The influence of tip shape on bending force during needle insertion

PubMed Central

van de Berg, Nick J.; de Jong, Tonke L.; van Gerwen, Dennis J.; Dankelman, Jenny; van den Dobbelsteen, John J.

2017-01-01

Steering of needles involves the planning and timely modifying of instrument-tissue force interactions to allow for controlled deflections during the insertion in tissue. In this work, the effect of tip shape on these forces was studied using 10 mm diameter needle tips. Six different tips were selected, including beveled and conical versions, with or without pre-bend or pre-curve. A six-degree-of-freedom force/torque sensor measured the loads during indentations in tissue simulants. The increased insertion (axial) and bending (radial) forces with insertion depth — the force-displacement slopes — were analyzed. Results showed that the ratio between radial and axial forces was not always proportional. This means that the tip load does not have a constant orientation, as is often assumed in mechanics-based steering models. For all tip types, the tip-load assumed a more radial orientation with increased axial load. This effect was larger for straight tips than for pre-bent or pre-curved tips. In addition, the force-displacement slopes were consistently higher for (1) increased tip angles, and for (2) beveled tips compared to conical tips. Needles with a bent or curved tip allow for an increased bending force and a decreased variability of the tip load vector orientation. PMID:28074939

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

PubMed

Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

2017-07-01

Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning

NASA Astrophysics Data System (ADS)

Hrinivich, W. Thomas; Hoover, Douglas A.; Surry, Kathleen; Edirisinghe, Chandima; Montreuil, Jacques; D'Souza, David; Fenster, Aaron; Wong, Eugene

2016-03-01

Background: High-dose-rate brachytherapy (HDR-BT) is a prostate cancer treatment option involving the insertion of hollow needles into the gland through the perineum to deliver a radioactive source. Conventional needle imaging involves indexing a trans-rectal ultrasound (TRUS) probe in the superior/inferior (S/I) direction, using the axial transducer to produce an image set for organ segmentation. These images have limited resolution in the needle insertion direction (S/I), so the sagittal transducer is used to identify needle tips, requiring a manual registration with the axial view. This registration introduces a source of uncertainty in the final segmentations and subsequent treatment plan. Our lab has developed a device enabling 3D-TRUS guided insertions with high S/I spatial resolution, eliminating the need to align axial and sagittal views. Purpose: To compare HDR-BT needle tip localization accuracy between 2D and 3D-TRUS. Methods: 5 prostate cancer patients underwent conventional 2D TRUS guided HDR-BT, during which 3D images were also acquired for post-operative registration and segmentation. Needle end-length measurements were taken, providing a gold standard for insertion depths. Results: 73 needles were analyzed from all 5 patients. Needle tip position differences between imaging techniques was found to be largest in the S/I direction with mean+/-SD of -2.5+/-4.0 mm. End-length measurements indicated that 3D TRUS provided statistically significantly lower mean+/-SD insertion depth error of -0.2+/-3.4 mm versus 2.3+/-3.7 mm with 2D guidance (p < .001). Conclusions: 3D TRUS may provide more accurate HDR-BT needle localization than conventional 2D TRUS guidance for the majority of HDR-BT needles.

Detecting stages of needle penetration into tissues through force estimation at needle tip using fiber Bragg grating sensors

NASA Astrophysics Data System (ADS)

Kumar, Saurabh; Shrikanth, Venkoba; Amrutur, Bharadwaj; Asokan, Sundarrajan; Bobji, Musuvathi S.

2016-12-01

Several medical procedures involve the use of needles. The advent of robotic and robot assisted procedures requires dynamic estimation of the needle tip location during insertion for use in both assistive systems as well as for automatic control. Most prior studies have focused on the maneuvering of solid flexible needles using external force measurements at the base of the needle holder. However, hollow needles are used in several procedures and measurements of forces in proximity of such needles can eliminate the need for estimating frictional forces that have high variations. These measurements are also significant for endoscopic procedures in which measurement of forces at the needle holder base is difficult. Fiber Bragg grating sensors, due to their small size, inert nature, and multiplexing capability, provide a good option for this purpose. Force measurements have been undertaken during needle insertion into tissue mimicking phantoms made of polydimethylsiloxane as well as chicken tissue using an 18-G needle instrumented with FBG sensors. The results obtained show that it is possible to estimate the different stages of needle penetration including partial rupture, which is significant for procedures in which precise estimation of needle tip position inside the organ or tissue is required.

A new needle on the block: EchoTip ProCore endobronchial ultrasound needle

PubMed Central

Dincer, H Erhan; Andrade, Rafael; Zamora, Felix; Podgaetz, Eitan

2016-01-01

Endobronchial ultrasound has become the first choice standard of care procedure to diagnose benign or malignant lesions involving mediastinum and lung parenchyma adjacent to the airways owing to its characteristics of being real-time and minimally invasive. Although the incidence of lung cancer has been decreasing, it is and will be the leading cause of cancer-related mortality in the next few decades. When compared to other cancers, lung cancer kills more females than breast and colon cancers combined and more males than colon and prostate cancers combined. The type of lung cancer has changed in recent decades and adenocarcinoma has become the most frequent cell type. Prognosis of lung cancer depends upon the cell type and the staging at the time of diagnosis. The cell type and molecular characteristics of adenocarcinoma may allow individualized targeted treatment. Other malignant conditions in the mediastinum and lung (eg, metastatic lung cancers and lymphoma) can be biopsied using endobronchial ultrasound needles. Endobronchial ultrasound needle biopsies provides mostly cytology specimens due to its small sizes of needles (22 gauge or larger) which may not give enough tissue to make a definitive diagnosis in malignant (eg, lymphoma) or benign conditions (eg, sarcoidosis). EchoTip ProCore endobronchial needle released in early 2014 provides histologic biopsy material. Larger tissue biopsies may potentially provide a higher diagnostic yield and it eliminates mediastinoscopy or other surgical interventions. Here we aim to review bronchoscopic approach in the diagnosis of mediastinal lesions with emphasis of EchoTip ProCore needles. PMID:27099535

Pseudomonas aeruginosa uses T3SS to inhibit diabetic wound healing

PubMed Central

Goldufsky, Josef; Wood, Stephen J.; Jayaraman, Vijayakumar; Majdobeh, Omar; Chen, Lin; Qin, Shanshan; Zhang, Chunxiang; DiPietro, Luisa A.; Shafikhani, Sasha H.

2015-01-01

Diabetic foot ulcers are responsible for more hospitalizations than any other complication of diabetes. Bacterial infection is recognized as an important factor associated with impaired healing in diabetic ulcers. Pseudomonas aeruginosa is the most frequently detected Gram-negative pathogen in diabetic ulcers. P. aeruginosa infection has been shown to impair healing in diabetic wounds in a manner that correlates with its ability to form biofilm. While the majority of infections in diabetic ulcers are biofilm associated, 33% of infections are nonbiofilm in nature. P. aeruginosa is the most prevalent Gram-negative pathogen in all diabetic wound types, which suggests that the deleterious impact of P. aeruginosa on healing in diabetic wounds goes beyond its ability to form biofilm and likely involves other factors. The Type III Secretion System (T3SS) virulence structure is required for the pathogenesis of all P. aeruginosa clinical isolates, suggesting that it may also play a role in the inhibition of wound repair in diabetic skin ulcers. We evaluated the role of T3SS in mediating P. aeruginosa–induced tissue damage in the wounds of diabetic mice. Our data demonstrate that P. aeruginosa establishes a robust and persistent infection in diabetic wounds independent of its ability to form biofilm and causes severe wound damage in a manner that primarily depends on its T3SS. PMID:25912785

Pseudomonas aeruginosa uses T3SS to inhibit diabetic wound healing.

PubMed

Goldufsky, Josef; Wood, Stephen J; Jayaraman, Vijayakumar; Majdobeh, Omar; Chen, Lin; Qin, Shanshan; Zhang, Chunxiang; DiPietro, Luisa A; Shafikhani, Sasha H

2015-01-01

Diabetic foot ulcers are responsible for more hospitalizations than any other complication of diabetes. Bacterial infection is recognized as an important factor associated with impaired healing in diabetic ulcers. Pseudomonas aeruginosa is the most frequently detected Gram-negative pathogen in diabetic ulcers. P. aeruginosa infection has been shown to impair healing in diabetic wounds in a manner that correlates with its ability to form biofilm. While the majority of infections in diabetic ulcers are biofilm associated, 33% of infections are nonbiofilm in nature. P. aeruginosa is the most prevalent Gram-negative pathogen in all diabetic wound types, which suggests that the deleterious impact of P. aeruginosa on healing in diabetic wounds goes beyond its ability to form biofilm and likely involves other factors. The Type III Secretion System (T3SS) virulence structure is required for the pathogenesis of all P. aeruginosa clinical isolates, suggesting that it may also play a role in the inhibition of wound repair in diabetic skin ulcers. We evaluated the role of T3SS in mediating P. aeruginosa-induced tissue damage in the wounds of diabetic mice. Our data demonstrate that P. aeruginosa establishes a robust and persistent infection in diabetic wounds independent of its ability to form biofilm and causes severe wound damage in a manner that primarily depends on its T3SS. © 2015 by the Wound Healing Society.

Type 3 Secretion System (T3SS) of Bradyrhizobium sp. DOA9 and Its Roles in Legume Symbiosis and Rice Endophytic Association.

PubMed

Songwattana, Pongpan; Noisangiam, Rujirek; Teamtisong, Kamonluck; Prakamhang, Janpen; Teulet, Albin; Tittabutr, Panlada; Piromyou, Pongdet; Boonkerd, Nantakorn; Giraud, Eric; Teaumroong, Neung

2017-01-01

The Bradyrhizobium sp. DOA9 strain isolated from a paddy field has the ability to nodulate a wide spectrum of legumes. Unlike other bradyrhizobia, this strain has a symbiotic plasmid harboring nod , nif , and type 3 secretion system (T3SS) genes. This T3SS cluster contains all the genes necessary for the formation of the secretory apparatus and the transcriptional activator (TtsI), which is preceded by a nod -box motif. An in silico search predicted 14 effectors putatively translocated by this T3SS machinery. In this study, we explored the role of the T3SS in the symbiotic performance of DOA9 by evaluating the ability of a T3SS mutant (Ω rhcN ) to nodulate legumes belonging to Dalbergioid, Millettioid, and Genistoid tribes. Among the nine species tested, four ( Arachis hypogea , Vigna radiata , Crotalaria juncea , and Macroptilium atropurpureum ) responded positively to the rhcN mutation (ranging from suppression of plant defense reactions, an increase in the number of nodules and a dramatic improvement in nodule development and infection), one ( Stylosanthes hamata ) responded negatively (fewer nodules and less nitrogen fixation) and four species ( Aeschynomene americana , Aeschynomene afraspera , Indigofera tinctoria , and Desmodium tortuosum ) displayed no phenotype. We also tested the role of the T3SS in the ability of the DOA9 strain to endophytically colonize rice roots, but detected no effect of the T3SS mutation, in contrast to what was previously reported in the Bradyrhizobium SUTN9-2 strain. Taken together, these data indicate that DOA9 contains a functional T3SS that interferes with the ability of the strain to interact symbiotically with legumes but not with rice.

Type 3 Secretion System (T3SS) of Bradyrhizobium sp. DOA9 and Its Roles in Legume Symbiosis and Rice Endophytic Association

PubMed Central

Songwattana, Pongpan; Noisangiam, Rujirek; Teamtisong, Kamonluck; Prakamhang, Janpen; Teulet, Albin; Tittabutr, Panlada; Piromyou, Pongdet; Boonkerd, Nantakorn; Giraud, Eric; Teaumroong, Neung

2017-01-01

The Bradyrhizobium sp. DOA9 strain isolated from a paddy field has the ability to nodulate a wide spectrum of legumes. Unlike other bradyrhizobia, this strain has a symbiotic plasmid harboring nod, nif, and type 3 secretion system (T3SS) genes. This T3SS cluster contains all the genes necessary for the formation of the secretory apparatus and the transcriptional activator (TtsI), which is preceded by a nod-box motif. An in silico search predicted 14 effectors putatively translocated by this T3SS machinery. In this study, we explored the role of the T3SS in the symbiotic performance of DOA9 by evaluating the ability of a T3SS mutant (ΩrhcN) to nodulate legumes belonging to Dalbergioid, Millettioid, and Genistoid tribes. Among the nine species tested, four (Arachis hypogea, Vigna radiata, Crotalaria juncea, and Macroptilium atropurpureum) responded positively to the rhcN mutation (ranging from suppression of plant defense reactions, an increase in the number of nodules and a dramatic improvement in nodule development and infection), one (Stylosanthes hamata) responded negatively (fewer nodules and less nitrogen fixation) and four species (Aeschynomene americana, Aeschynomene afraspera, Indigofera tinctoria, and Desmodium tortuosum) displayed no phenotype. We also tested the role of the T3SS in the ability of the DOA9 strain to endophytically colonize rice roots, but detected no effect of the T3SS mutation, in contrast to what was previously reported in the Bradyrhizobium SUTN9-2 strain. Taken together, these data indicate that DOA9 contains a functional T3SS that interferes with the ability of the strain to interact symbiotically with legumes but not with rice. PMID:28979252

A novel method for accurate needle-tip identification in trans-rectal ultrasound-based high-dose-rate prostate brachytherapy.

PubMed

Zheng, Dandan; Todor, Dorin A

2011-01-01

In real-time trans-rectal ultrasound (TRUS)-based high-dose-rate prostate brachytherapy, the accurate identification of needle-tip position is critical for treatment planning and delivery. Currently, needle-tip identification on ultrasound images can be subject to large uncertainty and errors because of ultrasound image quality and imaging artifacts. To address this problem, we developed a method based on physical measurements with simple and practical implementation to improve the accuracy and robustness of needle-tip identification. Our method uses measurements of the residual needle length and an off-line pre-established coordinate transformation factor, to calculate the needle-tip position on the TRUS images. The transformation factor was established through a one-time systematic set of measurements of the probe and template holder positions, applicable to all patients. To compare the accuracy and robustness of the proposed method and the conventional method (ultrasound detection), based on the gold-standard X-ray fluoroscopy, extensive measurements were conducted in water and gel phantoms. In water phantom, our method showed an average tip-detection accuracy of 0.7 mm compared with 1.6 mm of the conventional method. In gel phantom (more realistic and tissue-like), our method maintained its level of accuracy while the uncertainty of the conventional method was 3.4mm on average with maximum values of over 10mm because of imaging artifacts. A novel method based on simple physical measurements was developed to accurately detect the needle-tip position for TRUS-based high-dose-rate prostate brachytherapy. The method demonstrated much improved accuracy and robustness over the conventional method. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Presence of T3SS2β genes in trh⁺ Vibrio parahaemolyticus isolated from seafood harvested along Mangalore coast, India.

PubMed

Kumar, B K; Deekshit, V K; Rai, P; Shekar, M; Karunasagar, I; Karunasagar, I

2014-05-01

Vibrio parahaemolyticus is a seafood-borne pathogen autochthonous to the marine and estuarine ecosystem, responsible for gastroenteritis when contaminated raw seafood is consumed. The pathogenicity has been associated with thermostable direct haemolysin (TDH) and TDH-related haemolysin (TRH). Of late, the presence of T3SS2α and T3SS2β gene clusters has been well documented in clinical isolates of Vibrio parahaemolyticus and known to play an essential role in pathogenesis. However, reports on the presence of T3SSβ genes in V. parahaemolyticus isolated from the seafood and/or environmental samples are scanty. In this study, we have identified and analysed the distribution of the T3SS2β genes in V. parahaemolyticus isolated from seafood harvested along southwest coast of India. Results showed that T3SS2β genes are solely associated with trh⁺ and tdh⁺ /trh⁺ strains of V. parahaemolyticus. Reverse transcriptase PCR (RT-PCR) showed that the T3SS2β genes identified in trh⁺ V. parahaemolyticus were transcriptionally active. To our knowledge, this study appears to be the first description on the presence of T3SS2β-positive V. parahaemolyticus isolated from seafood in India. The study of T3SS2 along with other virulence factors will help in better understanding of the risk of seafood-borne illness due to V. parahaemolyticus. T3SSs (α or β) are the important virulence factors of Vibrio parahaemolyticus that contribute to their pathogenicity in humans. This study demonstrated the presence of T3SS2β genes in V. parahaemolyticus isolated from the seafood harvested along Mangalore coast. RT-PCR showed that the T3SS2β genes identified in seafood isolates of V. parahaemolyticus were found to be functional. To the best of our knowledge, this is the first description of T3SS2β genes in trh⁺ V. parahaemolyticus isolated from seafood in India. The presence of T3SS2 along with other virulence factors such as TDH and/or TRH highlights a potential health risk for

Identification of the Vibrio parahaemolyticus type III secretion system 2-associated chaperone VocC for the T3SS2-specific effector VopC.

PubMed

Akeda, Yukihiro; Kodama, Toshio; Saito, Kazunobu; Iida, Tetsuya; Oishi, Kazunori; Honda, Takeshi

2011-11-01

The enteropathogen Vibrio parahaemolyticus possesses two sets of type III secretion systems, T3SS1 and T3SS2. Effector proteins secreted by these T3SSs are delivered into host cells, leading to cell death or diarrhea. However, it is not known how specific effectors are secreted through a specific T3SS when both T3SSs are expressed within bacteria. One molecule thought to determine secretion specificity is a T3SS-associated chaperone; however, no T3SS2-specific chaperone has been identified. Therefore, we screened T3SS2 chaperone candidates by a pull-down assay using T3SS2 effectors fused with glutathione-S-transferase. A secretion assay revealed that the newly identified cognate chaperone VocC for the T3SS2-specific effector VopC was required for the efficient secretion of the substrate through T3SS2. Further experiments determined the chaperone-binding domain and the amino-terminal secretion signal of the cognate effector. These findings, in addition to the previously identified T3SS1-specific chaperone, VecA, provide a strategy to clarify the specificity of effector secretion through T3SSs of V. parahaemolyticus. 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

NASA Astrophysics Data System (ADS)

Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

2016-04-01

High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

YebC controls virulence by activating T3SS gene expression in the pathogen Edwardsiella piscicida.

