 are available in electronic form only at http://www.epjap.org

  20. Focused ultrasound treatment of VX2 tumors controlled by local harmonic motion

    NASA Astrophysics Data System (ADS)

    Curiel, Laura; Huang, Yuexi; Vykhodtseva, Natalia; Hynynen, Kullervo

    2009-06-01

    The purpose of this study was to evaluate the feasibility of using localized harmonic motion (LHM) to monitor and control focused ultrasound surgery (FUS) in VX2 tumors in vivo. FUS exposures were performed on 13 VX2 tumors implanted in nine rabbits. The same transducer induced coagulation and generated a localized oscillatory motion by periodically varying the radiation force. A separate diagnostic ultrasound transducer tracked motion by cross-correlating echo signals at different instances. A threshold in motion amplitude was instituted to cease exposure. Coagulation was confirmed by T2-weighted MR images, thermal dose obtained through MR thermometry and histological examinations. For tumor locations achieving coagulation, the LHM amplitude was 9% (p = 0.04) to 57% (p < 0.0001) lower than that before exposure. Control was successful for 74 (69%) out of 108 cases, with 52 (48%) reaching the threshold and achieving coagulation and 22 (21%) never reaching threshold nor coagulating. For the 34 (31%) unsuccessful exposures, 16 (15%) never reached the threshold but coagulation occurred, and 18 (16%) reached threshold without coagulation confirmed. Noise or radio-frequency signal changes explained motion over- or underestimation in 24 (22%) cases; the remaining 10 (9%) had other causes of error. The control was generally successful, but sudden change or noise in the acquired echo signal caused failure. Coagulation after exposure could be validated by comparing amplitudes before and after exposure.

  1. High-Intensity Focused Ultrasound (HIFU) for the Treatment of Localized Prostate Cancer using Sonablate-500

    NASA Astrophysics Data System (ADS)

    Uchida, Toyoaki; Ohkusa, Hiroshi; Yamashita, Hideyuki; Nagata, Yoshihiro

    2005-03-01

    We evaluated 181 patients with localized prostate cancer treated with high-intensity focused ultrasound (HIFU) for biochemical disease-free rate, safety, morbidity and predictors of biochemical outcome. A total of 181 patients underwent HIFU with the Sonablate-500 and with at least 12 months of follow-up. Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The biochemical disease-free rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease-free rates at 3 years for patients with pretreatment PSA less than 10 ng/ml, 10.01 to 20.0 ng/ml and more than 20.0 ng/ml were 94%, 75% and 35%, respectively (p<0.0001). According to multivariate analysis preoperative PSA (p<0.0001) was a significant independent predictor of time to biochemical recurrence. HIFU therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/ml.

  2. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    PubMed Central

    Zuhaib, Mohammed; Bonanthaya, Krishnamurthy; Parmar, Renu; Shetty, Pritham N.; Sharma, Pradeep

    2016-01-01

    Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the efficacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, significant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral

  3. Presurgical connectome and postsurgical seizure control in temporal lobe epilepsy

    PubMed Central

    Helpern, Joseph A.; Sainju, Rup; Nesland, Travis; Edwards, Jonathan C.; Glazier, Steven S.; Tabesh, Ali

    2013-01-01

    Objectives: The objective of this study was to evaluate whether patients with surgically refractory medial temporal lobe epilepsy (MTLE) exhibit a distinct pattern of structural network organization involving the temporal lobes and extratemporal regions. Methods: We retrospectively studied 18 healthy controls and 20 patients with medication refractory unilateral MTLE who underwent anterior temporal lobectomy for treatment of seizures. Patients were classified as seizure-free or not seizure-free at least 1 year after surgery. The presurgical brain connectome was calculated through probabilistic connectivity from MRI–diffusion tensor imaging from 83 anatomically defined regions of interest encompassing the whole brain. The connectivity patterns were analyzed regarding group differences in regional connectivity and network graph properties. Results: Compared with controls, patients exhibited a decrease in connectivity involving ipsilateral thalamocortical regions, with a pathologic increase in ipsilateral medial temporal lobe, insular, and frontal connectivity. Among patients, those not seizure-free exhibited a higher connectivity between structures in 1) the ipsilateral medial and lateral temporal lobe, 2) the ipsilateral medial temporal and parietal lobe, and 3) the contralateral temporal pole and parietal lobe. Patients not seizure-free also exhibited lower small-worldness in the subnetwork within the ipsilateral temporal lobe, with higher subnetwork integration at the expense of segregation. Conclusions: MTLE is associated with network rearrangement within, but not restricted to, the temporal lobe ipsilateral to the onset of seizures. Networks involving key components of the medial temporal lobe and structures traditionally not removed during surgery may be associated with seizure control after surgical treatment of MTLE. PMID:24107863

  4. Pulsed focused ultrasound exposures enhance locally administered gene therapy in a murine solid tumor model

    PubMed Central

    Ziadloo, Ali; Xie, Jianwu; Frenkel, Victor

    2013-01-01

    Gene therapy by intratumoral injection is a promising approach for treating solid tumors. However, this approach has limited success due to insufficient distribution of gene vectors used for gene delivery. Previous studies have shown that pulsed-focused ultrasound (pFUS) can enhance both systemic and local delivery of therapeutic agents in solid tumors and other disease models. Here, murine squamous cell carcinoma flank tumors were treated with single intratumoral injection of naked tumor necrosis factor-alpha (TNF-α) plasmid, either with or without a preceding pFUS exposure. The exposures were given at 1 MHz, at a spatial average, temporal peak intensity of 2660 W cm–2, using 50 ms pulses, given at a pulse repetition frequency of 1 Hz. One hundred pulses were given at individual raster points, spaced evenly over the projected surface of the tumor at a distance of 2 mm. Exposures alone had no effect on tumor growth. Significant growth inhibition was observed with injection of TNF-α plasmid, and tumor growth was further inhibited with pFUS. Improved results with pFUS correlated with larger necrotic regions in histological sections and improved distribution and penetration of fluorescent surrogate nanoparticles. Electron microscopy demonstrated enlarged gaps between cells in exposed tissue, and remote acoustic palpation showed decreases in tissue stiffness after pFUS. Combined, these results suggest pFUS effects may be reducing barriers for tissue transport and additionally lowering interstitial fluid pressure to further improve delivery and distribution of injected plasmid for greater therapeutic effects. This suggests that pFUS could potentially be beneficial for improving local gene therapy treatment of human malignancies. PMID:23464051

  5. Localized Ablation of Thyroid Tissue by High-Intensity Focused Ultrasound: an Alternative to Surgery?

    NASA Astrophysics Data System (ADS)

    Esnault, Olivier; Franc, Brigitte; Chapelon, Jean-Yves; Lacoste, Francois

    2006-05-01

    PURPOSE: The aim of this study was to evaluate the feasibility of using a High-intensity focused ultrasound (HIFU) device to obtain a localised destruction of the thyroid with no damage to adjacent tissues. MATERIALS AND METHODS: The ewe model was used because its thyroid gland is easily accessible with ultrasound. The animals were anaesthetised with 10 mg / kg IV injection of Penthothal. The HIFU pulses were generated by a 3-MHz spherical transducer under ultrasound guidance. Macroscopic and microscopic tissue lesions were identified after formalin fixation of the anterior part of the ewe's neck. RESULTS: After determining the optimal instrument settings to obtain localized thyroid ablation, the repeatability of the method was evaluated using a HIFU prototype designed specifically for human use: in 13 ewes (26 treated lobes), an average of 20 (range: 14-27) ultrasound pulses (pulse duration: 3 s) per lobe covering a mean volume of 0.5 cm3 (range: 0.3-0.7 cm3) were delivered. The ewes were sacrificed 2-5 weeks after treatment delivery. No damage to the nerves, trachea, esophagus or muscle was observed. Only 3 ewes suffered superficial skin burns. The desired thyroid lesions were obtained in 25/26 treated lobes, as demonstrated by fibrotic tissues, which replaced necrotic areas. CONCLUSION: These results obtained in the ewe model show that thyroid lesions of defined volume can be induced safely and suggest that the HIFU device is now ready for human trials.

  6. Focused Ultrasound Surgery Control Using Local Harmonic Motion: VX2 Tumor Study

    NASA Astrophysics Data System (ADS)

    Curiel, Laura; Chopra, Rajiv; Goertz, David; Hynynen, Kullervo

    2009-04-01

    The objective of this study was to develop a real-time method for controlling focused ultrasound surgery using ultrasound imaging. The approach uses measurements of localized harmonic motion (LHM) in order to perform controlled FUS exposures by detecting changes in the elastic properties of tissues during coagulation. Methods: Nine New Zealand rabbits with VX2 tumors implanted in the thigh were used for this study. LHM was generated within the tumors by periodic induction of radiation force using a FUS transducer (80-mm focal length, 100-mm diameter, 20-mm central hole, 1.485-MHz). Tissue motion was tracked by collecting and cross-correlating RF signals during the motion using a separate diagnostic transducer (3-kHz PRF, 5-MHz). After locating the tumor in MR images, a series of sonications were performed to treat the tumors using a reduction in LHM amplitude to control the exposure. Results: LHM was successfully used to control the sonications. A LHM amplitude threshold value was determined at which changes were considered significant and then the exposure was started and stopped when the LHM amplitude dropped below the threshold. The appearance of a lesion was then verified by MRI. The feasibility of LHM measurements to control FUS exposure was validated.

  7. Focused Ultrasound Surgery Control Using Local Harmonic Motion: VX2 Tumor Study

    SciTech Connect

    Curiel, Laura; Chopra, Rajiv; Goertz, David; Hynynen, Kullervo

    2009-04-14

    The objective of this study was to develop a real-time method for controlling focused ultrasound surgery using ultrasound imaging. The approach uses measurements of localized harmonic motion (LHM) in order to perform controlled FUS exposures by detecting changes in the elastic properties of tissues during coagulation. Methods: Nine New Zealand rabbits with VX2 tumors implanted in the thigh were used for this study. LHM was generated within the tumors by periodic induction of radiation force using a FUS transducer (80-mm focal length, 100-mm diameter, 20-mm central hole, 1.485-MHz). Tissue motion was tracked by collecting and cross-correlating RF signals during the motion using a separate diagnostic transducer (3-kHz PRF, 5-MHz). After locating the tumor in MR images, a series of sonications were performed to treat the tumors using a reduction in LHM amplitude to control the exposure. Results: LHM was successfully used to control the sonications. A LHM amplitude threshold value was determined at which changes were considered significant and then the exposure was started and stopped when the LHM amplitude dropped below the threshold. The appearance of a lesion was then verified by MRI. The feasibility of LHM measurements to control FUS exposure was validated.

  8. IN VIVO MONITORING OF FOCUSED ULTRASOUND SURGERY USING LOCAL HARMONIC MOTION

    PubMed Central

    Curiel, Laura; Chopra, Rajiv; Hynynen, Kullervo

    2009-01-01

    The present study established the feasibility of a technique for monitoring FUS lesion formation in vivo using localized harmonic motion (LHM) measurements. Oscillatory motion (frequencies between 50 and 300 Hz) was generated within tissues by induction of a periodic radiation force with a focused ultrasound (FUS) transducer. The harmonic motion was estimated using cross-correlation of RF ultrasonic signals acquired at different instances during the motion by using a confocal diagnostic ultrasound transducer. The technique was evaluated in vivo in rabbit muscle (14 locations) in an MR imager for simultaneous ultrasound harmonic motion tracking and MR thermometry. The measured maximum amplitude of the induced harmonic motion before and after the lesion formation was significantly different for all the tested motion frequencies and decreased between 17 and 81% depending on the frequency and location. During the FUS exposure a drop in the maximum amplitude value was observed and a threshold value could be associated to the formation of a thermal lesion. A series of controlled sonications was performed by stopping the exposure when the threshold value in LHM amplitude was reached and the presence of a thermal lesion was confirmed by MR imaging. LHM measurements were also used to perform a spatial scan of the tissues across the exposure region and the thermal lesions could be detected as a reduction in the maximum motion amplitude value at the sonication region. PMID:18805626

  9. Locally Appropriate Energy Strategies for the Developing World: A focus on Clean Energy Opportunities in Borneo

    NASA Astrophysics Data System (ADS)

    Shirley, Rebekah Grace

    This dissertation focuses on an integration of energy modeling tools to explore energy transition pathways for emerging economies. The spate of growth in the global South has led to a global energy transition, evidenced in part by a surge in the development of large scale energy infrastructure projects for the provision of reliable electricity service. The rational of energy security and exigency often usher these large scale projects through to implementation with minimal analysis of costs: social and environmental impact, ecological risk, or opportunity costs of alternative energy transition pathways foregone. Furthermore, development of energy infrastructure is inherently characterized by the involvement of a number of state and non-state actors, with varying interests, objectives and access to authority. Being woven through and into social institutions necessarily impacts the design, control and functionality of infrastructure. In this dissertation I therefore conceptualize energy infrastructure as lying at the intersection, or nexus, of people, the environment and energy security. I argue that energy infrastructure plans and policy should, and can, be informed by each of these fields of influence in order to appropriately satisfy local development needs. This case study explores the socio-techno-environmental context of contemporary mega-dam development in northern Borneo. I describe the key actors of an ongoing mega-dam debate and the constellation of their interaction. This highlights the role that information may play in public discourse and lends insight into how inertia in the established system may stymie technological evolution. I then use a combination of power system simulation, ecological modeling and spatial analysis to analyze the potential for, and costs and tradeoffs of, future energy scenarios. In this way I demonstrate reproducible methods that can support energy infrastructure decision making by directly addressing data limitation barriers. I

  10. Noninvasive, localized, and transient brain drug delivery using focused ultrasound and microbubbles

    NASA Astrophysics Data System (ADS)

    Choi, James J.

    In the United States, Alzheimer's disease (AD), Parkinson's disease (PD), and brain cancer caused 72,432, 19,566 and 12,886 deaths in 2006, respectively. Whereas the number of deaths due to major disorders such as heart disease, stroke, and prostate cancer have decreased since 2006, deaths attributed to AD, PD, and brain cancer have not. Treatment options for patients with CNS disorders remain limited despite significant advances in knowledge of CNS disease pathways and development of neurologically potent agents. One of the major obstacles is that the cerebral microvasculature is lined by a specialized and highly regulated blood-brain barrier (BBB) that prevents large agents from entering the brain extracellular space. The purpose of this dissertation is to design a noninvasive, localized, and transient BBB opening system using focused ultrasound (FUS) and determine ultrasound and microbubble conditions that can effectively and safely deliver large pharmacologically-relevant-sized agents to the brain. To meet this end, an in vivo mouse brain drug delivery system using a stereotactic-based targeting method was developed. FUS was applied noninvasively through the intact skin and skull, which allowed for long-term and high-throughput studies. With this system, more than 150 mice were exposed to one of 31 distinct acoustic and microbubble conditions. The feasibility of delivering a large MRI contrast agent was first demonstrated in vivo in both wild-type and transgenic Alzheimer's disease model (APP/PS1) mice. A wide range of acoustic and microbubble conditions were then evaluated for their ability to deliver agents to a target region. Interestingly, the possible design space of parameters was found to be vast and different conditions resulted in distinct spatial distributions and doses delivered. In particular, BBB opening was shown to be dependent on the microbubble diameter, acoustic pressure, pulse repetition frequency (PRF), and pulse length (PL). Each set of

  11. 3-dimensional local field polarization vector mapping of a focused radially polarized beam using gold nanoparticle functionalized tips.

    PubMed

    Ahn, J S; Kihm, H W; Kihm, J E; Kim, D S; Lee, K G

    2009-02-16

    We have measured local electric field polarization vectors in 3-dimensional space on the nanoscale. A radial polarized light is generated by using a radial polarization converter and focused by an objective lens. Gold nanoparticle functionalized tips are used to scatter the focused field into the far-field region. Two different methods, rotational analyzer ellipsometry and Stokes parameters, are used in determining the polarization state of the scattered light. Two methods give consistent results with each other. Three dimensional local polarization vectors could be reconstructed by applying back transformation of the fully characterized polarizability tensor of the tip. PMID:19219131

  12. Global versus Local Conservation Focus of U.S. State Agency Endangered Bird Species Lists

    PubMed Central

    Wells, Jeffrey V.; Robertson, Bruce; Rosenberg, Kenneth V.; Mehlman, David W.

    2010-01-01

    The development of species priorities for conservation at local or regional scales (for example, within a state or province) poses an interesting paradox. One the one hand, locally or regionally-derived species priorities may lead to greater interest in and resources directed to biodiversity conservation by local or regional institutions. On the other hand, locally or regionally-derived species priorities could overlook national or global priorities. We assessed U.S. state government agency endangered-threatened bird lists to determine the comparative representation of species of global versus local conservation significance on them. State lists tended to be represented primarily by species of low global risk-low global responsibility (range: 15–100%; mean 51%) and high global risk-high global responsibility (range: 0–73%; mean 35%). In 25 states, more than half of the species on the state lists were in the low global risk-low global responsibility category. Most U.S. state agency lists represent a combined strategy of highlighting species of both local and global conservation significance. Even with this combined local-global strategy, most state lists were predominated by species that represent local but not global conservation significance. Such a strategy could have profound negative consequences for many species that are not formally recognized under national endangered species protections but that are also left off of state-level endangered species lists. PMID:20062538

  13. Importance of Presurgical Breast MRI in Patients 60 Years of Age and Older

    PubMed Central

    Destounis, Stamatia V; Arieno, Andrea L; Morgan, Renee C

    2014-01-01

    Objective: To demonstrate the importance of presurgical bilateral breast Magnetic Resonance Imaging (MRI) in women 60 years of age and older. Materials and Methods: Institutional review board approval was obtained with waiver of informed consent for this retrospective review. From December 2003 to December 2011, all patients 60 years and older who had presurgical bilateral breast MRI were reviewed, revealing 1268 presurgical MRI examinations; 310 had a new lesion identified by MRI. Cases were excluded due to incomplete or missing data, resulting in 243 patients with 272 findings eligible for analysis. Data recorded included patient demographics, core biopsy method and pathology, type of surgery, and surgical pathology results. Results: Of 1268 exams performed in this population, 272 (21.5%) patients with suspicious MRI findings underwent needle biopsy. Malignancy was found in 114 (42%), benign findings in 127 (47%), and atypia in 31 (11%). Of the malignancies, 83 were in the ipsilateral breast and 31 in the contralateral breast to the original diagnosis. Of the ipsilateral findings, 47 were in the same quadrant as the primary diagnosis, 28 in a different quadrant, and 8 were metastatic lymph nodes. Of the 31 atypical findings, 14 were contralateral to the primary diagnosis and 17 were ipsilateral. Two hundred and thirty-three patients underwent surgical excision; 111 changed their surgical management as a lesion was seen on MRI and was diagnosed as cancer on needle biopsy. Conclusions: Among the patients aged 60 years and above who had presurgical bilateral breast MRI, we found additional cancers in 9.0% (n = 114/1268) and atypia in 2.4% (n = 31/1268). A change in management as a result of the MRI-detected lesion occurred in 8.8% (n = 111/1268). These results demonstrate that performing presurgical bilateral breast MRI is of value in women 60 years of age and above. PMID:25250195

  14. Social representations of climate change in Swedish lay focus groups: local or distant, gradual or catastrophic?

    PubMed

    Wibeck, Victoria

    2014-02-01

    This paper explores social representations of climate change, investigating how climate change is discussed by Swedish laypeople interacting in focus group interviews. The analysis focuses on prototypical examples and metaphors, which were key devices for objectifying climate change representations. The paper analyzes how the interaction of focus group participants with other speakers, ideas, arguments, and broader social representations shaped their representations of climate change. Climate change was understood as a global but distant issue with severe consequences. There was a dynamic tension between representations of climate change as a gradual vs. unpredictable process. Implications for climate change communication are discussed. PMID:23825264

  15. ACAL National Conference (Sydney, Australia, October 9-11, 1992). Conference Papers, Vol. 3, Workshops with a Local NSW Focus.

    ERIC Educational Resources Information Center

    Literacy & Numeracy Exchange, 1992

    1992-01-01

    This third of three volumes of the 1992 Australian Council for Adult Literacy (ACAL) Conference Papers is a special edition of "Literacy and Numeracy Exchange." It includes nine papers from workshops with a more local New South Wales focus. "Literacy, Language, and Numeracy in the Workplace in the Context of Industry Restructuring" (Ursula…

  16. Setting up Suicide Prevention Plans at the Local Level: The Methodology of Focus Groups with Stakeholders

    ERIC Educational Resources Information Center

    Poma, Stefano Zanone; Grossi, Antonello; Venturini, Monica; Cristina, Contessa; Toniolo, Emanuele

    2011-01-01

    In the prevention of suicide, there is a need to transform clinical studies into health promotion by a cooperation with territorial agencies. A survey on a group of stakeholders was performed with the methodology of focus group. The evaluation criteria used by the participants were practical and not methodological and were closely linked to the…

  17. The freely localized microwave discharge in air in the focused beam of the electromagnetic energy

    SciTech Connect

    Alexandrov, A.F.; Kuzovnikov, A.A.; Shibkov, V.M.

    1995-12-31

    The successfull use of the microwave discharge in many applications make it necessary to research the physics of a new kind of discharge - the electrodeless microwave discharge in the focused beam, in the free space and to search for ways to optimize this discharge parameters. The breakdown was performed in a discharge chamber at approximately free space conditions: R/{lambda}{much_gt}1, where R = 1 m is the discharge chamber`s dimension, {lambda} = 2 {divided_by} 10 cm is the wavelength of the microwave radiation. The focused electromagnetic beam was formed by a trumped-lens antenna. The electric field E{le}6 kV/cm, the density of energy flow S{le}10{sup 5} W/cm{sup 2}, the wave is linearity polarized. The microwave pulse duration could be changed from 1 {mu}s to 1 ms. The gas pressure (nitrogen, air) is varied from 1 to 760 torr.

  18. Using 3-dimensional printing to create presurgical models for endodontic surgery.

    PubMed

    Bahcall, James K

    2014-09-01

    Advances in endodontic surgery--from both a technological and procedural perspective-have been significant over the last 18 years. Although these technologies and procedural enhancements have significantly improved endodontic surgical treatment outcomes, there is still an ongoing challenge of overcoming the limitations of interpreting preoperative 2-dimensional (2-D) radiographic representation of a 3-dimensional (3-D) in vivo surgical field. Cone-beam Computed Tomography (CBCT) has helped to address this issue by providing a 3-D enhancement of the 2-D radiograph. The next logical step to further improve a presurgical case 3-D assessment is to create a surgical model from the CBCT scan. The purpose of this article is to introduce 3-D printing of CBCT scans for creating presurgical models for endodontic surgery. PMID:25197746

  19. Duration of recurrent ileitis after ileocolonic resection correlates with presurgical extent of Crohn's disease.

    PubMed Central

    D'Haens, G R; Gasparaitis, A E; Hanauer, S B

    1995-01-01

    Crohn's disease of the terminal ileum recurs in a predictable sequence proximal to the ileocolonic anastomosis after surgical resection. To confirm the suspicion that the duration of recurrent ileitis correlates with the extent of presurgical disease, this study investigated 23 consecutive patients with recurrent Crohn's disease symptoms who had undergone ileocaecal resections between 1982 and 1992 at our institution and had both preoperative and postoperative small bowel follow through studies available for comparison. All films were reviewed by a blinded gastrointestinal radiologist using uniform criteria. Symptomatic recurrence was reported at a mean (SEM) of 29 (25) months after resection. Presurgical length of inflammation averaged 26 (15) (8-57) cm and at recurrence 24 (14) (7-55) cm. The correlation coefficient (r) between pre and postsurgical extent of ileal disease was 0.70 (p < 0.0001). Seven patients had sequential small bowel series after 20 (10) (7-36) months without intervening surgery. The extent of measured inflammation between examinations correlated with r = 0.995 (p < 0.0001), showing the consistency of the measurement process. The close correlation between the duration of postoperative recurrence with the extent of presurgical disease is another example of individual patterns of recurrent Crohn's disease and is an additional factor to be considered when contemplating surgical resections. Images Figure 2 PMID:7797122

  20. A Nanoscale-Localized Ion Damage Josephson Junction Using Focused Ion Beam and Ion Implanter.

    PubMed

    Wu, C H; Ku, W S; Jhan, F J; Chen, J H; Jeng, J T

    2015-05-01

    High-T(c) Josephson junctions were fabricated by nanolithography using focused ion beam (FIB) milling and ion implantation. The junctions were formed in a YBa2Cu3O7-x, thin film in regions defined using a gold-film mask with 50-nm-wide (top) slits, engraved by FIB. The focused ion beam system parameters for dwell time and passes were set to remove gold up to a precise depth. 150 keV oxygen ions were implanted at a nominal dose of up to 5 x 10(13) ions/cm2 into YBa2Cu3O7-x microbridges through the nanoscale slits. The current-voltage curves of the ion implantation junctions exhibit resistive-shunted-junction-like behavior at 77 K. The junction had an approximately linear temperature dependence of critical current. Shapiro steps were observed under microwave irradiation. A 50-nm-wide slit and 0-20-nm-thick buffer layers were chosen in order to make Josephson junctions due to the V-shape of the FIB-milled trench. PMID:26504998

  1. Neural substrates of vulnerability to postsurgical delirium as revealed by presurgical diffusion MRI.

    PubMed

    Cavallari, Michele; Dai, Weiying; Guttmann, Charles R G; Meier, Dominik S; Ngo, Long H; Hshieh, Tammy T; Callahan, Amy E; Fong, Tamara G; Schmitt, Eva; Dickerson, Bradford C; Press, Daniel Z; Marcantonio, Edward R; Jones, Richard N; Inouye, Sharon K; Alsop, David C

    2016-04-01

    Despite the significant impact of postoperative delirium on surgical outcomes and the long-term prognosis of older patients, its neural basis has not yet been clarified. In this study we investigated the impact of premorbid brain microstructural integrity, as measured by diffusion tensor imaging before surgery, on postoperative delirium incidence and severity, as well as the relationship among presurgical cognitive performance, diffusion tensor imaging abnormalities and postoperative delirium. Presurgical diffusion tensor imaging scans of 136 older (≥70 years), dementia-free subjects from the prospective Successful Aging after Elective Surgery study were analysed blind to the clinical data and delirium status. Primary outcomes were postoperative delirium incidence and severity during the hospital stay, as assessed by the Confusion Assessment Method. We measured cognition before surgery using general cognitive performance, a composite score based on a battery of neuropsychological tests. We investigated the association between presurgical diffusion tensor imaging parameters of brain microstructural integrity (i.e. fractional anisotropy, axial, mean and radial diffusivity) with postoperative delirium incidence and severity. Analyses were adjusted for the following potential confounders: age, gender, vascular comorbidity status, and general cognitive performance. Postoperative delirium occurred in 29 of 136 subjects (21%) during hospitalization. Presurgical diffusion tensor imaging abnormalities of the cerebellum, cingulum, corpus callosum, internal capsule, thalamus, basal forebrain, occipital, parietal and temporal lobes, including the hippocampus, were associated with delirium incidence and severity, after controlling for age, gender and vascular comorbidities. After further controlling for general cognitive performance, diffusion tensor imaging abnormalities of the cerebellum, hippocampus, thalamus and basal forebrain still remained associated with delirium

  2. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs

    PubMed Central

    Clifford, Katie L.; Zaman, Muhammad H.