PubMed

Wei, Lifan; Wu, Yanyan; Qiao, Haoxian; Xu, Wensheng; Zhang, Yuanxing; Liu, Xiaohong; Wang, Qiyao

2018-06-12

Edwardsiella piscicida is an infectious Gram-negative bacterium that causes great losses to the aquaculture industry worldwide. Based on pattern analysis of conditional essentiality (PACE), a new method for transposon insertion sequencing (Tn-seq) data analysis, we investigated the genome-wide genetic requirements during the dynamic process of infection and colonization in turbot in this study. As a result, disruption of ETAE_1437 was discovered to lead to substantially reduced colonization, which was similar to the in vivo dynamic patterns of the mutants of T3SS or T6SS. Bioinformatics analysis indicated that ETAE_1437 is a YebC/PmpR family regulator. Moreover, we found that ETAE_1437 not only regulated quorum sensing by directly binding to the edwR promoter region but also activated T3SS expression by directly binding to the promoter region of the T3SS gene ETAE_0873. In addition, ETAE_1437 mutants exhibited substantial colonization defects and significantly decreased virulence in turbot. Overall, this study identified ETAE_1437 as a novel virulence regulator in E. piscicida and enriched our understanding of the pathogenesis of E. piscicida in fish. We thus reannotated ETAE_1437 as YebC.

Ultrasound-guided percutaneous treatment of hepatocellular carcinoma by radiofrequency hyperthermia with a 'cooled-tip needle'. A preliminary clinical experience.

PubMed

Francica, G; Marone, G

1999-05-01

Radiofrequency hyperthermia using the newly-developed 'cooled-tip' needle has recently been proposed as a therapeutic modality for hepatocellular carcinoma (HCC). Herein we report our preliminary results on feasibility and effectiveness of the thermal ablation of mono- or pauci-focal hepatocellular carcinoma with the cooled-tip needle. We treated 15 cirrhotic patients (mean age 68.8 years; 12 males; 14 HCV-positive; 13 in Child's Class A and 2 in Class B) with 20 hepatocellular carcinoma nodules (mean diameter 28.1 mm; range 10-43 mm; nine lesions with diameter greater than 3 cm). None of the patients had portal thrombosis and/or extrahepatic spread. We used a radiofrequency generator (100 W of power) connected to a 18 g perfusion electrode needle with an exposed tip of 2-3 cm. The circuit was closed through a dispersive electrode positioned under the patient's thighs. A peristaltic pump infused a chilled (2-5 degrees C) saline solution to guarantee the continuous cooling of the needle tip. The needle was placed into target lesions under US guidance. The interventional procedure was carried out in general anesthesia without intubation. Dynamic helical CT was carried out 15-20 days after thermal ablation to assess therapeutic efficacy. In all, 38 areas of coagulation necrosis (at 1000-1200 mA for 10-15 min) were generated in 24 sessions in the 20 hepatocellular carcinoma nodules (mean 1.9 lesions per nodule and 1.2 sessions per nodule). Complete necrosis as assessed at dynamic CT (lack of enhancement during the arteriographic phase) was achieved in 75% of cases in a single session; after a second RF session success rate was 90% (18 out of 20 nodules). A self-limited pleurisy along with a 5-fold increase in transaminases occurred in one patient; a 3-fold elevation of transaminases was encountered in three other patients. During the follow-up (median 15 months) five patients had recurrent hepatocellular carcinoma with a 1-year disease free interval of 64%. Of the

Localization of needle tip with color doppler during pericardiocentesis: In vitro validation and initial clinical application

NASA Technical Reports Server (NTRS)

Armstrong, G.; Cardon, L.; Vilkomerson, D.; Lipson, D.; Wong, J.; Rodriguez, L. L.; Thomas, J. D.; Griffin, B. P.

2001-01-01

This study evaluates a new device that uses color Doppler ultrasonography to enable real-time image guidance of the aspirating needle, which has not been possible until now. The ColorMark device (EchoCath Inc, Princeton, NJ) induces high-frequency, low-amplitude vibrations in the needle to enable localization with color Doppler. We studied this technique in 25 consecutive patients undergoing pericardiocentesis, and in vitro, in a urethane phantom with which the accuracy of color Doppler localization of the needle tip was compared with that obtained by direct measurement. Tip localization was excellent in vitro; errors axial to the ultrasound beam (velocity Doppler -0.13 +/- 0.90 mm, power Doppler -0.05 +/- 1.7 mm) were less than lateral errors (velocity -0.36 +/- 1.8 mm, power -0.02 +/- 2.8 mm). In 18 of 25 patients, the needle was identified and guided into the pericardial space with the ColorMark technique, and it allowed successful, uncomplicated drainage of fluid. Initial failures were the result of incorrect settings on the echocardiographic machine and inappropriate combinations of the needle puncture site and imaging window. This study demonstrates a novel color Doppler technique that is highly accurate at localizing a needle tip. The technique is feasible for guiding pericardiocentesis. Further clinical validation of this technique is required.

Comparative cyto-histological study of needle tip aspirates and entry sites after intravitreal injection using different needle types

PubMed Central

Lytvynchuk, Lyubomyr; Sergienko, Andrij; Savytska, Iryna; Albert, Réka; Glittenberg, Carl; Binder, Susanne; Petrovski, Goran

2017-01-01

A comparison of the cellular content of needle tip aspirates and entry sites after transconjunctival intravitreal injection (IVI) using different needle types was performed. White outbred rats and human cadaver eyes were used for IVI by hypodermic 27 gauge (G) and 30G needles, and spinal anesthesia Pencan 27G needles. Aspiration of vitreous for quantitative morphological and cell cultivation analysis, as well as cyto-histological analysis of aspirates and entry sites were carried out. The most common cells in the aspirates from all needle types were conjunctival epithelial-, ciliary body non-pigmented epithelial- and sclerocyte-like cells and granular proteins. Crystallized vitreous specimens were present in each aspirate. The entry sites of hypodermic needles showed marked trauma in all wall layers of rat and human eyes accompanied by cellular destruction and hemorrhages. Pencan 27G needle caused less tissue trauma with partial reposition of sclerocytes. Transconjunctival IVIs with hypodermic 27G and 30G, and Pencan 27G needles result in trauma of all layers of the eyeball. The possible consequences of cellular content being cut and injected into the eye, as well as the entry site wound shape deserve future consideration and improvements. PMID:28692684

Estimating needle tip deflection in biological tissue from a single transverse ultrasound image: application to brachytherapy.

PubMed

Rossa, Carlos; Sloboda, Ron; Usmani, Nawaid; Tavakoli, Mahdi

2016-07-01

This paper proposes a method to predict the deflection of a flexible needle inserted into soft tissue based on the observation of deflection at a single point along the needle shaft. We model the needle-tissue as a discretized structure composed of several virtual, weightless, rigid links connected by virtual helical springs whose stiffness coefficient is found using a pattern search algorithm that only requires the force applied at the needle tip during insertion and the needle deflection measured at an arbitrary insertion depth. Needle tip deflections can then be predicted for different insertion depths. Verification of the proposed method in synthetic and biological tissue shows a deflection estimation error of [Formula: see text]2 mm for images acquired at 35 % or more of the maximum insertion depth, and decreases to 1 mm for images acquired closer to the final insertion depth. We also demonstrate the utility of the model for prostate brachytherapy, where in vivo needle deflection measurements obtained during early stages of insertion are used to predict the needle deflection further along the insertion process. The method can predict needle deflection based on the observation of deflection at a single point. The ultrasound probe can be maintained at the same position during insertion of the needle, which avoids complications of tissue deformation caused by the motion of the ultrasound probe.

7 CFR 29.3154 - Tips (T Group).

Code of Federal Regulations, 2011 CFR

2011-01-01

... stalk. (See Rule 12.) Grades Grade names and specifications T3F Good Tan Tips. Medium body, mature to...″ in length, 85 percent uniform, and 15 percent injury tolerance. T4F Fair Tan Tips. Medium body..., and 20 percent injury tolerance. T5F Low Tan Tips. Medium body, mature, firm, wrinkly, dingy finish...

7 CFR 29.3154 - Tips (T Group).

Code of Federal Regulations, 2010 CFR

2010-01-01

... stalk. (See Rule 12.) Grades Grade names and specifications T3F Good Tan Tips. Medium body, mature to...″ in length, 85 percent uniform, and 15 percent injury tolerance. T4F Fair Tan Tips. Medium body..., and 20 percent injury tolerance. T5F Low Tan Tips. Medium body, mature, firm, wrinkly, dingy finish...

Extraforaminal needle tip position reduces risk of intravascular injection in CT-fluoroscopic lumbar transforaminal epidural steroid injections

PubMed Central

Yu, Robinson K.; Ghodadra, Anish; Agarwal, Vikas

2016-01-01

Background Lumbar transforaminal epidural steroid injection is a common and effective tool for managing lumbar radicular pain, although accidental intravascular injection can rarely result in paralysis. The purpose of this study is to determine the safest needle tip position for computed tomography (CT)-guided lumbar transforaminal epidural steroid injections as determined by incidence of intravascular injection. Methods Three radiologists, in consensus, reviewed procedural imaging for consecutive CT-fluoroscopic lumbar transforaminal epidural steroid injections performed during a 16-month period. Intravascular injections were identified and categorized by needle tip position, vessel type injected, intravascular injection volume and procedural phase containing the intravascular injection. Pearson chi-square and logistic regression testing were used to assess differences between groups, as appropriate. Results Intravascular injections occurred in 9% (52/606) of injections. The intravascular injection rate was significantly lower (P<0.001) for extraforaminal needle position (0%, 0/109) compared to junctional (8%, 27/319) and foraminal (14%, 25/178) needle tip positions. Of the intravascular injections, 4% (2/52) were likely arterial, 35% (18/52) were likely venous, and 62% (32/52) were indeterminate for vessel type injected. 46% (24/52) of intravascular injections were large volume, 33% (17/52) were small volume, and 21% (11/52) were trace volume. 56% (29/52) of intravascular injections occurred with the contrast trial dose, 29% (15/52) with the steroid/analgesic cocktail, and 15% (8/52) with both. Conclusions An extraforaminal needle position for CT-fluoroscopic lumbar transforaminal epidural steroid injections decreases the risk of intravascular injection and therefore may be safer than other needle tip positions. PMID:28097241

Needle Steering in 3-D Via Rapid Replanning

PubMed Central

Patil, Sachin; Burgner, Jessica; Webster, Robert J.; Alterovitz, Ron

2014-01-01

Steerable needles have the potential to improve the effectiveness of needle-based clinical procedures such as biopsy and drug delivery by improving targeting accuracy and reaching previously inaccessible targets that are behind sensitive or impenetrable anatomical regions. We present a new needle steering system capable of automatically reaching targets in 3-D environments while avoiding obstacles and compensating for real-world uncertainties. Given a specification of anatomical obstacles and a clinical target (e.g., from preoperative medical images), our system plans and controls needle motion in a closed-loop fashion under sensory feedback to optimize a clinical metric. We unify planning and control using a new fast algorithm that continuously replans the needle motion. Our rapid replanning approach is enabled by an efficient sampling-based rapidly exploring random tree (RRT) planner that achieves orders-of-magnitude reduction in computation time compared with prior 3-D approaches by incorporating variable curvature kinematics and a novel distance metric for planning. Our system uses an electromagnetic tracking system to sense the state of the needle tip during the procedure. We experimentally evaluate our needle steering system using tissue phantoms and animal tissue ex vivo. We demonstrate that our rapid replanning strategy successfully guides the needle around obstacles to desired 3-D targets with an average error of less than 3 mm. PMID:25435829

Fusion of electromagnetic trackers to improve needle deflection estimation: simulation study.

PubMed

Sadjadi, Hossein; Hashtrudi-Zaad, Keyvan; Fichtinger, Gabor

2013-10-01

We present a needle deflection estimation method to anticipate needle bending during insertion into deformable tissue. Using limited additional sensory information, our approach reduces the estimation error caused by uncertainties inherent in the conventional needle deflection estimation methods. We use Kalman filters to combine a kinematic needle deflection model with the position measurements of the base and the tip of the needle taken by electromagnetic (EM) trackers. One EM tracker is installed on the needle base and estimates the needle tip position indirectly using the kinematic needle deflection model. Another EM tracker is installed on the needle tip and estimates the needle tip position through direct, but noisy measurements. Kalman filters are then employed to fuse these two estimates in real time and provide a reliable estimate of the needle tip position, with reduced variance in the estimation error. We implemented this method to compensate for needle deflection during simulated needle insertions and performed sensitivity analysis for various conditions. At an insertion depth of 150 mm, we observed needle tip estimation error reductions in the range of 28% (from 1.8 to 1.3 mm) to 74% (from 4.8 to 1.2 mm), which demonstrates the effectiveness of our method, offering a clinically practical solution.

Sharp Central Venous Recanalization by Means of a TIPS Needle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Honnef, Dagmar, E-mail: honnef@rad.rwth-aachen.de; Wingen, Markus; Guenther, Rolf W.

The purpose of this study was to perform an alternative technique for recanalization of a chronic occlusion of the left brachiocephalic vein that could not be traversed with a guidewire. Restoration of a completely thrombosed left brachiocephalic vein was attempted in a 76-year-old male hemodialysis patient with massive upper inflow obstruction, massive edema of the face, neck, shoulder, and arm, and occlusion of the stented right brachiocephalic vein/superior vena cava. Vessel negotiation with several guidewires and multipurpose catheters proved unsuccessful. The procedure was also non-viable using a long, 21G puncture needle. Puncture of the superior vena cava (SVC) at themore » distal circumference of the stent in the right brachiocephalic vein/superior vena cava, however, was feasible with a transjugular intrahepatic portosystemic shunt (TIPS) set under biplanar fluoroscopy using the distal end of the right brachiocephalic vein as a target, followed by balloon dilatation and partial extraction of thrombotic material of the left brachiocephalic vein with a wire basket. Finally, two overlapping stents were deployed to avoid early re-occlusion. Venography demonstrated complete vessel patency with free contrast media flow via the stents into the SVC, which was reconfirmed in follow-up examinations. Immediate clinical improvement was observed. Venous vascular recanalization of chronic venous occlusion by means of a TIPS needle is feasible as a last resort under certain precautions.« less

Reassessment of MxiH subunit orientation and fold within native Shigella T3SS needles using surface labelling and solid-state NMR.

PubMed

Verasdonck, Joeri; Shen, Da-Kang; Treadgold, Alexander; Arthur, Christopher; Böckmann, Anja; Meier, Beat H; Blocker, Ariel J

2015-12-01

T3SSs are essential virulence determinants of many Gram-negative bacteria, used to inject bacterial effectors of virulence into eukaryotic host cells. Their major extracellular portion, a ∼50 nm hollow, needle-like structure, is essential to host cell sensing and the conduit for effector secretion. It is formed of a small, conserved subunit arranged as a helical polymer. The structure of the subunit has been studied by electron cryomicroscopy within native polymers and by solid-state NMR in recombinant polymers, yielding two incompatible atomic models. To resolve this controversy, we re-examined the native polymer used for electron cryomicroscopy via surface labelling and solid-state NMR. Our data show the orientation and overall fold of the subunit within this polymer is as established by solid-state NMR for recombinant polymers. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

7 CFR 29.3154 - Tips (T Group).

Code of Federal Regulations, 2013 CFR

2013-01-01

... stalk. (See Rule 12.) Grades Grade names and specifications T3F Good Tan Tips. Medium body, mature to..., mature, firm, wavy dull finish, weak color intensity, narrow, under 16″ in length, 80 percent uniform, and 20 percent injury tolerance. T5F Low Tan Tips. Medium body, mature, firm, wrinkly, dingy finish...

7 CFR 29.3154 - Tips (T Group).

Code of Federal Regulations, 2014 CFR

2014-01-01

... stalk. (See Rule 12.) Grades Grade names and specifications T3F Good Tan Tips. Medium body, mature to..., mature, firm, wavy dull finish, weak color intensity, narrow, under 16″ in length, 80 percent uniform, and 20 percent injury tolerance. T5F Low Tan Tips. Medium body, mature, firm, wrinkly, dingy finish...

7 CFR 29.3154 - Tips (T Group).

Code of Federal Regulations, 2012 CFR

2012-01-01

... stalk. (See Rule 12.) Grades Grade names and specifications T3F Good Tan Tips. Medium body, mature to..., mature, firm, wavy dull finish, weak color intensity, narrow, under 16″ in length, 80 percent uniform, and 20 percent injury tolerance. T5F Low Tan Tips. Medium body, mature, firm, wrinkly, dingy finish...

Helical-Tip Needle for Transthoracic Percutaneous Image-Guided Biopsy of Lung Tumors: Results of a Pilot Prospective Comparative Study with a Standard Tru-Cut Needle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veltri, Andrea, E-mail: andrea.veltri@unito.it; Busso, Marco; Sardo, Diego

PurposeTo prospectively evaluate feasibility and diagnostic performance of the 14-gauge helical-tip (Spirotome™, Cook{sup ®} Medical, Bloomington, USA) needle in transthoracic needle biopsy (TTNB) of lung lesions, compared to a conventional 18-gauge Tru-Cut needle.Materials and MethodsStudy was institutional review board approved, with informed consent obtained. Data from synchronous Spirotome and Tru-Cut image-guided TTNB of 20 consecutive patients with malignant peripheral lung tumors larger than 3 cm were enrolled for pathologic characterization and mutational analysis. Samples obtained with Spirotome and Tru-Cut needle were compared for fragmentation, length, weight, morphologic and immunohistochemistry typifying, tumor cellularity (TC) and DNA concentration.ResultsThe technical success rate for TTNBmore » with Spirotome was 100%, and no major complications occurred. Less fragmentation (mean 2 vs. 3 fragments, P = .418), greater weight (mean 13 vs. 8.5 mg, P = .027) and lower length (mean 10.2 vs. 12.6 mm, P = .174) were observed with Spirotome compared to Tru-Cut needle. Accuracy of Spirotome and Tru-Cut needle in defining cancer histotype was similar (90%). Absolute and relative TC (mean 42 vs. 38, 124 vs. 108/10HPF), and DNA concentration (mean 49.6 vs. 39.0 ng/μl) were higher with Spirotome compared to Tru-Cut needle, with no statistical significance (P = .787 and P = .140, respectively).Conclusions Percutaneous 14-gauge Spirotome TTNB of selected lesions is feasible and accurate. It provides adequate samples for diagnosis, comparable to 18-gauge Tru-Cut needle, with a higher amount of tumor tissue (weight, TC, DNA concentration) even in shorter samples.« less

A novel prototype 3/5 laparoscopic needle driver: A validation study with conventional laparoscopic needle driver.

PubMed

Ganpule, Arvind P; Deshmukh, Chaitanya S; Joshi, Tanmay

2018-01-01

The challenges in laparoscopic suturing include need to expertise to suture. Laparoscopic needle holder is a" key" instrument to accomplish this arduous task. The objective of this new invention was to develop a laparoscopic needle holder which would be adapted to avoid any wobble (with a shaft diameter same as a 5mm port), ensure accurate and dexterous suturing not just in adult patients but pediatric patients alike (with a short shaft diameter) and finally ensure seamless throw of knots with a narrow tip configuration. We did an initial evaluation to evaluate the validity of the prototype needle holder and its impact on laparoscopic suturing skills by experienced laparoscopic surgeons and novice laparoscopic Surgeons. Both the groups of surgeons performed two tasks. The first task was to grasp the needle and position it in an angle deemed ideal for suturing. The second task was to pass suture through two fixed points and make a single square knot. At the end of the tasks each participant was asked to complete a 5- point Likert's scale questionnaire (8 items; 4 items of handling and 4 items of suturing) rating each needle holder. In expert group, the mean time to complete task 1 was shorter with prototype 3/5 laparoscopic needle holder (11.8 sec Vs 20.8 sec). The mean time to complete task 2 was also shorter with prototype 3/5 laparoscopic needle holder (103.2 sec Vs 153.2 sec). In novice group, mean time to complete both the task was shorter with prototype 3/5 laparoscopic needle holder. The expert laparoscopic surgeons as well as novice laparoscopic surgeons performed laparoscopic suturing faster and with more ease while using the prototype 3/5 laparoscopic needle holder.

A novel prototype 3/5 laparoscopic needle driver: A validation study with conventional laparoscopic needle driver

PubMed Central

Ganpule, Arvind P.; Deshmukh, Chaitanya S.; Joshi, Tanmay

2018-01-01

Introduction: The challenges in laparoscopic suturing include need to expertise to suture. Laparoscopic needle holder is a ”key” instrument to accomplish this arduous task. Instrument: The objective of this new invention was to develop a laparoscopic needle holder which would be adapted to avoid any wobble (with a shaft diameter same as a 5mm port), ensure accurate and dexterous suturing not just in adult patients but pediatric patients alike (with a short shaft diameter) and finally ensure seamless throw of knots with a narrow tip configuration. Validation: We did an initial evaluation to evaluate the validity of the prototype needle holder and its impact on laparoscopic suturing skills by experienced laparoscopic surgeons and novice laparoscopic Surgeons. Both the groups of surgeons performed two tasks. The first task was to grasp the needle and position it in an angle deemed ideal for suturing. The second task was to pass suture through two fixed points and make a single square knot. At the end of the tasks each participant was asked to complete a 5- point Likert's scale questionnaire (8 items; 4 items of handling and 4 items of suturing) rating each needle holder. In expert group, the mean time to complete task 1 was shorter with prototype 3/5 laparoscopic needle holder (11.8 sec Vs 20.8 sec). The mean time to complete task 2 was also shorter with prototype 3/5 laparoscopic needle holder (103.2 sec Vs 153.2 sec). In novice group, mean time to complete both the task was shorter with prototype 3/5 laparoscopic needle holder. Conclusion: The expert laparoscopic surgeons as well as novice laparoscopic surgeons performed laparoscopic suturing faster and with more ease while using the prototype 3/5 laparoscopic needle holder. PMID:28782740

Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia - randomized clinical trial.

PubMed

Dau, M; Buttchereit, I; Ganz, C; Frerich, B; Anisimova, E N; Daubländer, M; Kämmerer, P W

2017-11-01

The aims of this in vivo study were to evaluate the impact of needle bevel design on patients' pain perception and the mechanical deformation of the needle tip after the injection. In a prospective single-blinded trial, 150 patients received conventional infiltration anaesthesia for dental treatment by one examiner. Patients were randomized for one out of three different needle bevel types (scalpel-designed bevel needle (SB), n=50; triple bevel needle (TB), n=50; regular bevel needle (RB), n=50). Subjects' self-reported injection pain perception was evaluated using a numeric rating scale (NRS). For each needle tip, deformations after single use were measured using SEM. A significant lower injection pain level was found in SB (mean 2.1±1.2) than in TB (mean 3.5±1.6;) and RB (mean 3.4±1.0; all P<0.001). A needle deformation was detected in about 97.3% of all needles (SB 50/50, TB 50/50, and RB: 46/50). A higher number of barbs were found in SB (29/50) versus TB (17/50) and RB (19/50). For dental local infiltration anaesthesia, injection needles with a scalpel-designed bevel demonstrated significantly less injection pain. Needle tip deflections after anaesthetic agent infiltration, especially barbed hooks on the non-cutting edge may result in greater soft tissue trauma. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Ferulic Acid, But Not All Hydroxycinnamic Acids, Is a Novel T3SS Inducer of Ralstonia solanacearum and Promotes Its Infection Process in Host Plants under Hydroponic Condition.

PubMed

Zhang, Yong; Li, Jing; Zhang, Weiqi; Wang, Rongsheng; Qiu, Qiaoqing; Luo, Feng; Hikichi, Yasufumi; Ohnishi, Kouhei; Ding, Wei

2017-01-01

Hydroxycinnamic acids (HCAs) are typical monocyclic phenylpropanoids, including cinnamic acid (Cin), coumaric acid (Cou), caffeic acid (Caf), ferulic acid (FA) and their isomers, and involved in the interactions between pathogens and host plants. Here, we focused on the impact of HCAs on expression of type III secretion system (T3SS) in Ralstonia solanacearum . FA significantly induced the expression of the T3SS and some type III effectors (T3Es) genes in hrp -inducing medium, while did not the other HCAs. However, exogenously supplemented FA did not affect the T3SS expression in planta and the elicitation of the hypersensitive response (HR) in tobacco leaves. Consistent with its central roles in pathogenicity, the FA-induced expression of the T3SS led to significant promotion on infection process of R. solanacearum in tomato plants under hydroponics cultivation. Moreover, the FA-induced expression of the T3SS was specifically mediated by the well-characterized signaling cascade PrhA-prhI/R-PrhJ-HrpG-HrpB, independent of the other known regulatory pathways. In summary, our results demonstrated that FA, a novel inducer of the T3SS in R. solanacearum , was able to promote its infection process in host plants under hydroponics condition.

Needle placement for piriformis injection using 3-D imaging.

PubMed

Clendenen, Steven R; Candler, Shawn A; Osborne, Michael D; Palmer, Scott C; Duench, Stephanie; Glynn, Laura; Ghazi, Salim M

2013-01-01

Piriformis syndrome is a pain syndrome originating in the buttock and is attributed to 6% - 8% of patients referred for the treatment of back and leg pain. The treatment for piriformis syndrome using fluoroscopy, computed tomography (CT), electromyography (EMG), and ultrasound (US) has become standard practice. The treatment of Piriformis Syndrome has evolved to include fluoroscopy and EMG with CT guidance. We present a case study of 5 successful piriformis injections using 3-D computer-assisted electromagnet needle tracking coupled with ultrasound. A 6-degree of freedom electromagnetic position tracker was attached to the ultrasound probe that allowed the system to detect the position and orientation of the probe in the magnetic field. The tracked ultrasound probe was used to find the posterior superior iliac spine. Subsequently, 3 points were captured to register the ultrasound image with the CT or magnetic resonance image scan. Moreover, after the registration was obtained, the navigation system visualized the tracked needle relative to the CT scan in real-time using 2 orthogonal multi-planar reconstructions centered at the tracked needle tip. Conversely, a recent study revealed that fluoroscopically guided injections had 30% accuracy compared to ultrasound guided injections, which tripled the accuracy percentage. This novel technique exhibited an accurate needle guidance injection precision of 98% while advancing to the piriformis muscle and avoiding the sciatic nerve. The mean (± SD) procedure time was 19.08 (± 4.9) minutes. This technique allows for electromagnetic instrument tip tracking with real-time 3-D guidance to the selected target. As with any new technique, a learning curve is expected; however, this technique could offer an alternative, minimizing radiation exposure.

AtlasT4SS: a curated database for type IV secretion systems.

PubMed

Souza, Rangel C; del Rosario Quispe Saji, Guadalupe; Costa, Maiana O C; Netto, Diogo S; Lima, Nicholas C B; Klein, Cecília C; Vasconcelos, Ana Tereza R; Nicolás, Marisa F

2012-08-09

The type IV secretion system (T4SS) can be classified as a large family of macromolecule transporter systems, divided into three recognized sub-families, according to the well-known functions. The major sub-family is the conjugation system, which allows transfer of genetic material, such as a nucleoprotein, via cell contact among bacteria. Also, the conjugation system can transfer genetic material from bacteria to eukaryotic cells; such is the case with the T-DNA transfer of Agrobacterium tumefaciens to host plant cells. The system of effector protein transport constitutes the second sub-family, and the third one corresponds to the DNA uptake/release system. Genome analyses have revealed numerous T4SS in Bacteria and Archaea. The purpose of this work was to organize, classify, and integrate the T4SS data into a single database, called AtlasT4SS - the first public database devoted exclusively to this prokaryotic secretion system. The AtlasT4SS is a manual curated database that describes a large number of proteins related to the type IV secretion system reported so far in Gram-negative and Gram-positive bacteria, as well as in Archaea. The database was created using the RDBMS MySQL and the Catalyst Framework based in the Perl programming language and using the Model-View-Controller (MVC) design pattern for Web. The current version holds a comprehensive collection of 1,617 T4SS proteins from 58 Bacteria (49 Gram-negative and 9 Gram-Positive), one Archaea and 11 plasmids. By applying the bi-directional best hit (BBH) relationship in pairwise genome comparison, it was possible to obtain a core set of 134 clusters of orthologous genes encoding T4SS proteins. In our database we present one way of classifying orthologous groups of T4SSs in a hierarchical classification scheme with three levels. The first level comprises four classes that are based on the organization of genetic determinants, shared homologies, and evolutionary relationships: (i) F-T4SS, (ii) P-T4SS, (iii

Evaluation of Magnetic Resonance Imaging-Compatible Needles and Interactive Sequences for Musculoskeletal Interventions Using an Open High-Field Magnetic Resonance Imaging Scanner

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wonneberger, Uta, E-mail: uta.wonneberger@charite.d; Schnackenburg, Bernhard, E-mail: bernhard.schnackenburg@philips.co; Streitparth, Florian, E-mail: florian.streitparth@charite.de

2010-04-15

In this article, we study in vitro evaluation of needle artefacts and image quality for musculoskeletal laser-interventions in an open high-field magnetic resonance imaging (MRI) scanner at 1.0T with vertical field orientation. Five commercially available MRI-compatible puncture needles were assessed based on artefact characteristics in a CuSO4 phantom (0.1%) and in human cadaveric lumbar spines. First, six different interventional sequences were evaluated with varying needle orientation to the main magnetic field B0 (0{sup o} to 90{sup o}) in a sequence test. Artefact width, needle-tip error, and contrast-to-noise ratio (CNR) were calculated. Second, a gradient-echo sequence used for thermometric monitoring wasmore » assessed and in varying echo times, artefact width, tip error, and signal-to-noise ratio (SNR) were measured. Artefact width and needle-tip error correlated with needle material, instrument orientation to B0, and sequence type. Fast spin-echo sequences produced the smallest needle artefacts for all needles, except for the carbon fibre needle (width <3.5 mm, tip error <2 mm) at 45{sup o} to B0. Overall, the proton density-weighted spin-echo sequences had the best CNR (CNR{sub Muscle/Needle} >16.8). Concerning the thermometric gradient echo sequence, artefacts remained <5 mm, and the SNR reached its maximum at an echo time of 15 ms. If needle materials and sequences are accordingly combined, guidance and monitoring of musculoskeletal laser interventions may be feasible in a vertical magnetic field at 1.0T.« less

Needle Tip Position and Bevel Direction Have No Effect in the Fluoroscopic Epidural Spreading Pattern in Caudal Epidural Injections: A Randomized Trial

PubMed Central

Kwon, Won Kyoung; Kim, Ah Na; Lee, Pil Moo; Park, Cheol Hwan; Kim, Jae Hun

2016-01-01

Background. Caudal epidural steroid injections (CESIs) are an effective treatment for pain. If the injection spreads in a specific pattern depending on the needle position or bevel direction, it would be possible to inject the agent into a specific and desired area. Objectives. We conducted a prospective randomized trial to determine if the needle position and bevel direction have any effect on the epidural spreading pattern in CESI. Methods. Demographic data of the patient were collected. During CESI, the needle position (middle or lateral) and direction (ventral or dorsal) were randomly allocated. Following fluoroscope-guided injection of 4 mL contrast media and 10 mL of injectates, the epidural spreading patterns (ventral or dorsal, bilateral or lateral) were imaged. Results. In the 210 CESIs performed, the needle tip position and bevel direction did not influence the epidural spreading patterns at L4-5 and L5-S1 disc levels. A history of Lumbar spine surgery was associated with a significantly limited spread to each disc level. A midline needle tip position was more effective than the lateral position in spreading to the distant disc levels. Conclusions. Neither the needle tip position nor the bevel direction affected the epidural drug spreading pattern during CESI. PMID:27445609

Structure of the bacteriophage T4 long tail fiber receptor-binding tip

PubMed Central

Bartual, Sergio G.; Otero, José M.; Garcia-Doval, Carmela; Llamas-Saiz, Antonio L.; Kahn, Richard; Fox, Gavin C.; van Raaij, Mark J.

2010-01-01

Bacteriophages are the most numerous organisms in the biosphere. In spite of their biological significance and the spectrum of potential applications, little high-resolution structural detail is available on their receptor-binding fibers. Here we present the crystal structure of the receptor-binding tip of the bacteriophage T4 long tail fiber, which is highly homologous to the tip of the bacteriophage lambda side tail fibers. This structure reveals an unusual elongated six-stranded antiparallel beta-strand needle domain containing seven iron ions coordinated by histidine residues arranged colinearly along the core of the biological unit. At the end of the tip, the three chains intertwine forming a broader head domain, which contains the putative receptor interaction site. The structure reveals a previously unknown beta-structured fibrous fold, provides insights into the remarkable stability of the fiber, and suggests a framework for mutations to expand or modulate receptor-binding specificity. PMID:21041684

3T MR-guided in-bore transperineal prostate biopsy: A comparison of robotic and manual needle-guidance templates.

PubMed

Tilak, Gaurie; Tuncali, Kemal; Song, Sang-Eun; Tokuda, Junichi; Olubiyi, Olutayo; Fennessy, Fiona; Fedorov, Andriy; Penzkofer, Tobias; Tempany, Clare; Hata, Nobuhiko

2015-07-01

To demonstrate the utility of a robotic needle-guidance template device as compared to a manual template for in-bore 3T transperineal magnetic resonance imaging (MRI)-guided prostate biopsy. This two-arm mixed retrospective-prospective study included 99 cases of targeted transperineal prostate biopsies. The biopsy needles were aimed at suspicious foci noted on multiparametric 3T MRI using manual template (historical control) as compared with a robotic template. The following data were obtained: the accuracy of average and closest needle placement to the focus, histologic yield, percentage of cancer volume in positive core samples, complication rate, and time to complete the procedure. In all, 56 cases were performed using the manual template and 43 cases were performed using the robotic template. The mean accuracy of the best needle placement attempt was higher in the robotic group (2.39 mm) than the manual group (3.71 mm, P < 0.027). The mean core procedure time was shorter in the robotic (90.82 min) than the manual group (100.63 min, P < 0.030). Percentage of cancer volume in positive core samples was higher in the robotic group (P < 0.001). Cancer yields and complication rates were not statistically different between the two subgroups (P = 0.557 and P = 0.172, respectively). The robotic needle-guidance template helps accurate placement of biopsy needles in MRI-guided core biopsy of prostate cancer. © 2014 Wiley Periodicals, Inc.

Regulation of the Yersinia type III secretion system: traffic control

PubMed Central

Dewoody, Rebecca S.; Merritt, Peter M.; Marketon, Melanie M.

2013-01-01

Yersinia species, as well as many other Gram-negative pathogens, use a type III secretion system (T3SS) to translocate effector proteins from the bacterial cytoplasm to the host cytosol. This T3SS resembles a molecular syringe, with a needle-like shaft connected to a basal body structure, which spans the inner and outer bacterial membranes. The basal body of the injectisome shares a high degree of homology with the bacterial flagellum. Extending from the T3SS basal body is the needle, which is a polymer of a single protein, YscF. The distal end of the needle serves as a platform for the assembly of a tip complex composed of LcrV. Though never directly observed, prevailing models assume that LcrV assists in the insertion of the pore-forming proteins YopB and YopD into the host cell membrane. This completes a bridge between the bacterium and host cell to provide a continuous channel through which effectors are delivered. Significant effort has gone into understanding how the T3SS is assembled, how its substrates are recognized and how substrate delivery is controlled. Arguably the latter topic is the least understood; however, recent advances have provided new insight, and therefore, this review will focus primarily on summarizing the current state of knowledge regarding the control of substrate delivery by the T3SS. Specifically, we will discuss the roles of YopK, as well as YopN and YopE, which have long been linked to regulation of translocation. We also propose models whereby the YopK regulator communicates with the basal body of the T3SS to control translocation. PMID:23390616

Robot-Assisted Needle Steering

PubMed Central

Reed, Kyle B.; Majewicz, Ann; Kallem, Vinutha; Alterovitz, Ron; Goldberg, Ken; Cowan, Noah J.; Okamura, Allison M.

2012-01-01

Needle insertion is a critical aspect of many medical treatments, diagnostic methods, and scientific studies, and is considered to be one of the simplest and most minimally invasive medical procedures. Robot-assisted needle steering has the potential to improve the effectiveness of existing medical procedures and enable new ones by allowing increased accuracy through more dexterous control of the needle tip path and acquisition of targets not accessible by straight-line trajectories. In this article, we describe a robot-assisted needle steering system that uses three integrated controllers: a motion planner concerned with guiding the needle around obstacles to a target in a desired plane, a planar controller that maintains the needle in the desired plane, and a torsion compensator that controls the needle tip orientation about the axis of the needle shaft. Experimental results from steering an asymmetric-tip needle in artificial tissue demonstrate the effectiveness of the system and its sensitivity to various environmental and control parameters. In addition, we show an example of needle steering in ex vivo biological tissue to accomplish a clinically relevant task, and highlight challenges of practical needle steering implementation. PMID:23028210

Development of Repulsive Barrier Discharge from Twin Needles

NASA Astrophysics Data System (ADS)

Ueno, Hideki; Hata, Koji; Nakayama, Hiroshi

2007-03-01

Barrier discharge characteristics have been investigated for a twin needles-to-plane electrode configuration in dry air. The characteristics of barrier discharge under ac voltage application have been investigated for various distances between two needle tips (d=1.0--4.0 mm). We have found that corona discharge behavior strongly depends on needle-tip distance. In the case of a twin-needles configuration with a long needle-tip distance (d=4.0 mm), discharges from the two needle tips develop into a dielectric barrier with almost a straight path. On the contrary, the development of repulsive discharges from two needle tips in the gap between needles and a barrier was obtained for the shortest needle-tip distance investigated here (d=1.0 mm) and it was enhanced by increasing the peak voltage. From detailed time-resolved observations, development of repulsive discharge was observed only during positive polarity upon ac voltage application. Moreover, the degree of repulsion increased with increasing applied voltage of positive polarity. The observed unique discharge behavior can be interpreted as the effect of field relaxation induced not only by charge accumulation on the barrier surface, which is markedly enhanced at a short needle-tip distance, but also by space charge by coronas between two needles.