    2016-01-01

    The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM) disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide excellence in education, attract nontraditional STEM students, and foster a sense of innovation. However, a traditional lack of engineering–global health collaborations, as well as limited faculty and inadequate STEM research funding in low-income countries, has stifled progress. Still, the impact of higher education on development efforts holds great potential. This value will be realized in low-income countries through strengthening local capacity, supporting innovation through educational initiatives, and encouraging the inclusion of women and minorities in STEM programs. Current international university-level partnerships are working towards integrating engineering into global health research and strengthening STEM innovation among universities in low-income countries, but more can be done. Global health research informs sustainable development, and through integrating engineering into research efforts through university partnerships, we can accelerate progress and work towards a healthier future for all. PMID:26790462

  3. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs.

    PubMed

    Clifford, Katie L; Zaman, Muhammad H

    2016-01-01

    The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM) disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide excellence in education, attract nontraditional STEM students, and foster a sense of innovation. However, a traditional lack of engineering-global health collaborations, as well as limited faculty and inadequate STEM research funding in low-income countries, has stifled progress. Still, the impact of higher education on development efforts holds great potential. This value will be realized in low-income countries through strengthening local capacity, supporting innovation through educational initiatives, and encouraging the inclusion of women and minorities in STEM programs. Current international university-level partnerships are working towards integrating engineering into global health research and strengthening STEM innovation among universities in low-income countries, but more can be done. Global health research informs sustainable development, and through integrating engineering into research efforts through university partnerships, we can accelerate progress and work towards a healthier future for all. PMID:26790462

  4. A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate

    PubMed Central

    Subramanian, Chitravelu Siva; Prasad, N. K. K. Koteswara; Chitharanjan, Arun B.; Liou, Eric Jein Wein

    2016-01-01

    Nasoalveolar molding (NAM) can be done effectively to reshape the nasal cartilage and mold the maxillary dentoalveolar arch before surgical cleft lip repair and primary rhinoplasty. Presurgical NAM helps as an adjunct procedure to enhance the esthetic and functional outcome of the surgical procedures. We have developed a modified NAM device to suit to the needs of the patients coming from distant places for the treatment. This device helps in reducing the number of frequent visits the patient needs to take to the craniofacial center. The purpose of this presentation is to report this treatment technique and discuss its application. PMID:27403068

  5. A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate.

    PubMed

    Subramanian, Chitravelu Siva; Prasad, N K K Koteswara; Chitharanjan, Arun B; Liou, Eric Jein Wein

    2016-01-01

    Nasoalveolar molding (NAM) can be done effectively to reshape the nasal cartilage and mold the maxillary dentoalveolar arch before surgical cleft lip repair and primary rhinoplasty. Presurgical NAM helps as an adjunct procedure to enhance the esthetic and functional outcome of the surgical procedures. We have developed a modified NAM device to suit to the needs of the patients coming from distant places for the treatment. This device helps in reducing the number of frequent visits the patient needs to take to the craniofacial center. The purpose of this presentation is to report this treatment technique and discuss its application. PMID:27403068

  6. Resting-state blood oxygen level-dependent functional magnetic resonance imaging for presurgical planning.

    PubMed

    Kamran, Mudassar; Hacker, Carl D; Allen, Monica G; Mitchell, Timothy J; Leuthardt, Eric C; Snyder, Abraham Z; Shimony, Joshua S

    2014-11-01

    Resting-state functional MR imaging (rsfMR imaging) measures spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signal and can be used to elucidate the brain's functional organization. It is used to simultaneously assess multiple distributed resting-state networks. Unlike task-based functional MR imaging, rsfMR imaging does not require task performance. This article presents a brief introduction of rsfMR imaging processing methods followed by a detailed discussion on the use of rsfMR imaging in presurgical planning. Example cases are provided to highlight the strengths and limitations of the technique. PMID:25441506

  7. Resting state BOLD fMRI for pre-surgical planning

    PubMed Central

    Kamran, Mudassar; Hacker, Carl D; Allen, Monica G; Mitchell, Timothy J; Leuthardt, Eric C; Snyder, Abraham Z; Shimony, Joshua S

    2014-01-01

    SYNOPSIS Resting state functional MRI (rsfMRI) measures spontaneous fluctuations in the BOLD signal and can be used to elucidate the brain’s functional organization. It can be used to simultaneously assess multiple distributed resting state networks. Unlike task fMRI, rsfMRI does not require task performance and thus can be performed in any subject that can obtain an MRI scan. In this article we present a brief introduction of rsfMRI processing methods followed by a detailed discussion on the use of rsfMRI in pre-surgical planning. Example cases are provided to highlight the strengths and limitations of the technique. PMID:25441506

  8. High-Intensity Focused Ultrasound for the Treatment of Localized and Locally Advanced Hormone-Resistant Prostate Cancer: 2,5 Year Outcome

    NASA Astrophysics Data System (ADS)

    Solovov, V. A.; Dvoynikov, S. Y.; Vozdvizhenskiy, M. O.

    2011-09-01

    Introduction & Objectives: High-Intensity Focused Ultrasound (HIFU) has been shown to be a successful treatment for localised prostate cancer (PC). Here we have explored the effectiveness of the HIFU treatment for hormone-resistant prostate cancer (HRPC). Materials & Methods: 341 patients were treated in our center between September 2007 and December 2009; all of them showed treatment failure following hormone ablation. The median time before hormone-resistance was 20 (3-48) months. In the group with localised PC: number of patients 237, Gleason score ≤7, stage T1-2N0M0, age 69 (60-89) years, mean PSA before treatment 40,0 (5,8-92,9) ng/ml, mean prostate volume—39,3 (28-92) cc; in the group with locally advanced PC: number of patients 104, Gleason score ≤9, stage T2-3N0M0, age 72 (52-83) years, PSA before treatment 30,3 (20,1-60) ng/ml, mean prostate volume—41,2 (25-198) cc. HIFU was delivered under spinal anesthesia using the Ablatherm HIFU device (EDAP, France). Pre HIFU transurethral resection of the prostate (TURP) was performed for all patients. Mean follow-up time 18 months (3-30). Results: The median PSA level 12 months after HIFU treatment was 0,04 (0-2,24) ng/ml—localised PC, and for locally advanced disease—0,05 (0-48,4) ng/ml, at 18 months after HIFU treatment this was 0,2 (0,02-2,0) ng/ml for localised PC, and for locally advanced disease 0,18 (0,04-7,45) ng/ml. Patients with localised PC has 4,5% recurrence, those with locally advanced PC 20%. Kaplan-Meir analyses of the total group indicated that the risk of recurrence after 1 year follow-up was 10%, the risk of recurrence was 19% after 2 years of follow-up. Conclusions: Our initial experience shows that ultrasound ablation is safe, minimally invasive and effective as a treatment for localised and locally advanced hormone-resistant prostate cancer.

  9. Adaptive Localization of Focus Point Regions via Random Patch Probabilistic Density from Whole-Slide, Ki-67-Stained Brain Tumor Tissue

    PubMed Central

    Alomari, Yazan M.; MdZin, Reena Rahayu

    2015-01-01

    Analysis of whole-slide tissue for digital pathology images has been clinically approved to provide a second opinion to pathologists. Localization of focus points from Ki-67-stained histopathology whole-slide tissue microscopic images is considered the first step in the process of proliferation rate estimation. Pathologists use eye pooling or eagle-view techniques to localize the highly stained cell-concentrated regions from the whole slide under microscope, which is called focus-point regions. This procedure leads to a high variety of interpersonal observations and time consuming, tedious work and causes inaccurate findings. The localization of focus-point regions can be addressed as a clustering problem. This paper aims to automate the localization of focus-point regions from whole-slide images using the random patch probabilistic density method. Unlike other clustering methods, random patch probabilistic density method can adaptively localize focus-point regions without predetermining the number of clusters. The proposed method was compared with the k-means and fuzzy c-means clustering methods. Our proposed method achieves a good performance, when the results were evaluated by three expert pathologists. The proposed method achieves an average false-positive rate of 0.84% for the focus-point region localization error. Moreover, regarding RPPD used to localize tissue from whole-slide images, 228 whole-slide images have been tested; 97.3% localization accuracy was achieved. PMID:25793010

  10. Adaptive localization of focus point regions via random patch probabilistic density from whole-slide, Ki-67-stained brain tumor tissue.

    PubMed

    Alomari, Yazan M; Sheikh Abdullah, Siti Norul Huda; MdZin, Reena Rahayu; Omar, Khairuddin

    2015-01-01

    Analysis of whole-slide tissue for digital pathology images has been clinically approved to provide a second opinion to pathologists. Localization of focus points from Ki-67-stained histopathology whole-slide tissue microscopic images is considered the first step in the process of proliferation rate estimation. Pathologists use eye pooling or eagle-view techniques to localize the highly stained cell-concentrated regions from the whole slide under microscope, which is called focus-point regions. This procedure leads to a high variety of interpersonal observations and time consuming, tedious work and causes inaccurate findings. The localization of focus-point regions can be addressed as a clustering problem. This paper aims to automate the localization of focus-point regions from whole-slide images using the random patch probabilistic density method. Unlike other clustering methods, random patch probabilistic density method can adaptively localize focus-point regions without predetermining the number of clusters. The proposed method was compared with the k-means and fuzzy c-means clustering methods. Our proposed method achieves a good performance, when the results were evaluated by three expert pathologists. The proposed method achieves an average false-positive rate of 0.84% for the focus-point region localization error. Moreover, regarding RPPD used to localize tissue from whole-slide images, 228 whole-slide images have been tested; 97.3% localization accuracy was achieved. PMID:25793010

  11. Focused acoustic beam imaging of grain structure and local Young's modulus with Rayleigh and surface skimming longitudinal waves

    SciTech Connect

    Martin, R. W.; Sathish, S.; Blodgett, M. P.

    2013-01-25

    The interaction of a focused acoustic beam with materials generates Rayleigh surface waves (RSW) and surface skimming longitudinal waves (SSLW). Acoustic microscopic investigations have used the RSW amplitude and the velocity measurements, extensively for grain structure analysis. Although, the presence of SSLW has been recognized, it is rarely used in acoustic imaging. This paper presents an approach to perform microstructure imaging and local elastic modulus measurements by combining both RSW and SSLW. The acoustic imaging of grain structure was performed by measuring the amplitude of RSW and SSLW signal. The microstructure images obtained on the same region of the samples with RSW and SSLW are compared and the difference in the contrast observed is discussed based on the propagation characteristics of the individual surface waves. The velocity measurements are determined by two point defocus method. The surface wave velocities of RSW and SSLW of the same regions of the sample are combined and presented as average Young's modulus image.

  12. Presurgical navigated TMS motor cortex mapping improves outcome in glioblastoma surgery: a controlled observational study.

    PubMed

    Picht, Thomas; Frey, Dietmar; Thieme, Stefan; Kliesch, Stefan; Vajkoczy, Peter

    2016-02-01

    The authors report on an observational study designed to isolate the impact of navigated transcranial magnetic stimulation (nTMS) on surgical outcome in glioblastoma treatment. We undertook a controlled observational study to identify the additive impact of presurgical nTMS in patients scheduled for surgical treatment of glioblastoma in or near motor eloquent locations. The trial data is derived from a large university hospital with a differential availability of its nTMS mapping service at its two campuses, both equally served by a single neurosurgical department. When available, the nTMS cortical mapping data and nTMS-based fiber tractography are used for surgical planning and patient counseling as well as intraoperative identification of the primary motor cortex and guidance in subcortical motor mapping. The addition of preoperative nTMS mapping data to a clinical routine already incorporating preoperative fiber tractography and intraoperative neuronavigation and electrophysiology was shown to improve surgical outcomes by increasing the extent of resection, without compromising patient safety or long-term functional outcomes in comparison to the concurrent non-TMS control group. This study is the first to prove that the improved surgical outcomes observed in previous studies after the implementation of nTMS to presurgical work-up are not caused by any overall improvement in patient care or a paradigm shift toward more aggressive resection but by the additional functional data provided by nTMS. PMID:26566653

  13. Current status of presurgical infant orthopaedic treatment for cleft lip and palate patients: A critical review

    PubMed Central

    Niranjane, P. Priyanka; Kamble, R. H.; Diagavane, S. Pallavi; Shrivastav, S. Sunita; Batra, Puneet; Vasudevan, S. D.; Patil, Pushkar

    2014-01-01

    Rehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO) was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results. PMID:25593413

  14. Dynamic modulation of electronic properties of graphene by localized carbon doping using focused electron beam induced deposition.

    PubMed

    Kim, S; Russell, M; Henry, M; Kim, S S; Naik, R R; Voevodin, A A; Jang, S S; Tsukruk, V V; Fedorov, A G

    2015-09-28

    We report on the first demonstration of controllable carbon doping of graphene to engineer local electronic properties of a graphene conduction channel using focused electron beam induced deposition (FEBID). Electrical measurements indicate that an "n-p-n" junction on graphene conduction channel is formed by partial carbon deposition near the source and drain metal contacts by low energy (<50 eV) secondary electrons due to inelastic collisions of long range backscattered primary electrons generated from a low dose of high energy (25 keV) electron beam (1 × 10(18) e(-) per cm(2)). Detailed AFM imaging provides direct evidence of the new mechanism responsible for dynamic evolution of the locally varying graphene doping. The FEBID carbon atoms, which are physisorbed and weakly bound to graphene, diffuse towards the middle of graphene conduction channel due to their surface chemical potential gradient, resulting in negative shift of Dirac voltage. Increasing a primary electron dose to 1 × 10(19) e(-) per cm(2) results in a significant increase of carbon deposition, such that it covers the entire graphene conduction channel at high surface density, leading to n-doping of graphene channel. Collectively, these findings establish a unique capability of FEBID technique to dynamically modulate the doping state of graphene, thus enabling a new route to resist-free, "direct-write" functional patterning of graphene-based electronic devices with potential for on-demand re-configurability. PMID:26302897

  15. High-Intensity Focused Ultrasound (HIFU) Using Sonablate-500 for the Treatment of Localized Prostate Cancer: 6-year experience

    NASA Astrophysics Data System (ADS)

    Uchida, Toyoaki; Shoji, Sunao; Nagata, Yoshihiro

    2006-05-01

    We evaluated 281 patients of localized prostate cancer treated with high-intensity focused ultrasound (HIFU) for biochemical disease-free rate, safety, morbidity and predictors of biochemical outcome. A total of 281 patients underwent HIFU with the use of Sonablate-500 and with at least 12 months of follow-up. Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The biochemical disease-free rates at 1, 3 and 5 years in all patients were 78%, 74% and 72%, respectively. The biochemical disease-free rates at 5 years for patients with pretreatment PSA less than 10 ng/ml, 10.01 to 20.0 ng/ml and more than 20.0 ng/ml were 88%, 70% and 17%, respectively (p<0.0001). According to multivariate analysis preoperative PSA (p<0.0001) was significant independent predictors of time to biochemical recurrence. HIFU therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/ml.

  16. Role of Focal Therapy with High-Intensity Focused Ultrasound in the Management of Clinically Localized Prostate Cancer.

    PubMed

    Kuru, Timur H; van Essen, Julius; Pfister, David; Porres, Daniel

    2015-01-01

    Overtreatment of prostate cancer (PC) remains one of the main burdens in uro-oncology. Focal therapy may be a reasonable alternative with less side effects and morbidity. Application of high-intensity focused ultrasound (HIFU) induces immediate and irreversible coagulation. The treatment leads to consecutive necrosis with sharply delineated margins, making HIFU a promising tool for the focal therapy of localized PC. Unlike radiation, the treatment leaves no collateral damage outside of the heated tissue, allowing repeated use of HIFU, if necessary. In case of non-organ-confined relapse, additional radical salvage therapy can be performed. This review gives an overview of the existing evidence on focal HIFU. Today, 3 HIFU devices are approved for the treatment of localized PC: Sonablate™, Ablatherm™ and the FocalOne™ device. In summary, the first published results of focal HIFU are promising. The quality of life and potency of the patients are well preserved. Therefore, HIFU treatment, and especially focal ablation of tumor foci, seems to be a safe alternative to standard treatment, with low side effects. The oncologic results seem satisfactory but need further follow-up to validate this practice of PC control. PMID:26632846

  17. PET/MRI and PET/MRI/SISCOM coregistration in the presurgical evaluation of refractory focal epilepsy.

    PubMed

    Fernández, S; Donaire, A; Serès, E; Setoain, X; Bargalló, N; Falcón, C; Sanmartí, F; Maestro, I; Rumià, J; Pintor, L; Boget, T; Aparicio, J; Carreño, M

    2015-03-01

    We aimed to investigate the usefulness of coregistration of positron emission tomography (PET) and magnetic resonance imaging (MRI) findings (PET/MRI) and of coregistration of PET/MRI with subtraction ictal single-photon emission computed tomography (SPECT) coregistered to MRI (SISCOM) (PET/MRI/SISCOM) in localizing the potential epileptogenic zone in patients with drug-resistant epilepsy. We prospectively included 35 consecutive patients with refractory focal epilepsy whose presurgical evaluation included a PET study. Separately acquired PET and structural MRI images were coregistered for each patient. When possible, ictal SPECT and SISCOM were obtained and coregistered with PET/MRI. The potential location of the epileptogenic zone determined by neuroimaging was compared with the seizure onset zone determined by long-term video-EEG monitoring and with invasive EEG studies in patients who were implanted. Structural MRI showed no lesions in 15 patients. In these patients, PET/MRI coregistration showed a hypometabolic area in 12 (80%) patients that was concordant with seizure onset zone on EEG in 9. In 7 patients without MRI lesions, PET/MRI detected a hypometabolism that was undetected on PET alone. SISCOM, obtained in 25 patients, showed an area of hyperperfusion concordant with the seizure onset zone on EEG in 7 (58%) of the 12 of these patients who had normal MRI findings. SISCOM hyperperfusion was less extensive than PET hypometabolism. A total of 19 patients underwent surgery; 11 of these underwent invasive-EEG monitoring and the seizure onset zone was concordant with PET/MRI in all cases. PET/MRI/SISCOM coregistration, performed in 4 of these patients, was concordant in 3 (75%). After epilepsy surgery, 13 (68%) patients are seizure-free after a mean follow-up of 4.5 years. PET/MRI and PET/MRI/SISCOM coregistration are useful for determining the potential epileptogenic zone and thus for planning invasive EEG studies and surgery more precisely, especially in

  18. An Examination of the Effects of Pre-Surgical Education on Patient Expectations in Total Knee Arthroplasties

    ERIC Educational Resources Information Center

    Montez-Ray, Natasha Dawn

    2011-01-01

    As patients prepare for total-knee arthroplasty surgery, they have numerous expectations related to their long-term recovery and function. This research discerned whether the use of a pre-surgical patient education class with an additional long-term expectation module addressing recovery during the first 12 months after surgery was more effective…

  19. The Contribution of Functional Near-Infrared Spectroscopy (fNIRS) to the Presurgical Assessment of Language Function in Children

    ERIC Educational Resources Information Center

    Gallagher, Anne; Beland, Renee; Lassonde, Maryse

    2012-01-01

    Before performing neurosurgery, an exhaustive presurgical assessment is required, usually including an investigation of language cerebral lateralization. Among the available procedures, the intracarotid amobarbital test (IAT) was formerly the most widely used. However, this procedure has many limitations: it is invasive and potentially traumatic,…

  20. An Intelligibility Assessment of Toddlers with Cleft Lip and Palate Who Received and Did Not Receive Presurgical Infant Orthopedic Treatment.

    ERIC Educational Resources Information Center

    Konst, Emmy M.; Weersink-Braks, Hanny; Rietveld, Toni; Peters, Herman

    2000-01-01

    The influence of presurgical infant orthopedic treatment (PIO) on speech intelligibility was evaluated with 10 toddlers who used PIO during the first year of life and 10 who did not. Treated children were rated as exhibiting greater intelligibility, however, transcription data indicated there were not group differences in actual intelligibility.…

  1. Dynamic modulation of electronic properties of graphene by localized carbon doping using focused electron beam induced deposition

    NASA Astrophysics Data System (ADS)

    Kim, S.; Russell, M.; Henry, M.; Kim, S. S.; Naik, R. R.; Voevodin, A. A.; Jang, S. S.; Tsukruk, V. V.; Fedorov, A. G.

    2015-09-01

    We report on the first demonstration of controllable carbon doping of graphene to engineer local electronic properties of a graphene conduction channel using focused electron beam induced deposition (FEBID). Electrical measurements indicate that an ``n-p-n'' junction on graphene conduction channel is formed by partial carbon deposition near the source and drain metal contacts by low energy (<50 eV) secondary electrons due to inelastic collisions of long range backscattered primary electrons generated from a low dose of high energy (25 keV) electron beam (1 × 1018 e- per cm2). Detailed AFM imaging provides direct evidence of the new mechanism responsible for dynamic evolution of the locally varying graphene doping. The FEBID carbon atoms, which are physisorbed and weakly bound to graphene, diffuse towards the middle of graphene conduction channel due to their surface chemical potential gradient, resulting in negative shift of Dirac voltage. Increasing a primary electron dose to 1 × 1019 e- per cm2 results in a significant increase of carbon deposition, such that it covers the entire graphene conduction channel at high surface density, leading to n-doping of graphene channel. Collectively, these findings establish a unique capability of FEBID technique to dynamically modulate the doping state of graphene, thus enabling a new route to resist-free, ``direct-write'' functional patterning of graphene-based electronic devices with potential for on-demand re-configurability.We report on the first demonstration of controllable carbon doping of graphene to engineer local electronic properties of a graphene conduction channel using focused electron beam induced deposition (FEBID). Electrical measurements indicate that an ``n-p-n'' junction on graphene conduction channel is formed by partial carbon deposition near the source and drain metal contacts by low energy (<50 eV) secondary electrons due to inelastic collisions of long range backscattered primary electrons generated

  2. Highly Localized Acoustic Streaming and Size-Selective Submicrometer Particle Concentration Using High Frequency Microscale Focused Acoustic Fields.

    PubMed

    Collins, David J; Ma, Zhichao; Ai, Ye

    2016-05-17

    Concentration and separation of particles and biological specimens are fundamental functions of micro/nanofluidic systems. Acoustic streaming is an effective and biocompatible way to create rapid microscale fluid motion and induce particle capture, though the >100 MHz frequencies required to directly generate acoustic body forces on the microscale have traditionally been difficult to generate and localize in a way that is amenable to efficient generation of streaming. Moreover, acoustic, hydrodynamic, and electrical forces as typically applied have difficulty manipulating specimens in the submicrometer regime. In this work, we introduce highly focused traveling surface acoustic waves (SAW) at high frequencies between 193 and 636 MHz for efficient and highly localized production of acoustic streaming vortices on microfluidic length scales. Concentration occurs via a novel mechanism, whereby the combined acoustic radiation and streaming field results in size-selective aggregation in fluid streamlines in the vicinity of a high-amplitude acoustic beam, as opposed to previous acoustic radiation induced particle concentration where objects typically migrate toward minimum pressure locations. Though the acoustic streaming is induced by a traveling wave, we are able to manipulate particles an order of magnitude smaller than possible using the traveling wave force alone. We experimentally and theoretically examine the range of particle sizes that can be captured in fluid streamlines using this technique, with rapid particle concentration demonstrated down to 300 nm diameters. We also demonstrate that locations of trapping and concentration are size-dependent, which is attributed to the combined effects of the acoustic streaming and acoustic forces. PMID:27102956

  3. Twelve years' experience with high-intensity focused ultrasound (HIFU) using sonablate™ devices for the treatment of localized prostate cancer

    NASA Astrophysics Data System (ADS)

    Uchida, Toyoaki; Nakano, Muyura; Shoji, Sunao; Nagata, Yoshihiro; Usui, Yukio; Terachi, Toshiro

    2012-10-01

    To report on the long-term results of high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. Patients with clinical Stage T1c-T3N0M0, biopsy proven, localized prostate cancer, with a serum prostate specific antigen (PSA) level of <30 ng/ml, any Gleason score were included. All patients underwent HIFU using the Sonablate™ (S) device and were required to have a minimal follow-up of 2 years after the last HIFU session to be included in this analysis. Four different generation HIFU devices, S200, S500, S500 version 4 and S500 TCM, have been used for this study. Biochemical failure was defined according to the Phoenix definition (PSA nadir+2ng/ml). Seven hundred and fifty-three men with prostate cancer were included. The patients were divided into two groups: in the Former group, 421 patients were treated with S200 and 500 from 1990 to 2005; in the Latter group, 332 patients were treated with S500 ver. 4 and TCM from 2005 to 2009. The mean age, PSA, Gleason score, operation time, and follow-up period in the Former and Latter groups were 68 and 67 years, 11.3 and 9.7 ng/ml, 6.2 and 6.6, 167 and 101 min, and 49 and 38 months, respectively. The biochemical disease-free rate (BDFR) in the groups at 5 years was, respectively, 67% and 53%, and was 50% at 10 years in the Former group (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the Former group at 5 and 10 years were 68% and 65%, 52% and 48%, and 43% and 40%, respectively (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the Latter group at 5 years were 83%, 76%, and 42% (p<0.0001). The negative prostate biopsy rate in the Former and Latter groups was 81% and 93%, respectively. Postoperative erectile dysfunction was noted in 45%, 38%, and 24% of patients at 6 months, 12 months, and 2 years after HIFU. The results after long-term follow-up have indicated that HIFU is an efficient and safe treatment for patients with

  4. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis.