Structure of a bacterial type III secretion system in contact with a host membrane in situ.

PubMed

Nans, Andrea; Kudryashev, Mikhail; Saibil, Helen R; Hayward, Richard D

2015-12-11

Many bacterial pathogens of animals and plants use a conserved type III secretion system (T3SS) to inject virulence effector proteins directly into eukaryotic cells to subvert host functions. Contact with host membranes is critical for T3SS activation, yet little is known about T3SS architecture in this state or the conformational changes that drive effector translocation. Here we use cryo-electron tomography and sub-tomogram averaging to derive the intact structure of the primordial Chlamydia trachomatis T3SS in the presence and absence of host membrane contact. Comparison of the averaged structures demonstrates a marked compaction of the basal body (4 nm) occurs when the needle tip contacts the host cell membrane. This compaction is coupled to a stabilization of the cytosolic sorting platform-ATPase. Our findings reveal the first structure of a bacterial T3SS from a major human pathogen engaged with a eukaryotic host, and reveal striking 'pump-action' conformational changes that underpin effector injection.

Structure of a bacterial type III secretion system in contact with a host membrane in situ

NASA Astrophysics Data System (ADS)

Nans, Andrea; Kudryashev, Mikhail; Saibil, Helen R.; Hayward, Richard D.

2015-12-01

Many bacterial pathogens of animals and plants use a conserved type III secretion system (T3SS) to inject virulence effector proteins directly into eukaryotic cells to subvert host functions. Contact with host membranes is critical for T3SS activation, yet little is known about T3SS architecture in this state or the conformational changes that drive effector translocation. Here we use cryo-electron tomography and sub-tomogram averaging to derive the intact structure of the primordial Chlamydia trachomatis T3SS in the presence and absence of host membrane contact. Comparison of the averaged structures demonstrates a marked compaction of the basal body (4 nm) occurs when the needle tip contacts the host cell membrane. This compaction is coupled to a stabilization of the cytosolic sorting platform-ATPase. Our findings reveal the first structure of a bacterial T3SS from a major human pathogen engaged with a eukaryotic host, and reveal striking `pump-action' conformational changes that underpin effector injection.

TU-H-CAMPUS-JeP3-05: Adaptive Determination of Needle Sequence HDR Prostate Brachytherapy with Divergent Needle-By-Needle Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borot de Battisti, M; Maenhout, M; Lagendijk, J J W

Purpose: To develop a new method which adaptively determines the optimal needle insertion sequence for HDR prostate brachytherapy involving divergent needle-by-needle dose delivery by e.g. a robotic device. A needle insertion sequence is calculated at the beginning of the intervention and updated after each needle insertion with feedback on needle positioning errors. Methods: Needle positioning errors and anatomy changes may occur during HDR brachytherapy which can lead to errors in the delivered dose. A novel strategy was developed to calculate and update the needle sequence and the dose plan after each needle insertion with feedback on needle positioning errors. Themore » dose plan optimization was performed by numerical simulations. The proposed needle sequence determination optimizes the final dose distribution based on the dose coverage impact of each needle. This impact is predicted stochastically by needle insertion simulations. HDR procedures were simulated with varying number of needle insertions (4 to 12) using 11 patient MR data-sets with PTV, prostate, urethra, bladder and rectum delineated. Needle positioning errors were modeled by random normally distributed angulation errors (standard deviation of 3 mm at the needle’s tip). The final dose parameters were compared in the situations where the needle with the largest vs. the smallest dose coverage impact was selected at each insertion. Results: Over all scenarios, the percentage of clinically acceptable final dose distribution improved when the needle selected had the largest dose coverage impact (91%) compared to the smallest (88%). The differences were larger for few (4 to 6) needle insertions (maximum difference scenario: 79% vs. 60%). The computation time of the needle sequence optimization was below 60s. Conclusion: A new adaptive needle sequence determination for HDR prostate brachytherapy was developed. Coupled to adaptive planning, the selection of the needle with the largest dose coverage

C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty.

PubMed

Tam, Alda L; Mohamed, Ashraf; Pfister, Marcus; Chinndurai, Ponraj; Rohm, Esther; Hall, Andrew F; Wallace, Michael J

2010-05-01

Retrospective review. To report our early clinical experience using C-arm cone beam computed tomography (C-arm CBCT) with fluoroscopic overlay for needle guidance during vertebroplasty. C-arm CBCT is advanced three-dimensional (3-D) imaging technology that is currently available on state-of-the-art flat panel based angiography systems. The imaging information provided by C-arm CBCT allows for the acquisition and reconstruction of "CT-like" images in flat panel based angiography/interventional suites. As part of the evolution of this technology, enhancements allowing the overlay of cross-sectional imaging information can now be integrated with real time fluoroscopy. We report our early clinical experience with C-arm CBCT with fluoroscopic overlay for needle guidance during vertebroplasty. This is a retrospective review of 10 consecutive oncology patients who underwent vertebroplasty of 13 vertebral levels using C-arm CBCT with fluoroscopic overlay for needle guidance from November 2007 to December 2008. Procedural data including vertebral level, approach (transpedicular vs. extrapedicular), access (bilateral vs. unilateral) and complications were recorded. Technical success with the overlay technology was assessed based on accuracy which consisted of 4 measured parameters: distance from target to needle tip, distance from planned path to needle tip, distance from midline to needle tip, and distance from the anterior 1/3 of the vertebral body to needle tip. Success within each parameter required that the distance between the needle tip and parameter being evaluated be no more than 5 mm on multiplanar CBCT or fluoroscopy. Imaging data for 12 vertebral levels was available for review. All vertebral levels were treated using unilateral access and 9 levels were treated with an extrapedicular approach. Technical success rates were 92% for both distance from planned path and distance from midline to final needle tip, 100% when distance from needle tip to the anterior 1/3

Investigation of tissue cellularity at the tip of the core biopsy needle with optical coherence tomography.

PubMed

Iftimia, Nicusor; Park, Jesung; Maguluri, Gopi; Krishnamurthy, Savitri; McWatters, Amanda; Sabir, Sharjeel H

2018-02-01

We report the development and the pre-clinical testing of a new technology based on optical coherence tomography (OCT) for investigating tissue composition at the tip of the core biopsy needle. While ultrasound, computed tomography, and magnetic resonance imaging are routinely used to guide needle placement within a tumor, they still do not provide the resolution needed to investigate tissue cellularity (ratio between viable tumor and benign stroma) at the needle tip prior to taking a biopsy core. High resolution OCT imaging, however, can be used to investigate tissue morphology at the micron scale, and thus to determine if the biopsy core would likely have the expected composition. Therefore, we implemented this capability within a custom-made biopsy gun and evaluated its capability for a correct estimation of tumor tissue cellularity. A pilot study on a rabbit model of soft tissue cancer has shown the capability of this technique to provide correct evaluation of tumor tissue cellularity in over 85% of the cases. These initial results indicate the potential benefit of the OCT-based approach for improving the success of the core biopsy procedures.

T3SS-dependent differential modulations of the jasmonic acid pathway in susceptible and resistant genotypes of Malus spp. challenged with Erwinia amylovora.

PubMed

Dugé De Bernonville, Thomas; Gaucher, Matthieu; Flors, Victor; Gaillard, Sylvain; Paulin, Jean-Pierre; Dat, James F; Brisset, Marie-Noëlle

2012-06-01

Fire blight is a bacterial disease of Maloideae caused by Erwinia amylovora (Ea). This necrogenic enterobacterium uses a type III secretion system (T3SS) to inject type III effectors into the plant cells to cause disease on its susceptible hosts, including economically important crops like apple and pear. The expressions of marker genes of the salicylic acid (SA) and jasmonic acid (JA) defense regulation pathways were monitored by RT-qPCR in leaves of two apple genotypes, one susceptible and one resistant, challenged with a wild type strain, a T3SS-deficient strain or water. The transcriptional data taken together with hormone level measurements indicated that the SA pathway was similarly induced in both apple genotypes during infection by Ea. On the contrary, the data clearly showed a strong T3SS-dependent down-regulation of the JA pathway in leaves of the susceptible genotype but not in those of the resistant one. Accordingly, methyl-jasmonate treated susceptible plants displayed an increased resistance to Ea. Bacterial mutant analysis indicated that JA manipulation by Ea mainly relies on the type III effector DspA/E. Taken together, our data suggest that the T3SS-dependent down-regulation of the JA pathway is a critical step in the infection process of Malus spp. by Ea. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Structure and biophysics of type III secretion in bacteria.

PubMed

Chatterjee, Srirupa; Chaudhury, Sukanya; McShan, Andrew C; Kaur, Kawaljit; De Guzman, Roberto N

2013-04-16

Many plant and animal bacterial pathogens assemble a needle-like nanomachine, the type III secretion system (T3SS), to inject virulence proteins directly into eukaryotic cells to initiate infection. The ability of bacteria to inject effectors into host cells is essential for infection, survival, and pathogenesis for many Gram-negative bacteria, including Salmonella, Escherichia, Shigella, Yersinia, Pseudomonas, and Chlamydia spp. These pathogens are responsible for a wide variety of diseases, such as typhoid fever, large-scale food-borne illnesses, dysentery, bubonic plague, secondary hospital infections, and sexually transmitted diseases. The T3SS consists of structural and nonstructural proteins. The structural proteins assemble the needle apparatus, which consists of a membrane-embedded basal structure, an external needle that protrudes from the bacterial surface, and a tip complex that caps the needle. Upon host cell contact, a translocon is assembled between the needle tip complex and the host cell, serving as a gateway for translocation of effector proteins by creating a pore in the host cell membrane. Following delivery into the host cytoplasm, effectors initiate and maintain infection by manipulating host cell biology, such as cell signaling, secretory trafficking, cytoskeletal dynamics, and the inflammatory response. Finally, chaperones serve as regulators of secretion by sequestering effectors and some structural proteins within the bacterial cytoplasm. This review will focus on the latest developments and future challenges concerning the structure and biophysics of the needle apparatus.

Toward a 3D transrectal ultrasound system for verification of needle placement during high-dose-rate interstitial gynecologic brachytherapy.

PubMed

Rodgers, Jessica Robin; Surry, Kathleen; Leung, Eric; D'Souza, David; Fenster, Aaron

2017-05-01

postinsertion CT scan based on the vaginal cylinder of the needle template. The positions of the tips and the trajectory of the needle paths were compared between the modalities. The observed geometric errors of the system were ≤ 0.3 mm in each of the three coordinate planes of the 3D US image and the mean measured volumetric error was 0.10 cm 3 . In the phantom study, the mean needle tip difference was 1.54 ± 0.71 mm and the mean trajectory difference was 0.94 ± 0.89 degrees (n = 14). In the in vivo study, a total of 73 needles were placed, of which 88% of needles were visible and 79% of tips were identifiable in the 3D TRUS images. Six of the nine needles that were not visible were due to shadowing artifacts created by the presence of the vaginal cylinder of the needle template. The mean distance between corresponding needle tips in the two modalities was 3.82 ± 1.86 mm and the mean trajectory difference was 3.04 ± 1.63 degrees for the five patients. In this proof-of-concept study, the 3D TRUS system allowed for localization of needles not obscured by shadowing artifacts, providing a method for visualizing needles intra-operatively during HDR interstitial brachytherapy of gynecologic cancers and providing the potential for 3D image-guidance. © 2017 American Association of Physicists in Medicine.

The Vibrio alginolyticus T3SS effectors, Val1686 and Val1680, induce cell rounding, apoptosis and lysis of fish epithelial cells

PubMed Central

Zhao, Zhe; Liu, Jinxin; Deng, Yiqin; Huang, Wen; Ren, Chunhua; Call, Douglas R.; Hu, Chaoqun

2018-01-01

ABSTRACT Vibrio alginolyticus is a Gram-negative bacterium that is an opportunistic pathogen of both marine animals and people. Its pathogenesis likely involves type III secretion system (T3SS) mediated induction of rapid apoptosis, cell rounding and osmotic lysis of infected eukaryotic cells. Herein, we report that effector proteins, Val1686 and Val1680 from V. alginolyticus, were responsible for T3SS-mediated death of fish cells. Val1686 is a Fic-domain containing protein that not only contributed to cell rounding by inhibiting Rho guanosine triphosphatases (GTPases), but was requisite for the induction of apoptosis because the deletion mutant (Δval1686) was severely weakened in its ability to induce cell rounding and apoptosis in fish cells. In addition, Val1686 alone was sufficient to induce cell rounding and apoptosis as evidenced by the transfection of Val1686 into fish cells. Importantly, the Fic-domain essential for cell rounding activity was equally important to activation of apoptosis of fish cells, indicating that apoptosis is a downstream event of Val1686-dependent GTPase inhibition. V. alginolyticus infection likely activates JNK and ERK pathways with sequential activation of caspases (caspase-8/-10, -9 and -3) and subsequent apoptosis. Val1680 contributed to T3SS-dependent lysis of fish cells in V. alginolyticus, but did not induce autophagy as has been reported for its homologue (VopQ) in V. parahaemolyticus. Together, Val1686 and Val1680 work together to induce apoptosis, cell rounding and cell lysis of V. alginolyticus-infected fish cells. These findings provide new insights into the mechanism of cell death caused by T3SS of V. alginolyticus. PMID:29252102

Escherichia coli type III secretion system 2: a new kind of T3SS?

PubMed

Zhou, Mingxu; Guo, Zhiyan; Duan, Qiangde; Hardwidge, Philip R; Zhu, Guoqiang

2014-03-19

Type III secretion systems (T3SSs) are employed by Gram-negative bacteria to deliver effector proteins into the cytoplasm of infected host cells. Enteropathogenic Escherichia coli use a T3SS to deliver effector proteins that result in the creation of the attaching and effacing lesions. The genome sequence of the Escherichia coli pathotype O157:H7 revealed the existence of a gene cluster encoding components of a second type III secretion system, the E. coli type III secretion system 2 (ETT2). Researchers have revealed that, although ETT2 may not be a functional secretion system in most (or all) strains, it still plays an important role in bacterial virulence. This article summarizes current knowledge regarding the E. coli ETT2, including its genetic characteristics, prevalence, function, association with virulence, and prospects for future work.

Methods for Improving the Curvature of Steerable Needles in Biological Tissue

PubMed Central

Adebar, Troy K.; Greer, Joseph D.; Laeseke, Paul F.; Hwang, Gloria L.; Okamura, Allison M.

2016-01-01

Robotic needle steering systems have the potential to improve percutaneous interventions such as radiofrequency ablation of liver tumors, but steering techniques described to date have not achieved sufficiently small radius of curvature in biological tissue to be relevant to this application. In this work, the impact of tip geometry on steerable needle curvature is examined. Finite-element simulations and experiments with bent-tip needles in ex vivo liver tissue demonstrate that selection of tip length and angle can greatly improve curvature, with radius of curvature below 5 cm in liver tissue possible through judicious selection of these parameters. Motivated by the results of this analysis, a new articulated-tip steerable needle is described, in which a distal section is actively switched by a robotic system between a straight tip (resulting in a straight path) and a bent tip (resulting in a curved path). This approach allows the tip length and angle to be increased, while the straight configuration allows the needle tip to still pass through an introducer sheath and rotate inside the body. Validation testing in liver tissue shows that the new articulated-tip steerable needle achieves smaller radius of curvature compared to bent-tip needles described in previous work. Steerable needles with optimized tip parameters, which can generate tight curves in liver tissue, increase the clinical relevance of needle steering to percutaneous interventions. PMID:26441438

Spa47 is an oligomerization-activated type three secretion system (T3SS) ATPase from Shigella flexneri.

PubMed

Burgess, Jamie L; Jones, Heather B; Kumar, Prashant; Toth, Ronald T; Middaugh, C Russell; Antony, Edwin; Dickenson, Nicholas E

2016-05-01

Gram-negative pathogens often use conserved type three secretion systems (T3SS) for virulence. The Shigella type three secretion apparatus (T3SA) penetrates the host cell membrane and provides a unidirectional conduit for injection of effectors into host cells. The protein Spa47 localizes to the base of the apparatus and is speculated to be an ATPase that provides the energy for T3SA formation and secretion. Here, we developed an expression and purification protocol, producing active Spa47 and providing the first direct evidence that Spa47 is a bona fide ATPase. Additionally, size exclusion chromatography and analytical ultracentrifugation identified multiple oligomeric species of Spa47 with the largest greater than 8 fold more active for ATP hydrolysis than the monomer. An ATPase inactive Spa47 point mutant was then engineered by targeting a conserved Lysine within the predicted Walker A motif of Spa47. Interestingly, the mutant maintained a similar oligomerization pattern as active Spa47, but was unable to restore invasion phenotype when used to complement a spa47 null S. flexneri strain. Together, these results identify Spa47 as a Shigella T3SS ATPase and suggest that its activity is linked to oligomerization, perhaps as a regulatory mechanism as seen in some related pathogens. Additionally, Spa47 catalyzed ATP hydrolysis appears to be essential for host cell invasion, providing a strong platform for additional studies dissecting its role in virulence and providing an attractive target for anti-infective agents. © 2016 The Protein Society.

Coaxial needle insertion assistant with enhanced force feedback.

PubMed

De Lorenzo, Danilo; Koseki, Yoshihiko; De Momi, Elena; Chinzei, Kiyoyuki; Okamura, Allison M

2013-02-01

Many medical procedures involving needle insertion into soft tissues, such as anesthesia, biopsy, brachytherapy, and placement of electrodes, are performed without image guidance. In such procedures, haptic detection of changing tissue properties at different depths during needle insertion is important for needle localization and detection of subsurface structures. However, changes in tissue mechanical properties deep inside the tissue are difficult for human operators to sense, because the relatively large friction force between the needle shaft and the surrounding tissue masks the smaller tip forces. A novel robotic coaxial needle insertion assistant, which enhances operator force perception, is presented. This one-degree-of-freedom cable-driven robot provides to the operator a scaled version of the force applied by the needle tip to the tissue, using a novel design and sensors that separate the needle tip force from the shaft friction force. The ability of human operators to use the robot to detect membranes embedded in artificial soft tissue was tested under the conditions of 1) tip force and shaft force feedback, and 2) tip force only feedback. The ratio of successful to unsuccessful membrane detections was significantly higher (up to 50%) when only the needle tip force was provided to the user.

Experimental and Numerical Study of Needle Peening Effects in Aluminium Alloy 2024-T3 Sheets

NASA Astrophysics Data System (ADS)

Mendez Romero, Julio Alberto

Peening of metallic components is an effective treatment used in aerospace and automotive applications to improve fatigue properties or to blend and repair localized damage. This process is typically carried out using metallic airborne media, called shot. However, different processes make use of different media, such is the case of hard, pneumatically powered needles of needle peening equipment. In order to obtain a better understanding of the effects of needle peening in the same context as shot peening, this research work had as an objective to study in detail the behavior of the needle peening equipment in order to characterize the process, design an experimental campaign to measure the effects of needle peening on AA2024-T3 and to develop and validate a Finite Element (FE) model capable of replicating the results of needle peening. The needle peening equipment prototype, called SPIKERRTM, was developed by Shockform Aeronautique Inc. The equipment was characterized by utilizing high-speed camera recording in order to study its behaviour by varying the operating pressure. The obtained collection of images was ran through a newly developed digital image algorithm, so as to quantify the needles' velocity and frequency. The impact velocity and impact frequency were determined for different equipment operating parameters. It was concluded that both the average impact velocity and the impact frequency increase as the pressure becomes larger. Behaviour anomalies among the different needles, such as frequency and velocity variations, were brought to light; these conclusions could be of interest to the manufacturer. Ideally, all of the needles should behave as similarly as possible so as to produce a more uniform process. The response to needle peening of AA2024-T3 in 1.6 mm thick sheet form was studied by needle peening test specimens with dimensions of an Almen strips using the SPIKERRTM. AA2024-T3 was selected since it was extensively studied at Ecole Polytechnique de

Kalman filter-based EM-optical sensor fusion for needle deflection estimation.

PubMed

Jiang, Baichuan; Gao, Wenpeng; Kacher, Daniel; Nevo, Erez; Fetics, Barry; Lee, Thomas C; Jayender, Jagadeesan

2018-04-01

In many clinical procedures such as cryoablation that involves needle insertion, accurate placement of the needle's tip at the desired target is the major issue for optimizing the treatment and minimizing damage to the neighboring anatomy. However, due to the interaction force between the needle and tissue, considerable error in intraoperative tracking of the needle tip can be observed as needle deflects. In this paper, measurements data from an optical sensor at the needle base and a magnetic resonance (MR) gradient field-driven electromagnetic (EM) sensor placed 10 cm from the needle tip are used within a model-integrated Kalman filter-based sensor fusion scheme. Bending model-based estimations and EM-based direct estimation are used as the measurement vectors in the Kalman filter, thus establishing an online estimation approach. Static tip bending experiments show that the fusion method can reduce the mean error of the tip position estimation from 29.23 mm of the optical sensor-based approach to 3.15 mm of the fusion-based approach and from 39.96 to 6.90 mm, at the MRI isocenter and the MRI entrance, respectively. This work established a novel sensor fusion scheme that incorporates model information, which enables real-time tracking of needle deflection with MRI compatibility, in a free-hand operating setup.

Modeling and Control of Needles with Torsional Friction

PubMed Central

Reed, Kyle B.; Okamura, Allison M.; Cowan, Noah J.

2010-01-01

A flexible needle can be accurately steered by robotically controlling the bevel tip orientation as the needle is inserted into tissue. Friction between the long, flexible needle shaft and the tissue can cause a significant discrepancy between the orientation of the needle tip and the orientation of the base where the needle angle is controlled. Our experiments show that several common phantom tissues used in needle steering experiments impart substantial friction forces to the needle shaft, resulting in a lag of over 45° for a 10 cm insertion depth in some phantoms; clinical studies report torques large enough to cause similar errors during needle insertions. Such angle discrepancies will result in poor performance or failure of path planners and image-guided controllers, since the needles used in percutaneous procedures are too small for state-of-the-art imaging to accurately measure the tip angle. To compensate for the angle discrepancy, we develop an estimator using a mechanics-based model of the rotational dynamics of a needle being inserted into tissue. Compared to controllers that assume a rigid needle in a frictionless environment, our estimator-based controller improves the tip angle convergence time by nearly 50% and reduces the path deviation of the needle by 70%. PMID:19695979

Automatic Robotic Steering of Flexible Needles from 3D Ultrasound Images in Phantoms and Ex Vivo Biological Tissue.

PubMed

Mignon, Paul; Poignet, Philippe; Troccaz, Jocelyne

2018-05-29

Robotic control of needle bending aims at increasing the precision of percutaneous procedures. Ultrasound feedback is preferable for its clinical ease of use, cost and compactness but raises needle detection issues. In this paper, we propose a complete system dedicated to robotized guidance of a flexible needle under 3D ultrasound imaging. This system includes a medical robot dedicated to transperineal needle positioning and insertion, a rapid path planning for needle steering using bevel-tip needle natural curvature in tissue, and an ultrasound-based automatic needle detection algorithm. Since ultrasound-based automatic needle steering is often made difficult by the needle localization in biological tissue, we quantify the benefit of using flexible echogenic needles for robotized guidance under 3D ultrasound. The "echogenic" term refers to the etching of microstructures on the needle shaft. We prove that these structures improve needle visibility and detection robustness in ultrasound images. We finally present promising results when reaching targets using needle steering. The experiments were conducted with various needles in different media (synthetic phantoms and ex vivo biological tissue). For instance, with nitinol needles the mean accuracy is 1.2 mm (respectively 3.8 mm) in phantoms (resp. biological tissue).

Chitin-induced T6SS in Vibrio cholerae is dependent on ChiS activation.

PubMed

Chourashi, Rhishita; Das, Suman; Dhar, Debarpan; Okamoto, Keinosuke; Mukhopadhyay, Asish K; Chatterjee, Nabendu Sekhar

2018-05-01

Vibrio cholerae regularly colonizes the chitinous exoskeleton of crustacean shells in the aquatic region. The type 6 secretion system (T6SS) in V. cholerae is an interbacterial killing device. This system is thought to provide a competitive advantage to V. cholerae in a polymicrobial community of the aquatic region under nutrient-poor conditions. V. cholerae chitin sensing is known to be initiated by the activation of a two-component sensor histidine kinase ChiS in the presence of GlcNAc2 (N,N'-diacetylchitobiose) residues generated by the action of chitinases on chitin. It is known that T6SS in V. cholerae is generally induced by chitin. However, the effect of ChiS activation on T6SS is unknown. Here, we found that ChiS inactivation resulted in impaired bacterial killing and reduced expression of T6SS genes. Active ChiS positively affected T6SS-mediated natural transformation in V. cholerae. ChiS depletion or inactivation also resulted in reduced colonization on insoluble chitin surfaces. Therefore, we have shown that V. cholerae colonization on chitinous surfaces activates ChiS, which promotes T6SS-dependent bacterial killing and horizontal gene transfer. We also highlight the importance of chitinases in T6SS upregulation.

Fabrication of Fine Electrodes on the Tip of Hypodermic Needle Using Photoresist Spray Coating and Flexible Photomask for Biomedical Applications.

PubMed

Yun, Joho; Kim, Jinhwan; Lee, Jong-Hyun

2017-11-28

We have introduced a fabrication method for electrical impedance spectroscopy (EIS)-on-a-needle (EoN: EIS-on-a-needle) to locate target tissues in the body by measuring and analyzing differences in the electrical impedance between dissimilar biotissues. This paper describes the fabrication method of fine interdigitated electrodes (IDEs) at the tip of a hypodermic needle using a photoresist spray coating and flexible film photomask in the photolithography process. A polyethylene terephthalate (PET) heat shrink tube (HST) with a wall thickness of 25 µm is employed as the insulation and passivation layer. The PET HST shows a higher mechanical durability compared with poly(p-xylylene) polymers, which have been widely used as a dielectric coating material. Furthermore, the HST shows good chemical resistance to most acids and bases, which is advantageous for limiting chemical damage to the EoN. The use of the EoN is especially preferred for the characterization of chemicals/biomaterials or fabrication using acidic/basic chemicals. The fabricated gap and width of the IDEs are as small as 20 µm, and the overall width and length of the IDEs are 400 µm and 860 µm, respectively. The fabrication margin from the tip (distance between the tip of hypodermic needle and starting point of the IDEs) of the hypodermic needle is as small as 680 µm, which indicates that unnecessarily excessive invasion into biotissues can be avoided during the electrical impedance measurement. The EoN has a high potential for clinical use, such as for thyroid biopsies and anesthesia drug delivery in a spinal space. Further, even in surgery that involves the partial resection of tumors, the EoN can be employed to preserve as much normal tissue as possible by detecting the surgical margin (normal tissue that is removed with the surgical excision of a tumor) between the normal and lesion tissues.

Needle path planning and steering in a three-dimensional non-static environment using two-dimensional ultrasound images

PubMed Central

Vrooijink, Gustaaf J.; Abayazid, Momen; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

Needle insertion is commonly performed in minimally invasive medical procedures such as biopsy and radiation cancer treatment. During such procedures, accurate needle tip placement is critical for correct diagnosis or successful treatment. Accurate placement of the needle tip inside tissue is challenging, especially when the target moves and anatomical obstacles must be avoided. We develop a needle steering system capable of autonomously and accurately guiding a steerable needle using two-dimensional (2D) ultrasound images. The needle is steered to a moving target while avoiding moving obstacles in a three-dimensional (3D) non-static environment. Using a 2D ultrasound imaging device, our system accurately tracks the needle tip motion in 3D space in order to estimate the tip pose. The needle tip pose is used by a rapidly exploring random tree-based motion planner to compute a feasible needle path to the target. The motion planner is sufficiently fast such that replanning can be performed repeatedly in a closed-loop manner. This enables the system to correct for perturbations in needle motion, and movement in obstacle and target locations. Our needle steering experiments in a soft-tissue phantom achieves maximum targeting errors of 0.86 ± 0.35 mm (without obstacles) and 2.16 ± 0.88 mm (with a moving obstacle). PMID:26279600

The Post-transcriptional Regulator rsmA/csrA Activates T3SS by Stabilizing the 5′ UTR of hrpG, the Master Regulator of hrp/hrc Genes, in Xanthomonas

PubMed Central

Andrade, Maxuel O.; Farah, Chuck S.; Wang, Nian

2014-01-01

The RsmA/CsrA family of the post-transcriptional regulators of bacteria is involved in the regulation of many cellular processes, including pathogenesis. In this study, we demonstrated that rsmA not only is required for the full virulence of the phytopathogenic bacterium Xanthomonas citri subsp. citri (XCC) but also contributes to triggering the hypersensitive response (HR) in non-host plants. Deletion of rsmA resulted in significantly reduced virulence in the host plant sweet orange and a delayed and weakened HR in the non-host plant Nicotiana benthamiana. Microarray, quantitative reverse-transcription PCR, western-blotting, and GUS assays indicated that RsmA regulates the expression of the type 3 secretion system (T3SS) at both transcriptional and post-transcriptional levels. The regulation of T3SS by RsmA is a universal phenomenon in T3SS-containing bacteria, but the specific mechanism seems to depend on the interaction between a particular bacterium and its hosts. For Xanthomonads, the mechanism by which RsmA activates T3SS remains unknown. Here, we show that RsmA activates the expression of T3SS-encoding hrp/hrc genes by directly binding to the 5′ untranslated region (UTR) of hrpG, the master regulator of the hrp/hrc genes in XCC. RsmA stabilizes hrpG mRNA, leading to increased accumulation of HrpG proteins and subsequently, the activation of hrp/hrc genes. The activation of the hrp/hrc genes by RsmA via HrpG was further supported by the observation that ectopic overexpression of hrpG in an rsmA mutant restored its ability to cause disease in host plants and trigger HR in non-host plants. RsmA also stabilizes the transcripts of another T3SS-associated hrpD operon by directly binding to the 5′ UTR region. Taken together, these data revealed that RsmA primarily activates T3SS by acting as a positive regulator of hrpG and that this regulation is critical to the pathogenicity of XCC. PMID:24586158

The 3DBiopsy Prostate Biopsy System: Preclinical Investigation of a Needle, Actuator, and Specimen Collection Device Allowing Sampling of Individualized Prostate Lengths Between 20 and 60 mm.

PubMed

Stone, Nelson N; Mouraviev, Vladimir; Schechter, David; Lucia, M Scott; Smith, Elizabeth E; Arangua, Paul; Hoenemeyer, John; Rosa, Jim; Bawa, Rajan; Crawford, E David

2017-09-01

To increase the likelihood of detecting anterior cancers within the prostate and provide a specimen that spans the length of the gland. Newly designed 17- and 15-gauge (G) biopsy needles, a variable actuator, and an integrated pathology system intended for the longer cores were developed and tested for this purpose. Testing was performed comparing 2 common cannula tip grinds, a Vet-point (sharp tip) and a Menghini-point (atraumatic tip), and were tested against 18-G Bard Monopty in porcine kidney. A variable actuator was developed to fire the needle 20-60 mm and tested in cadaver prostates. The aggregate firings for 3 different shot lengths comparing the Vet- with the Menghini-tip cannulas demonstrated 91% vs 85.2% fill (length of specimen/length of core bed, P = .007). A 15-G trocar needle with the Vet-tip cannula also had the best performance, with an aggregate standard deviation of 6.4% across 3 firing ranges and a minimum to maximum specimen length of 81%-105% of potential fill. Cadaver testing with the Vet-tip needles in the actuator for the transrectal (17-G) and transperineal (15-G) biopsies demonstrated mean fills of 93.3% and 76.5%, respectively. The new transrectal ultrasound needle obtained a 2-fold increase in specimen length over the standard Bard device (P <.001). Longer and consistent cores were obtained using the new biopsy needles. Combined with an adjustable actuator, the physician can obtain specimens that include peripheral and anterior zone tissue in 1 core. Determination of cancer location on the longer specimens could enhance focal therapy planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Singleshot T1 Mapping using Simultaneous Acquisitions of Spin- and STimulated-Echo Planar Imaging (2D ss-SESTEPI)

PubMed Central

Shi, Xianfeng; Kim, Seong-Eun; Jeong, Eun-Kee

2011-01-01

The conventional stimulated-echo NMR sequence only measures the longitudinal component, while discarding the transverse component, after tipping up the prepared magnetization. This transverse magnetization can be used to measure a spin-echo, in addition to the stimulated-echo. 2D ss-SESTEPI is an EPI-based singleshot imaging technique that simultaneously acquires a spin-echo-planar image (SEPI) and a stimulated-echo-planar image (STEPI) after a single RF excitation. The magnitudes of SEPI and STEPI differ by T1 decay and diffusion weighting for perfect 90° RF, and thus can be used to rapidly measure T1. However, the spatial variation of B1 amplitude induces un-even splitting of the transverse magnetization for SEPI and STEPI within the imaging FOV. Correction for B1 inhomogeneity is therefore critical for 2D ss-SESTEPI to be used for T1 measurement. We developed a method for B1 inhomogeneity correction by acquiring an additional STEPI with minimal mixing time, calculating the difference between the spin-echo and the stimulated-echo and multiplying the STEPI by the inverse functional map. Diffusion-induced decay is corrected by measuring the average diffusivity during the prescanning. Rapid singleshot T1 mapping may be useful for various applications, such as dynamic T1 mapping for real-time estimation of the concentration of contrast agent in DCE-MRI. PMID:20564579

A microfluidic needle for sampling and delivery of chemical signals by segmented flows

NASA Astrophysics Data System (ADS)

Feng, Shilun; Liu, Guozhen; Jiang, Lianmei; Zhu, Yonggang; Goldys, Ewa M.; Inglis, David W.

2017-10-01

We have developed a microfluidic needle-like device that can extract and deliver nanoliter samples. The device consists of a T-junction to form segmented flows, parallel channels to and from the needle tip, and seven hydrophilic capillaries at the tip that form a phase-extraction region. The main microchannel is hydrophobic and carries segmented flows of water-in-oil. The hydrophilic capillaries transport the aqueous phase with a nearly zero pressure gradient but require a pressure gradient of 19 kPa for mineral oil to invade and flow through. Using this device, we demonstrate the delivery of nanoliter droplets and demonstrate sampling through the formation of droplets at the tip of our device. During sampling, we recorded the fluorescence intensities of the droplets formed at the tip while varying the concentration of dye outside the tip. We measured a chemical signal response time of approximately 3 s. The linear relationship between the recorded fluorescence intensity of samples and the external dye concentration (10-40 μg/ml) indicates that this device is capable of performing quantitative, real-time measurements of rapidly varying chemical signals.

Endpoint Accuracy in Manual Control of a Steerable Needle.

PubMed

van de Berg, Nick J; Dankelman, Jenny; van den Dobbelsteen, John J

2017-02-01

To study the ability of a human operator to manually correct for errors in the needle insertion path without partial withdrawal of the needle by means of an active, tip-articulated steerable needle. The needle is composed of a 1.32-mm outer-diameter cannula, with a flexure joint near the tip, and a retractable stylet. The bending stiffness of the needle resembles that of a 20-gauge hypodermic needle. The needle functionality was evaluated in manual insertions by steering to predefined targets and a lateral displacement of 20 mm from the straight insertion line. Steering tasks were conducted in 5 directions and 2 tissue simulants under image guidance from a camera. The repeatability in instrument actuations was assessed during 100 mm deep automated insertions with a linear motor. In addition to tip position, tip angles were tracked during the insertions. The targeting error (mean absolute error ± standard deviation) during manual steering to 5 different targets in stiff tissue was 0.5 mm ± 1.1. This variability in manual tip placement (1.1 mm) was less than the variability among automated insertions (1.4 mm) in the same tissue type. An increased tissue stiffness resulted in an increased lateral tip displacement. The tip angle was directly controlled by the user interface, and remained unaffected by the tissue stiffness. This study demonstrates the ability to manually steer needles to predefined target locations under image guidance. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

EUS Needle Identification Comparison and Evaluation study (with videos).

PubMed

Tang, Shou-Jiang; Vilmann, Andreas S; Saftoiu, Adrian; Wang, Wanmei; Streba, Costin Teodor; Fink, Peter P; Griswold, Michael; Wu, Ruonan; Dietrich, Christoph F; Jenssen, Christian; Hocke, Michael; Kantowski, Marcus; Pohl, Jürgen; Fockens, Paul; Annema, Jouke T; van der Heijden, Erik H F M; Havre, Roald Flesland; Pham, Khanh Do-Cong; Kunda, Rastislav; Deprez, Pierre H; Mariana, Jinga; Vazquez-Sequeiros, Enrique; Larghi, Alberto; Buscarini, Elisabetta; Fusaroli, Pietro; Lahav, Maor; Puri, Rajesh; Garg, Pramod Kumar; Sharma, Malay; Maluf-Filho, Fauze; Sahai, Anand; Brugge, William R; Lee, Linda S; Aslanian, Harry R; Wang, Andrew Y; Shami, Vanessa M; Markowitz, Arnold; Siddiqui, Ali A; Mishra, Girish; Scheiman, James M; Isenberg, Gerard; Siddiqui, Uzma D; Shah, Raj J; Buxbaum, James; Watson, Rabindra R; Willingham, Field F; Bhutani, Manoop S; Levy, Michael J; Harris, Cynthia; Wallace, Michael B; Nolsøe, Christian Pállson; Lorentzen, Torben; Bang, Niels; Sørensen, Sten Mellerup; Gilja, Odd Helge; D'Onofrio, Mirko; Piscaglia, Fabio; Gritzmann, Norbert; Radzina, Maija; Sparchez, Zeno Adrian; Sidhu, Paul S; Freeman, Simon; McCowan, Timothy C; de Araujo, Cyrillo Rodrigues; Patel, Akash; Ali, Mohammad Adel; Campbell, Garth; Chen, Edward; Vilmann, Peter

2016-09-01

EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development. Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices. There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001). All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity. Copyright © 2016 American Society for Gastrointestinal Endoscopy. All rights reserved.