    PubMed

    Aoun, Fouad; Limani, Ksenija; Peltier, Alexandre; Marcelis, Quentin; Zanaty, Marc; Chamoun, Alexandre; Vanden Bossche, Marc; Roumeguère, Thierry; van Velthoven, Roland

    2015-01-01

    Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ (2) test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p < 0.05). Median oncologic follow-up was 83 months (13-123 months) in the HIFU cohort and 44 months (13-89 months) in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p < 0.05). No statistically significant difference in metastasis-free, cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results. PMID:26357511

  5. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis

    PubMed Central

    Aoun, Fouad; Limani, Ksenija; Peltier, Alexandre; Marcelis, Quentin; Zanaty, Marc; Chamoun, Alexandre; Vanden Bossche, Marc; Roumeguère, Thierry; van Velthoven, Roland

    2015-01-01

    Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ2 test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p < 0.05). Median oncologic follow-up was 83 months (13–123 months) in the HIFU cohort and 44 months (13–89 months) in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p < 0.05). No statistically significant difference in metastasis-free, cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results. PMID:26357511

  6. Functional MRI in clinical practice: Assessment of language and motor for pre-surgical planning.

    PubMed

    Mahdavi, Ali; Azar, Ramyar; Shoar, Majid Haghighat; Hooshmand, Sina; Mahdavi, Arash; Kharrazi, Homayoon Hadizadeh

    2015-10-01

    Functional magnetic resonance imaging (fMRI) has been widely used for pre-neurosurgical planning and may eventually become a routine pre-surgical imaging modality. The validity of fMRI for clinical application depends on various factors such as proper task selection, correct statistical analysis and threshold setting with appropriate patient cooperation. This study was performed on 40 patients with different types of brain mass lesions or hippocampal sclerosis to assess the role of appropriate patient selection for achieving a reliable fMRI result. Accurate and reproducible fMRI strongly depends on the patient's cooperation. In this study we observed that a pre-test mock fMRI session held by a radiologist may help to predict which patients are more or less suitable candidates for fMRI. PMID:26443298

  7. Midtrimester spontaneous torsion of unruptured gravid rudimentary horn: Presurgical diagnosis on magnetic resonance imaging.

    PubMed

    Singh, Pragya; Gupta, Rohini; Das, Banashree; Bajaj, Sunil Kumar; Misra, Ritu

    2015-09-01

    Unicornuate uterus with rudimentary horn occurs due to failure of complete development and partial fusion of one of the Müllerian ducts. Pregnancy in a non-communicating rudimentary horn is extremely rare, with a reported incidence of 1 in 76 000-150 000 pregnancies, and usually terminates in rupture during the first or second trimester. Clinical diagnosis of rudimentary horn pregnancy in a woman with history of normal vaginal delivery in prior gestations is difficult. The role of sonography, and more recently, magnetic resonance imaging, in the presurgical diagnosis of rudimentary horn pregnancy is established. We present a case of magnetic resonance imaging diagnosis of 20-week pregnancy in the unruptured non-communicating rudimentary horn in a patient with previous history of two full-term normal vaginal deliveries. The novelty of the case lies in the fact that there was associated torsion of the gravid rudimentary horn and ipsilateral ovary, which has not been reported previously. PMID:26013913

  8. Presurgical Trial of Metformin in Overweight and Obese Patients with Newly Diagnosed Breast Cancer

    PubMed Central

    Kalinsky, Kevin; Crew, Katherine D.; Refice, Susan; Xiao, Tong; Wang, Antai; Feldman, Sheldon M.; Taback, Bret; Ahmad, Aqeel; Cremers, Serge; Hibshoosh, Hanina; Maurer, Matthew; Hershman, Dawn L.

    2015-01-01

    Introduction We conducted a presurgical trial to assess the tissue-related effects of metformin in overweight/obese breast cancer (BC) patients. Methods Metformin 1,500 mg daily was administered to 35 nondiabetics with stage 0–III BC, body mass index (BMI) ≥ 25 kg/m2. The primary endpoint was tumor proliferation change (i.e., ki-67). Tumor proliferation change was compared to untreated historical controls, matched by age, BMI, and stage. Results There was no reduction in ln(ki-67) after metformin (p = .98) or compared to controls (p = .47). There was a significant reduction in BMI, cholesterol, and leptin. Conclusion Despite no proliferation changes, we observed reductions in other relevant biomarkers. PMID:24605899

  9. American Clinical Magnetoencephalography Society Clinical Practice Guideline 2: Presurgical Functional Brain Mapping Using Magnetic Evoked Fields*

    PubMed Central

    Burgess, Richard C.; Funke, Michael E.; Bowyer, Susan M.; Lewine, Jeffrey D.; Kirsch, Heidi E.; Bagić, Anto I.

    2012-01-01

    The following are “minimum standards” for the routine clinical recording of magnetic evoked fields (MEFs) in all age-groups. Practicing at minimum standards should not be the goal of a magnetoencephalography (MEG) center but rather a starting level for continued improvement. Minimum standards meet only the most basic responsibilities to the patient and the referring physician. These minimum standards have been put forth to improve standardization of procedures, to facilitate interchange of recordings and reports among laboratories in the United States, and to confirm the expectations of referring physicians. Recommendations regarding Laboratory (Center) Environment and Preparation for MEG Recordings are detailed in the American Clinical Magnetoencephalography Society Clinical Practice Guideline (CPG) 1 : Recording and Analysis of Spontaneous Cerebral Activity, except for its EEG aspect that is not considered necessary (although may be helpful in trained hands) for MEFs (presurgical functional brain mapping). PMID:21811122

  10. Tailored disconnection based on presurgical evidence in catastrophic epilepsy: report of 2 cases.

    PubMed

    Park, Jun T; Manjila, Sunil V; Tangen, Rachel B; Cohen, Mark L; Shahid, Asim M; Sweet, Jennifer A; Tuxhorn, Ingrid E; Miller, Jonathan P

    2016-06-01

    Catastrophic epilepsy in infants, often due to extensive cortical dysplasia, has devastating consequences with respect to brain development. Conventional lobar, multilobar, or hemispheric resection in these infants is challenging, carrying an increased operative risk compared with that in older children. Removing a larger tissue volume versus removing or disconnecting the epileptogenic region does not always guarantee better seizure outcome. The authors describe 2 infants with catastrophic epilepsy who benefited from individually tailored disconnections based on a hypothesized epileptogenic zone following intensive presurgical evaluation. Two infants with catastrophic epilepsy and epileptic spasms underwent leukotomies between 3 and 12 months of age. They were followed up postoperatively for 19-36 months. Both patients had 90%-100% seizure reduction and a significantly improved neurodevelopmental outcome without postoperative complication. Cortical malformation was seen in both patients. Modifications of established surgical disconnection techniques, tailored to each patient's specific epileptogenic zone, optimized seizure and neurodevelopmental outcomes while minimizing the risks associated with more extensive resections. PMID:26870899

  11. The role of MEG in pre-surgical evaluation of epilepsy: current use and future directions.

    PubMed

    Ahmed, Raheel; Rutka, James T

    2016-07-01

    Identification of the epileptogenic zone is a critical determinant of seizure control outcomes following surgical resection in medically refractory seizures. There has been increasing recognition of the contributive value of Magnetoencephalography (MEG) studies in the diagnostic evaluation of epilepsy. Biomagnetic signals recorded by MEG studies in combination with source modeling techniques can yield diagnostic information regarding the underlying epileptogenic zone. MEG evaluation is particularly useful in evaluation of non lesional neocortical epilepsy. In these cases, MEG spike sources can guide presurgical and perioperative invasive monitoring. The incorporation of MEG-based diagnostic information into the surgical evaluation and management plan has consistently been shown to be associated with improved seizure control outcomes. PMID:27101469

  12. Relations between Perceptual and Conceptual Scope: How Global versus Local Processing Fits a Focus on Similarity versus Dissimilarity

    ERIC Educational Resources Information Center

    Forster, Jens

    2009-01-01

    Nine studies showed a bidirectional link (a) between a global processing style and generation of similarities and (b) between a local processing style and generation of dissimilarities. In Experiments 1-4, participants were primed with global versus local perception styles and then asked to work on an allegedly unrelated generation task. Across…

  13. Continuous EEG-fMRI in Pre-Surgical Evaluation of a Patient with Symptomatic Seizures: Bold Activation Linked to Interictal Epileptic Discharges Caused by Cavernoma.

    PubMed

    Avesani, M; Formaggio, E; Milanese, F; Baraldo, A; Gasparini, A; Cerini, R; Bongiovanni, L G; Pozzi Mucelli, R; Fiaschi, A; Manganotti, P

    2008-04-01

    We used continuous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) to identify the linkage between the "epileptogenic" and the "irritative" area in a patient with symptomatic epilepsy (cavernoma, previously diagnosed and surgically treated), i.e. a patient with a well known "epileptogenic area", and to increase the possibility of a non invasive pre-surgical evaluation of drug-resistant epilepsies. A compatible MRI system was used (EEG with 29 scalp electrodes and two electrodes for ECG and EMG) and signals were recorded with a 1.5 Tesla MRI scanner. After the recording session and MRI artifact removal, EEG data were analyzed offline and used as paradigms in fMRI study. Activation (EEG sequences with interictal slow-spiked-wave activity) and rest (sequences of normal EEG) conditions were compared to identify the potential resulting focal increase in BOLD signal and to consider if this is spatially linked to the interictal focus used as a paradigm and to the lesion. We noted an increase in the BOLD signal in the left neocortical temporal region, laterally and posteriorly to the poro-encephalic cavity (residual of cavernoma previously removed), that is around the "epileptogenic area". In our study "epileptogenic" and "irritative" areas were connected with each other. Combined EEG-fMRI may become routine in clinical practice for a better identification of an irritative and lesional focus in patients with symptomatic drug-resistant epilepsy. PMID:24256824

  14. Presurgical orthodontic decompensation alters alveolar bone condition around mandibular incisors in adults with skeletal Class III malocclusion

    PubMed Central

    Sun, Boyang; Tang, Jun; Xiao, Ping; Ding, Ying

    2015-01-01

    This study is to use cone beam computed tomography (CBCT) to acquire accurate radiographic images for alveolar bone in lower incisors and the change after presurgical orthodontic treatment. Seventeen patients with skeletal Class III malocclusion, ten normal occlusion subjects, and fifteen patients treated with orthodontic treatment and orthognathic surgery were included. CBCT images were obtained. The labial and lingual inclinations of mandibular incisors, the thickness of alveolar bone, the vertical alveolar height and root length were measured. Alveolar bone thickness at the apex in patients with skeletal Class III malocclusion was thinner than normal subjects. The vertical alveolar bone heights at labial and lingual sides in patients with skeletal Class III malocclusion were both reduced compared with normal subjects, especially at the labial side. There were statistically significant correlations between lower incisor inclination and alveolar bone morphology. After orthodontics, the incisors root apex was closer to the lingual side of alveolar bone. The alveolar bone thickness at apex was not statistically changed. The vertical alveolar bone heights at the labial and lingual sides were both significantly reduced especially the lingual side after presurgical orthodontic treatment. The root length was not significantly changed. In conclusion, the alveolar bone thickness at apex is thinner and the vertical alveolar height is reduced at the labial side. Forward movement of lower incisors during presurgical orthodontic treatment can render the lower incisors root apex closer to the lingual side and the vertical alveolar height is reduced. PMID:26550202

  15. Pros and cons in endocrine practice: pre-surgical treatment with somatostatin analogues in acromegaly.

    PubMed

    Losa, Marco; Bollerslev, Jens

    2016-06-01

    The aim of this commentary is to balance the pros and cons for pre-surgical SSA treatment in a modern perspective ending up with a pragmatic recommendation for treatment based on the current evidence and expertise of the authors. Even though prospective and randomized studies in this particular area are hampered by obvious limitations, the interpretation of the four published trials has in general been in favor of pre-treatment with SSA, showing a better outcome following surgery. However, major drawbacks of these studies, such as non-optimal diagnostic criteria for cure, potential selection bias, and timing of the postoperative evaluation in SSA pre-treated patients, limit their overall interpretation. Three matched-controlled studies showed remarkably similar results with no apparent beneficial effect of SSA pre-treatment on surgical outcome. Both prospective, randomized studies and retrospective studies did not find any significant difference in the rate of endocrine and non-endocrine complications related to surgery, despite the beneficial clinical effects of SSA treatment in most acromegalic patients. The newly diagnosed patient with acromegaly should be carefully evaluated in the trans-disciplinary neuroendocrine team and treatment individualized accordingly. The issue of SSA pre-treatment to improve surgical outcome is yet to be settled and further methodologically sound studies are probably necessary to clarify this point. PMID:26785848

  16. [Quality guidelines for presurgical epilepsy diagnosis and operative epilepsy therapy: 1st revised version].

    PubMed

    Rosenow, F; Bast, T; Czech, T; Hans, V; Helmstaedter, C; Huppertz, H-J; Seeck, M; Trinka, E; Wagner, K

    2014-06-01

    In patients with pharmacorefractory epilepsy, preoperative epilepsy evaluation and subsequent epilepsy surgery lead to a significant improvement of seizure control, proportion of seizure-free patients, quality of life and social participation. The aims of preoperative epilepsy evaluation are to define the chance of complete seizure freedom and the likelihood of inducing new neurological deficits in a given patient. As epilepsy surgery is an elective procedure quality standards are particularly high. As detailed in the first edition of these practice guidelines, quality control relates to seven different domains: (1) establishing centres with a sufficient number of sufficiently and specifically trained personnel, (2) minimum technical standards and equipment, (3) continuing medical education of employees, (4) surveillance by trained personnel during the video electroencephalography (EEG) monitoring (VEM), (5) systematic acquisition of clinical and outcome data, (6) the minimum number of preoperative evaluations and epilepsy surgery procedures and (7) cooperation of epilepsy centres. In the first edition of these practice guidelines published in 2000 it was defined which standards were desirable and that their implementation should be aimed for. These standards related especially to the certification required for different groups of medical doctors involved and to the minimum numbers of procedures required. In the subsequent decade quite a number of colleagues have been certified by the trinational Working Group (Arbeitsgemeinschaft, AG) for Presurgical Epilepsy Diagnosis and Operative Epilepsy Treatment (http://www.ag-epilepsiechirurgie.de) and therefore, on 8 May 2013 the executive board of the AG decided to now make these standards obligatory. PMID:24861193

  17. A Bayesian non-parametric Potts model with application to pre-surgical FMRI data.

    PubMed

    Johnson, Timothy D; Liu, Zhuqing; Bartsch, Andreas J; Nichols, Thomas E

    2013-08-01

    The Potts model has enjoyed much success as a prior model for image segmentation. Given the individual classes in the model, the data are typically modeled as Gaussian random variates or as random variates from some other parametric distribution. In this article, we present a non-parametric Potts model and apply it to a functional magnetic resonance imaging study for the pre-surgical assessment of peritumoral brain activation. In our model, we assume that the Z-score image from a patient can be segmented into activated, deactivated, and null classes, or states. Conditional on the class, or state, the Z-scores are assumed to come from some generic distribution which we model non-parametrically using a mixture of Dirichlet process priors within the Bayesian framework. The posterior distribution of the model parameters is estimated with a Markov chain Monte Carlo algorithm, and Bayesian decision theory is used to make the final classifications. Our Potts prior model includes two parameters, the standard spatial regularization parameter and a parameter that can be interpreted as the a priori probability that each voxel belongs to the null, or background state, conditional on the lack of spatial regularization. We assume that both of these parameters are unknown, and jointly estimate them along with other model parameters. We show through simulation studies that our model performs on par, in terms of posterior expected loss, with parametric Potts models when the parametric model is correctly specified and outperforms parametric models when the parametric model in misspecified. PMID:22627277

  18. Presurgical Rehearsals for Patients Considering “Awake” Deep Brain Stimulation

    PubMed Central

    Falconer, Ramsey A.; Rogers, Sean L.; Brewer, Cristie M.; Piscitani, Franco; Shenai, Mahesh B.

    2016-01-01

    Simulated surgical environments are rapidly gaining adoption in training students, residents, and members of specialized surgical teams. However, minimal attention has been given to the use of simulated surgical environments to educate patients on surgical processes, particularly procedures that require the active participation of the patient. “Awake” neurosurgery provides a unique situation in which patients openly participate in their operation. We describe a case report, in which a 62-year-old male was referred for “awake” deep brain stimulation implantation, in relation to medically refractory Parkinson’s disease. The patient had significant concerns regarding anxiety and claustrophobia, and toleration of the “awake” procedure. Consequently, we designed a simulated OR environment and process, to recreate the physical experience of the procedure, with minimal cost or risk. This experience was crucial in determining the care plan, as after this experience, the patient opted for an “asleep” alternative. Thus, in certain settings, presurgical rehearsals may have a dramatic impact in the overall course of care. PMID:27532036

  19. Focusing of the lowest-order antisymmetric Lamb mode behind a gradient-index acoustic metalens with local resonators

    NASA Astrophysics Data System (ADS)

    Zhao, Jinfeng; Bonello, Bernard; Boyko, Olga

    2016-05-01

    We have investigated the focusing of the lowest-order antisymmetric Lamb mode (A0) behind a positive gradient-index (GRIN) acoustic metalens consisting of air holes drilled in a silicon plate with silicon pillars erected on one face of the lens. We have analyzed the focusing in the near field as the result of the coupling between the flexural resonant mode of the pillars and the vibration mode of the air/silicon phononic crystal. We highlight the role played by the polarization coherence between the resonant mode and the vibration of the plate. We demonstrate both numerically and experimentally the focusing behind the lens over a spot less than half a wavelength, paving a way for performance of acoustic lenses beyond the diffraction limit. Our findings can be easily extended to other types of elastic wave.

  20. Disentangling Stability, Variability and Adaptability in Human Performance: Focus on the Interplay between Local Variance and Serial Correlation

    ERIC Educational Resources Information Center

    Torre, Kjerstin; Balasubramaniam, Ramesh

    2011-01-01

    We address the complex relationship between the stability, variability, and adaptability of psychological systems by decomposing the global variance of serial performance into two independent parts: the local variance (LV) and the serial correlation structure. For two time series with equal LV, the presence of persistent long-range correlations…

  1. Presurgical nasoalveolar molding orthopedic treatment improves the outcome of primary cheiloplasty of unilateral complete cleft lip and palate, as assessed by naris morphology and cleft gap.

    PubMed

    Sasaki, Hiroyoshi; Togashi, Shinji; Karube, Rei; Yanagawa, Toru; Nakane, Shizuo; Tabuchi, Katsuhiko; Ishibashi, Naomi; Shinya, Yoshiko; Ito, Hiroyuki; Yamagata, Kenji; Onizawa, Kojiro; Adachi, Koji; Sekido, Mitsuru; Bukawa, Hiroki

    2012-11-01

    We evaluated the effects of presurgical nasoalveolar molding (NAM) with an orthopedic appliance and compared them with a passive orthopedic method (Hotz plate, HP), focusing on the naris morphology and width of the alveolar and palate cleft gap. The subjects were 28 unilateral complete cleft lip and palate patients treated with primary cheiloplasty at Tsukuba University Hospital from 2004 to 2011. Thirteen patients were treated preoperatively with NAM (NAM group), and 15 with HP (HP group). The surgical outcome was assessed according to left-right naris symmetry, as measured by the area ratio, perimeter ratio, aspect a/u ratio (aspect ratio of the affected side/aspect ratio of the unaffected side), and Hausdorff distance. In addition, the alveolar and palate cleft width was measured at the times of orthopedic plate setting and primary cheiloplasty. The aspect ratio was significantly smaller in the NAM group than in the HP group before the operation. In both groups, the aspect ratio, perimeter ratio, and Hausdorff distance were significantly smaller after the operation than before. The width of the alveolar and palate cleft gap was significantly narrowed in the NAM group, and the cleft gap at the initiation of NAM correlated significantly with the Hausdorff distance after cheiloplasty. We found that NAM improved the form of the naris after primary cheiloplasty and decreased the palate cleft gap more effectively than HP and that the width of the palate cleft gap was correlated with the surgical outcome of the naris. PMID:23147280

  2. Interannual variability in the South-East Atlantic Ocean, focusing on the Benguela Upwelling System: Remote versus local forcing

    NASA Astrophysics Data System (ADS)

    Bachèlery, Marie-Lou; Illig, Serena; Dadou, Isabelle

    2016-01-01

    We investigate the respective roles of equatorial remote (Equatorial Kelvin Waves) and local atmospheric (wind, heat fluxes) forcing on coastal variability in the South-East Atlantic Ocean extending up to the Benguela Upwelling System (BUS) over the 2000-2008 period. We carried out a set of six numerical experiments based on a regional ocean model, that differ only by the prescribed forcing (climatological or total) at surface and lateral boundaries. Results show that at subseasonal timescales (<100 days), the coastal oceanic variability (currents, thermocline, and sea level) is mainly driven by local forcing, while at interannual timescales it is dominated by remote equatorial forcing. At interannual timescales (13-20 months), remotely forced Coastal-Trapped Waves (CTW) propagate poleward along the African southwest coast up to the northern part of the BUS at 24°S, with phase speeds ranging from 0.8 to 1.1 m.s-1. We show that two triggering mechanisms limit the southward propagation of CTW: interannual variability of the equatorward Benguela Current prescribed at the model's southern boundary (30°S) and variability of local atmospheric forcing that modulates the magnitude of observed coastal interannual events. When local wind stress forcing is in (out) of phase, the magnitude of the interannual event increases (decreases). Finally, dynamical processes associated with CTW propagations are further investigated using heat budget for two intense interannual events in 2001 and 2003. Results show that significant temperature anomalies (±2°C), that are mostly found in the subsurface, are primarily driven by alongshore and vertical advection processes.

  3. Effect of Metformin on Breast Ductal Carcinoma In Situ Proliferation in a Randomized Presurgical Trial.

    PubMed

    DeCensi, Andrea; Puntoni, Matteo; Guerrieri-Gonzaga, Aliana; Cazzaniga, Massimiliano; Serrano, Davide; Lazzeroni, Matteo; Vingiani, Andrea; Gentilini, Oreste; Petrera, Marilena; Viale, Giuseppe; Cuzick, Jack; Bonanni, Bernardo; Pruneri, Giancarlo

    2015-10-01

    Metformin is associated with lower breast cancer risk in epidemiologic studies and showed decreased proliferation in HER2-positive breast cancer in a presurgical trial. To provide insight into its preventive potential, we measured proliferation by Ki-67 labeling index (LI) of intraepithelial lesions surrounding breast cancer. We randomly assigned 200 nondiabetic patients diagnosed with invasive breast cancer in core biopsies to metformin, 1,700 mg or placebo once daily for 28 days before surgery. Upon surgery, five to seven specimens of cancer adjacent (≤1 cm) and distant (>1 cm) tissue were screened for LCIS, ductal carcinoma in situ (DCIS), and ductal hyperplasia (DH). The prevalence of LCIS, DCIS, and DH was 4.5% (9/200), 67% (133/200), and 35% (69/200), respectively. Overall, metformin did not affect Ki-67 LI in premalignant disorders. The median posttreatment Ki-67 LI (IQR) in the metformin and placebo arm was, respectively, 15% (5-15) versus 5% (4-6) in LCIS (P = 0.1), 12% (8-20) versus 10% (7-24) in DCIS (P = 0.9), and 3% (1-4) versus 3% (1-4) in DH (P = 0.5). However, posttreatment Ki-67 in HER2-positive DCIS lesions was significantly lower in women randomized to metformin especially when ER was coexpressed: 22% (11-32) versus 35% (30-40) in HER2-positive DCIS (n = 22, P = .06); 12% (7-18) versus 32% (27-42) in ER-positive/HER2-positive DCIS (n = 15, P = .004). Eight of 22 (36%) HER2-positive DCIS were adjacent to HER2-negative invasive breast cancer. In tissue samples obtained following 4 weeks of study drug, proliferation was lower in HER2-positive DCIS for women randomized to metformin versus placebo. An adjuvant trial incorporating metformin in HER2-positive DCIS is warranted. PMID:26276754

  4. Q-Elastography in the Presurgical Diagnosis of Thyroid Nodules with Indeterminate Cytology

    PubMed Central

    Guaitoli, Eleonora; De Vito, Corrado; Caruso, Riccardo; Mocini, Renzo; D’Andrea, Vito; Ascoli, Valeria; Antonaci, Alfredo; Catalano, Carlo; Nardi, Francesco; Redler, Adriano; Ricci, Paolo; De Antoni, Enrico; Sorrenti, Salvatore

    2012-01-01

    Quantitative ultrasound (US) elastography (Q-USE), able to evaluate tissue stiffness has been indicated as a new diagnostic tool to differentiate benign from malignant thyroid lesions. Aim of this prospective study, conducted at the Department of Surgical Sciences, of the “Sapienza” University of Rome, was to evaluate the diagnostic accuracy of Q-USE, compared with US parameters, in thyroid nodules with indeterminate cytology (Thy3).The case study included 140 nodules from 140 consecutive patients. Patient’s thyroid nodules were evaluated by Q-USE, measuring the strain ratio (SR) of stiffness between nodular and surrounding normal thyroid tissue, and conventional US parameters prior fine-needle aspiration cytology. Those with Thy3 diagnosis were included in the study. Forty of the nodules analyzed harbored a malignant lesion. Q-USE demonstrated that malignant nodules have a significant higher stiffness with respect to benign one and an optimun SR cut-off value of 2.05 was individuated following ROC analysis. Univariate analysis showed that hypoechogenicity, irregular margins and SR >2.05 associated with malignancy, with an accuracy of 67.2%, 81,0% and 89.8%, respectively. Data were unaffected by nodule size or thyroiditis. These findings were confirmed in multivariate analysis demonstrating a significant association of the SR and the irregular margins with thyroid nodule’s malignancy. In conclusion, we demonstrated the diagnostic utility of Q-USE in the differential diagnosis of thyroid nodules with indeterminate cytology that, if confirmed, could be of major clinical utility in patients’ presurgical selection. PMID:23209819

  5. Q-elastography in the presurgical diagnosis of thyroid nodules with indeterminate cytology.

    PubMed

    Cantisani, Vito; Ulisse, Salvatore; Guaitoli, Eleonora; De Vito, Corrado; Caruso, Riccardo; Mocini, Renzo; D'Andrea, Vito; Ascoli, Valeria; Antonaci, Alfredo; Catalano, Carlo; Nardi, Francesco; Redler, Adriano; Ricci, Paolo; De Antoni, Enrico; Sorrenti, Salvatore

    2012-01-01

    Quantitative ultrasound (US) elastography (Q-USE), able to evaluate tissue stiffness has been indicated as a new diagnostic tool to differentiate benign from malignant thyroid lesions. Aim of this prospective study, conducted at the Department of Surgical Sciences, of the "Sapienza" University of Rome, was to evaluate the diagnostic accuracy of Q-USE, compared with US parameters, in thyroid nodules with indeterminate cytology (Thy3).The case study included 140 nodules from 140 consecutive patients. Patient's thyroid nodules were evaluated by Q-USE, measuring the strain ratio (SR) of stiffness between nodular and surrounding normal thyroid tissue, and conventional US parameters prior fine-needle aspiration cytology. Those with Thy3 diagnosis were included in the study. Forty of the nodules analyzed harbored a malignant lesion. Q-USE demonstrated that malignant nodules have a significant higher stiffness with respect to benign one and an optimun SR cut-off value of 2.05 was individuated following ROC analysis. Univariate analysis showed that hypoechogenicity, irregular margins and SR >2.05 associated with malignancy, with an accuracy of 67.2%, 81,0% and 89.8%, respectively. Data were unaffected by nodule size or thyroiditis. These findings were confirmed in multivariate analysis demonstrating a significant association of the SR and the irregular margins with thyroid nodule's malignancy. In conclusion, we demonstrated the diagnostic utility of Q-USE in the differential diagnosis of thyroid nodules with indeterminate cytology that, if confirmed, could be of major clinical utility in patients' presurgical selection. PMID:23209819

  6. Building a diagnostic algorithm on localized neuropathic pain (LNP) and targeted topical treatment: focus on 5% lidocaine-medicated plaster

    PubMed Central

    Casale, Roberto; Mattia, Consalvo

    2014-01-01

    Within the broad definition of neuropathic pain, the refinement of clinical diagnostic procedures has led to the introduction of the concept of localized neuropathic pain (LNP). It is characterized by consistent and circumscribed area(s) of maximum pain, which are associated with negative or positive sensory signs and/or spontaneous symptoms typical of neuropathic pain. This description outlines the clinical features (currently lacking in guidelines and treatment recommendations) in patients for whom topical targeted treatment with 5% lidocaine-medicated plaster is suggested as first-line therapy. Few epidemiologic data are present in the literature but it is generally estimated that about 60% of neuropathic pain conditions are localized, and therefore identifiable as LNP. A mandatory clinical criterion for the diagnosis of LNP is that signs and symptoms must be present in a clearly identified and defined area(s). Cartographic recordings can help to define each area and to assess variations. The diagnosis of LNP relies on careful neurological examination more than on pain questionnaires, but it is recognized that they can be extremely useful for recording the symptom profiles and establishing a more targeted treatment. The most widely studied frequent/relevant clinical presentations of LNP are postherpetic neuralgia, diabetic neuropathy, and neuropathic postoperative pain. They successfully respond to treatment with 5% lidocaine-medicated plaster with equal if not better pain control but with fewer side effects versus conventional systemic treatments. Generally, the more localized the pain (ie, the area of an A4 sheet of paper) the better the results of topical treatment. This paper proposes an easy-to-understand algorithm to identify patients with LNP and to guide targeted topical treatments with 5% lidocaine medicated plaster. PMID:24790451

  7. Effect of local application of epidermal growth factor on innate immunity and cell composition of destruction focus in experimental thermal injury.

    PubMed

    Osikov, M V; Telesheva, L F; Likhacheva, A G

    2014-07-01

    The effect of recombinant human epidermal growth factor (rhEGF) on innate immunity and cellular composition of the destruction focus in the third-degree (IIIA) burn (skin contact with an object heated to 100°C; 4% body surface) was studied in experiments on outbred albino rats. On days 7-28 after burn, blood count of phagocytes and their absorbing capacity and oxygen-dependent metabolism increased, which correlated with the increase in serum IL-1β level and neutrophil count in the destruction focus. Local application of rhEGF led to earlier (on day 14) normalization of the count and functional activity of blood phagocytes and decrease in serum IL-1β level and accelerated neutrophil and lymphocyte replacement with fibroblasts in the focus of injury. PMID:25065306

  8. Does pre-surgical central modulation of pain influence outcome after total knee replacement? A systematic review.

    PubMed

    Baert, I A C; Lluch, E; Mulder, T; Nijs, J; Noten, S; Meeus, M

    2016-02-01

    The aim of this study is to systematically review whether the presence of altered central pain modulation pre-surgical influences outcome after total knee replacement (TKR) in patients with knee osteoarthritis (OA), and if so which indices of central pain modulation predict poor outcome after TKR. To identify relevant articles, PubMed and Web of Science were searched. The search strategy was a combination of key words related to "Knee Osteoarthritis and Total Knee Replacement", "Central Pain Modulation" and "Post-Surgical Outcome Measures". Articles fulfilling the inclusion criteria were screened for methodological quality and results were analyzed and summarized. Sixteen prospective cohort studies were included. Strong evidence is available that presence of catastrophic thinking and poor coping strategies predict more pain after TKR and that there is no association between fear of movement and post-surgical pain or function. Evidence on other psychosocial influences is limited or conflicting. Literature on the influence of other signs of altered central pain modulation on post-surgical outcome is scarce. It is plausible that pre-surgical signs of altered central pain modulation, such as joint pain at rest or widespread pain sensitization, predict more post-surgical pain. Surgeons should be attentive for patients with signs of altered central pain modulation before surgery as they might be at risk for unfavorable outcome. A broader therapeutic approach aiming to desensitize the central nervous system can be adapted in these patients. Further research is however needed to identify the influence of central pain modulation pre-surgical in predicting outcome after TKR. PMID:26382109

  9. Studying Coxiella burnetii Type IV Substrates in the Yeast Saccharomyces cerevisiae: Focus on Subcellular Localization and Protein Aggregation

    PubMed Central

    Rodríguez-Escudero, María; Cid, Víctor J.; Molina, María; Schulze-Luehrmann, Jan; Lührmann, Anja; Rodríguez-Escudero, Isabel

    2016-01-01

    Coxiella burnetii is a Gram-negative obligate parasitic bacterium that causes the disease Q-fever in humans. To establish its intracellular niche, it utilizes the Icm/Dot type IVB secretion system (T4BSS) to inject protein effectors into the host cell cytoplasm. The host targets of most cognate and candidate T4BSS-translocated effectors remain obscure. We used the yeast Saccharomyces cerevisiae as a model to express and study six C. burnetii effectors, namely AnkA, AnkB, AnkF, CBU0077, CaeA and CaeB, in search for clues about their role in C. burnetii virulence. When ectopically expressed in HeLa cells, these effectors displayed distinct subcellular localizations. Accordingly, GFP fusions of these proteins produced in yeast also decorated distinct compartments, and most of them altered cell growth. CaeA was ubiquitinated both in yeast and mammalian cells and, in S. cerevisiae, accumulated at juxtanuclear quality-control compartments (JUNQs) and insoluble protein deposits (IPODs), characteristic of aggregative or misfolded proteins. AnkA, which was not ubiquitinated, accumulated exclusively at the IPOD. CaeA, but not AnkA or the other effectors, caused oxidative damage in yeast. We discuss that CaeA and AnkA behavior in yeast may rather reflect misfolding than recognition of conserved targets in the heterologous system. In contrast, CBU0077 accumulated at vacuolar membranes and abnormal ER extensions, suggesting that it interferes with vesicular traffic, whereas AnkB associated with the yeast nucleolus. Both effectors shared common localization features in HeLa and yeast cells. Our results support the idea that C. burnetii T4BSS effectors manipulate multiple host cell targets, which can be conserved in higher and lower eukaryotic cells. However, the behavior of CaeA and AnkA prompt us to conclude that heterologous protein aggregation and proteostatic stress can be a limitation to be considered when using the yeast model to assess the function of bacterial effectors

  10. "Relations between perceptual and conceptual scope: How global versus local processing fits a focus on similarity versus dissimilarity": Retraction of Förster (2009).

    PubMed

    2016-03-01

    Reports the retraction of "Relations between perceptual and conceptual scope: How global versus local processing fits a focus on similarity versus dissimilarity" by Jens Förster (Journal of Experimental Psychology: General, 2009[Feb], Vol 138[1], 88-111). This retraction follows the results of an investigation by the University of Amsterdam into the work of Jens Förster. The University requested the retraction of this article based on its qualitative judgement of "strong statistical evidence for low veracity". (The following abstract of the original article appeared in record 2009-01083-008.) Nine studies showed a bidirectional link (a) between a global processing style and generation of similarities and (b) between a local processing style and generation of dissimilarities. In Experiments 1-4, participants were primed with global versus local perception styles and then asked to work on an allegedly unrelated generation task. Across materials, participants generated more similarities than dissimilarities after global priming, whereas for participants with local priming, the opposite was true. Experiments 5-6 demonstrated a bidirectional link whereby participants who were first instructed to search for similarities attended more to the gestalt of a stimulus than to its details, whereas the reverse was true for those who were initially instructed to search for dissimilarities. Because important psychological variables are correlated with processing styles, in Experiments 7-9, temporal distance, a promotion focus, and high power were predicted and shown to enhance the search for similarities, whereas temporal proximity, a prevention focus, and low power enhanced the search for dissimilarities. (PsycINFO Database Record PMID:26881989

  11. Modeling localized delivery of Doxorubicin to the brain following focused ultrasound enhanced blood-brain barrier permeability

    NASA Astrophysics Data System (ADS)

    Nhan, Tam; Burgess, Alison; Lilge, Lothar; Hynynen, Kullervo

    2014-10-01

    Doxorubicin (Dox) is a well-established chemotherapeutic agent, however it has limited efficacy in treating brain malignancies due to the presence of the blood-brain barrier (BBB). Recent preclinical studies have demonstrated that focused ultrasound induced BBB disruption (BBBD) enables efficient delivery of Dox to the brain. For future treatment planning of BBBD-based drug delivery, it is crucial to establish a mathematical framework to predict the effect of transient BBB permeability enhancement on the spatiotemporal distribution of Dox at the targeted area. The constructed model considers Dox concentrations within three compartments (plasma, extracellular, intracellular) that are governed by various transport processes (e.g. diffusion in interstitial space, exchange across vessel wall, clearance by cerebral spinal fluid, uptake by brain cells). By examining several clinical treatment aspects (e.g. sonication scheme, permeability enhancement, injection mode), our simulation results support the experimental findings of optimal interval delay between two consecutive sonications and therapeutically-sufficient intracellular concentration with respect to transfer constant Ktrans range of 0.01-0.03 min-1. Finally, the model suggests that infusion over a short duration (20-60 min) should be employed along with single-sonication or multiple-sonication at 10 min interval to ensure maximum delivery to the intracellular compartment while attaining minimal cardiotoxicity via suppressing peak plasma concentration.

  12. Serial follow-up of presurgical treatment using pasireotide long-acting release with or without octreotide long-acting release for naïve active acromegaly.

    PubMed

    Chang, Jan-Shun; Tseng, Ham-Min; Chang, Tien-Chun

    2016-06-01

    The aim of the present study was to evaluate the serial changes of GH and IGF-1 in seven patients with naïve, active acromegaly following presurgical treatment of the somatostatin analog pasireotide long-acting release (LAR) and octreotide LAR. The patients were treated with pasireotide LAR with or without octreotide LAR for two years and underwent transsphenoidal adenomectomy. After treatment with the somatostatin analogs, the surgical cure rate was similar to that in patients who underwent transsphenoidal surgery alone. Diabetes insipidus was not identified in any patients after the operation. Pasireotide LAR was effective on GH as well as IGF-1 suppression and tumor size decreasing when used as the primary therapy. Future large-population studies to investigate the surgical curative rate after presurgical treatment with somatostatin analogs in patients with acromegaly and macroadenomas close to the cavernous sinus are warranted. However, that hyperglycemia developed following pre-surgical treatment with pasireotide should take into consideration. PMID:27117887

  13. Pre-surgical Alveolar Molding in A Newborn Patient with Complete Unilateral Cleft Lip and Palate-A Report

    PubMed Central

    Nandlal, B; Reddy, Sudhakar

    2014-01-01

    Clefts of the lip, alveolus and palate (CLAP) are the most common congenital malformations seen in the head and neck region. Children with CLAP face a vast variety of problems like feeding difficulties, hearing loss (ear infections), missing or malformed teeth and speech defects, along with psychosocial stigma which influences the social development and rehabilitation of such patients. Management of CLAP has been recognized as a unique challenge for parents as well as medical team. Pre-surgical alveolar molding has shown promising results in solving the problems which are associated with CLAP, to a great extent. We are reporting a case of a newborn patient with complete unilateral cleft lip and palate, who had inability in suckling and nasal regurgitation of oral fluids since birth, which were aided by providing a Pre-surgical alveolar molding to facilitate feeding and also to improve future facial appearance. This article highlights the effectiveness of alveolar molding appliance which was used to direct growth of the alveolar ridges and lips in the pre surgical treatment of cleft lip and palate. As a result of this appliance, the primary surgical repair of the nose and lip which was done, healed under minimal tension, thereby reducing scar formation and improving the aesthetic results. PMID:24995251

  14. High-Intensity Focused Ultrasound (HIFU) Using Sonablate® Devices for the Treatment of Benign Prostatic Hyperplasia and Localized Prostate Cancer: 18-year experience

    NASA Astrophysics Data System (ADS)

    Uchida, Toyoaki

    2011-09-01

    From 1993 to 2010, we have treated 156 patients benign prostatic hyperplasia (BPH) and 1,052 patients localized prostate cancer high-intensity focused ultrasound (HIFU). Four different HIFU devices, SonablateR-200, SonablateR-500, SonablateR-500 version 4 and Sonablate® TCM, have been used for this study. Clinical outcome of HIFU for BPH did not show any superior effects to transurethral resection of the prostate, laser surgery or transurethral vapolization of the prostate. However, HIFU appears to be a safe and minimally invasive therapy for patients with localized prostate cancer, especially low- and intermediate-risk patients. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

  15. What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study.

    PubMed

    Vatcharavongvan, Pasitpon; Hepworth, Julie; Lim, Joanne; Marley, John

    2014-02-01

    This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems. PMID:23054542

  16. Modulation of in Vivo Tumor Radiation Response via Gold Nanoshell-Mediated Vascular-Focused Hyperthermia: Characterizing an Integrated Antihypoxic and Localized Vascular Disrupting Targeting Strategy

    PubMed Central

    Diagaradjane, Parmeswaran; Shetty, Anil; Wang, James C.; Elliott, Andrew M.; Schwartz, Jon; Shentu, Shujun; Park, Hee C.; Deorukhkar, Amit; Stafford, R. Jason; Cho, Sang H.; Tunnell, James W.; Hazle, John D.; Krishnan, Sunil

    2014-01-01

    We report noninvasive modulation of in vivo tumor radiation response using gold nanoshells. Mild-temperature hyperthermia generated by near-infrared illumination of gold nanoshell-laden tumors, noninvasively quantified by magnetic resonance temperature imaging, causes an early increase in tumor perfusion that reduces the hypoxic fraction of tumors. A subsequent radiation dose induces vascular disruption with extensive tumor necrosis. Gold nanoshells sequestered in the perivascular space mediate these two tumor vasculature-focused effects to improve radiation response of tumors. This novel integrated antihypoxic and localized vascular disrupting therapy can potentially be combined with other conventional antitumor therapies. PMID:18412402

  17. Environmental education with a local focus: The development of action competency in community leaders through participation in an environmental leadership program

    NASA Astrophysics Data System (ADS)

    Cairns, Karen Jean

    2001-07-01

    This dissertation is a historical and theoretical examination of environmental education to promote community leadership in local environmental issues. It begins with an overview of the history of environmental education, historical perspectives of the beginning of the field, ongoing differences in perspectives of practitioners, and its relationship to the larger field of education. Using a prevalent definition of environmental education as education with an aim of promoting actions, which are environmentally responsible and careful, I examine a variety of educational approaches and their results in achieving this objective. Reasons for using a local focus in terms of promotion of community sustainability are explored, and the literature review ends with a discussion of the value of community action through participatory democratic processes. The dissertation is divided into five chapters, covering an introduction to the purpose and significance of the study, literature review, methodology, results and analysis, and conclusion and implications of the research. Two programs, one at a city or urban level and one at a state level, and outcomes for their participants are explored and compared through data collected from interviews, field observation, and program documents. Findings demonstrated the value of a local focus for environmental education programs, plus the importance of experiential learning, or learning through some sort of personal connection and involvement. Examples of the types of experiential learning involved are tours or field trips, role-playing, and games illustrating concepts. Results emphasized the importance of educational process over content, information, or factual knowledge. The urban leadership program demonstrated the value of a local focus and experiential process in increasing motivation for action. The state program demonstrated the value of education of environmental leaders in democratic processes, especially collaboration, inclusion

  18. [Diagnosis and treatment of local recurrence of prostate cancer using hystoscanning and high-intensity focused ultrasound in patients after radical prostatectomy].

    PubMed

    Glybochko, P V; Aliaev, Iu G; Krupinov, G E; Rapoport, L M; Amosov, A V; Bezrukov, E A; Novichkov, N D; Lachinov, É L; Ganzha, T M; Obukhov, A A; Lerner, Iu V

    2014-01-01

    The study was aimed to the improvement of the diagnosis and treatment of patients with prostate cancer (PC). The study included 46 patients with recurrent prostate cancer after radical prostatectomy (RPE). The examination included contrast enhanced magnetic resonance imaging (endorectal coil 1.5T) and hystoscanning. All patients had local recurrence confirmed by the morphologically results of transrectal biopsy of the area of vesicourethral anastomosis. All patients underwent high-intensity focused ultrasound (HIFU). Before RPE, protate volume ranged from 21 to 102 cm3. The median age was 62 (46-68) years. PSA levels before a HIFU session ranged from 0.4 to 18 ng/ml. Nadir PSA level after 3 months of follow up was 0.1 ng/ml. Five-year disease-free survival in patients with locally recurrent prostate cancer after HIFU in the group of low cancer risk was 10 (81%), moderate risk--18 (57%), high risk--12 (42%). Contrast enhanced magnetic resonance imaging and hystoscanning are highly informative methods for diagnosis of local recurrence after radical prostatectomy, and HIFU can be categorized as highly effective treatment. PMID:25807764

  19. High-intensity interval training (HIT) for effective and time-efficient pre-surgical exercise interventions.

    PubMed

    Weston, Matthew; Weston, Kathryn L; Prentis, James M; Snowden, Chris P

    2016-01-01

    The advancement of perioperative medicine is leading to greater diversity in development of pre-surgical interventions, implemented to reduce patient surgical risk and enhance post-surgical recovery. Of these interventions, the prescription of pre-operative exercise training is gathering momentum as a realistic means for enhancing patient surgical outcome. Indeed, the general benefits of exercise training have the potential to pre-operatively optimise several pre-surgical risks factors, including cardiorespiratory function, frailty and cognitive function. Any exercise programme incorporated into the pre-operative pathway of care needs to be effective and time efficient in that any fitness gains are achievable in the limited period between the decision for surgery and operation (e.g. 4 weeks). Fortunately, there is a large volume of research describing effective and time-efficient exercise training programmes within the discipline of sports science. Accordingly, the objective of our commentary is to synthesise contemporary exercise training research, both from non-clinical and clinical populations, with the overarching aim of informing the development of effective and time-efficient pre-surgical exercise training programmes. The development of such exercise training programmes requires the careful consideration of several key principles, namely frequency, intensity, time, type and progression of exercise. Therefore, in light of more recent evidence demonstrating the effectiveness and time efficiency of high-intensity interval training-which involves brief bouts of intense exercise interspersed with longer recovery periods-the principles of exercise training programme design will be discussed mainly in the context of such high-intensity interval training programmes. Other issues pertinent to the development, implementation and evaluation of pre-operative exercise training programmes, such as individual exercise prescription, training session monitoring and potential

  20. A DEMONSTRATION OF A PRESURGICAL BEHAVIORAL MEDICINE EVALUATION FOR CATEGORIZING PATIENTS FOR IMPLANTABLE THERAPIES: A PRELIMINARY STUDY

    PubMed Central

    Schocket, Kimberly Gardner; Gatchel, Robert J.; Stowell, Anna Wright; Deschner, Martin; Robinson, Richard; Lou, Leland; Whitworth, Tony; Bernstein, Dana

    2010-01-01

    Objectives The aim of the current study was to evaluate the potential efficacy of a presurgical behavioral medicine evaluation (PBME) screening algorithm with patients undergoing evaluation for implantable pain management devices. Methods Sixty patients were evaluated for prognostic recommendations regarding outcomes from surgery for spinal cord stimulators and intrathecal pumps. Diagnostic interviews, review of medical charts, and psychosocial and functional measures were used in the initial evaluation. Results Patients were classified into one of four prognostic groups, from low to increasing risks: Green, Yellow-I, Yellow-II, and Red. The Green group showed the most positive biopsychosocial profile, while the Red groups showed the worst profiles. Conclusions This preliminary study suggests that the PBME algorithm may be an effective method for categorizing patients into prognostic groups. Psychological and adverse clinical features appear to have the most power in the classification of such patients. PMID:20657728

  1. The development of a common risk assessment methodology for local authorities in southeast Europe focusing on climate change related hazards - first results from the SEERISK project

    NASA Astrophysics Data System (ADS)

    Papathoma-Koehle, Maria; Promper, Catrin; Glade, Thomas

    2013-04-01

    Climate change is expected to influence the magnitude and frequency of a number of natural hazards in the future and hence, change the spatial patterns of risk and vulnerability. Local authorities, emergency planners and other decision makers are in need of tools that enable the assessment of the risks associated with the natural hazards. This research is embedded in the EU-funded SEERISK project ("Joint disaster management risk assessment and preparedness for the Danube macro-region"). The principle aim of this project is to improve coherence and consistency among risk assessments undertaken by the partner countries in national, regional and local level. The project focuses on bringing decision makers from southeast Europe together and it attempts the development of a common methodology for risk assessment of climate change related hazards that will be applied in various pilot areas in the partner countries (Hungary, Bulgaria, Slovakia, Bosnia Herzegovina and Romania). The common methodology takes into consideration the lack of data in most of the cases and it offers alternatives for the risk assessment but also for the data collection following future events. The common methodology is presented here in the form of methodological steps for four different natural hazards, namely, floods, droughts, heat waves and extreme wind. The proposed methodology is in line with the EC Guidelines for Risk assessment and mapping and will be implemented in the near future in respective regions.

  2. Activation of signaling pathways following localized delivery of systemically administered neurotrophic factors across the blood-brain barrier using focused ultrasound and microbubbles

    NASA Astrophysics Data System (ADS)

    Baseri, Babak; Choi, James J.; Deffieux, Thomas; Samiotaki, Gesthimani; Tung, Yao-Sheng; Olumolade, Oluyemi; Small, Scott A.; Morrison, Barclay, III; Konofagou, Elisa E.

    2012-04-01

    The brain-derived neurotrophic factor (BDNF) has been shown to have broad neuroprotective effects in addition to its therapeutic role in neurodegenerative disease. In this study, the efficacy of delivering exogenous BDNF to the left hippocampus is demonstrated in wild-type mice (n = 7) through the noninvasively disrupted blood-brain barrier (BBB) using focused ultrasound (FUS). The BDNF bioactivity was found to be preserved following delivery as assessed quantitatively by immunohistochemical detection of the pTrkB receptor and activated pAkt, pMAPK, and pCREB in the hippocampal neurons. It was therefore shown for the first time that systemically administered neurotrophic factors can cross the noninvasively disrupted BBB and trigger neuronal downstream signaling effects in a highly localized region in the brain. This is the first time that the administered molecule is tracked through the BBB and localized in the neuron triggering molecular effects. Additional preliminary findings are shown in wild-type mice with two additional neurotrophic factors such as the glia-derived neurotrophic factor (n = 12) and neurturin (n = 2). This further demonstrates the impact of FUS for the early treatment of CNS diseases at the cellular and molecular level and strengthens its premise for FUS-assisted drug delivery and efficacy.

  3. Local modifications of magnetism and structure in FePt (001) epitaxial thin films by focused ion beam: Two-dimensional perpendicular patterns

    SciTech Connect

    Albertini, F.; Nasi, L.; Casoli, F.; Fabbrici, S.; Valeri, S.; Contri, S. F.

    2008-09-01

    Focused ion beam was utilized to locally modify magnetism and structure of L1{sub 0} FePt perpendicular thin films. As a first step, we have performed a magnetic, morphological, and structural study of completely irradiated FePt films with different Ga{sup +} doses (1x10{sup 13} -4x10{sup 16} ions/cm{sup 2}) and ion beam energy of 30 keV. For doses of 1x10{sup 14} ions/cm{sup 2} and above a complete transition from the ordered L1{sub 0} to the disordered A1 phase was found to occur, resulting in a drop of magnetic anisotropy and in the consequent moment reorientation from out-of-plane to in-plane. The lowest effective dose in disordering the structure (1x10{sup 14} ions/cm{sup 2}) was found not to affect the film morphology. Taking advantage of these results, continuous two-dimensional (2D) patterns of perpendicular magnetic structures (250 nm dots, 1 {mu}m dots, 1 {mu}m-large stripes) were produced by focused ion beam without affecting the morphology. The 2D patterns were revealed by means of magnetic force microscopy, that evidenced peculiar domain structures in the case of 1 {mu}m dots.

  4. Transitioning from conventional radiotherapy to intensity-modulated radiotherapy for localized prostate cancer: changing focus from rectal bleeding to detailed quality of life analysis.

    PubMed

    Yamazaki, Hideya; Nakamura, Satoaki; Nishimura, Takuya; Yoshida, Ken; Yoshioka, Yasuo; Koizumi, Masahiko; Ogawa, Kazuhiko

    2014-11-01

    With the advent of modern radiation techniques, we have been able to deliver a higher prescribed radiotherapy dose for localized prostate cancer without severe adverse reactions. We reviewed and analyzed the change of toxicity profiles of external beam radiation therapy (EBRT) from the literature. Late rectal bleeding is the main adverse effect, and an incidence of >20% of Grade ≥2 adverse events was reported for 2D conventional radiotherapy of up to 70 Gy. 3D conformal radiation therapy (3D-CRT) was found to reduce the incidence to ∼10%. Furthermore, intensity-modulated radiation therapy (IMRT) reduced it further to a few percentage points. However, simultaneously, urological toxicities were enhanced by dose escalation using highly precise external radiotherapy. We should pay more attention to detailed quality of life (QOL) analysis, not only with respect to rectal bleeding but also other specific symptoms (such as urinary incontinence and impotence), for two reasons: (i) because of the increasing number of patients aged >80 years, and (ii) because of improved survival with elevated doses of radiotherapy and/or hormonal therapy; age is an important prognostic factor not only for prostate-specific antigen (PSA) control but also for adverse reactions. Those factors shift the main focus of treatment purpose from survival and avoidance of PSA failure to maintaining good QOL, particularly in older patients. In conclusion, the focus of toxicity analysis after radiotherapy for prostate cancer patients is changing from rectal bleeding to total elaborate quality of life assessment. PMID:25204643

  5. Localized delivery of doxorubicin in vivo from polymer-modified thermosensitive liposomes with MR-guided focused ultrasound-mediated heating

    PubMed Central

    Ta, Terence; Bartolak-Suki, Elizabeth; Park, Eun-Joo; Karrobi, Kavon M.; McDannold, Nathan J.; Porter, Tyrone M.