Conformational stability and differential structural analysis of LcrV, PcrV, BipD, and SipD from type III secretion systems

PubMed Central

Espina, Marianela; Ausar, S. Fernando; Middaugh, C. Russell; Baxter, M. Aaron; Picking, William D.; Picking, Wendy L.

2007-01-01

Diverse Gram-negative bacteria use type III secretion systems (T3SS) to translocate effector proteins into the cytoplasm of eukaryotic cells. The type III secretion apparatus (T3SA) consists of a basal body spanning both bacterial membranes and an external needle. A sensor protein lies at the needle tip to detect environmental signals that trigger type III secretion. The Shigella flexneri T3SA needle tip protein, invasion plasmid antigen D (IpaD), possesses two independently folding domains in vitro. In this study, the solution behavior and thermal unfolding properties of IpaD's functional homologs SipD (Salmonella spp.), BipD (Burkholderia pseudomallei), LcrV (Yersinia spp.), and PcrV (Pseudomonas aeruginosa) were examined to identify common features within this protein family. CD and FTIR data indicate that all members within this group are α-helical with properties consistent with an intramolecular coiled-coil. SipD showed the most complex unfolding profile consisting of two thermal transitions, suggesting the presence of two independently folding domains. No evidence of multiple folding domains was seen, however, for BipD, LcrV, or PcrV. Thermal studies, including DSC, revealed significant destabilization of LcrV, PcrV, and BipD after N-terminal deletions. This contrasted with SipD and IpaD, which behaved like two-domain proteins. The results suggest that needle tip proteins share significant core structural similarity and thermal stability that may be the basis for their common function. Moreover, IpaD and SipD possess properties that distinguish them from the other tip proteins. PMID:17327391

Deoxycholate-Enhanced Shigella Virulence Is Regulated by a Rare π-Helix in the Type Three Secretion System Tip Protein IpaD.

PubMed

Bernard, Abram R; Jessop, T Carson; Kumar, Prashant; Dickenson, Nicholas E

2017-12-12

Type three secretion systems (T3SS) are specialized nanomachines that support infection by injecting bacterial proteins directly into host cells. The Shigella T3SS has uniquely evolved to sense environmental levels of the bile salt deoxycholate (DOC) and upregulate virulence in response to DOC. In this study, we describe a rare i + 5 hydrogen bonding secondary structure element (π-helix) within the type three secretion system tip protein IpaD that plays a critical role in DOC-enhanced virulence. Specifically, engineered mutations within the π-helix altered the pathogen's response to DOC, with one mutant construct in particular exhibiting an unprecedented reduction in virulence following DOC exposure. Fluorescence polarization binding assays showed that these altered DOC responses are not the result of differences in affinity between IpaD and DOC, but rather differences in the DOC-dependent T3SS tip maturation resulting from binding of IpaD to translocator/effector protein IpaB. Together, these findings begin to uncover the complex mechanism of DOC-enhanced Shigella virulence while identifying an uncommon structural element that may provide a much needed target for non-antibiotic treatment of Shigella infection.

Short beveled sharp cutting needle is superior to facet tip needle for ultrasound-guided rectus sheath block in children with umbilical hernia: a case series.

PubMed

Alsaeed, A; Thallaj, A; Alzahrani, T; Khalil, N; Aljazaeri, A

2014-10-01

The most common peripheral nerve blocks used in umbilical hernia repair are rectus sheath block and regional block (caudal block). Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this study is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery, and to evaluate the easiness of soft tissue puncture and ultrasonic appearance of two different needle types. Twenty two (22) pediatric patients (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz linear probe. An ultrasound-guided rectus sheath block in the lateral edge of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). A 22 gauge short beveled sharp cutting needle 1.1 x 30 mm needle A (BD Insyte--W, Vialon material. Spain) was used in one side, and a Stimuplex A insulated Needle 22G 50mm (needle B) was used on the other side. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia were evaluated. Ultrasonograghic visualization of the posterior sheath was possible in all patients. Needle A scored 72.7% of excellent needle tip and shaft view (16 out of 22) compared to 63.63% for needle B (14 out of 22). None of the needles scored poor view. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one child who postoperatively requested morphine 0.1 mg/kg intravenously in recovery room. There were no complications. Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia in the lateral edge of the rectus muscle. Use of the sharp short beveled needle of 22 gauge intravenous (IV) cannula stylet provides easy, less traumatic skin and rectus muscle

Torsional Dynamics of Steerable Needles: Modeling and Fluoroscopic Guidance

PubMed Central

Swensen, John P.; Lin, MingDe; Okamura, Allison M.; Cowan, Noah J.

2017-01-01

Needle insertions underlie a diversity of medical interventions. Steerable needles provide a means by which to enhance existing needle-based interventions and facilitate new ones. Tip-steerable needles follow a curved path and can be steered by twisting the needle base during insertion, but this twisting excites torsional dynamics that introduce a discrepancy between the base and tip twist angles. Here, we model the torsional dynamics of a flexible rod—such as a tip-steerable needle—during subsurface insertion and develop a new controller based on the model. The torsional model incorporates time-varying mode shapes to capture the changing boundary conditions inherent during insertion. Numerical simulations and physical experiments using two distinct setups—stereo camera feedback in semi-transparent artificial tissue and feedback control with real-time X-ray imaging in optically opaque artificial tissue— demonstrate the need to account for torsional dynamics in control of the needle tip. PMID:24860026

MIX and match: mobile T6SS MIX-effectors enhance bacterial fitness

PubMed Central

Salomon, Dor

2016-01-01

ABSTRACT Protein secretion systems that mediate interbacterial competition secret a wide repertoire of antibacterial toxins. A major player in these competitions is the newly discovered bacterial type VI secretion system (T6SS). We recently found that a subset of polymorphic MIX-effectors, which are a widespread class of effectors secreted by T6SSs, are horizontally shared between marine bacteria and are used to diversify their T6SS effector repertoires, thus enhancing their environmental fitness. In this commentary, I expand on the ideas that were introduced in the previous report, and further speculate on the possible mobility of other MIX-effectors. In addition, I discuss the possible role of horizontal gene transfer in the dissemination of MIX-effectors through bacterial genomes, as well as its possible role in diversifying the T6SS effector repertoire. PMID:27066305

360-degree 3D transvaginal ultrasound system for high-dose-rate interstitial gynaecological brachytherapy needle guidance

NASA Astrophysics Data System (ADS)

Rodgers, Jessica R.; Surry, Kathleen; D'Souza, David; Leung, Eric; Fenster, Aaron

2017-03-01

Treatment for gynaecological cancers often includes brachytherapy; in particular, in high-dose-rate (HDR) interstitial brachytherapy, hollow needles are inserted into the tumour and surrounding area through a template in order to deliver the radiation dose. Currently, there is no standard modality for visualizing needles intra-operatively, despite the need for precise needle placement in order to deliver the optimal dose and avoid nearby organs, including the bladder and rectum. While three-dimensional (3D) transrectal ultrasound (TRUS) imaging has been proposed for 3D intra-operative needle guidance, anterior needles tend to be obscured by shadowing created by the template's vaginal cylinder. We have developed a 360-degree 3D transvaginal ultrasound (TVUS) system that uses a conventional two-dimensional side-fire TRUS probe rotated inside a hollow vaginal cylinder made from a sonolucent plastic (TPX). The system was validated using grid and sphere phantoms in order to test the geometric accuracy of the distance and volumetric measurements in the reconstructed image. To test the potential for visualizing needles, an agar phantom mimicking the geometry of the female pelvis was used. Needles were inserted into the phantom and then imaged using the 3D TVUS system. The needle trajectories and tip positions in the 3D TVUS scan were compared to their expected values and the needle tracks visualized in magnetic resonance images. Based on this initial study, 360-degree 3D TVUS imaging through a sonolucent vaginal cylinder is a feasible technique for intra-operatively visualizing needles during HDR interstitial gynaecological brachytherapy.

Electromagnetic needles with submicron pole tip radii for nanomanipulation of biomolecules and living cells

NASA Astrophysics Data System (ADS)

Matthews, Benjamin D.; LaVan, David A.; Overby, Darryl R.; Karavitis, John; Ingber, Donald E.

2004-10-01

We describe the design and fabrication of a temperature-controlled electromagnetic microneedle (EMN) to generate custom magnetic field gradients for biomedical and biophysical applications. An electropolishing technique was developed to sharpen the EMN pole tip to any desired radius between 100 nm and 20 μm. The EMN can be used to apply strong static or dynamic forces (>50nN) to micrometer- or nanometer-sized magnetic beads without producing significant heating or needle movement. Large tip radii (20 μm) allow magnetic force application to multiple magnetic beads over a large area, while small radii (0.1-6 μm) can be used to selectively pull or capture single magnetic beads from within a large population of similar particles. The customizable EMN is thus well suited for micro- and nanomanipulation of magnetic particles linked to biomolecules or living cells.

Imaging of implant needles for real-time HDR-brachytherapy prostate treatment using biplane ultrasound transducers.

PubMed

Siebert, Frank-André; Hirt, Markus; Niehoff, Peter; Kovács, György

2009-08-01

Ultrasound imaging is becoming increasingly important in prostate brachytherapy. In high-dose-rate (HDR) real-time planning procedures the definition of the implant needles is often performed by transrectal ultrasound. This article describes absolute measurements of the visibility and accuracy of manual detection of implant needle tips and compares measurement results of different biplane ultrasound systems in transversal and longitudinal (i.e., sagittal) ultrasound modes. To obtain a fixed coordinate system and stable conditions the measurements were carried out in a water tank using a dedicated marker system. Needles were manually placed in the phantom until the observer decided by the real-time ultrasound image that the zero position was reached. A comparison of three different ultrasound systems yielded an offset between 0.8 and 3.1 mm for manual detection of the needle tip in ultrasound images by one observer. The direction of the offset was discovered to be in the proximal direction, i.e., the actual needle position was located more distally compared to the ultrasound-based definition. In the second part of the study, the ultrasound anisotropy of trocar implant needles is reported. It was shown that the integrated optical density in a region of interest around the needle tip changes with needle rotation. Three peaks were observed with a phase angle of 120 degrees. Peaks appear not only in transversal but also in longitudinal ultrasound images, with a phase shift of 60 degrees. The third section of this study shows results of observer dependent influences on needle tip detection in sagittal ultrasound images considering needle rotation. These experiments were carried out using the marker system in a water tank. The needle tip was placed exactly at the position z=0 mm. It was found that different users tend to differently interpret the same ultrasound images. The needle tip was manually detected five times in the ultrasound images by three experienced observers

Transperineal prostate biopsy under magnetic resonance image guidance: a needle placement accuracy study.

PubMed

Blumenfeld, Philip; Hata, Nobuhiko; DiMaio, Simon; Zou, Kelly; Haker, Steven; Fichtinger, Gabor; Tempany, Clare M C

2007-09-01

To quantify needle placement accuracy of magnetic resonance image (MRI)-guided core needle biopsy of the prostate. A total of 10 biopsies were performed with 18-gauge (G) core biopsy needle via a percutaneous transperineal approach. Needle placement error was assessed by comparing the coordinates of preplanned targets with the needle tip measured from the intraprocedural coherent gradient echo images. The source of these errors was subsequently investigated by measuring displacement caused by needle deflection and needle susceptibility artifact shift in controlled phantom studies. Needle placement error due to misalignment of the needle template guide was also evaluated. The mean and standard deviation (SD) of errors in targeted biopsies was 6.5 +/- 3.5 mm. Phantom experiments showed significant placement error due to needle deflection with a needle with an asymmetrically beveled tip (3.2-8.7 mm depending on tissue type) but significantly smaller error with a symmetrical bevel (0.6-1.1 mm). Needle susceptibility artifacts observed a shift of 1.6 +/- 0.4 mm from the true needle axis. Misalignment of the needle template guide contributed an error of 1.5 +/- 0.3 mm. Needle placement error was clinically significant in MRI-guided biopsy for diagnosis of prostate cancer. Needle placement error due to needle deflection was the most significant cause of error, especially for needles with an asymmetrical bevel. (c) 2007 Wiley-Liss, Inc.

In-plane ultrasonic needle tracking using a fiber-optic hydrophone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xia, Wenfeng, E-mail: wenfeng.xia@ucl.ac.uk; Desjardins, Adrien E.; Mari, Jean Martial

Purpose: Accurate and efficient guidance of needles to procedural targets is critically important during percutaneous interventional procedures. Ultrasound imaging is widely used for real-time image guidance in a variety of clinical contexts, but with this modality, uncertainties about the location of the needle tip within the image plane lead to significant complications. Whilst several methods have been proposed to improve the visibility of the needle, achieving accuracy and compatibility with current clinical practice is an ongoing challenge. In this paper, the authors present a method for directly visualizing the needle tip using an integrated fiber-optic ultrasound receiver in conjunction withmore » the imaging probe used to acquire B-mode ultrasound images. Methods: Needle visualization and ultrasound imaging were performed with a clinical ultrasound imaging system. A miniature fiber-optic ultrasound hydrophone was integrated into a 20 gauge injection needle tip to receive transmissions from individual transducer elements of the ultrasound imaging probe. The received signals were reconstructed to create an image of the needle tip. Ultrasound B-mode imaging was interleaved with needle tip imaging. A first set of measurements was acquired in water and tissue ex vivo with a wide range of insertion angles (15°–68°) to study the accuracy and sensitivity of the tracking method. A second set was acquired in an in vivo swine model, with needle insertions to the brachial plexus. A third set was acquired in an in vivo ovine model for fetal interventions, with insertions to different locations within the uterine cavity. Two linear ultrasound imaging probes were used: a 14–5 MHz probe for the first and second sets, and a 9–4 MHz probe for the third. Results: During insertions in tissue ex vivo and in vivo, the imaged needle tip had submillimeter axial and lateral dimensions. The signal-to-noise (SNR) of the needle tip was found to depend on the insertion angle

Influence of Crack-Tip Configurations on the Fracture Response of 0.04-Inch Thick 2024-T3 Aluminum Alloy Sheet

NASA Technical Reports Server (NTRS)

Johnston, William M.; Newman, James C. (Technical Monitor)

2002-01-01

A series of fracture tests were conducted on Middle-crack tension M(T) and compact tension C(T) specimens to determine the effects of specimen type, specimen width, notch tip sharpness and buckling on the fracture behavior of cracked thin sheet (0.04 inch thick) 2024-T3 aluminum alloy material. A series of M(T) specimens were tested with three notch tip configurations: (1) a fatigue pre-cracked notch, (2) a 0.010-inch-diameter wire electrical discharge machined (EDM) notch, and (3) a EDM notch sharpened with a razor blade. The test procedures are discussed and the experimental results for failure stress, load vs. crack extension and the material stress-strain response are reported.

Performance of a New Blunt-Tip Coaxial Needle for Percutaneous Biopsy and Drainage of "Hard-To-Reach" Targets.

PubMed

Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Caudrelier, Jean; Bauones, Salem; Tsoumakidou, Georgia; Koch, Guillaume; Gangi, Afshin

2017-09-01

To present a new blunt-tip coaxial needle (SoftGuard) applied to access "hard-to-reach" targets undergoing percutaneous image-guided biopsy or drainage. All consecutive patients presenting between August and December 2016 with "hard-to-reach" (<10 mm from a critical nearby structure such as vessels, nerves, bowel or adjacent parenchymal organs) solid lesions requiring biopsy (group A) or abscesses requiring drainage for sepsis (group B) were prospectively included. The individual features of each patient and lesion as well as technical and clinical data were collected and analysed. Twenty-six patients (18 males, 8 females, mean age 59.81 ± 17.53 years) were enrolled in group A and nine (6 males, 3 females, mean age 58.33 ± 13.8 years) in group B. Technical success was achieved in 92.3% of cases from group A and 100% of cases from group B. Five (19.2%) minor complications were noted in group A (four small self-limiting pneumothoraces and one small self-limiting peri-pancreatic haematoma). There were no complications in group B. Histological results in group A accounted for 95% sensitivity, 100% specificity and 95.2% diagnostic accuracy. In group B, mean post-operative C-reactive protein was 41 ± 48.3 mg/L in comparison with 155 ± 117.5 mg/L at baseline (P = 0.004). The SoftGuard blunt-tip needle is a safe and effective tool when applied as a coaxial working cannula for percutaneous biopsy or drainage of "hard-to-reach" targets.

THE STRUCTURES OF COILED-COIL DOMAINS FROM TYPE THREE SECRETION SYSTEM TRANSLOCATORS REVEAL HOMOLOGY TO PORE-FORMING TOXINS

PubMed Central

Barta, Michael L.; Dickenson, Nicholas E.; Patil, Mrinalini; Keightley, Andrew; Wyckoff, Gerald J.; Picking, William D.; Picking, Wendy L.; Geisbrecht, Brian V.

2012-01-01

Many pathogenic Gram-negative bacteria utilize type III secretion systems (T3SS) to alter the normal functions of target cells. Shigella flexneri uses its T3SS to invade human intestinal cells to cause bacillary dysentery (shigellosis) which is responsible for over one million deaths per year. The Shigella type III secretion apparatus (T3SA) is comprised of a basal body spanning both bacterial membranes and an exposed oligomeric needle. Host altering effectors are secreted through this energized unidirectional conduit to promote bacterial invasion. The active needle tip complex of S. flexneri is composed of a tip protein, IpaD, and two pore-forming translocators, IpaB and IpaC. While the atomic structure of IpaD has been elucidated and studied, structural data on the hydrophobic translocators from the T3SS family remain elusive. We present here the crystal structures of a protease-stable fragment identified within the N-terminal regions of IpaB from S. flexneri and SipB from Salmonella enterica serovar Typhimurium determined at 2.1 Å and 2.8 Å limiting resolution, respectively. These newly identified domains are comprised of extended length (114 Å in IpaB and 71 Å in SipB) coiled-coil motifs that display a high degree of structural homology to one another despite the fact that they share only 21% sequence identity. Further structural comparisons also reveal substantial similarity to the coiled-coil regions of pore-forming proteins from other Gram-negative pathogens, notably colicin Ia. This suggests that these mechanistically-separate and functionally-distinct membrane-targeting proteins may have diverged from a common ancestor during the course of pathogen-specific evolutionary events. PMID:22321794

Decreased Spontaneous Electrical Activity and Acetylcholine at Myofascial Trigger Spots after Dry Needling Treatment: A Pilot Study.