    2014-01-01

    Thermosensitive liposomes have emerged as a viable strategy for localized delivery and triggered release of chemotherapy. MR-guided focused ultrasound (MRgFUS) has the capability of heating tumors in a controlled manner, and when combined with thermosensitive liposomes can potentially reduce tumor burden in vivo. However, the impact of this drug delivery strategy has rarely been investigated. We have developed a unique liposome formulation modified with p(NIPAAm-co-PAA), a polymer that confers sensitivity to both temperature and pH. These polymer-modified thermosensitive liposomes (PTSL) demonstrated sensitivity to focused ultrasound, and required lower thermal doses and were more cytotoxic than traditional formulations in vitro. A set of acoustic parameters characterizing optimal release from PTSL in vitro was applied in the design of a combined MRgFUS/PTSL delivery platform. This platform more effectively reduced tumor burden in vivo when compared to free drug and traditional formulations. Histological analysis indicated greater tumor penetration, more extensive ECM remodeling, and greater cell destruction in tumors administered PTSL, correlating with improved response to the therapy. PMID:25151982

  6. Damage localization for multi-story buildings focusing on shift in the center of rigidity using an adaptive extended Kalman filter

    NASA Astrophysics Data System (ADS)

    Takeuchi, Tsubasa; Mita, Akira

    2015-04-01

    Recently damage detection methods based on measured vibration data for structural health monitoring (SHM) have been intensively studied. In order to decrease the number of required sensors, however, most of their methods focus only on single dimensional systems, in spite that there are some cases that torsional vibration greatly affect for structural damage. Although some studies consider multiple dimensional systems using frame structures, usually they need lots of sensors and calculation is time-consuming. Therefore, the balance between the cost and the particularity is very important for SHM system. In this paper, a method to localize the damaged area of multi-story buildings considering torsional components is proposed to detect the damage simply and particularly. This method focuses on shift in the center of rigidity caused by induced damage. The damaged quadrant of a certain story is identified comparing story eccentric distances of before and after damage-inducing seismic events. An adaptive extended Kalman filter (AEKF) is utilized to identify unknown structural parameters. Using a model which has four columns in each floor, several cases are considered in the verification study to disclose the capability of our proposed method.

  7. The Use of Susceptibility-Weighted Magnetic Resonance Imaging to Characterize the Safety Window of Focused Ultrasound Exposure for Localized Blood—Brain-Barrier Disruption

    NASA Astrophysics Data System (ADS)

    Liu, Hao-Li; Hsu, Po-Hong; Wai, Yau-Yau; Chen, Jin-Chung; Yen, Tzu-Chen; Wang, Jiun-Jie

    2009-04-01

    High-intensity focused ultrasound has been discovered to be able to locally and reversibly increase the permeability of the blood—brain barrier (BBB), which can be detected using magnetic resonance imaging (MRI). However, side effects such as microhemorrhage, erythrocyte extravasations, or even extensive hemorrhage can also occur. Although current contrast-enhanced T1-weighted MRI can be used to detect the changes in BBB permeability, its efficacy in detecting tissue hemorrhage after focused-ultrasound sonication remains limited. The purpose of this study was to determine the feasibility of using MR susceptibility-weighted imaging (SWI) to identify tissue hemorrhage associated with the process of BBB permeability increase and characterize the safety window of acoustic pressure level. Brains of 42 Sprague-Dawley rats were subjected to 107 sonications either unilaterally or bilaterally. Contrast-enhanced T1-weighted images, together with SWI were performed. Tissue damage and hemorrhage were analyzed histologically with light microscopy and staining by Evan's blue, HE staining as well as TUNEL staining. Our results showed that contrast-enhanced T1 weighted imaging is sensitive to the presence of the BBB disrupture, but was unable to differentiate from extensive tissue damage such as hemorrhage. Also, SWI proved to be a superior tool for the realtime monitoring of the presence of hemorrhage, which is essential to the clinical concerns. The safety operation window in vivo in our study indicated a pressure of 0.78 to 1.1 MPa. to increase the BBB permeability successfully without hemorrhage. Potential applications such as drug delivery in the brain might be benefited.

  8. Localized Down-regulation of P-glycoprotein by Focused Ultrasound and Microbubbles induced Blood-Brain Barrier Disruption in Rat Brain.

    PubMed

    Cho, HongSeok; Lee, Hwa-Youn; Han, Mun; Choi, Jong-Ryul; Ahn, Sanghyun; Lee, Taekwan; Chang, Yongmin; Park, Juyoung

    2016-01-01

    Multi-drug resistant efflux transporters found in Blood-Brain Barrier (BBB) acts as a functional barrier, by pumping out most of the drugs into the blood. Previous studies showed focused ultrasound (FUS) induced microbubble oscillation can disrupt the BBB by loosening the tight junctions in the brain endothelial cells; however, no study was performed to investigate its impact on the functional barrier of the BBB. In this study, the BBB in rat brains were disrupted using the MRI guided FUS and microbubbles. The immunofluorescence study evaluated the expression of the P-glycoprotein (P-gp), the most dominant multi-drug resistant protein found in the BBB. Intensity of the P-gp expression at the BBB disruption (BBBD) regions was significantly reduced (63.2 ± 18.4%) compared to the control area. The magnitude of the BBBD and the level of the P-gp down-regulation were significantly correlated. Both the immunofluorescence and histologic analysis at the BBBD regions revealed no apparent damage in the brain endothelial cells. The results demonstrate that the FUS and microbubbles can induce a localized down-regulation of P-gp expression in rat brain. The study suggests a clinically translation of this method to treat neural diseases through targeted delivery of the wide ranges of brain disorder related drugs. PMID:27510760

  9. Noninvasive localized delivery of Herceptin to the mouse brain by MRI-guided focused ultrasound-induced blood-brain barrier disruption

    NASA Astrophysics Data System (ADS)

    Kinoshita, Manabu; McDannold, Nathan; Jolesz, Ferenc A.; Hynynen, Kullervo

    2006-08-01

    Antibody-based anticancer agents are promising chemotherapeutic agents. Among these agents, Herceptin (trastuzumab), a humanized anti-human epidermal growth factor receptor 2 (HER2/c-erbB2) monoclonal antibody, has been used successfully in patients with breast cancer. However, in patients with brain metastasis, the blood-brain barrier limits its use, and a different delivery method is needed to treat these patients. Here, we report that Herceptin can be delivered locally and noninvasively into the mouse central nervous system through the blood-brain barrier under image guidance by using an MRI-guided focused ultrasound blood-brain barrier disruption technique. The amount of Herceptin delivered to the target tissue was correlated with the extent of the MRI-monitored barrier opening, making it possible to estimate indirectly the amount of Herceptin delivered. Histological changes attributable to this procedure were minimal. This method may represent a powerful technique for the delivery of macromolecular agents such as antibodies to treat patients with diseases of the central nervous system. brain tumor | microbubble

  10. Localized Down-regulation of P-glycoprotein by Focused Ultrasound and Microbubbles induced Blood-Brain Barrier Disruption in Rat Brain

    PubMed Central

    Cho, HongSeok; Lee, Hwa-Youn; Han, Mun; Choi, Jong-ryul; Ahn, Sanghyun; Lee, Taekwan; Chang, Yongmin; Park, Juyoung

    2016-01-01

    Multi-drug resistant efflux transporters found in Blood-Brain Barrier (BBB) acts as a functional barrier, by pumping out most of the drugs into the blood. Previous studies showed focused ultrasound (FUS) induced microbubble oscillation can disrupt the BBB by loosening the tight junctions in the brain endothelial cells; however, no study was performed to investigate its impact on the functional barrier of the BBB. In this study, the BBB in rat brains were disrupted using the MRI guided FUS and microbubbles. The immunofluorescence study evaluated the expression of the P-glycoprotein (P-gp), the most dominant multi-drug resistant protein found in the BBB. Intensity of the P-gp expression at the BBB disruption (BBBD) regions was significantly reduced (63.2 ± 18.4%) compared to the control area. The magnitude of the BBBD and the level of the P-gp down-regulation were significantly correlated. Both the immunofluorescence and histologic analysis at the BBBD regions revealed no apparent damage in the brain endothelial cells. The results demonstrate that the FUS and microbubbles can induce a localized down-regulation of P-gp expression in rat brain. The study suggests a clinically translation of this method to treat neural diseases through targeted delivery of the wide ranges of brain disorder related drugs. PMID:27510760

  11. The Relevance of Interictal Bold Changes to Lateralize Seizure Focus Using Simultaneous EEG-fMRI

    PubMed Central

    Mangalore, Sandhya; Bharath, Rose Dawn; Upadhyay, Neeraj; Chaitanya, Ganne; Panda, Rajanikanth; Gupta, AK; Chandra, P Satish; Rao, Malla Bhaskar; Mahadevan, Anita

    2015-01-01

    Background and Purpose: The main challenge in assessing patients with epilepsy is the localization of neuronal networks involved in seizure generation and the lateralization of seizure onset. Electro encephalogram-functional magnetic resonance imaging (EEG-fMRI) is a noninvasive multimodal imaging technique for epilepsies where the data is acquired based on the interictal epileptiform discharges (IED). Since this is a new technique, the specificity for lateralizing epileptic focus is yet to be established. The peak blood oxygen level dependent (BOLD) signal in an interictal recording is known to correlate with seizure onset focus. In this study we are proposing a simple and practical method without the need for high end post processing techniques of fmri data. The peak BOLD signal derived from EEG-fMRI aids to lateralise seizure focus in a given cerebral lobe (region of interest, ROI). This is a very useful tool in a clinical setting on a given individual clinical case, when other modalities may be conflicting or inconclusive. Methods: We analyzed simultaneous EEG-fMRI of 10 different types of refractory epilepsy. The lateralization index was calculated from the statistical significant clusters obtained between the different ROI and results were validated with other modalities. Results: Lateralization of seizure focus corroborated well in temporal and extratemporal lobe epilepsy, reflex epilepsy and lesional epilepsy. The only drawback of EEG-fMRI in our study was if insignificant BOLD changes were associated with the given IED. Conclusions: EEG-fMRI can be helpful additional tool in the pre-surgical work-up of refractory epilepsy particularly when lateralization with other modalities is conflicting or inconclusive. PMID:26819937

  12. High-intensity focused ultrasound (HIFU) using Sonablate{trade mark, serif} devices for the treatment of localized prostate cancer: 13-year experience

    NASA Astrophysics Data System (ADS)

    Uchida, Toyoaki; Tomonaga, Tetsuro; Shoji, Sunao; Kim, Hakushi; Nagata, Yoshihiro

    2012-11-01

    To report on the long-term results of high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. Eight hundred and eighty-four men with prostate cancer treated with Sonablate® (SB) devices were included. All patients were followed for more than 2 years. The patients were divided into three groups: in the first group, 419 patients were treated with SB200/500 from 1999 to 2006; in the second group, 263 patients were treated with SB 500 ver. 4 from 2005 to 2009: in the third group, 202 patients were treated with SB 500 TCM from 2007 up to present. Biochemical failure was defined according to the Phoenix definition (PSA nadir + 2 ng/ml). The mean age, PSA, Gleason score, operation time, and follow-up period in each group were 68, 66 and 67 years, 11.2, 9.7 and 9.3 ng/ml, 6.2, 6.6 and 6.7, 167, 101 and 106 min, and 56, 48 and 36 months, respectively. The biochemical disease-free rate (bDFR) in each group at 5 years was, respectively, 54%, 61% and 84%, and was 50% at 10 years in the SB200/500 group (p<0.0001). The bDFR in patients in the low-, intermediate-, and high-risk groups in all patients at 10 years were 72% and 58%, 44%, respectively (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the SB500 TCM group at 5 years were 97%, 83%, and 74% (p=0.0056). The negative prostate biopsy rates in 3 groups were 81%, 92% and 88%, respectively. As post HIFU complications, urethral stricture, acute epididymitis and urinary incontinence were noted in 18.0%, 6.2% and 1.9%, respectively. Rectourethral fistula was occurred in 0.6% in the first HIFU cases, Postoperative erectile dysfunction was noted in 27% of patients at 2 years after HIFU. HIFU therapy appears to be minimally invasive, efficacious, and safe for patients with localized prostate cancer. Technological advances as well as cultural and economic vectors have caused a shift from to minimally invasive techniques.

  13. Ten-year Biochemical Disease-free Survival After High-intensity Focused Ultrasound (HIFU) for Localized Prostate Cancer: Comparison with Four Different Generation Devices

    NASA Astrophysics Data System (ADS)

    Uchida, T.; Nakano, M.; Shoji, S.; Omata, T.; Harano, Y.; Nagata, Y.; Usui, Y.; Terachi, T.

    2010-03-01

    HIFU has been recognized as a minimally invasive treatment option for localized prostate cancer. The purpose of the study was to assess with a long-term outcome of HIFU for prostate cancer. From January 1999, a total of 657 patients who had HIFU with at least 2 year follow-up were treated with four different types of Sonablate® (Focus Surgery, Indianapolis, USA) devices. Thirty-three patients were treated with Sonablate® 200 (S200) from 1999 to 2001, 406 patients with Sonablate® 500 (S500) from 2001 to 2005, 200 patients with Sonablate® 500 version 4 (V4) from 2005-2008 and 19 patients with Sonablate® 500 TCM (TCM) from 2007. Biochemical disease-free survival rate (bDFS) in all patients was 59% in 8 years. bDFS in 8 years in patients with S200 and S500 groups were 55% and 56%, and bDFS in 4 and 2 years in patients with V4 and TCM group were 72% and 84%, respectively. bDFS in low, intermediate, and high risk groups were 75%, 54%, and 43% in S200/S500 and 93%, 72%, and 58% in V4/TCM group. Negative prostate biopsy rate after HIFU was 97% in S200, 79% in S500, 94% in V4 and 100% in TCM group. HIFU as primary therapy for prostate cancer is indicated in patients with low- and intermediate-risk (T1-T2b N0M0 disease, a Gleason score of ⩽7, a PSA level of <20 ng/mL) and a prostate volume of less than 40 mL. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

  14. Ten-year Biochemical Disease-free Survival After High-intensity Focused Ultrasound (HIFU) for Localized Prostate Cancer: Comparison with Four Different Generation Devices

    SciTech Connect

    Uchida, T.; Nakano, M.; Shoji, S.; Omata, T.; Harano, Y.; Nagata, Y.; Usui, Y.; Terachi, T.

    2010-03-09

    HIFU has been recognized as a minimally invasive treatment option for localized prostate cancer. The purpose of the study was to assess with a long-term outcome of HIFU for prostate cancer. From January 1999, a total of 657 patients who had HIFU with at least 2 year follow-up were treated with four different types of Sonablate registered (Focus Surgery, Indianapolis, USA) devices. Thirty-three patients were treated with Sonablate registered 200 (S200) from 1999 to 2001, 406 patients with Sonablate registered 500 (S500) from 2001 to 2005, 200 patients with Sonablate registered 500 version 4 (V4) from 2005-2008 and 19 patients with Sonablate registered 500 TCM (TCM) from 2007. Biochemical disease-free survival rate (bDFS) in all patients was 59% in 8 years. bDFS in 8 years in patients with S200 and S500 groups were 55% and 56%, and bDFS in 4 and 2 years in patients with V4 and TCM group were 72% and 84%, respectively. bDFS in low, intermediate, and high risk groups were 75%, 54%, and 43% in S200/S500 and 93%, 72%, and 58% in V4/TCM group. Negative prostate biopsy rate after HIFU was 97% in S200, 79% in S500, 94% in V4 and 100% in TCM group. HIFU as primary therapy for prostate cancer is indicated in patients with low- and intermediate-risk (T1-T2b N0M0 disease, a Gleason score of <=7, a PSA level of <20 ng/mL) and a prostate volume of less than 40 mL. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

  15. Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and Swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment.

    PubMed

    Rosenow, Felix; Bast, Thomas; Czech, Thomas; Feucht, Martha; Hans, Volkmar H; Helmstaedter, Christoph; Huppertz, Hans-Jürgen; Noachtar, Soheyl; Oltmanns, Frank; Polster, Tilman; Seeck, Margitta; Trinka, Eugen; Wagner, Kathrin; Strzelczyk, Adam

    2016-08-01

    The definition of minimal standards remains pivotal as a basis for a high standard of care and as a basis for staff allocation or reimbursement. Only limited publications are available regarding the required staffing or methodologic expertise in epilepsy centers. The executive board of the working group (WG) on presurgical epilepsy diagnosis and operative epilepsy treatment published the first guidelines in 2000 for Austria, Germany, and Switzerland. In 2014, revised guidelines were published and the WG decided to publish an unaltered English translation in this report. Because epilepsy surgery is an elective procedure, quality standards are particularly high. As detailed in the first edition of these guidelines, quality control relates to seven different domains: (1) establishing centers with a sufficient number of sufficiently and specifically trained personnel, (2) minimum technical standards and equipment, (3) continuous medical education of employees, (4) surveillance by trained personnel during video electroencephalography (EEG) monitoring (VEM), (5) systematic acquisition of clinical and outcome data, (6) the minimum number of preoperative evaluations and epilepsy surgery procedures, and (7) the cooperation of epilepsy centers. These standards required the certification of the different professions involved and minimum numbers of procedures. In the subsequent decade, quite a number of colleagues were certified by the trinational WG; therefore, the executive board of the WG decided in 2013 to make these standards obligatory. This revised version is particularly relevant given that the German procedure classification explicitly refers to the guidelines of the WG with regard to noninvasive/invasive preoperative video-EEG monitoring and invasive intraoperative diagnostics in epilepsy. PMID:27354263

  16. 11C-Methionine positron emission tomography-computed tomography in localization of methoxyisobutyl isonitrile negative ectopic parathyroid adenoma

    PubMed Central

    Seniaray, Nikhil; Sharma, Harshul; Arbind, Arpana; Jaimini, Abhinav; D’souza, Maria; Saw, Sanjeev; Hazari, Puja Panwar; Mishra, A. K.; Sharma, Rajnish; Mondal, Anupam

    2016-01-01

    Primary hyperparathyroidism is caused by parathyroid adenomas in 85% of the cases. Since parathyroid adenomas are known for their ectopic location, presurgical localization of the suspected site of adenoma is desirable. However, current imaging modalities are not always successful in localizing ectopic parathyroid adenomas. The aim of this case report is to show that 11C-methionine positron emission tomography could accurately localize ectopic parathyroid adenomas in patients in whom conventional imaging had failed or is inconclusive. PMID:26917896

  17. A Randomized, Placebo-Controlled, Phase II, Presurgical Biomarker Trial of Celecoxib Versus Exemestane in Postmenopausal Breast Cancer Patients.

    PubMed

    Aristarco, Valentina; Serrano, Davide; Gandini, Sara; Johansson, Harriet; Macis, Debora; Guerrieri-Gonzaga, Aliana; Lazzeroni, Matteo; Feroce, Irene; Pruneri, Giancarlo; Pagani, Gianmatteo; Toesca, Antonio; Caldarella, Pietro; DeCensi, Andrea; Bonanni, Bernardo

    2016-05-01

    In breast cancer presurgical trials, the Ki-67 labeling index predicts disease outcome and offers clues to the preventive potential of drugs. We conducted a placebo-controlled trial to evaluate the activity of exemestane and celecoxib before surgery. The main endpoint was the change in Ki-67. Secondary endpoints were the modulation of circulating biomarkers. Postmenopausal women with histologically confirmed estrogen receptor-positive breast cancer were randomly assigned to exemestane 25 mg/day (n = 50), or celecoxib 800 mg/day (n = 50), or placebo (n = 25) for 6 weeks before surgery. Changes in biomarkers were analyzed through an ANCOVA model adjusting for baseline values. Exemestane showed a median absolute 10% reduction in Ki-67 [from 22 (interquartile range, IQR, 16-27), to 8 (IQR 5-18)], and a 15% absolute reduction in PgR expression [from 50 (IQR 3-90) to 15 (IQR -0-30)] after 6 weeks of treatment. Exemestane significantly increased testosterone [median change 0.21 ng/mL, (IQR 0.12-0.35)], decreased SHBG [median change -14.6 nmol/L, (IQR -23.1 to -8.6)], decreased total and HDL cholesterol by -10 mg/dL (IQR -21-2) and -7 mg/dL, (IQR -14 to -2), respectively. Triglycerides were reduced by both agents [median change -0.5 mg/dL (IQR -17.5-13.5) and -8 mg/dL (IQR -28-9) for celecoxib and exemestane, respectively]. Exemestane showed a remarkable antiproliferative effect on breast cancer, whereas celecoxib did not affect breast cancer proliferation. Given the proven preventive efficacy of exemestane, these findings support the use of Ki-67 to explore the optimal exemestane dose and schedule in the prevention setting. Cancer Prev Res; 9(5); 349-56. ©2016 AACR. PMID:26928670

  18. Proteomics, and metabolomics: magnetic resonance spectroscopy for the presurgical screening of thyroid nodules.

    PubMed

    Minuto, Michele N; Shintu, Laetitia; Caldarelli, Stefano

    2014-06-01

    We review the progress and state-of-the-art applications of studies in Magnetic Resonance Spectroscopy (MRS) and Imaging as an aid for diagnosis of thyroid lesions of different nature, especially focusing our attention to those lesions that are cytologically undetermined. It appears that the high-resolution of High-Resolution Magic-Angle-Spinning (HRMAS) MRS improves the overall accuracy of the analysis of thyroid lesions to a point that a significant improvement in the diagnosis of cytologically undetermined lesions can be expected. This analysis, in the meantime, allows a more precise comprehension of the alterations in the metabolic pathways induced by the development of the different tumors. Although these results are promising, at the moment, a clinical application of the method to the common workup of thyroid nodules cannot be used, due to both the limitation in the availability of this technology and the wide range of techniques, that are not uniformly used. The coming future will certainly see a wider application of these methods to the clinical practice in patients affected with thyroid nodules and various other neoplastic diseases. PMID:24955025

  19. Interictal SPECT in the presurgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis.

    PubMed

    Marques, Lucia H N; Ferraz-Filho, José R L; Lins-Filho, Mário L M; Maciel, Marina G; Yoshitake, Rafael; Filetti, Sarah V

    2009-09-01

    The aim of this study was to evaluate the sensitivity of interictal compared to ictal SPECT in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (TLE) patients that present with normal magnetic resonance imaging (MRI) or bilateral mesial temporal sclerosis (MTS). Thirty patients with TLE, for whom MRI examinations were normal or who presented with bilateral MTS, were retrospectively studied. Using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal SPECTs. In conclusion the interictal SPECT is only useful when associated with the ictal SPECT and does not substitute it in the localization of epileptogenic areas in patients with normal MRI or bilateral MTS. PMID:19722041

  20. Collaboration of local government and experts responding to increase in environmental radiation level due to the nuclear disaster: focusing on their activities and latest radiological discussion.

    PubMed

    Iimoto, T; Nunokawa, J; Fujii, H; Takashima, R; Hashimoto, M; Fukuhara, T; Yajima, T; Matsuzawa, H; Kurosawa, K; Yanagawa, Y; Someya, S

    2015-11-01

    Activities were introduced in Kashiwa city in the Tokyo metropolitan area to correspond to the elevated environmental radiation level after the disaster of the Fukushima Daiichi nuclear power plant. These were based on a strong cooperation between local governments and experts. Ambient dose rate and radioactivity of foodstuff produced inside of the city have been monitored. Representative ambient dose rates around living environments have almost already become their original levels of the pre-accident because of the decontamination activity, natural washout and effective half-lives of radioactivity. The internal annual dose due to radioactive cesium under the policy of 'Local Production for Local Consumption' is estimated as extremely low comparing the variation range due to natural radioactivity. Systematic survey around a retention basin has been started. All of these latest monitoring data would be one of the core information for the policy making as well as a cost-benefit discussion and risk communication. PMID:25982790

  1. A novel model evaluation approach focusing on local and advected contributions to urban PM2.5 levels - application to Paris, France

    NASA Astrophysics Data System (ADS)

    Petetin, H.; Beekmann, M.; Sciare, J.; Bressi, M.; Rosso, A.; Sanchez, O.; Ghersi, V.

    2014-07-01

    Aerosol simulations in chemistry transport models (CTMs) still suffer from numerous uncertainties, and diagnostic evaluations are required to point out major error sources. This paper presents an original approach to evaluate CTMs based on local and imported contributions in a large megacity rather than urban background concentrations. The study is applied to the CHIMERE model in the Paris region (France) and considers the fine particulate matter (PM2.5) and its main chemical constituents (elemental and organic carbon, nitrate, sulfate and ammonium), for which daily measurements are available during a whole year at various stations (PARTICULES project). Back-trajectory data are used to locate the upwind station, from which the concentration is identified as the import, the local production being deduced from the urban concentration by subtraction. Uncertainties on these contributions are quantified. Small biases in urban background PM2.5 simulations (bias of +16%) hide significant error compensations between local and advected contributions, as well as in PM2.5 chemical compounds. In particular, winter time organic matter (OM) imports appear strongly underestimated while local OM and elemental carbon (EC) production is overestimated all along the year. Erroneous continental wood burning emissions and missing secondary organic aerosol (SOA) pathways may explain errors on advected OM, while the carbonaceous compounds is likely to be related to errors in emissions and dynamics. A statistically significant local formation of nitrate is also highlighted from observations, but missed by the model. Together with the overestimation of nitrate imports, it leads to a bias of +51% on the local PM2.5 contribution. Such an evaluation finally gives more detailed insights on major gaps in current CTMs on which future efforts are needed.

  2. Work First. How To Implement an Employment-Focused Approach to Welfare Reform. A How-to Guide. ReWORKing Welfare. Technical Assistance for States and Localities.

    ERIC Educational Resources Information Center

    Brown, Amy

    This guide, which is intended for planners, administrators, and staff involved in state and local welfare reform efforts, summarizes information about the "work first" approach to welfare reform that was gained from comprehensive evaluations of work first programs and discussions with program managers, practitioners, and participants. The…

  3. Nuclear localization of mouse Ku70 in interphase cells and focus formation of mouse Ku70 at DNA damage sites immediately after irradiation.

    PubMed

    Koike, Manabu; Yutoku, Yasutomo; Koike, Aki

    2015-09-01

    To elucidate the mechanisms of DNA repair pathway is critical for developing next-generation radiotherapies and chemotherapeutic drugs for cancer. Ionizing radiation and many chemotherapeutic drugs kill tumor cells mainly by inducing DNA double-strand breaks (DSBs). The classical nonhomologous DNA-end joining (NHEJ) (C-NHEJ) pathway repairs a predominant fraction of DSBs in mammalian cells. The C-NHEJ pathway appears to start with the binding of Ku (heterodimer of Ku70 and Ku80) to DNA break ends. Therefore, recruitment of Ku to DSB sites might play a critical role in regulating NHEJ activity. Indeed, human Ku70 and Ku80 localize in the nuclei and accumulate at microirradiated DSB sites. However, the localization and regulation mechanisms of Ku70 and Ku80 homologues in animal models, such as mice and other species, have not been elucidated in detail, particularly in cells immediately after microirradiation. Here, we show that EYFP-tagged mouse Ku70 localizes in the interphase nuclei of mouse fibroblasts and epithelial cells. Furthermore, our findings indicate that EYFP-mouse Ku70 accumulates with its heterodimeric partner Ku80 immediately at laser-microirradiated DSB sites. We also confirmed that the structure of Ku70 nuclear localization signal (NLS) is highly conserved among various rodent species, such as the mouse, rat, degu and ground squirrel, supporting the idea that NLS is important for the regulation of rodent Ku70 function. Collectively, these results suggest that the mechanisms of regulating the localization and accumulation of Ku70 at DSBs might be well conserved between the mouse and human species. PMID:25947323

  4. Clinical management of critically ill patients with Cushing's disease due to ACTH-secreting pituitary macroadenomas: effectiveness of presurgical treatment with pasireotide.

    PubMed

    Cannavo, S; Messina, E; Albani, A; Ferrau, F; Barresi, V; Priola, S; Esposito, F; Angileri, F

    2016-06-01

    The management of critically ill Cushing's disease (CD) patients is extremely challenging. Pasireotide is indicated for the treatment of CD patients when pituitary surgery is unfeasible or has not been curative, but no data are available about the use of this drug as pre-operative treatment in critically ill patients. We report the effects of presurgical pasireotide therapy in CD patients in whom hypercortisolism caused life-threatening hypokalemia, alkalosis, and cardio-respiratory complications precluding surgical approach. Clinical, biochemical, and radiological data of two critically ill patients with ACTH-secreting pituitary macroadenoma, before and during first-line presurgical pasireotide treatment (600 μg s.c. bid). During the first 21 days of treatment, pasireotide therapy induced a rapid, partial decrease of plasma ACTH, serum cortisol, and urinary free cortisol levels, with the consequent normalization of serum potassium concentration and arterial blood gases parameters, in both the patients. They did not experience unmanageable side effects and underwent endoscopic transsphenoidal surgery after 4 weeks of effective treatment. Pre-operative MRI evaluation did not show pituitary tumor shrinkage. Surgical cure of CD was obtained in the first patient, while debulking allowed the pharmacological control of hypercortisolism in the second case. We suggest that pasireotide can induce a rapid improvement of clinical and metabolic conditions in critically ill CD patients in whom surgical approach is considered hazardous and need to be delayed. PMID:25877016

  5. Dynamic changes in subcellular localization of cattle XLF during cell cycle, and focus formation of cattle XLF at DNA damage sites immediately after irradiation

    PubMed Central

    KOIKE, Manabu; YUTOKU, Yasutomo; KOIKE, Aki

    2015-01-01

    Clinically, many chemotherapeutics and ionizing radiation (IR) have been applied for the treatment of various types of human and animal malignancies. These treatments kill tumor cells by causing DNA double-strand breaks (DSBs). Core factors of classical nonhomologous DNA-end joining (C-NHEJ) play a vital role in DSB repair. Thus, it is indispensable to clarify the mechanisms of C-NHEJ in order to develop next-generation chemotherapeutics for cancer. The XRCC4-like factor (XLF; also called Cernunnos or NHEJ1) is the lastly identified core NHEJ factor. The localization of core NHEJ factors might play a critical role in regulating NHEJ activity. The localization and function of XLF have not been elucidated in animal species other than mice and humans. Domestic cattle (Bos taurus) are the most common and vital domestic animals in many countries. Here, we show that the localization of cattle XLF changes dynamically during the cell cycle. Furthermore, EYFP-cattle XLF accumulates quickly at microirradiated sites and colocalizes with the DSB marker γH2AX. Moreover, nuclear localization and accumulation of cattle XLF at DSB sites are dependent on 12 amino acids (288–299) of the C-terminal region of XLF (XLF CTR). Furthermore, basic amino acids on the XLF CTR are highly conserved among domestic animals including cattle, goat and horses, suggesting that the CTR is essential for the function of XLF in domestic animals. These findings might be useful to develop the molecular-targeting therapeutic drug taking XLF as a target molecule for human and domestic animals. PMID:25947322

  6. Dynamic changes in subcellular localization of cattle XLF during cell cycle, and focus formation of cattle XLF at DNA damage sites immediately after irradiation.

    PubMed

    Koike, Manabu; Yutoku, Yasutomo; Koike, Aki

    2015-09-01

    Clinically, many chemotherapeutics and ionizing radiation (IR) have been applied for the treatment of various types of human and animal malignancies. These treatments kill tumor cells by causing DNA double-strand breaks (DSBs). Core factors of classical nonhomologous DNA-end joining (C-NHEJ) play a vital role in DSB repair. Thus, it is indispensable to clarify the mechanisms of C-NHEJ in order to develop next-generation chemotherapeutics for cancer. The XRCC4-like factor (XLF; also called Cernunnos or NHEJ1) is the lastly identified core NHEJ factor. The localization of core NHEJ factors might play a critical role in regulating NHEJ activity. The localization and function of XLF have not been elucidated in animal species other than mice and humans. Domestic cattle (Bos taurus) are the most common and vital domestic animals in many countries. Here, we show that the localization of cattle XLF changes dynamically during the cell cycle. Furthermore, EYFP-cattle XLF accumulates quickly at microirradiated sites and colocalizes with the DSB marker γH2AX. Moreover, nuclear localization and accumulation of cattle XLF at DSB sites are dependent on 12 amino acids (288-299) of the C-terminal region of XLF (XLF CTR). Furthermore, basic amino acids on the XLF CTR are highly conserved among domestic animals including cattle, goat and horses, suggesting that the CTR is essential for the function of XLF in domestic animals. These findings might be useful to develop the molecular-targeting therapeutic drug taking XLF as a target molecule for human and domestic animals. PMID:25947322

  7. Cross-correlation focus method with an electrostatic sensor array for local particle velocity measurement in dilute gas-solid two-phase flow

    NASA Astrophysics Data System (ADS)

    Wang, Chao; Zhang, Jingyu; Gao, Wenbin; Ding, Hongbing; Wu, Weiping

    2015-11-01

    The gas-solid two-phase flow has been widely applied in the power, chemical and metallurgical industries. It is of great significance in the research of gas-solid two-phase flow to measure particle velocity at different locations in the pipeline. Thus, an electrostatic sensor array comprising eight arc-shaped electrodes was designed. The relationship between the cross-correlation (CC) velocity and the distribution of particle velocity, charge density and electrode spatial sensitivity was analysed. Then the CC sensitivity and its calculation method were proposed. According to the distribution of CC sensitivity, it was found that, between different electrode pairs, it had different focus areas. The CC focus method was proposed for particle velocity measurement at different locations and validated by a belt-style electrostatic induction experiment facility. Finally, the particle velocities at different locations with different flow conditions were measured to research the particle velocity distribution in a dilute horizontal pneumatic conveying pipeline.

  8. Abundance and parity rate of Lutzomyia cruciata (Diptera:Psychodidae) in an endemic focus of localized cutaneous leishmaniasis in southern Mexico.

    PubMed

    Rebollar-Tellez, E A; Reyes-Villanueva, F; Fernandez-Salas, I; Andrade-Narvaez, F J

    1996-07-01

    Human bait catches were carried out from 5 through 27 March 1994 in an endemic focus of cutaneous leishmaniasis in the state of Campeche, Mexico. Females of Lutzomyia cruciata (Coquillet) were dissected and 67% were parous. The number of total and parous females collected per day was analyzed by time series, but neither the gonotrophic cycle length nor survivorship could be estimated. However, a survival rate per oviposition cycle of 0.68 was estimated from the least square regression of parous on total females. Additional evidence for L. cruciata as a vector of human leishmaniasis is discussed. PMID:8699467

  9. Ictal fear auras after selective amygdalohippocampectomy: the use of ictal SPECT and scalp EEG in the presurgical reevaluation.

    PubMed

    Urbanic, Purkart Tadeja; Zaar, Karla; Eder, Hans; Gruber-Cichocky, Lucia; Feichtinger, Michael

    2011-11-01

    The perception of fear aura in complex partial seizures is linked to epileptic discharges within mesial temporal lobe structures. Although selective amygdalohippocampectomy often leads to favorable seizure control, persistence of fear auras after surgery can hamper quality of life significantly. We describe two patients with persistent fear auras after selective amygdalohippocampectomy who had to be reevaluated for a second operative procedure. In one patient, ictal SPECT revealed focal hyperperfusion within the left temporal pole. In the other patient, localization of the focus was possible with ictal scalp EEG, which revealed closely time-related focal theta activity in the right frontotemporal electrodes. Both patients underwent a second surgery leading to complete remission. The persistence of fear auras after selective amygdalohippocampectomy provides an example of involvement of a complex neuronal network in the generation of this emotional state during mesiotemporal lobe seizures. Ictal SPECT or ictal scalp EEG may be valuable in identifying the involved areas and in guiding the surgeon to render these patients seizure free. PMID:21890418

  10. Focused ion beam and electron microscopy characterization of nanosharp tips and microbumps on silicon and metal thin films formed via localized single-pulse laser irradiation

    SciTech Connect

    Moening, Joseph P.; Georgiev, Daniel G.; Lawrence, Joseph G.

    2011-01-01

    Cross-sections of laser fabricated nanosharp tips and microbumps on silicon and metal thin films are produced and examined in this work. These structures are formed with a Q-switched neodymium doped yttrium aluminum garnet nanosecond-pulse laser, emitting at its fourth harmonic of 266 nm, using a mask projection technique to generate circular laser spots, several microns in diameter. Cross-section of selected structures were produced using a focused ion beam and were characterized via electron microscopy. The diffraction patterns of the silicon samples indicate that the laser formed tip maintains the same single crystal structure as the original silicon film. Examinations of the laser formed structures in metal films confirm that the microbumps are hollow, while revealing that the vertical protrusions are solid.

  11. Local control of magnetic damping in ferromagnetic/non-magnetic bilayers by interfacial intermixing induced by focused ion-beam irradiation

    SciTech Connect

    King, J. A.; Burn, D. M.; Sallabank, E. A.; Hindmarch, A. T.; Atkinson, D. E-mail: abarman@bose.res.in; Ganguly, A.; Pal, S.; Barman, A. E-mail: abarman@bose.res.in; Hase, T. P. A.

    2014-06-16

    The influence of interfacial intermixing on the picosecond magnetization dynamics of ferromagnetic/non-magnetic thin-film bilayers was studied. Low-dose focused-ion-beam irradiation was used to induce intermixing across the interface between a 10 nm Ni{sub 81}Fe{sub 19} layer and a 2–3 nm capping layer of either Au or Cr. Time-resolved magneto-optical Kerr effect was used to study magnetization dynamics as a function of ion-beam dose. With an Au cap, the damping of the un-irradiated bilayer was comparable with native Ni{sub 81}Fe{sub 19} and increased with increasing ion dose. In contrast, for Ni{sub 81}Fe{sub 19}/Cr the damping was higher than that for native Ni{sub 81}Fe{sub 19}, but the damping decreased with increasing dose.

  12. Ion focusing

    SciTech Connect

    Cooks, Robert Graham; Baird, Zane; Peng, Wen-Ping

    2015-11-10

    The invention generally relates to apparatuses for focusing ions at or above ambient pressure and methods of use thereof. In certain embodiments, the invention provides an apparatus for focusing ions that includes an electrode having a cavity, at least one inlet within the electrode configured to operatively couple with an ionization source, such that discharge generated by the ionization source is injected into the cavity of the electrode, and an outlet. The cavity in the electrode is shaped such that upon application of voltage to the electrode, ions within the cavity are focused and directed to the outlet, which is positioned such that a proximal end of the outlet receives the focused ions and a distal end of the outlet is open to ambient pressure.

  13. Perception of local inhabitants regarding the socioeconomic impact of tourism focused on provisioning wild dolphins in Novo Airão, Central Amazon, Brazil.

    PubMed

    Alves, Luiz C P S; Zappes, Camilah A; Oliveira, Rafael G; Andriolo, Artur; Azevedo, Alexandre de F

    2013-01-01

    Botos (Inia geoffrensis) are currently provisioned for use in tourist attractions in five sites in the Brazilian Amazon. Despite the known negative effects associated with human-wild dolphin interactions, this activity has been regulated and licensed in the Anavilhanas National Park in Novo Airão, Amazonas State, Brazil. We present an updated evaluation of the perception of the local community concerning the possible socioeconomic impacts of this tourism in Novo Airão. In April 2011, 45 interviews were conducted with inhabitants. A small segment of Novo Airão perceives currently itself as being economically dependent on the botos feeding tourism. Despite that, the economic benefits of this controversial activity apparently are not shared among most inhabitants, and botos feeding tourism is perceived as generating diverse negative effects. We conclude that if the activity was banned or modified into a less impacting tourist activity, this action would probably not majorly affect the lives of the general population. PMID:24346803

  14. Modulation of the interstitial fluid pressure by high intensity focused ultrasound as a way to alter local fluid and solute movement: insights from a mathematical model.

    PubMed

    Sassaroli, E; O'Neill, B E

    2014-11-21

    High intensity focused ultrasound (HIFU) operated in thermal mode has been reported to reduce interstitial fluid pressure and improve the penetration of large macromolecules and nanoparticles in tumor and normal tissue. Little is understood about how the interstitial fluid pressure and velocity as well as the interstitial macromolecule transport are affected by HIFU exposure. A mathematical model is presented here which sheds light on the initial biophysical changes brought about HIFU. Our continuum model treats tissue as an effective poro-elastic material that reacts to elevated temperatures with a rapid drop in interstitial elastic modulus. Using parameters from the literature, the model is extrapolated to derive information on the effect in tumors, and to predict its impact on the convective and diffusive transport of macromolecular drugs. The model is first solved using an analytical approximation with step-wise changes at each boundary, and then solved numerically starting from a Gaussian beam approximation of the ultrasound treatment. Our results indicate that HIFU causes a rapid drop in interstitial fluid pressure that may be exploited to facilitate convection of macromolecules from vasculature to the exposed region. However, following a short recovery period in which the interstitial fluid pressure is normalized, transport returns to normal and the advantages disappear over time. The results indicate that this effect is strongest for the delivery of large molecules and nanoparticles that are in the circulation at the time of treatment. The model may be easily applied to more complex situations involving effects on vascular permeability and diffusion. PMID:25327766

  15. Modulation of the interstitial fluid pressure by high intensity focused ultrasound as a way to alter local fluid and solute movement: insights from a mathematical model

    NASA Astrophysics Data System (ADS)

    Sassaroli, E.; O'Neill, B. E.

    2014-11-01

    High intensity focused ultrasound (HIFU) operated in thermal mode has been reported to reduce interstitial fluid pressure and improve the penetration of large macromolecules and nanoparticles in tumor and normal tissue. Little is understood about how the interstitial fluid pressure and velocity as well as the interstitial macromolecule transport are affected by HIFU exposure. A mathematical model is presented here which sheds light on the initial biophysical changes brought about HIFU. Our continuum model treats tissue as an effective poro-elastic material that reacts to elevated temperatures with a rapid drop in interstitial elastic modulus. Using parameters from the literature, the model is extrapolated to derive information on the effect in tumors, and to predict its impact on the convective and diffusive transport of macromolecular drugs. The model is first solved using an analytical approximation with step-wise changes at each boundary, and then solved numerically starting from a Gaussian beam approximation of the ultrasound treatment. Our results indicate that HIFU causes a rapid drop in interstitial fluid pressure that may be exploited to facilitate convection of macromolecules from vasculature to the exposed region. However, following a short recovery period in which the interstitial fluid pressure is normalized, transport returns to normal and the advantages disappear over time. The results indicate that this effect is strongest for the delivery of large molecules and nanoparticles that are in the circulation at the time of treatment. The model may be easily applied to more complex situations involving effects on vascular permeability and diffusion.

  16. Modulation of the interstitial fluid pressure by high intensity focused ultrasound as a way to alter local fluid and solute movement: insights from a mathematical model

    PubMed Central

    Sassaroli, E; O’Neill, B E

    2014-01-01

    High intensity focused ultrasound (HIFU) operated in thermal mode has been reported to reduce interstitial fluid pressure and improve the penetration of large macromolecules and nanoparticles in tumor and normal tissue. Little is understood about how the interstitial fluid pressure and velocity as well as the interstitial macromolecule transport are affected by HIFU exposure. A mathematical model is presented here which sheds light on the initial biophysical changes brought about HIFU. Our continuum model treats tissue as an effective poro-elastic material that reacts to elevated temperatures with a rapid drop in interstitial elastic modulus. Using parameters from the literature, the model is extrapolated to derive information on the effect in tumors, and to predict its impact on the convective and diffusive transport of macromolecular drugs. The model is first solved using an analytical approximation with step-wise changes at each boundary, and then solved numerically starting from a Gaussian beam approximation of the ultrasound treatment. Our results indicate that HIFU causes rapid drop in interstitial fluid pressure that may be exploited to facilitate convection of macromolecules from vasculature to the exposed region. However, following a short recovery period in which the interstitial fluid pressure is normalized, transport returns to normal and the advantages disappear over time. The results indicate that this effect is strongest for the delivery of large molecules and nanoparticles that are in the circulation at the time of treatment. The model may be easily applied to more complex situations involving effects on vascular permeability and diffusion. PMID:25327766

  17. An Evaluation of Hemi-Ablation Therapy Using High-Intensity Focused Ultrasound in the Treatment of Localized Adenocarcinoma of the Prostate

    NASA Astrophysics Data System (ADS)

    Ahmed, Hashim Uddin; Freeman, Alex; Allen, Clare; Kirkham, Alex; Illing, Rowland; Emberton, Mark

    2007-05-01

    The current choice for men with localised prostate cancer lies between active surveillance and radical therapy. The best evidence for the difference between these two extremes of care is 5% in terms of cancer-related absolute mortality at 8 years. It is generally accepted that this small difference will decrease for men diagnosed in the PSA-era. Therein lays a dilemma for men. If they choose active surveillance they accept anxiety of living with a cancer diagnosis and risk of under-treatment in the long term. On the other hand, radical therapy carries significant toxicity (incontinence, impotence, rectal problems) because it treats the whole gland and damages surrounding structures in up to half of men. With increasing PSA screening practices men are diagnosed younger with lower risk disease — early stage, lower Gleason grade and lower volume of cancer. Many have unifocal or unilateral disease. We propose a new concept whereby only the tumour focus and a margin of normal tissue is treated. With emerging techniques that can accurately localise tumour in the gland and technology that can treat to within millimetre accuracy, focal therapy of prostate cancer is now possible. By treating focally, the psychological burden of active surveillance is avoided. Equally, it is proposed that toxicity will decrease whilst at the same time retaining effective cancer control.

  18. Youth Violence: Developing Local and State Solutions. Hearings before the Subcommittee on Youth Violence of the Committee on the Judiciary. United States Senate, One Hundred Fourth Congress, Second Session on Focusing on Youth Violence and Developing Local and State Solutions (Memphis and Nashville, TN, February 15 and 16, 1996).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

    This hearing focused on youth violence and the importance of developing local and state solutions. Senator Fred Thompson made an introductory statement. This was followed by four panels on each of 2 days of testimony. Day one's first panel included involved students and business people from Memphis, TN. The second panel included two Tennessee…

  19. High Avidity CD8+ T Cells Efficiently Eliminate Motile HIV-Infected Targets and Execute a Locally Focused Program of Anti-Viral Function

    PubMed Central

    Foley, Maria Hottelet; Forcier, Talitha; McAndrew, Elizabeth; Gonzalez, Michael; Chen, Huabiao; Juelg, Boris; Walker, Bruce D.; Irvine, Darrell J.

    2014-01-01

    stationary secretory phase to control local viral infection. PMID:24551068

  20. Tsunami focusing

    NASA Astrophysics Data System (ADS)

    Spillane, M. C.; Titov, V. V.; Moore, C. W.; Aydin, B.; Kanoglu, U.; Synolakis, C. E.

    2010-12-01

    Tsunamis are long waves generated by impulsive disturbances of the seafloor or coastal topography caused by earthquakes, submarine/subaerial mass failures. They evolve substantially through three dimensional - 2 spatial+1 temporal - spreading as the initial surface deformation propagates. This is referred to as its directivity and focusing. A directivity function was first defined by Ben-Menahem (1961, Bull. Seismol. Soc. Am. 51, 401-435) using the source length and the rupture velocity. Okal (2003, Pure Appl. Geophys. 160, 2189-2221) discussed the details of the analysis of Ben-Menahem (1961) and demonstrated the distinct difference between the directivity patterns of landslide and earthquake generated tsunamis. Marchuk and Titov (1989, Proc. IUGG/IOC International Tsunami Symposium, July 31 - August 3, 1989, Novosibirsk, USSR. p.11-17) described the process of tsunami focusing for a rectangular initial deformation combining positive and negative surface displacements. They showed the existence of a focusing point where abnormal tsunami wave height can be registered. Here, first, we describe and quantify numerically tsunami focusing processes for a combined positive and negative - N-wave type - strip source representing the 17 July 1998 Papua New Guinea and 17 July 2006 Java events. Specifically, considering field observations and tsunami focusing, we propose a source mechanism for the 17 July 2006 Java event. Then, we introduce a new analytical solution for a strip source propagating over a flat bottom using the linear shallow-water wave equation. The analytical solution of Carrier and Yeh (2005, Computer Modeling In Engineering & Sciences, 10(2), 113-121) appears to have two drawbacks. One, the solution involves singular complete elliptic integral of the first kind which results in a self-similar approximate solution for the far-field at large times. Two, only the propagation of Gaussian shaped finite-crest wave profiles can be modeled. Our solution is not only

  1. Measures against increased environmental radiation dose by the TEPCO Fukushima Dai-ichi NPP accident in some local governments in the Tokyo metropolitan area: focusing on examples of both Kashiwa and Nagareyama cities in Chiba prefecture.

    PubMed

    Iimoto, T; Fujii, H; Oda, S; Nakamura, T; Hayashi, R; Kuroda, R; Furusawa, M; Umekage, T; Ohkubo, Y

    2012-11-01

    The accident of the Fukushima Dai-ichi nuclear power plant of Tokyo Electric Power Cooperation (TEPCO) after the great east Japan earthquake (11 March 2011) elevated the background level of environmental radiation in Eastern Japan. Around the Tokyo metropolitan area, especially around Kashiwa and Nagareyama cities, the ambient dose equivalent rate has been significantly increased after the accident. Responding to strong requests from citizens, the local governments started to monitor the ambient dose equivalent rate precisely and officially, about 3 months after the accident had occurred. The two cities in cooperation with each other also organised a local forum supported by three radiation specialists. In this article, the activities of the local governments are introduced, with main focus on radiation monitoring and measurements. Topics are standardisation of environmental radiation measurements for ambient dose rate, dose mapping activity, investigation of foodstuff and drinking water, lending survey meters to citizens, etc. Based on the data and facts mainly gained by radiation monitoring, risk management and relating activity have been organised. 'Small consultation meetings in kindergartens', 'health consultation service for citizens', 'education meeting on radiation protection for teachers, medical staffs, local government staffs, and leaders of active volunteer parties' and 'decontamination activity', etc. are present key activities of the risk management and restoration around the Tokyo metropolitan area. PMID:22927655

  2. Electrophoretic Focusing

    NASA Technical Reports Server (NTRS)

    Snyder, Robert S.

    2001-01-01

    Electrophoretic focusing is a new method of continuous flow electrophoresis that introduces precision flow control to achieve high resolution separations. The electric field is applied perpendicular to an incoming sample lamina and buffer but also perpendicular to the broad faces of the thin rectangular chamber. A uniform fluid cross-flow then enters and exits the separation chamber through the same broad faces which are porous. A balance is achieved by adjusting either the electric field or the cross-flow so the desired sample fraction with its specific migration velocity encounters an opposing flow of the same velocity. Applying an electric field transverse to the incoming sample lamina and opposing this field with a carefully configured buffer flow, a sample constituent can be selected and focused into a narrow stream for subsequent analysis. Monotonically changing either electric field or buffer cross-flow will yield a scan of all constituents of the sample. Stopping the scan increases the collection time for minor constituents to improve their analysis. Using the high voltage gradients and/or cross-flow to rapidly deflect extraneous sample through the porous screens and into either of the side (purge) chambers, the selected sample is focused in the center plane of the separation chamber and collected without contact or interaction with the separation chamber walls. Results will be presented on the separation of a range of materials including dyes, proteins, and monodisperse polystyrene latexes. Sources of sample dispersion inherent in other electrokinetic techniques will be shown to be negligible for a variety of sample concentrations, buffer properties and operating conditions.

  3. A systematic review of functional magnetic resonance imaging and diffusion tensor imaging modalities used in presurgical planning of brain tumour resection.

    PubMed

    Dimou, S; Battisti, R A; Hermens, D F; Lagopoulos, J

    2013-04-01

    Historically, brain tumour resection has relied upon standardised anatomical atlases and classical mapping techniques for successful resection. While these have provided adequate results in the past, the emergence of new technologies has heralded a wave of less invasive, patient-specific techniques for the mapping of brain function. Functional magnetic resonance imaging (fMRI) and, more recently, diffusion tensor imaging (DTI) are two such techniques. While fMRI is able to highlight localisation of function within the cortex, DTI represents the only technique able to elucidate white matter structures in vivo. Used in conjunction, both of these techniques provide important presurgical information for thorough preoperative planning, as well as intraoperatively via integration into frameless stereotactic neuronavigational systems. Together, these techniques show great promise for improved neurosurgical outcomes. While further research is required for more widespread clinical validity and acceptance, results from the literature provide a clear road map for future research and development to cement these techniques into the clinical setup of neurosurgical departments globally. PMID:23187966

  4. Three-dimensional printed prototypes refine the anatomy of post-modified Norwood-1 complex aortic arch obstruction and allow presurgical simulation of the repair.