PubMed

Liu, Qing-Guang; Liu, Lin; Huang, Qiang-Min; Nguyen, Thi-Tham; Ma, Yan-Tao; Zhao, Jia-Min

2017-01-01

The aims of this study are to investigate the changes in spontaneous electrical activities (SEAs) and in acetylcholine (ACh), acetylcholine receptor (AChR), and acetylcholine esterase (AChE) levels after dry needling at myofascial trigger spots in model rats. Forty-eight male Sprague-Dawley rats were divided into four groups. Thirty-six rats were assigned to three model groups, which underwent MTrSs modeling intervention. Twelve rats were assigned to the blank control (BC) group. After model construction, the 36 model rats were randomly subdivided into three groups according to treatment: MTrSs model control (MC) and two dry needling groups. One dry needling group received puncturing at MTrSs (DN-M), whereas the other underwent puncturing at non-MTrSs (DN-nM). Dry needling treatment will last for two weeks, once a week. SEAs and ACh, AChR, and AChE levels were measured after one-week rest of dry needling treatment. The amplitudes and frequencies of endplate noise (EPN) and endplate spike (EPS) significantly decreased after dry needling treatment in the DN-M group. Moreover, ACh and AChR levels significantly decreased, whereas AChE significantly increased after dry needling treatment in the DN-M group. Dry needling at the exact MTrSs is more effective than dry needling at non-MTrSs.

Decreased Spontaneous Electrical Activity and Acetylcholine at Myofascial Trigger Spots after Dry Needling Treatment: A Pilot Study

PubMed Central

2017-01-01

Objective The aims of this study are to investigate the changes in spontaneous electrical activities (SEAs) and in acetylcholine (ACh), acetylcholine receptor (AChR), and acetylcholine esterase (AChE) levels after dry needling at myofascial trigger spots in model rats. Materials and Methods Forty-eight male Sprague-Dawley rats were divided into four groups. Thirty-six rats were assigned to three model groups, which underwent MTrSs modeling intervention. Twelve rats were assigned to the blank control (BC) group. After model construction, the 36 model rats were randomly subdivided into three groups according to treatment: MTrSs model control (MC) and two dry needling groups. One dry needling group received puncturing at MTrSs (DN-M), whereas the other underwent puncturing at non-MTrSs (DN-nM). Dry needling treatment will last for two weeks, once a week. SEAs and ACh, AChR, and AChE levels were measured after one-week rest of dry needling treatment. Results The amplitudes and frequencies of endplate noise (EPN) and endplate spike (EPS) significantly decreased after dry needling treatment in the DN-M group. Moreover, ACh and AChR levels significantly decreased, whereas AChE significantly increased after dry needling treatment in the DN-M group. Conclusion Dry needling at the exact MTrSs is more effective than dry needling at non-MTrSs. PMID:28592980

Further Characterization of a Type III Secretion System (T3SS) and of a New Effector Protein from a Clinical Isolate of Aeromonas Hydrophila - Part I

EPA Science Inventory

A type III secretion system (T3SS)-associated cytotoxin, AexT, with ADP-ribosyltransferase activity and homology to Pseudomonas aeruginosa bifuncational toxins ExoT/S, was recently identified from a fish pathogen Aeromonas salmonicida. In this study, we reported the molecular cha...

Transbronchial needle aspiration with a new electromagnetically-tracked TBNA needle

NASA Astrophysics Data System (ADS)

Choi, Jae; Popa, Teo; Gruionu, Lucian

2009-02-01

Transbronchial needle aspiration (TBNA) is a common method used to collect tissue for diagnosis of different chest diseases and for staging lung cancer, but the procedure has technical limitations. These limitations are mostly related to the difficulty of accurately placing the biopsy needles into the target mass. Currently, pulmonologists plan TBNA by examining a number of Computed Tomography (CT) scan slices before the operation. Then, they manipulate the bronchoscope down the respiratory track and blindly direct the biopsy. Thus, the biopsy success rate is low. The diagnostic yield of TBNA is approximately 70 percent. To enhance the accuracy of TBNA, we developed a TBNA needle with a tip position that can be electromagnetically tracked. The needle was used to estimate the bronchoscope's tip position and enable the creation of corresponding virtual bronchoscopic images from a preoperative CT scan. The TBNA needle was made with a flexible catheter embedding Wang Transbronchial Histology Needle and a sensor tracked by electromagnetic field generator. We used Aurora system for electromagnetic tracking. We also constructed an image-guided research prototype system incorporating the needle and providing a user-friendly interface to assist the pulmonologist in targeting lesions. To test the feasibility of the accuracy of the newly developed electromagnetically-tracked needle, a phantom study was conducted in the interventional suite at Georgetown University Hospital. Five TBNA simulations with a custom-made phantom with a bronchial tree were performed. The experimental results show that our device has potential to enhance the accuracy of TBNA.

In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle

NASA Astrophysics Data System (ADS)

Li, Yu-Tao; Tang, Li-Na; Ning, Yong; Shu, Qing; Liang, Feng-Xia; Wang, Hua; Zhang, Guo-Jun

2016-06-01

Acupuncture treatment is amazing but controversial. Up to now, the mechanism of treating diseases by acupuncture and moxibustion is still unclear, especially the occurrence of the molecular events in local acupoints. Herein, we report an extremely stable microsensor by modifying carbon nanotube (CNT) to the tip surface of acupuncture needle and applying this CNT-modified acupuncture needle for real time monitoring of serotonin (5-HT) in vivo. To stabilize CNT modification on the needle tip surface, poly(3,4-ethylenedioxythiophene)(PEDOT) was employed as glue water to stick CNT on the needle. The detection limit of the CNT-modified needle was found to be approximately 50 nM and 78 nM in the PBS and the cell medium, respectively. In addition, the needle showed good selectivity to some inflammatory mediators and some electroactive molecules. For the first time, the CNT-modified needle could be directly probed into rat body for real time monitoring of 5-HT in vivo, showing a great potential for better understanding the mechanism of acupuncture treatment.

Ozone production of hollow-needle-to-mesh negative corona discharge enhanced by dielectric tube on the needle electrode

NASA Astrophysics Data System (ADS)

Pekárek, Stanislav

2014-12-01

For the hollow-needle-to-mesh negative corona discharge in air, we studied the effect of placing the dielectric tube on the needle electrode and the effect of various positions of the end of this tube with respect to the tip of the needle electrode on the concentration of ozone produced by the discharge, the ozone production yield and the discharge V-A characteristics. We found that the placement of the dielectric tube on the needle electrode with a suitable position of this tube end with respect to the tip of the needle electrode for a particular discharge power led to a more than fourfold increase in the concentration of ozone produced by the discharge and also, for a constant airflow, the ozone production yield.

A prospective, randomized evaluation of the effects of epidural needle rotation on the distribution of epidural block.

PubMed

Borghi, Battista; Agnoletti, Vanni; Ricci, Alessandro; van Oven, Hanna; Montone, Nicoletta; Casati, Andrea

2004-05-01

We evaluated the effects of turning the tip of the Tuohy needle 45 degrees toward the operative side before threading the epidural catheter (45 degrees -rotation group, n = 24) as compared to a conventional insertion technique with the tip of the Tuohy needle oriented at 90 degrees cephalad (control group, n = 24) on the distribution of 10 mL of 0.75% ropivacaine with 10 microg sufentanil in 48 patients undergoing total hip replacement. The catheter was introduced 3 to 4 cm beyond the tip of the Tuohy needle. A blinded observer recorded sensory and motor blocks on both sides, quality of analgesia, and volumes of local anesthetic used during the first 48 h of patient-controlled epidural analgesia. Readiness to surgery required 21 +/- 6 min in the control group and 17 +/- 7 min in the 45 degree-rotation group (P > 0.50). The maximum sensory level reached on the operative side was T10 (T10-7) in the control group and T9 (T10-6) in the 45 degree-rotation group (P > 0.50); whereas the maximum sensory level reached on the nonoperative side was T10 (T12-9) in the control group and L3 (L5-T12) in the 45 degree-rotation group (P = 0.0005). Complete motor blockade of the operative limb was achieved earlier in the 45 degree-rotation than in the control group, and motor block of the nonoperative side was more intense in patients in the control group. Two-segment regression of sensory level on the surgical side was similar in the two groups, but occurred earlier on the nonoperative side in the 45 degree-rotation group (94 +/- 70 min) than in the control group (178 +/- 40 min) (P = 0.0005). Postoperative analgesia was similar in the 2 groups, but the 45 degree-rotation group consumed less local anesthetic (242 +/- 35 mL) than the control group (297 +/- 60 mL) (P = 0.0005). We conclude that the rotation of the Tuohy introducer needle 45 degrees toward the operative side before threading the epidural catheter provides a preferential distribution of sensory and motor block toward

Needle Steering in Biological Tissue using Ultrasound-based Online Curvature Estimation

PubMed Central

Moreira, Pedro; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2014-01-01

Percutaneous needle insertions are commonly performed for diagnostic and therapeutic purposes. Accurate placement of the needle tip is important to the success of many needle procedures. The current needle steering systems depend on needle-tissue-specific data, such as maximum curvature, that is unavailable prior to an interventional procedure. In this paper, we present a novel three-dimensional adaptive steering method for flexible bevel-tipped needles that is capable of performing accurate tip placement without previous knowledge about needle curvature. The method steers the needle by integrating duty-cycled needle steering, online curvature estimation, ultrasound-based needle tracking, and sampling-based motion planning. The needle curvature estimation is performed online and used to adapt the path and duty cycling. We evaluated the method using experiments in a homogenous gelatin phantom, a two-layer gelatin phantom, and a biological tissue phantom composed of a gelatin layer and in vitro chicken tissue. In all experiments, virtual obstacles and targets move in order to represent the disturbances that might occur due to tissue deformation and physiological processes. The average targeting error using our new adaptive method is 40% lower than using the conventional non-adaptive duty-cycled needle steering method. PMID:26229729

Needle twins and right-angled twins in minerals: comparison between experiment and theory

USGS Publications Warehouse

Salje, E.K.H.; Buckley, A.; Van Tendeloo, G.; Ishibashi, Y.; Nord, G.L.

1998-01-01

Transformation twinning in minerals forms isolated twin walls, intesecting walls with corner junctions, and wedge-shaped twins as elements of hierarchical patterns. When cut perpendicular to the twin walls, the twins have characteristic shapes, right-angled and needle-shaped wall traces, which can be observed by transmission electron microscopy or by optical microscopy. Theoretical geometries of wall shapes recently derived for strain-related systems should hold for most displacive and order-disorder type phase transitions: 1) right-angled twins show curved junctions; 2) needle-shaped twins contain flat wall segments near the needle tip if the elastic behaviour of the mineral is dominated by its anisotroyp; 3) additional bending forces and pinning effects lead to curved walls near the junction that make the needle tip appear more blunt. Bent right-angled twins were analyzed in Gd2(MoO4)3. Linear needle tips were found in WO3, [N(CH3)4]2.ZnBr4 CrAl, BiVO4, GdBa2Cu3O7, and PbZrO. Parabolic tips occur in K2Ba(NO2)4, and GeTe whereas exponential curvatures appear in BaTiO3, KSCN, Pb3(PO4)2, CaTiO3, alkali feldspars, YBa2Cu3O7, and MnAl. The size and shape of the twin microstructure relates to its formation during the phase transition and the subsequent annealing history. The mobility of the twin walls after formation depends not only on the thermal activation but also on the structure of the wall, which may be pinned to impurities on a favorable structural site. Depinnign energies are often large compared with thermal energies for diffusion. This leads to kinetic time scales for twin coarsening that are comparable to geological time scales. Therefore, transformation twins that exhibit needle domains not only indicate that the mineral underwent a structural phase transition but also contain information about its subsequent geological history.

T3SS-Independent Uptake of the Short-Trip Toxin-Related Recombinant NleC Effector of Enteropathogenic Escherichia coli Leads to NF-κB p65 Cleavage.

PubMed

Stolle, Anne-Sophie; Norkowski, Stefanie; Körner, Britta; Schmitz, Jürgen; Lüken, Lena; Frankenberg, Maj; Rüter, Christian; Schmidt, M Alexander

2017-01-01

Effector proteins secreted by the type 3 secretion system (T3SS) of pathogenic bacteria have been shown to precisely modulate important signaling cascades of the host for the benefit of the pathogens. Among others, the non-LEE encoded T3SS effector protein NleC of enteropathogenic Escherichia coli (EPEC) is a Zn-dependent metalloprotease and suppresses innate immune responses by directly targeting the NF-κB signaling pathway. Many pathogenic bacteria release potent bacterial toxins of the A-B type, which-in contrast to the direct cytoplasmic injection of T3SS effector proteins-are released first into the environment. In this study, we found that NleC displays characteristics of bacterial A-B toxins, when applied to eukaryotic cells as a recombinant protein. Although lacking a B subunit, that typically mediates the uptake of toxins, recombinant NleC (rNleC) induces endocytosis via lipid rafts and follows the endosomal-lysosomal pathway. The conformation of rNleC is altered by low pH to facilitate its escape from acidified endosomes. This is reminiscent of the homologous A-B toxin AIP56 of the fish pathogen Photobacterium damselae piscicida ( Phdp ). The recombinant protease NleC is functional inside eukaryotic cells and cleaves p65 of the NF-κB pathway. Here, we describe the endocytic uptake mechanism of rNleC, characterize its intracellular trafficking and demonstrate that its specific activity of cleaving p65 requires activation of host cells e.g., by IL1β. Further, we propose an evolutionary link between some T3SS effector proteins and bacterial toxins from apparently unrelated bacteria. In summary, these properties might suggest rNleC as an interesting candidate for future applications as a potential therapeutic against immune disorders.

Needle localization using a moving stylet/catheter in ultrasound-guided regional anesthesia: a feasibility study

NASA Astrophysics Data System (ADS)

Beigi, Parmida; Rohling, Robert

2014-03-01

Despite the wide range and long history of ultrasound guided needle insertions, an unresolved issue in many cases is clear needle visibility. A well-known ad hoc technique to detect the needle is to move the stylet and look for changes in the needle appearance. We present a new method to automatically locate a moving stylet/catheter within a stationary cannula using motion detection. We then use this information to detect the needle trajectory and the tip. The differences between the current frame and the previous frame are detected and localized, to minimize the influence of tissue global motions. A polynomial fit based on the detected needle axis determines the estimated stylet shaft trajectory, and the extent of the differences along the needle axis represents the tip. Over a few periodic movements of the stylet including its full insertion into the cannula to the tip, a combination of polynomial fits determines the needle trajectory and the last detected point represents the needle tip. Experiments are conducted in water bath and bovine muscle tissue for several stylet/catheter materials. Results show that a plastic stylet has the best needle shaft and tip localization accuracy in the water bath with RMSE = 0:16 mm and RMSE = 0:51 mm, respectively. In the bovine tissue, the needle tip was best localized with the plastic catheter with RMSE = 0:33 mm. The stylet tip localization was most accurate with the steel stylet, with RMSE = 2:81 mm and the shaft was best localized with the plastic catheter, with RMSE = 0:32 mm.

Thermoelectric needle probe for temperature measurements in biological materials.

PubMed

Korn, U; Rav-Noy, Z; Shtrikman, S; Zafrir, M

1980-04-01

In certain biological and medical applications it is important to measure and follow temperature changes inside a body or tissue. Any probe inserted into a tissue causes damage to tissue and distortion to the initial temperature distribution. To minimize this interference, a fine probe is needed. Thus, thin film technology is advantageous and was utilized by us to produce sensitive probes for these applications. The resulting probe is a small thermocouple at the tip of a thin needle (acupuncture stainless steel needle, approximately 0.26 mm in diameter and length in the range 5-10 cm was used). The junction was produced at the needle's tip by coating the needle with thin layers of insulating and thermoelectric materials. The first layer is an insulating one and is composed of polyacrylonitrile (PAN) and polymide produced by plasma polymerization and dip-coating respectively. This layer covers all the needle except the tip. The second layer is a vacuum deposited thermoelectric thin layer of Bi-5% Sb alloy coating also the tip. The third layer is for insulation and protection and is composed of PAN and polyimide. In this arrangement the junction is at the needle's tip, the needle is one conductor, the thermoelectric layer is the other and they are isolated by the plastic layer. The probe is handy and mechanically sturdy. The sensitivity is typically 77 microV/degrees C at room temperature and is constant to within 2% up to 90 degrees C. The response is fast (less than 1 sec) the noise is small, (less than 0.05 degrees C) and because of the small dimension, damage to tissue and disturbance to the measured temperature field are minimal.

[Research on electron density in DC needle-plate corona discharge at atmospheric pressure].

PubMed

Liu, Zhi-Qiang; Guo, Wei; Liu, Tao-Tao; Wu, Wen-Shuo; Liu, Shu-Min

2013-11-01

Using needle-plate discharge device, corona discharge experiment was done in the atmosphere. Through photo of spot size of light-emitting area, the relationship between the voltage and thickness of corona layer was discussed. When the distance between tip and plate is fixed, the thickness of corona layer increases with the increase in voltage; when the voltage is fixed, the thickness of corona layer decreases with the increase in the distance between tip and plate. As spectral intensity of N2 (C3pi(u)) (337.1 nm)reflects high energy electron density, it was measured with emission spectrometry. The results show that high energy electron density is the biggest near the needle tip and the relationship between high energy electron density and voltage is basically linear increasing. Fixing voltage, high energy electron density decreases with the increase in the distance between tip and plate. When the voltage and the distance between tip and plate are fixed, the high energy electron density increases with the decrease in the curvature radius of needle tip. These results are of great importance for the study of plasma parameters of corona discharge.

Simulation and experimental studies in needle-tissue interactions.

PubMed

Konh, Bardia; Honarvar, Mohammad; Darvish, Kurosh; Hutapea, Parsaoran

2017-08-01

This work aims to introduce a new needle insertion simulation to predict the deflection of a bevel-tip needle inside soft tissue. The development of such a model, which predicts the steering behavior of the needle during needle-tissue interactions, could improve the performance of many percutaneous needle-based procedures such as brachytherapy and thermal ablation, by means of the virtual path planning and training systems of the needle toward the target and thus reducing possible incidents of complications in clinical practices. The Arbitrary-Lagrangian-Eulerian (ALE) formulation in LS-DYNA software was used to model the solid-fluid interactions between the needle and tissue. Since both large deformation and fracture of the continuum need to be considered in this model, applying ALE method for fluid analysis was considered a suitable approach. A 150 mm long needle was used to bend within the tissue due to the interacting forces on its asymmetric bevel tip. Three experimental cases of needle steering in a soft phantom were performed to validate the simulation. An error measurement of less than 10 % was found between the predicted deflection by the simulations and the one observed in experiments, validating our approach with reasonable accuracy. The effect of the needle diameter and its bevel tip angle on the final shape of the needle was investigated using this model. To maneuver around the anatomical obstacles of the human body and reach the target location, thin sharp needles are recommended, as they would create a smaller radius of curvature. The insertion model presented in this work is intended to be used as a base structure for path planning and training purposes for future studies.