    PubMed

    Kiraly, Laszlo; Tofeig, Magdi; Jha, Neerod Kumar; Talo, Haitham

    2016-02-01

    Three-dimensional (3D) printed prototypes of malformed hearts have been used for education, communication, presurgical planning and simulation. We present a case of a 5-month old infant with complex obstruction at the neoaortic to transverse arch and descending aortic junction following the neonatal modified Norwood-1 procedure for hypoplastic left heart syndrome. Digital 3D models were created from a routine 64-slice CT dataset; then life-size solid and magnified hollow models were printed with a 3D printer. The solid model provided further insights into details of the anatomy, whereas the surgical approach and steps of the operation were simulated on the hollow model. Intraoperative assessment confirmed the anatomical accuracy of the 3D models. The operation was performed in accordance with preoperative simulation: sliding autologous flaps achieved relief of the obstruction without additional patching. Knowledge gained from the models fundamentally contributed to successful outcome and improved patient safety. This case study presents an effective use of 3D models in exploring complex spatial relationship at the aortic arch and in simulation-based planning of the operative procedure. PMID:26590304

  5. Comparison of Cone Beam Computed Tomography, Orthopantomography with Direct Ridge Mapping for Pre-Surgical Planning to Place Implants in Cadaveric Mandibles: An Ex-Vivo Study

    PubMed Central

    Amarnath, G S; Kumar, Ullash; Hilal, Mohammed; Muddugangadhar, B C; Anshuraj, Kopal; Shruthi, C S

    2015-01-01

    Background: Implant treatment is today a common and most widely accepted prosthetic therapy worldwide. The quality and quantity of the bone available at the anticipated implant site is of prime importance. Accurate measurement of alveolar bone and adjacent anatomic structures are of paramount importance in implant insertion. Proper pre-surgical assessment requires precise radiographic visualization of anatomic structures and pathologic conditions. However, the concern for radiation exposure has also grown. Materials and Methods: A total of 15 partially or completely edentulous human cadaveric mandibles were used which were further subdivided into three further groups for cone-beam computed tomography (CBCT), orthopantomography (OPG), and direct measurements (DM). Mandibles were prepared for each sample and subjected to radiographs according to the respective techniques, and radiographic measurements were done using the appropriate software. The cadaveric mandibles were then sectioned, and the actual measurements were done using a digital vernier caliper. Results: Analysis of variance test revealed that there was no significant difference among the three different measurements techniques. Conclusion: A sizable portion of the CBCT measurements with respect to width showed slight overestimation when compared to DMs. There were no statistically significant differences found between CBCT, OPG, and DM when height was taken into consideration. PMID:26225103

  6. Motion tracking to enable pre-surgical margin mapping in basal cell carcinoma using optical imaging modalities: initial feasibility study using optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Duffy, M.; Richardson, T. J.; Craythorne, E.; Mallipeddi, R.; Coleman, A. J.

    2014-02-01

    A system has been developed to assess the feasibility of using motion tracking to enable pre-surgical margin mapping of basal cell carcinoma (BCC) in the clinic using optical coherence tomography (OCT). This system consists of a commercial OCT imaging system (the VivoSight 1500, MDL Ltd., Orpington, UK), which has been adapted to incorporate a webcam and a single-sensor electromagnetic positional tracking module (the Flock of Birds, Ascension Technology Corp, Vermont, USA). A supporting software interface has also been developed which allows positional data to be captured and projected onto a 2D dermoscopic image in real-time. Initial results using a stationary test phantom are encouraging, with maximum errors in the projected map in the order of 1-2mm. Initial clinical results were poor due to motion artefact, despite attempts to stabilise the patient. However, the authors present several suggested modifications that are expected to reduce the effects of motion artefact and improve the overall accuracy and clinical usability of the system.

  7. Fast presurgical magnetic resonance imaging of meniscal tears and concurrent subchondral bone marrow lesions. Study of dogs with naturally occurring cranial cruciate ligament rupture.

    PubMed

    Olive, J; d'Anjou, M-A; Cabassu, J; Chailleux, N; Blond, L

    2014-01-01

    Meniscal tears and subchondral bone marrow lesions have both been described in dogs with cranial cruciate ligament rupture, but their possible concurrence has not been evaluated. In a population of 14 dogs exhibiting signs of stifle pain with surgically confirmed cranial cruciate ligament rupture, a short presurgical 1.5T magnetic resonance (MR) imaging protocol including dorsal proton density, dorsal T1-weighted gradient recalled echo, and sagittal fat-saturated dual echo sequences was tested to further investigate these features and illustrate meniscal tears. Interobserver agreement for detection of medial meniscal tears (k=0.83) and bone marrow lesions (k=0.87) was excellent. Consensus MR reading allowed detection of nine out of 12 surgically confirmed medial meniscal tears and there was no false positive. All dogs had cruciate ligament enthesis-related bone marrow lesions in the tibia, femur or both bones. Additionally, among the 12 dogs with confirmed medial meniscal tears, subchondral bone marrow lesions were present in the caudomedial (9 dogs) and caudoaxial (11 dogs) regions of the tibial plateau, resulting in odds ratios (13.6, p=0.12, and 38.3, p=0.04, respectively) that had large confidence intervals due to the small group size of this study. The other two dogs had neither tibial bone marrow lesions in these locations nor medial meniscal tears. These encouraging preliminary results warrant further investigation using this clinically realistic preoperative MR protocol. As direct diagnosis of meniscal tears remained challenging in dogs even with high-field MR, identification of associated signs such as subchondral bone marrow lesions might indirectly allow suspicion of an otherwise unrecognized meniscal tear. PMID:24226972

  8. Quantum focusing conjecture

    NASA Astrophysics Data System (ADS)

    Bousso, Raphael; Fisher, Zachary; Leichenauer, Stefan; Wall, Aron C.

    2016-03-01

    We propose a universal inequality that unifies the Bousso bound with the classical focusing theorem. Given a surface σ that need not lie on a horizon, we define a finite generalized entropy Sgen as the area of σ in Planck units, plus the von Neumann entropy of its exterior. Given a null congruence N orthogonal to σ , the rate of change of Sgen per unit area defines a quantum expansion. We conjecture that the quantum expansion cannot increase along N . This extends the notion of universal focusing to cases where quantum matter may violate the null energy condition. Integrating the conjecture yields a precise version of the Strominger-Thompson quantum Bousso bound. Applied to locally parallel light-rays, the conjecture implies a novel inequality, the quantum null energy condition, a lower bound on the stress tensor in terms of the second derivative of the von Neumann entropy. We sketch a proof of the latter relation in quantum field theory.

  9. Extensive lesions in the gustatory cortex in the rat do not disrupt the retention of a presurgically conditioned taste aversion and do not impair unconditioned concentration-dependent licking of sucrose and quinine.

    PubMed

    Hashimoto, Koji; Spector, Alan C

    2014-01-01

    Although damage to gustatory cortex (GC) in the rat has been reported to severely impair, if not eliminate, retention of a presurgically conditioned taste aversion (CTA), it has equivocal effects on taste preference as measured by intake tests. Because intake tests can be influenced by nongustatory (e.g., postingestive) factors, we employed the brief-access taste test to assess the effects of ibotenic acid-induced lesions targeting the GC on unconditioned licking to a sucrose and then a quinine concentration series in a specialized lickometer. As a functional lesion assessment, a presurgical CTA to 0.1M NaCl was established in thirsty rats by following 15-min intake with intraperitoneal administration of either LiCl (or NaCl for control) on 2 occasions. Both conditioned sham-operated (SHAM) rats and rats with histologically confirmed extensive damage to the GC (GCX) avoided a NaCl concentration series relative to unconditioned controls in a postsurgical brief-access CTA test, with no difference between the surgical groups in their responses to NaCl or similar concentrations of KCl. GCX rats also did not differ from SHAM rats in the EC50 of concentration-response functions for sucrose or quinine. Clearly, the critical cortical area required for the retention of a presurgical CTA falls outside of the extensive area of damage, which was well centered within the conventionally defined gustatory zone of the insular cortex. The absence of an effect on unconditioned responsiveness to sucrose and quinine suggests that the damaged region is also unnecessary for the normal expression of affective licking responses to tastants. PMID:24226296

  10. Mesial temporal lobe morphology in intractable pediatric epilepsy: so-called hippocampal malrotation, associated findings, and relevance to presurgical assessment.

    PubMed

    Leach, James L; Awwad, Reem; Greiner, Hansel M; Vannest, Jennifer J; Miles, Lili; Mangano, Francesco T

    2016-06-01

    .33); however, this was not significant when hippocampal sclerosis cases were excluded. HIMAL findings were more prevalent and MTL scores were higher in patients with resections involving the temporal lobes. On group analysis, HIMAL findings did not predict eventual surgical side and did not predict outcome, although the numbers are small. In 4 patients the abnormally rotated hippocampus was resected and showed hippocampal sclerosis and/or dysplastic changes on histopathology. All of these patients had a good outcome after surgery. CONCLUSIONS While increased in prevalence in children with intractable epilepsy, imaging findings of HIMAL did not have preoperative lateralizing utility in this group. Findings of HIMAL (including round hippocampus, architectural blurring, and vertical collateral sulcus) did not predict outcome after surgery, although the small number of patients with these findings limits evaluation. In the small number of patients in which the malrotated hippocampus was removed, outcome was good. Further research is needed to continue to define this association in children with intractable epilepsy, focusing on a temporal lobe cohort. PMID:26870898

  11. Subsurface contaminants focus area

    SciTech Connect

    1996-08-01

    The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites.

  12. EEG-fMRI correlation patterns in the presurgical evaluation of focal epilepsy: a comparison with electrocorticographic data and surgical outcome measures.

    PubMed

    van Houdt, Petra J; de Munck, Jan C; Leijten, Frans S S; Huiskamp, Geertjan J M; Colon, Albert J; Boon, Paul A J M; Ossenblok, Pauly P W

    2013-07-15

    EEG-correlated functional MRI (EEG-fMRI) visualizes brain regions associated with interictal epileptiform discharges (IEDs). This technique images the epileptiform network, including multifocal, superficial and deeply situated cortical areas. To understand the role of EEG-fMRI in presurgical evaluation, its results should be validated relative to a gold standard. For that purpose, EEG-fMRI data were acquired for a heterogeneous group of surgical candidates (n=16) who were later implanted with subdural grids and strips (ECoG). The EEG-fMRI correlation patterns were systematically compared with brain areas involved in IEDs ECoG, using a semi-automatic analysis method, as well as to the seizure onset zone, resected area, and degree of seizure freedom. In each patient at least one of the EEG-fMRI areas was concordant with an interictally active ECoG area, always including the early onset area of IEDs in the ECoG data. This confirms that EEG-fMRI reflects a pattern of onset and propagation of epileptic activity. At group level, 76% of the BOLD regions that were covered with subdural grids, were concordant with interictally active ECoG electrodes. Due to limited spatial sampling, 51% of the BOLD regions were not covered with electrodes and could, therefore, not be validated. From an ECoG perspective it appeared that 29% of the interictally active ECoG regions were missed by EEG-fMRI and that 68% of the brain regions were correctly identified as inactive with EEG-fMRI. Furthermore, EEG-fMRI areas included the complete seizure onset zone in 83% and resected area in 93% of the data sets. No clear distinction was found between patients with a good or poor surgical outcome: in both patient groups, EEG-fMRI correlation patterns were found that were either focal or widespread. In conclusion, by comparison of EEG-fMRI with interictal invasive EEG over a relatively large patient population we were able to show that the EEG-fMRI correlation patterns are spatially accurate at the

  13. EDITORIAL: Focus on Plasmonics FOCUS ON PLASMONICS

    NASA Astrophysics Data System (ADS)

    Bozhevolnyi, Sergey; García-Vidal, Francisco

    2008-10-01

    Plasmonics is an emerging field in optics dealing with the so-called surface plasmons whose extraordinary properties are being both analyzed from a fundamental point of view and exploited for numerous technological applications. Surface plasmons associated with surface electron density oscillations decorating metal-dielectric interfaces were discovered by Rufus Ritchie in the 1950s. Since the seventies, the subwavelength confinement of electromagnetic fields as well as their enhancement inherent to the surface plasmon excitation has been widely used for spectroscopic purposes. Recent advances in nano-fabrication, characterization and modelling techniques have allowed unique properties of these surface electromagnetic modes to be explored with respect to subwavelength field localization and waveguiding, opening the path to truly nanoscale plasmonic optical devices. This area of investigation also has interesting links with research on photonic band gap materials and the field of optical metamaterials. Nowadays, plasmonics can be seen as a mature interdisciplinary area of research in which scientists coming from different backgrounds (chemistry, physics, optics and engineering) strive to discover and exploit new and exciting phenomena associated with surface plasmons. The already made and forthcoming discoveries will have impacts in many fields of science and technology, including not only photonics and materials science but also computation, biology and medicine, among others. This focus issue of New Journal of Physics is intended to cover all the aforementioned capabilities of surface plasmons by presenting a current overview of state-of-the-art advances achieved by the leading groups in this field of research. The below list of articles represents the first contributions to the collection and further additions will appear soon. Focus on Plasmonics Contents Nanoantenna array-induced fluorescence enhancement and reduced lifetimes Reuben M Bakker, Vladimir P Drachev

  14. "Only" and Focus.

    ERIC Educational Resources Information Center

    Vallduvi, Enric

    The relationship of the word "only," one of a class of words known as scalar particles, focus adverbs, focus inducers, or focus-sensitive particles, with the "focus" of the sentence is examined. It is suggested, based on analysis of discourse structure, that this "association with focus" is not an inherent property of this scalar particle. The…

  15. Quantitative comparisons on hand motor functional areas determined by resting state and task BOLD fMRI and anatomical MRI for pre-surgical planning of patients with brain tumors

    PubMed Central

    Hou, Bob L.; Bhatia, Sanjay; Carpenter, Jeffrey S.

    2016-01-01

    For pre-surgical planning we present quantitative comparison of the location of the hand motor functional area determined by right hand finger tapping BOLD fMRI, resting state BOLD fMRI, and anatomically using high resolution T1 weighted images. Data were obtained on 10 healthy subjects and 25 patients with left sided brain tumors. Our results show that there are important differences in the locations (i.e., > 20 mm) of the determined hand motor voxels by these three MR imaging methods. This can have significant effect on the pre-surgical planning of these patients depending on the modality used. In 13 of the 25 cases (i.e., 52%) the distances between the task-determined and the rs-fMRI determined hand areas were more than 20 mm; in 13 of 25 cases (i.e., 52%) the distances between the task-determined and anatomically determined hand areas were > 20 mm; and in 16 of 25 cases (i.e., 64%) the distances between the rs-fMRI determined and anatomically determined hand areas were more than 20 mm. In just three cases, the distances determined by all three modalities were within 20 mm of each other. The differences in the location or fingerprint of the hand motor areas, as determined by these three MR methods result from the different underlying mechanisms of these three modalities and possibly the effects of tumors on these modalities. PMID:27069871

  16. Focused Ultrasound and Lithotripsy.

    PubMed

    Ikeda, Teiichiro; Yoshizawa, Shin; Koizumi, Norihiro; Mitsuishi, Mamoru; Matsumoto, Yoichiro

    2016-01-01

    Shock wave lithotripsy has generally been a first choice for kidney stone removal. The shock wave lithotripter uses an order of microsecond pulse durations and up to a 100 MPa pressure spike triggered at approximately 0.5-2 Hz to fragment kidney stones through mechanical mechanisms. One important mechanism is cavitation. We proposed an alternative type of lithotripsy method that maximizes cavitation activity to disintegrate kidney stones using high-intensity focused ultrasound (HIFU). Here we outline the method according to the previously published literature (Matsumoto et al., Dynamics of bubble cloud in focused ultrasound. Proceedings of the second international symposium on therapeutic ultrasound, pp 290-299, 2002; Ikeda et al., Ultrasound Med Biol 32:1383-1397, 2006; Yoshizawa et al., Med Biol Eng Comput 47:851-860, 2009; Koizumi et al., A control framework for the non-invasive ultrasound the ragnostic system. Proceedings of 2009 IEEE/RSJ International Conference on Intelligent Robotics and Systems (IROS), pp 4511-4516, 2009; Koizumi et al., IEEE Trans Robot 25:522-538, 2009). Cavitation activity is highly unpredictable; thus, a precise control system is needed. The proposed method comprises three steps of control in kidney stone treatment. The first step is control of localized high pressure fluctuation on the stone. The second step is monitoring of cavitation activity and giving feedback on the optimized ultrasound conditions. The third step is stone tracking and precise ultrasound focusing on the stone. For the high pressure control we designed a two-frequency wave (cavitation control (C-C) waveform); a high frequency ultrasound pulse (1-4 MHz) to create a cavitation cloud, and a low frequency trailing pulse (0.5 MHz) following the high frequency pulse to force the cloud into collapse. High speed photography showed cavitation collapse on a kidney stone and shock wave emission from the cloud. We also conducted in-vitro erosion tests of model and natural

  17. Particle Swarm Optimization Applied to EEG Source Localization of Somatosensory Evoked Potentials.

    PubMed

    Shirvany, Yazdan; Mahmood, Qaiser; Edelvik, Fredrik; Jakobsson, Stefan; Hedstrom, Anders; Persson, Mikael

    2014-01-01

    One of the most important steps in presurgical diagnosis of medically intractable epilepsy is to find the precise location of the epileptogenic foci. Electroencephalography (EEG) is a noninvasive tool commonly used at epilepsy surgery centers for presurgical diagnosis. In this paper, a modified particle swarm optimization (MPSO) method is used to solve the EEG source localization problem. The method is applied to noninvasive EEG recording of somatosensory evoked potentials (SEPs) for a healthy subject. A 1 mm hexahedra finite element volume conductor model of the subject's head was generated using T1-weighted magnetic resonance imaging data. Special consideration was made to accurately model the skull and cerebrospinal fluid. An exhaustive search pattern and the MPSO method were then applied to the peak of the averaged SEP data and both identified the same region of the somatosensory cortex as the location of the SEP source. A clinical expert independently identified the expected source location, further corroborating the source analysis methods. The MPSO converged to the global minima with significantly lower computational complexity compared to the exhaustive search method that required almost 3700 times more evaluations. PMID:24122569

  18. EDITORIAL: Focus on Graphene

    NASA Astrophysics Data System (ADS)

    Peres, N. M. R.; Ribeiro, Ricardo M.

    2009-09-01

    Graphene physics is currently one of the most active research areas in condensed matter physics. Countless theoretical and experimental studies have already been performed, targeting electronic, magnetic, thermal, optical, structural and vibrational properties. Also, studies that modify pristine graphene, aiming at finding new physics and possible new applications, have been considered. These include patterning nanoribbons and quantum dots, exposing graphene's surface to different chemical species, studying multilayer systems, and inducing strain and curvature (modifying in this way graphene's electronic properties). This focus issue includes many of the latest developments on graphene research. Focus on Graphene Contents Electronic properties of graphene and graphene nanoribbons with 'pseudo-Rashba' spin-orbit coupling Tobias Stauber and John Schliemann Strained graphene: tight-binding and density functional calculations R M Ribeiro, Vitor M Pereira, N M R Peres, P R Briddon and A H Castro Neto The effect of sublattice symmetry breaking on the electronic properties of doped graphene A Qaiumzadeh and R Asgari Interfaces within graphene nanoribbons J Wurm, M Wimmer, I Adagideli, K Richter and H U Baranger Weak localization and transport gap in graphene antidot lattices J Eroms and D Weiss Electronic properties of graphene antidot lattices J A Fürst, J G Pedersen, C Flindt, N A Mortensen, M Brandbyge, T G Pedersen and A-P Jauho Splitting of critical energies in the n=0 Landau level of graphene Ana L C Pereira Double-gated graphene-based devices S Russo, M F Craciun, M Yamamoto, S Tarucha and A F Morpurgo Pinning and switching of magnetic moments in bilayer graphene Eduardo V Castro, M P López-Sancho and M A H Vozmediano Electronic transport properties of graphene nanoribbons Katsunori Wakabayashi, Yositake Takane, Masayuki Yamamoto and Manfred Sigrist Many-body effects on out-of-plane phonons in graphene J González and E Perfetto Graphene zigzag ribbons, square

  19. Focus Curriculum Manual; A Focus Dissemination Project.

    ERIC Educational Resources Information Center

    Human Resource Associates, Inc., Hastings, Minn.

    This training manual is for use in preparing staff members to use the Focus Model, which is a "school within a school" for disaffected high school students. The material is designed to be used as a resource aid following participation in an in-service workshop. Information is presented to help implement a contracting system to establish and…

  20. Prostate Focused Ultrasound Therapy.

    PubMed

    Chapelon, Jean-Yves; Rouvière, Olivier; Crouzet, Sébastien; Gelet, Albert

    2016-01-01

    The tremendous progress in engineering and computing power coupled with ultrasound transducer technology and imaging modalities over the past 20 years have encouraged a revival of clinical interest in ultrasound therapy, mainly in High-Intensity Focused Ultrasound (HIFU). So far, the most extensive results from HIFU obtained in urology involve transrectal prostate ablation, which appears to be an effective therapeutic alternative for patients with malignant prostate tumors. Prostate cancer (PCa) is one of the most frequently diagnosed cancers in men. Several treatment options with different therapeutic approaches exist, including HIFU for localized PCa that has been in use for over 15 years. Since the early 2000s, two systems have been marketed for this application, and other devices are currently in clinical trials. HIFU treatment can be used either alone or in combination with (before- or after-) external beam radiotherapy (EBRT) (before or after HIFU) and can be repeated multiple times. HIFU treatment is performed under real-time monitoring with ultrasound or guided by MRI. Two indications are validated today: Primary care treatment and EBRT failure. The results of HIFU for primary care treatment are similar to standard conformal EBRT, even though no randomized comparative studies have been performed and no 10-year follow up data is yet available for HIFU. Salvage HIFU after EBRT failure is increasing with oncological outcomes, similar to those achieved with surgery but with the advantage of fewer adverse effects. HIFU is an evolving technology perfectly adapted for focal treatment. Thus, HIFU focal therapy is another pathway that must be explored when considering the accuracy and reliability for PCa mapping techniques. HIFU would be particularly suited for such a therapy since it is clear that HIFU outcomes and toxicity are relative to the volume of prostate treated. PMID:26486330

  1. Focus screen optimization.

    PubMed

    Plummer, W T

    1975-11-01

    Ground glass used for camera focus screens often has far from optimum diffusion properties. An analysis of the function of the focus screen shows that a screen with random (Gaussian) diffusion properties can be constructed with both brightness and focus efficiencies above 84%. These considerations have led to the design of an unusually bright and effective focus screen for the Polaroid SX-70 Land camera. PMID:20155099

  2. Focus Intonation in Bengali

    ERIC Educational Resources Information Center

    Hasan, Md. Kamrul

    2015-01-01

    This work attempts to investigate the role of prosody in the syntax of focus in Bangla. The aim of this study is to show the intonation pattern of Bangla in emphasis and focus. In order to do that, the author has looked at the pattern of focus without-i/o as well as with the same. Do they really pose any different focus intonation pattern from…

  3. Alternating phase focused linacs

    DOEpatents

    Swenson, Donald A.

    1980-01-01

    A heavy particle linear accelerator employing rf fields for transverse and ongitudinal focusing as well as acceleration. Drift tube length and gap positions in a standing wave drift tube loaded structure are arranged so that particles are subject to acceleration and succession of focusing and defocusing forces which contain the beam without additional magnetic or electric focusing fields.

  4. Tsunami Amplification due to Focusing

    NASA Astrophysics Data System (ADS)

    Moore, C. W.; Kanoglu, U.; Titov, V. V.; Aydin, B.; Spillane, M. C.; Synolakis, C. E.

    2012-12-01

    Tsunami runup measurements over the periphery of the Pacific Ocean after the devastating Great Japan tsunami of 11 March 2011 showed considerable variation in far-field and near-field impact. This variation of tsunami impact have been attributed to either directivity of the source or by local topographic effects. Directivity arguments alone, however, cannot explain the complexity of the radiated patterns in oceans with trenches and seamounts. Berry (2007, Proc. R. Soc. Lond. A 463, 3055-3071) discovered how such underwater features may concentrate tsunamis into cusped caustics and thus cause large local amplifications at specific focal points. Here, we examine focusing and local amplification, not by considering the effects of underwater diffractive lenses, but by considering the details of the dipole nature of the initial profile, and propose that certain regions of coastline are more at-risk, not simply because of directivity but because typical tsunami deformations create focal regions where abnormal tsunami wave height can be registered (Marchuk and Titov, 1989, Proc. IUGG/IOC International Tsunami Symposium, Novosibirsk, USSR). In this work, we present a new general analytical solution of the linear shallow-water wave equation for the propagation of a finite-crest-length source over a constant depth without any restriction on the initial profile. Unlike the analytical solution of Carrier and Yeh (2005, Comp. Mod. Eng. & Sci. 10(2), 113-121) which was restricted to initial conditions with Gaussian profiles and involved approximation, our solution is not only exact, but also general and allows the use of realistic initial waveform such as N-waves as defined by Tadepalli and Synolakis (1994, Proc. R. Soc. Lond. A 445, 99-112). We then verify our analytical solution for several typical wave profiles, both with the NOAA tsunami forecast model MOST (Titov and Synolakis, 1998, J. Waterw. Port Coast. Ocean Eng. 124(4), 157-171) which is validated and verified through

  5. Recognizing focus in noise filled sentences

    NASA Astrophysics Data System (ADS)

    Xu, Ching X.; Xu, Yi

    2003-04-01

    This study is designed to help identify the intrinsic constituents of focus. Twelve four-word Mandarin sentences were recorded by a native speaker five times, each time either with focus on one of the words, or without any focus. Then, one, two or three words in each sentence produced by the speaker were replaced by pink noise. The noise-filled sentences were presented to subjects along with the text. The subjects' task was to determine if the sentence had a focus, and if yes, on which word. Ten native Mandarin speakers participated as subjects. Their performance was compared across noise replacement conditions. It was found that, when both on-focus and post-focus words were present, focus could be recognized consistently. When only the focused word was present, focus could be recognized fairly well unless the focus position was sentence final, in which case it was not very distinct from no focus. When post-focus word(s) was(were) left intact while focused words were replaced by noise, focus could still be detected successfully, but its exact localization was sometimes judged wrong. These results seem to support the dual-component hypothesis about focus. Further implications of the findings will be discussed.

  6. Localization of Interictal Epileptiform Activity Using Magnetoencephalography with Synthetic Aperture Magnetometry in Patients with a Vagus Nerve Stimulator

    PubMed Central

    Stapleton-Kotloski, Jennifer R.; Kotloski, Robert J.; Boggs, Jane A.; Popli, Gautam; O’Donovan, Cormac A.; Couture, Daniel E.; Cornell, Cassandra; Godwin, Dwayne W.

    2014-01-01

    Magnetoencephalography (MEG) provides useful and non-redundant information in the evaluation of patients with epilepsy, and in particular, during the pre-surgical evaluation of pharmaco-resistant epilepsy. Vagus nerve stimulation (VNS) is a common treatment for pharmaco-resistant epilepsy. However, interpretation of MEG recordings from patients with a VNS is challenging due to the severe magnetic artifacts produced by the VNS. We used synthetic aperture magnetometry (g2) [SAM(g2)], an adaptive beamformer that maps the excessive kurtosis, to map interictal spikes to the coregistered MRI image, despite the presence of contaminating VNS artifact. We present a series of eight patients with a VNS who underwent MEG recording. Localization of interictal epileptiform activity by SAM(g2) is compared to invasive electrophysiologic monitoring and other localizing approaches. While the raw MEG recordings were uninterpretable, analysis of the recordings with SAM(g2) identified foci of peak kurtosis and source signal activity that was unaffected by the VNS artifact. SAM(g2) analysis of MEG recordings in patients with a VNS produces interpretable results and expands the use of MEG for the pre-surgical evaluation of epilepsy. PMID:25505894

  7. Focusing the surgical microscope.

    PubMed

    Socea, Sergiu D; Barak, Yoreh; Blumenthal, Eytan Z

    2015-01-01

    A well-focused operating microscope addresses several needs that are all secondary to the surgeon's need to see clearly at all times. These needs include: the assistant; the sharpness of the video and monitor; as well as field of view, asthenopia, and focusing issues related to zoom, accommodation, and presbyopia. We provide a practical approach to achieve optimal focus that we call the sloping paper calibration method. PMID:25891029

  8. FOCUS: Sustainable Mathematics Successes

    ERIC Educational Resources Information Center

    Mireles, Selina V.; Acee, Taylor W.; Gerber, Lindsey N.

    2014-01-01

    The FOCUS (Fundamentals of Conceptual Understanding and Success) Co-Requisite Model Intervention (FOCUS Intervention) for College Algebra was developed as part of the Developmental Education Demonstration Projects (DEDP) in Texas. The program was designed to use multiple services, courses, and best practices to support student completion of a…

  9. Microfabricated particle focusing device

    DOEpatents

    Ravula, Surendra K.; Arrington, Christian L.; Sigman, Jennifer K.; Branch, Darren W.; Brener, Igal; Clem, Paul G.; James, Conrad D.; Hill, Martyn; Boltryk, Rosemary June

    2013-04-23

    A microfabricated particle focusing device comprises an acoustic portion to preconcentrate particles over large spatial dimensions into particle streams and a dielectrophoretic portion for finer particle focusing into single-file columns. The device can be used for high throughput assays for which it is necessary to isolate and investigate small bundles of particles and single particles.

  10. Focus: Teaching by Genre.

    ERIC Educational Resources Information Center

    Wimer, Frances N., Ed.

    1974-01-01

    The focus of this bulletin is teaching the various literary genres in the secondary English class. Contents include "The Song Within: An Approach to Teaching Poetry,""Teaching Folk-Rock,""Approaches to Teaching Poetry,""Focus on an Elective Program: Twentieth Century Lyrical Poetry,""Hoffman and Poe: Masters of the Grotesque,""Plays: Shared and…

  11. Presurgical evaluation for partial epilepsy: Relative contributions of chronic depth-electrode recordings versus FDG-PET and scalp-sphenoidal ictal EEG

    SciTech Connect

    Engel, J. Jr.; Henry, T.R.; Risinger, M.W.; Mazziotta, J.C.; Sutherling, W.W.; Levesque, M.F.; Phelps, M.E.

    1990-11-01

    One hundred fifty-three patients with medically refractory partial epilepsy underwent chronic stereotactic depth-electrode EEG (SEEG) evaluations after being studied by positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) and scalp-sphenoidal EEG telemetry. We carried out retrospective standardized reviews of local cerebral metabolism and scalp-sphenoidal ictal onsets to determine when SEEG recordings revealed additional useful information. FDG-PET localization was misleading in only 3 patients with temporal lobe SEEG ictal onsets for whom extratemporal or contralateral hypometabolism could be attributed to obvious nonepileptic structural defects. Two patients with predominantly temporal hypometabolism may have had frontal epileptogenic regions, but ultimate localization remains uncertain. Scalp-sphenoidal ictal onsets were misleading in 5 patients. For 37 patients with congruent focal scalp-sphenoidal ictal onsets and temporal hypometabolic zones, SEEG recordings never demonstrated extratemporal or contralateral epileptogenic regions; however, 3 of these patients had nondiagnostic SEEG evaluations. The results of subsequent subdural grid recordings indicated that at least 1 of these patients may have been denied beneficial surgery as a result of an equivocal SEEG evaluation. Weighing risks and benefits, it is concluded that anterior temporal lobectomy is justified without chronic intracranial recording when specific criteria for focal scalp-sphenoidal ictal EEG onsets are met, localized hypometabolism predominantly involves the same temporal lobe, and no other conflicting information has been obtained from additional tests of focal functional deficit, structural imaging, or seizure semiology.

  12. Absorption driven focus shift

    NASA Astrophysics Data System (ADS)

    Harrop, N.; Wolf, S.; Maerten, O.; Dudek, K.; Ballach, S.; Kramer, R.

    2016-03-01

    Modern high brilliance near infrared lasers have seen a tremendous growth in applications throughout the world. Increased productivity has been achieved by higher laser power and increased brilliance of lasers. Positive impacts on the performance and costs of parts are opposed to threats on process stability and quality, namely shift of focus position over time. A high initial process quality will be reduced by contamination of optics, eventually leading to a focus shift or even destruction of the optics. Focus analysis at full power of multi-kilowatt high brilliance lasers is a very demanding task because of high power densities in the spot and the high power load on optical elements. With the newly developed high power projection optics, the High-Power Micro-Spot Monitor High Brilliance (HP-MSM-HB) is able to measure focus diameter as low as 20 μm at power levels up to 10 kW at very low internal focus shift. A main driving factor behind thermally induced focus shift is the absorption level of the optical element. A newly developed measuring system is designed to determine the relative absorption level in reference to a gold standard. Test results presented show a direct correlation between absorption levels and focus shift. The ability to determine the absorption level of optical elements as well as their performance at full processing power before they are put to use, enables a high level of quality assurance for optics manufacturers and processing head manufacturers alike.

  13. Flat focusing mirror.

    PubMed

    Cheng, Y C; Kicas, S; Trull, J; Peckus, M; Cojocaru, C; Vilaseca, R; Drazdys, R; Staliunas, K

    2014-01-01

    The control of spatial propagation properties of narrow light beams such as divergence, focusing or imaging are main objectives in optics and photonics. In this letter, we propose and demonstrate experimentally a flat focusing mirror, based on an especially designed dielectric structure without any optical axis. More generally, it also enables imaging any light pattern in reflection. The flat focusing mirror with a transversal invariance can largely increase the applicability of structured photonic materials for light beam propagation control in small-dimension photonic circuits. PMID:25228358

  14. Flat Focusing Mirror

    PubMed Central

    Cheng, Y. C.; Kicas, S.; Trull, J.; Peckus, M.; Cojocaru, C.; Vilaseca, R.; Drazdys, R.; Staliunas, K.

    2014-01-01

    The control of spatial propagation properties of narrow light beams such as divergence, focusing or imaging are main objectives in optics and photonics. In this letter, we propose and demonstrate experimentally a flat focusing mirror, based on an especially designed dielectric structure without any optical axis. More generally, it also enables imaging any light pattern in reflection. The flat focusing mirror with a transversal invariance can largely increase the applicability of structured photonic materials for light beam propagation control in small-dimension photonic circuits. PMID:25228358

  15. Final focus test beam

    SciTech Connect

    Not Available

    1991-03-01

    This report discusses the following: the Final Focus Test Beam Project; optical design; magnets; instrumentation; magnetic measurement and BPM calibration; mechanical alignment and stabilization; vacuum system; power supplies; control system; radiation shielding and personnel protection; infrastructure; and administration.

  16. Focusing corner cube

    DOEpatents

    Monjes, J.A.

    1985-09-12

    This invention retortreflects and focuses a beam of light. The invention comprises a modified corner cube reflector wherein one reflective surface is planar, a second reflective surface is spherical, and the third reflective surface may be planar or convex cylindrical.

  17. Facility Focus: Food Service.

    ERIC Educational Resources Information Center

    College Planning & Management, 2002

    2002-01-01

    Describes the Hawthorn Court Community Center at Iowa State University, Ames, and the HUB-Robeson Center at Pennsylvania State University. Focuses on the food service offered in these new student-life buildings. Includes photographs. (EV)

  18. Inertial Focusing in Microfluidics

    PubMed Central

    Martel, Joseph M.; Toner, Mehmet

    2015-01-01

    When Segré and Silberberg in 1961 witnessed particles in a laminar pipe flow congregating at an annulus in the pipe, scientists were perplexed and spent decades learning why such behavior occurred, finally understanding that it was caused by previously unknown forces on particles in an inertial flow. The advent of microfluidics opened a new realm of possibilities for inertial focusing in the processing of biological fluids and cellular suspensions and created a field that is now rapidly expanding. Over the past five years, inertial focusing has enabled high-throughput, simple, and precise manipulation of bodily fluids for a myriad of applications in point-of-care and clinical diagnostics. This review describes the theoretical developments that have made the field of inertial focusing what it is today and presents the key applications that will make inertial focusing a mainstream technology in the future. PMID:24905880

  19. Current focusing and steering

    PubMed Central

    Bonham, Ben H.; Litvak, Leonid M.

    2008-01-01

    Current steering and current focusing are stimulation techniques designed to increase the number of distinct perceptual channels available to cochlear implant (CI) users by adjusting currents applied simultaneously to multiple CI electrodes. Previous studies exploring current steering and current focusing stimulation strategies are reviewed, including results of research using computational models, animal neurophysiology, and human psychophysics. Preliminary results of additional neurophysiological and human psychophysical studies are presented that demonstrate the success of current steering strategies in stimulating auditory nerve regions lying between physical CI electrodes, as well as current focusing strategies that excite regions narrower than those stimulated using monopolar configurations. These results are interpreted in the context of perception and speech reception by CI users. Disparities between results of physiological and psychophysical studies are discussed. The differences in stimulation used for physiological and psychophysical studies are hypothesized to contribute to these disparities. Finally, application of current steering and focusing strategies to other types of auditory prostheses is also discussed. PMID:18501539

  20. Electron beam focusing system

    SciTech Connect

    Dikansky, N.; Nagaitsev, S.; Parkhomchuk, V.

    1997-09-01

    The high energy electron cooling requires a very cold electron beam. Thus, the electron beam focusing system is very important for the performance of electron cooling. A system with and without longitudinal magnetic field is presented for discussion. Interaction of electron beam with the vacuum chamber as well as with the background ions and stored antiprotons can cause the coherent electron beam instabilities. Focusing system requirements needed to suppress these instabilities are presented.

  1. High harmonics focusing undulator

    SciTech Connect

    Varfolomeev, A.A.; Hairetdinov, A.H.; Smirnov, A.V.; Khlebnikov, A.S.

    1995-12-31

    It was shown in our previous work that there exist a possibility to enhance significantly the {open_quote}natural{close_quote} focusing properties of the hybrid undulator. Here we analyze the actual undulator configurations which could provide such field structure. Numerical simulations using 2D code PANDIRA were carried out and the enhanced focusing properties of the undulator were demonstrated. The obtained results provide the solution for the beam transport in a very long (short wavelength) undulator schemes.

  2. Planar-focusing cathodes.

    SciTech Connect

    Lewellen, J. W.; Noonan, J.; Accelerator Systems Division

    2005-01-01

    Conventional {pi}-mode rf photoinjectors typically use magnetic solenoids for emittance compensation. This provides independent focusing strength but can complicate rf power feed placement, introduce asymmetries (due to coil crossovers), and greatly increase the cost of the photoinjector. Cathode-region focusing can also provide for a form of emittance compensation. Typically this method strongly couples focusing strength to the field gradient on the cathode, however, and usually requires altering the longitudinal position of the cathode to change the focusing. We propose a new method for achieving cathode-region variable-strength focusing for emittance compensation. The new method reduces the coupling to the gradient on the cathode and does not require a change in the longitudinal position of the cathode. Expected performance for an S-band system is similar to conventional solenoid-based designs. This paper presents the results of rf cavity and beam dynamics simulations of the new design. We have proposed a method for performing emittance compensation using a cathode-region focusing scheme. This technique allows the focusing strength to be adjusted somewhat independently of the on-axis field strength. Beam dynamics calculations indicate performance should be comparable to presently in-use emittance compensation schemes, with a simpler configuration and fewer possibilities for emittance degradation due to the focusing optics. There are several potential difficulties with this approach, including cathode material selection, cathode heating, and peak fields in the gun. We hope to begin experimenting with a cathode of this type in the near future, and several possibilities exist for reducing the peak gradients to more acceptable levels.

  3. Plutonium focus area

    SciTech Connect

    1996-08-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this new approach, EM developed a management structure and principles that led to the creation of specific Focus Areas. These organizations were designed to focus the scientific and technical talent throughout DOE and the national scientific community on the major environmental restoration and waste management problems facing DOE. The Focus Area approach provides the framework for intersite cooperation and leveraging of resources on common problems. After the original establishment of five major Focus Areas within the Office of Technology Development (EM-50, now called the Office of Science and Technology), the Nuclear Materials Stabilization Task Group (EM-66) followed the structure already in place in EM-50 and chartered the Plutonium Focus Area (PFA). The following information outlines the scope and mission of the EM, EM-60, and EM-66 organizations as related to the PFA organizational structure.

  4. Local aspects of sleep: observations from intracerebral recordings in humans.

    PubMed

    Nobili, Lino; De Gennaro, Luigi; Proserpio, Paola; Moroni, Fabio; Sarasso, Simone; Pigorini, Andrea; De Carli, Fabrizio; Ferrara, Michele

    2012-01-01

    Human sleep is considered a global phenomenon, orchestrated by central specialized neuronal networks modulating the whole-brain activity. However, recent studies point to a local regulation of sleep. Sleep disorders, such as sleepwalking, suggest that electroencephalographic (EEG) features of sleep and wakefulness might be simultaneously present in different cerebral regions. Recently, intracranial EEG recording techniques, mainly applied for the presurgical evaluation of drug-resistant epileptic patients, have provided new and interesting information on the activity of different cortical and subcortical structures during sleep in humans. In particular, it has been observed that the thalamus, during the transition between wake and sleep undergoes a deactivation process that precedes the one occurring within the cortex, with extensive cortical territories maintaining an activated pattern for several minutes after the thalamic deactivation. Very recent intracerebral EEG studies have also shown that human NREM sleep can be characterized by the coexistence of wake-like and sleep-like EEG patterns in different cortical areas. Moreover, unit-firing recordings in multiple brain regions of neurosurgical patients evidenced that most sleep slow waves and the underlying active and inactive neuronal states do occur locally. These findings add a new dimension to the concept of local sleep regulation and opens new perspectives in the interpretation of the substrates underlying behavioral states of vigilance. The implications for sleep medicine are also discussed. PMID:22877668

  5. Decontamination & decommissioning focus area

    SciTech Connect

    1996-08-01

    In January 1994, the US Department of Energy Office of Environmental Management (DOE EM) formally introduced its new approach to managing DOE`s environmental research and technology development activities. The goal of the new approach is to conduct research and development in critical areas of interest to DOE, utilizing the best talent in the Department and in the national science community. To facilitate this solutions-oriented approach, the Office of Science and Technology (EM-50, formerly the Office of Technology Development) formed five Focus AReas to stimulate the required basic research, development, and demonstration efforts to seek new, innovative cleanup methods. In February 1995, EM-50 selected the DOE Morgantown Energy Technology Center (METC) to lead implementation of one of these Focus Areas: the Decontamination and Decommissioning (D & D) Focus Area.

  6. Sagittal focusing Laue monochromator

    DOEpatents

    Zhong; Zhong , Hanson; Jonathan , Hastings; Jerome , Kao; Chi-Chang , Lenhard; Anthony , Siddons; David Peter , Zhong; Hui

    2009-03-24

    An x-ray focusing device generally includes a slide pivotable about a pivot point defined at a forward end thereof, a rail unit fixed with respect to the pivotable slide, a forward crystal for focusing x-rays disposed at the forward end of the pivotable slide and a rearward crystal for focusing x-rays movably coupled to the pivotable slide and the fixed rail unit at a distance rearward from the forward crystal. The forward and rearward crystals define reciprocal angles of incidence with respect to the pivot point, wherein pivoting of the slide about the pivot point changes the incidence angles of the forward and rearward crystals while simultaneously changing the distance between the forward and rearward crystals.

  7. Deliberative Discussion Focus Groups.

    PubMed

    Rothwell, Erin; Anderson, Rebecca; Botkin, Jeffrey R

    2016-05-01

    This article discusses a new approach for the conduct of focus groups in health research. Identifying ways to educate and inform participants about the topic of interest prior to the focus group discussion can promote more quality data from informed opinions. Data on this deliberative discussion approach are provided from research within three federally funded studies. As healthcare continues to improve from scientific and technological advancements, educating the research participants prior to data collection about these complexities is essential to gather quality data. PMID:26078330

  8. Bilingual Education. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1998

    1998-01-01

    This theme issue focuses on instructional practices, evaluation, and the state of bilingual education. "Effective Implementation of Bilingual Programs: Reflections from the Field" (Abelardo Villarreal, Adela Solis) describes the key characteristics of successful bilingual programs: vision and goals; program leadership; linkage to central office…

  9. Focus on stochastic thermodynamics

    NASA Astrophysics Data System (ADS)

    Van den Broeck, Christian; Sasa, Shin-ichi; Seifert, Udo

    2016-02-01

    We introduce the thirty papers collected in this ‘focus on’ issue. The contributions explore conceptual issues within and around stochastic thermodynamics, use this framework for the theoretical modeling and experimental investigation of specific systems, and provide further perspectives on and for this active field.

  10. Focus on Rashomon.

    ERIC Educational Resources Information Center

    Richie, Donald S., Ed.

    This Film Focus series is a collection of reviews, essays, and commentaries on the Japanese film Rashomon. The plot consists of an attack, a rape, and a robbery, all of which probably occurred during the Middle Ages. Each character relates his own version of what happened, or might have happened, revealing the outward and inner driving forces,…

  11. Focusing on Mathematical Arguments

    ERIC Educational Resources Information Center

    Singletary, Laura M.; Conner, AnnaMarie

    2015-01-01

    "Collective argumentation" occurs when a group works together to arrive at a conclusion (supporting it with evidence). Simplistically, this occurs when students give answers to questions and tell how they arrived at the answer, perhaps prompted by a teacher. But collective argumentation can be much richer, with a focus on the process of…

  12. Youth Leadership. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1995

    1995-01-01

    This theme issue focuses on motivating young people to learn by providing leadership opportunities in school. "Coca-Cola Valued Youth Program: Assessing Progress" (Josie Danini Supik) examines the program's success. This program, which trains high-risk middle and high school students as tutors of younger children, has dramatically lowered dropout…

  13. Focus on Basics, 1997.

    ERIC Educational Resources Information Center

    Focus on Basics, 1997

    1997-01-01

    Together, these four newsletters contain 36 articles devoted to adult literacy research and practice and the relationship between them. The following articles are included: "A Productive Partnership" (Richard J. Murnane, Bob Bickerton); "Welcome to 'Focus on Basics'" (Barbara Garner); "Applying Research on the Last Frontier" (Karen Backlund, Kathy…

  14. Instructional Technology. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1997

    1997-01-01

    This theme issue includes five articles that focus on implementing instructional technology in ways that benefit all students, including limited-English-proficient, minority, economically disadvantaged, and at-risk students. "Cruising the Web with English Language Learners" (Laura Chris Green) presents three scenarios using the World Wide Web in…

  15. Focused on Student Success

    ERIC Educational Resources Information Center

    California Community Colleges, Chancellor's Office, 2014

    2014-01-01

    In January 2011, the California Community Colleges Board of Governors formed a task force to chart a roadmap for system-wide focus on student success. The task force identified best practices and designed evidence-based recommendations to ensure student success is a driving theme in colleges. This comprehensive plan, known as the Student Success…

  16. Design-Focused Evaluation

    ERIC Educational Resources Information Center

    Smith, Calvin

    2008-01-01

    In this paper an approach to the writing of evaluation questions is outlined and developed which focuses attention on the question of the effectiveness of an educational design for bringing about the learning it is intended to facilitate. The approach develops from the idea that all educational designs rely on instructional alignment, implicitly…

  17. Apartheid: Focus on Health

    PubMed Central

    Dines, George B.

    1979-01-01

    This paper focuses on health in the Republic of South Africa and calls not only for technical warfare against disease, poverty, and bigotry but also for attention to predisposing causes of disease and ill health among the African majority. PMID:522192

  18. Lifelong Learning. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1995

    1995-01-01

    This theme issue focuses on the need for adult literacy programs, as well as recent innovations in literacy education. "Adult Literacy and Leadership: Current Innovations" (Aurelio M. Montemayor) describes an adult literacy outreach program in Texas, and discusses the importance of family literacy for parents' involvement in their children's…

  19. Homework. Focus On

    ERIC Educational Resources Information Center

    Rahal, Michelle Layer

    2010-01-01

    Homework has been an integral part of the educational system for over 100 years. What likely began as simple memorization tasks has evolved into complex projects and sparked an increasingly heated debate over the purpose and value of homework assignments. This "Focus On" examines the purpose of homework, how to create homework that has value,…

  20. Young Children. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1998

    1998-01-01

    This theme issue includes five articles that focus on educational, cognitive, and brain research with implications for early childhood educators, including those who work with limited-English-proficient, minority, and economically disadvantaged children. "Coming to Grips with Reading Instruction at the Early Grades" (Christie L. Goodman) reports…

  1. Theme: Focus on Teaching.

    ERIC Educational Resources Information Center

    Connors, James J.; And Others

    1996-01-01

    Includes "The More Things Change..." (Connors); "Students--Bored of Education?" (Earle); "Yesterday, Today and Tomorrow" (Wesch et al.); "Attitude and the Value of Environment" (Foster); "Fins, Feathers and Fur" (Crank); "Greenhouse as a Focus for Agriscience" (Hurst); and "Agricultural and Environmental Education at Milton Hershey School"…

  2. Focusing on the Invisible

    ERIC Educational Resources Information Center

    Haley, Tim R.

    2008-01-01

    This article seeks to answer the question of whether or not the design and development of an educational laboratory really changes when the focus is on nanotechnology. It explores current laboratory building trends and the added considerations for building a nanotechnology laboratory. The author leaves the reader with additional points to consider…

  3. Focus on Distance Education.

    ERIC Educational Resources Information Center

    Grenzky, Janet; Maitland, Christine

    2001-01-01

    As a followup to a survey of distance education faculty, the National Education Association conducted two 3-hour focus groups with 12 higher education faculty members in June 2000. The purpose of the groups was to gain more understanding of the complexity of feelings and opinions expressed in a telephone survey conducted in March 2000. The…

  4. Focus: International Economics.

    ERIC Educational Resources Information Center

    Lynch, Gerald J.; Watts, Michael W.; Wentworth, Donald R.

    The "Focus" series, part of the National Council on Economic Education's (NCEE) EconomicsAmerica program, uses economics to enhance learning in subjects such as history, geography, civics, and personal finance, as well as economics. Activities are interactive, reflecting the belief that students learn best through active, highly personalized…

  5. Focus on the President.

    ERIC Educational Resources Information Center

    Optometric Education, 1996

    1996-01-01

    In an interview, the incoming president of the Association of Schools and Colleges of Optometry (ASCO), Thomas L. Lewis, discusses his goals for the association, the challenges facing optometric education in the next decade, cooperation between ASCO and other professional organizations in optometry, his mentors in the profession, his focus as a…

  6. Focus on the President.

    ERIC Educational Resources Information Center

    Optometric Education, 2000

    2000-01-01

    An interview with the new president of the Association of Schools and Colleges of Optometry, John Schoessler, considers issues the president wishes to focus on during his presidency, changes in optometry students over the years, people who influenced his educational ideas, and research currently being conducted at Ohio State University College of…

  7. Quality-Focused Management.

    ERIC Educational Resources Information Center

    Needham, Robbie Lee

    1993-01-01

    Presents the quality-focused management (QFM) system and explains the departure QFM makes from established community college management practices. Describes the system's self-directed teams engaged in a continuous improvement process driven by customer demand and long-term commitment to quality and cost control. (13 references.) (MAB)

  8. Focus: Economic Systems.

    ERIC Educational Resources Information Center

    McCorkle, Sarapage; Meszaros, Bonnie T.; Odorzynski, Sandra J.; Schug, Mark C.; Watts, Michael

    The "Focus" series, part of the National Council on Economic Education's (NCEE) EconomicsAmerica program, uses economics to enhance learning in subjects such as history, geography, civics, and personal finance, as well as economics. Activities are interactive, reflecting the belief that students learn best through active, highly personalized…

  9. Focusing educational initiatives

    NASA Technical Reports Server (NTRS)

    Parks, George K.

    1990-01-01

    The United States will soon be facing a critical shortage of aerospace scientists and engineers. To address this problem, Space Grant Colleges can assist in focusing interest in existing educational initiatives and in creating new educational opportunities, particularly for women and underrepresented minorities.

  10. Focus on Efficient Management.

    ERIC Educational Resources Information Center

    Kentucky State Dept. of Education, Frankfort. Office of Resource Management.

    Compiled as a workshop handbook, this guide presents information to help food service program administrators comply with federal regulations and evaluate and upgrade their operations. Part I discusses requirements of the National School Lunch Program, focusing on the "offer versus serve" method of service enacted in 1976 to reduce waste. After an…