Hyper- and viscoelastic modeling of needle and brain tissue interaction.

PubMed

Lehocky, Craig A; Yixing Shi; Riviere, Cameron N

2014-01-01

Deep needle insertion into brain is important for both diagnostic and therapeutic clinical interventions. We have developed an automated system for robotically steering flexible needles within the brain to improve targeting accuracy. In this work, we have developed a finite element needle-tissue interaction model that allows for the investigation of safe parameters for needle steering. The tissue model implemented contains both hyperelastic and viscoelastic properties to simulate the instantaneous and time-dependent responses of brain tissue. Several needle models were developed with varying parameters to study the effects of the parameters on tissue stress, strain and strain rate during needle insertion and rotation. The parameters varied include needle radius, bevel angle, bevel tip fillet radius, insertion speed, and rotation speed. The results will guide the design of safe needle tips and control systems for intracerebral needle steering.

Study on design and cutting parameters of rotating needles for core biopsy.

PubMed

Giovannini, Marco; Ren, Huaqing; Cao, Jian; Ehmann, Kornel

2018-06-15

Core needle biopsies are widely adopted medical procedures that consist in the removal of biological tissue to better identify a lesion or an abnormality observed through a physical exam or a radiology scan. These procedures can provide significantly more information than most medical tests and they are usually performed on bone lesions, breast masses, lymph nodes and the prostate. The quality of the samples mainly depends on the forces exerted by the needle during the cutting process. The reduction of these forces is critical to extract high-quality tissue samples. The most critical factors that affect the cutting forces are the geometry of the needle tip and its motion while it is penetrating the tissue. However, optimal needle tip configurations and cutting parameters are not well established for rotating insertions. In this paper, the geometry and cutting forces of hollow needles are investigated. The fundamental goal of this study is to provide a series of guidelines for clinicians and surgeons to properly select the optimal tip geometries and speeds. Analytical models related to the cutting angles of several needle tip designs are presented and compared. Several needle tip geometries were manufactured from a 14-gauge cannula, commonly adopted during breast biopsies. The needles were then tested at different speeds and on different phantom tissues. According to these experimental measurements recommendations were formulated for rotating needle insertions. The findings of this study can be applied and extended to several biopsy procedures in which a cannula is used to extract tissue samples. Copyright © 2018 Elsevier Ltd. All rights reserved.

Viewing a needle pricking a hand that you perceive as yours enhances unpleasantness of pain.

PubMed

Höfle, Marion; Hauck, Michael; Engel, Andreas K; Senkowski, Daniel

2012-05-01

"Don't look and it won't hurt" is commonly heard advice when receiving an injection, which implies that observing needle pricks enhances pain perception. Throughout our lives, we repeatedly learn that sharp objects cause pain when penetrating our skin, but situational expectations, like information given by the clinician prior to an injection, may also influence how viewing needle pricks affects forthcoming pain. How both previous experiences and acute situational expectations related to viewing needle pricks modulate pain perception is unknown. We presented participants with video clips of a hand perceived as their own being either pricked by a needle or touched by a Q-tip, while concurrently applying painful or nonpainful electrical stimuli. Intensity and unpleasantness ratings, as well as pupil dilation responses, were monitored. Effects of situational expectations about the strength of electrical stimuli were investigated by manipulating the contingency between clips and electrical stimuli across experimental blocks. Participants were explicitly informed about the contingency. Intensity ratings of electrical stimuli were higher when a clip was associated with expectation of painful compared to nonpainful stimuli, suggesting that situational expectations about forthcoming pain bias perceived intensity. Unpleasantness ratings and pupil dilation responses were higher when participants viewed a needle prick, compared to when they viewed a Q-tip touch, suggesting that previous experiences with viewing needle pricks primarily act upon perceived unpleasantness. Thus, remote painful experiences with viewing needle pricks, together with information given prior to an injection, differentially shape the impact of viewing a needle prick on pain perception. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Double needle technique: an alternative method for performing difficult sacroiliac joint injections.

PubMed

Gupta, Sanjeeva

2011-01-01

The sacroiliac joint (SIJ) is a common source of low back pain. The most appropriate method of confirming SIJ pain is to inject local anesthesia into the joint to find out if the pain decreases. Unfortunately, although the SIJ is a large joint, it can be difficult to enter due to the complex nature of the joint and variations in anatomy. In my experience a double needle technique for sacroiliac joint injection can increase the chances of accurate injection into the SIJ in difficult cases. After obtaining appropriate fluoroscopic images, the tip of the needle is advanced into the SIJ. Once the tip of the needle is correctly placed, its position is checked under continuous fluoroscopy while moving the C-arm in the right and left oblique directions (dynamic fluoroscopy). On dynamic fluoroscopy the tip of the needle should remain within the joint line and not appear to be on the bone. If the tip of the needle appears to be on the bone a new joint line will need to be identified (the most translucent area through the joint) by dynamic fluoroscopy and another needle advanced into the newly identified joint line. Dynamic fluoroscopy is repeated again to confirm that the tip of the second needle remains within the joint line. Once both needles are in place contrast dye is injected through the needle that is most likely to be in the SIJ. If the contrast dye spread is not satisfactory then it is injected through the other needle. I have used this technique in 10 patients and found it very helpful in accurately performing SIJ injection which can at times be challenging.

[Echo-guided radiofrequency percutaneous ablation of hepatocellular carcinoma in cirrhosis using a cooled needle].

PubMed

Marone, G; Francica, G; D'Angelo, V; Iodice, G; Pastore, P; Altamura, G; Cusati, B; Siani, A

1998-06-01

Radiofrequency hyperthermia using the newly-developed "cooled-tip" needle is one of the latest US-guided percutaneous treatments of hepatocellular carcinoma arising in cirrhosis. The continuous cooling of the needle tip allows tissue heating and necrosis far from the electrode without tissue charring, which was the major drawback of the old monopolar technique. Herein we report our preliminary results on feasibility and effectiveness of the thermoablation of mono- or paucifocal hepatocellular carcinoma with the cooled-tip needle. November, 1996, to January, 1998, we treated thirteen cirrhotic patients (mean age 69.5 yrs, 10 men, 12 HCV-positive; 11 in Child's Class A and 2 in Class B) with 19 hepatocellular carcinoma nodules (mean diameter: 27 mm; range: 10-41 mm; 6 with diameter > 3 cm). None of the patients had portal thrombosis and/or extrahepatic spread. We used a radiofrequency generator (100 W power) connected to an 18 G perfusion electrode needle with an exposed tip of 2-3 cm. The circuit is closed through a dispersive electrode positioned under the patient's thighs. A peristaltic pump infuses a chilled (2-5 degrees C) saline solution to guarantee the continuous cooling of the needle tip. The needle was placed into target lesions under US guidance. The interventional procedure was carried out under general anesthesia using Propofol without intubation. Dynamic CT (more recently with the helical technique) was carried out 15-20 days after thermoablation to assess treatment efficacy. In all, 31 thermal injuries (at 1000-1200 mA for 10-15 minutes) were caused in 21 sessions in the 19 hepatocellular carcinoma nodules (mean: 1.5 lesions per nodule and 1.6 sessions per patient). Complete necrosis as assessed at dynamic CT (no enhancement during the arteriographic phase) was achieved in 16 of 19 nodules (84%). No side-effects occurred. During the follow-up (median: 11 months) no death occurred and five patients had recurrent hepatocellular carcinoma appearing either

Fiber sensor assisted in-vivo needle guidance for minimally invasive procedures (Conference Presentation)

NASA Astrophysics Data System (ADS)

Baghdadchi, Saharnaz; Chao, Cherng; Esener, Sadik; Mattrey, Robert F.; Eghtedari, Mohammad A.

2017-02-01

Image-guided procedures are performed frequently by radiologists to insert a catheter within a target vessel or lumen or to perform biopsy of a lesion. For instance, an interventional radiologist uses fluoroscopy during percutaneous biliary drainage procedure (a procedure during which a catheter is inserted through the skin to drain the bile from liver) to identify the location of the needle tip within liver parenchyma, hepatic blood vessel or bile duct. However, the identification of the target organ under fluoroscopy exposes the patient to x-ray irradiation, which may be significant if the time of procedure is prolonged. We have designed a fiber core needle system that may help the radiologist identify the location of the needle tip in real time without exposing the patient to x-ray. Our needle system transmits a low power modulated light into the tissue through a fiber cable embedded in the needle and detects the backscattered light using another fiber inside the needle. We were able to successfully distinguish the location of our prototype needle tip inside a cow liver phantom to identify if the needle tip was within liver parenchyma, liver vessels, or in the bile duct based on the recorded backscattered light.

Development of a high frequency single-element ultrasound needle transducer for anesthesia delivery

NASA Astrophysics Data System (ADS)

Ameri, Golafsoun; Son, Jungik; Liang, Jingwei; Foster, F. Stuart; Ganapathy, Sugantha; Peters, Terry M.

2017-03-01

Epidural anesthesia is one of the most commonly used and yet challenging techniques employed for pain management and anesthesia delivery. The major complications of this procedure are due to accidental dural puncture, with an incidence of 1-3%, which could lead to both temporary and irreversible permanent neurological complications. Needle placement under ultrasound (US) guidance has received increasing interest for improving needle placement accuracy. However, poor needle visibility in US, difficulties in displaying relevant anatomical structure such as dura mater due to attenuation and bone shadowing, and image interpretation variability among users pose significant hurdles for any US guidance system. As a result, US guidance for epidural injections has not been widely adopted for everyday use for the performance of neuraxial blocks. The difficulties in localizing the ligamentum flavum and dura with respect to the needle tip can be addressed by integrating A-mode US, provided by a single-element transducer at the needle tip, into the B-mode US guidance system. We have taken the first steps towards providing such a guidance system. Our goal is to improve the safety of this procedure with minimal changes to the clinical workflow. This work presents the design and development of a 20 MHz single-element US transducer housed at the tip of a 19 G needle hypodermic tube, which can fit inside an epidural introducer needle. In addition, the results from initial transducer characterization tests and performance evaluation of the transducer in a euthanized porcine model are provided.

A Pseudomonas T6SS effector recruits PQS-containing outer membrane vesicles for iron acquisition

PubMed Central

Lin, Jinshui; Zhang, Weipeng; Cheng, Juanli; Yang, Xu; Zhu, Kaixiang; Wang, Yao; Wei, Gehong; Qian, Pei-Yuan; Luo, Zhao-Qing; Shen, Xihui

2017-01-01

Iron sequestration by host proteins contributes to the defence against bacterial pathogens, which need iron for their metabolism and virulence. A Pseudomonas aeruginosa mutant lacking all three known iron acquisition systems retains the ability to grow in media containing iron chelators, suggesting the presence of additional pathways involved in iron uptake. Here we screen P. aeruginosa mutants defective in growth in iron-depleted media and find that gene PA2374, proximal to the type VI secretion system H3 (H3-T6SS), functions synergistically with known iron acquisition systems. PA2374 (which we have renamed TseF) appears to be secreted by H3-T6SS and is incorporated into outer membrane vesicles (OMVs) by directly interacting with the iron-binding Pseudomonas quinolone signal (PQS), a cell–cell signalling compound. TseF facilitates the delivery of OMV-associated iron to bacterial cells by engaging the Fe(III)-pyochelin receptor FptA and the porin OprF. Our results reveal links between type VI secretion, cell–cell signalling and classic siderophore receptors for iron acquisition in P. aeruginosa. PMID:28348410

Tn-Seq Analysis of Vibrio cholerae Intestinal Colonization Reveals a Role for T6SS-Mediated Antibacterial Activity in the Host

PubMed Central

Fu, Yang; Waldor, Matthew K.; Mekalanos, John J.

2014-01-01

SUMMARY Analysis of genes required for host infection will provide clues to the drivers of evolutionary fitness of pathogens like Vibrio cholerae, a mounting threat to global heath. We used transposon insertion site sequencing (Tn-seq) to comprehensively assess the contribution of nearly all V. cholerae genes toward growth in the infant rabbit intestine. Four hundred genes were identified as critical to V. cholerae in vivo fitness. These included most known colonization factors and several new genes affecting the bacterium's metabolic properties, resistance to bile, and ability to synthesize cyclic AMP-GMP. Notably, a mutant carrying an insertion in tsiV3, encoding immunity to a bacteriocidal type VI secretion system (T6SS) effector VgrG3, exhibited a colonization defect. The reduced in vivo fitness of tsiV3 mutants depends on their cocolonization with bacterial cells carrying an intact T6SS locus and VgrG3 gene, suggesting that the V. cholerae T6SS is functional and mediates antagonistic interbacterial interactions during infection. PMID:24331463

Effect of vibration frequency on biopsy needle insertion force.

PubMed

Tan, Lei; Qin, Xuemei; Zhang, Qinhe; Zhang, Hongcai; Dong, Hongjian; Guo, Tuodang; Liu, Guowei

2017-05-01

Needle insertion is critical in many clinical medicine procedures, such as biopsy, brachytherapy, and injection therapy. A platform with two degrees of freedom was set up to study the effect of vibration frequency on needle insertion force. The gel phantom deformation at the needle cutting edge and the Voigt model are utilized to develop a dynamic model to explain the relationship between the insertion force and needle-tip velocity. The accuracy of this model was verified by performing needle insertions into phantom gel. The effect of vibration on insertion force can be explained as the vibration increasing the needle-tip velocity and subsequently increasing the insertion force. In a series of needle insertion experiments with different vibration frequencies, the peak forces were selected for comparison to explore the effect of vibration frequency on needle insertion force. The experimental results indicate that the insertion force at 500Hz increases up to 17.9% compared with the force at 50Hz. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Teleoperated master-slave needle insertion.

PubMed

Abolhassani, Niki; Patel, Rajni V

2009-12-01

Accuracy of needle tip placement and needle tracking in soft tissue are of particular importance in many medical procedures. In recent years, developing autonomous and teleoperated systems for needle insertion has become an active area of research. In this study, needle insertion was performed using a master-slave set-up with multi-degrees of freedom. The effect of force feedback on the accuracy of needle insertion was investigated. In addition, this study compared autonomous, teleoperated and semi-autonomous needle insertion. The results of this study show that incorporation of force feedback can improve teleoperated needle insertion. However, autonomous and semi-autonomous needle insertions, which use feedback from a deflection model, provide significantly better performance. Development of a haptic master-slave needle insertion system, which is capable of performing some autonomous tasks based on feedback from tissue deformation and needle deflection models, can improve the performance of autonomous robotics-based insertions as well as non-autonomous teleoperated manual insertions. Copyright (c) 2009 John Wiley & Sons, Ltd.

Postdural puncture headache: comparison of 25-gauge Whitacre and Quincke needles.

PubMed

Buettner, J; Wresch, K P; Klose, R

1993-01-01

To evaluate the influence of the shape of the needle tip on postdural puncture headache (PDPH) independent of the needle diameter, a 25-gauge Whitacre and a 25-gauge Quincke needle were compared. In a prospective, randomized, double-blind fashion, the study was carried out on 400 patients who received spinal anesthesia for operations of the lower extremities. The 25-gauge Whitacre needle (group 1) and the 25-gauge Quincke needle (group 2) were randomly assigned to the patients, 200 in each group. Patients were interviewed postoperatively on days 1, 3, 5, and 7 using a standardized questionnaire. Only postural headache was defined as PDPH. The intensity of both postural and nonpostural headache were quantified using a 4-point rating scale and a visual analog pain scale (VAS). Statistical analysis was performed with parametric and nonparametric tests when appropriate, p < or = 0.05 was considered as significant. There were no differences in age and sex distribution between the two groups. Significantly more patients in group 2 (8.5%) complained of PDPH than in group 1 (3%, p < or = 0.02). Duration of PDPH ranged from 1-3 days (median: 1) in group 1, and from 1-9 days (median: 3) in group 2. This difference closely approached significance (p = 0.058). The mean maximal intensity of PDPH was comparable in both groups. Severe PDPH occurred only in two patients of group 2. One of them required a blood patch. With respect to the nonpostural headache, no significant differences were seen. The use of a conical tipped Whitacre needle results in significantly less PDPH compared to a standard Quincke spinal needle of the same size.

Structural properties 3,16-bis triisopropylsilylethynyl (pentacene) (TIPS-pentacene) thin films onto organic dielectric layer using slide coating method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rusnan, Fara Naila; Mohamad, Khairul Anuar; Seria, Dzul Fahmi Mohd Husin

3,16-bis triisopropylsilylethynyl (Pentacene) (TIPS-Pentacene) compactable interface property is important in order to have a good arrangement of molecular structure. Comparison for TIPS-Pentacene deposited between two different surface layers conducted. 0.1wt% TIPS-Pentacene diluted in chloroform were deposited onto poly(methylmeaclyrate) (PMMA) layered transparent substrates using slide coating method. X-ray diffraction (XRD) used to determine crystallinity of thin films. Series of (00l) diffraction peaks obtained with sharp first peaks (001) for TIPS-Pentacene deposited onto PMMA layer at 5.35° and separation of 16.3 Å. Morphology and surface roughness were carried out using scanning electron microscope (SEM) and surface profilemeter LS500, respectively.TIPS-Pentacene deposited onto PMMAmore » layer formed needled-like-shape grains with 10.26 nm surface roughness. These properties were related as thin film formed and its surface roughness plays important role towards good mobility devices.« less

1.5 T augmented reality navigated interventional MRI: paravertebral sympathetic plexus injections

PubMed Central

Marker, David R.; U-Thainual, Paweena; Ungi, Tamas; Flammang, Aaron J.; Fichtinger, Gabor; Iordachita, Iulian I.; Carrino, John A.; Fritz, Jan

2017-01-01

PURPOSE The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner. METHODS A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%), and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1.5 Tesla (T) MRI scanner and augmented reality navigation system. MRI-conditional needles were used. Gadolinium-DTPA-enhanced saline was injected. Outcome variables included the number of control magnetic resonance images, target error of the needle tip, punctures of critical nontarget structures, distribution of the injected fluid, and procedure length. RESULTS Augmented-reality navigated MRI guidance at 1.5 T provided detailed anatomical visualization for successful targeting of the paravertebral space, needle placement, and perineural paravertebral injections in 46 of 46 targets (100%). A mean of 2 images (range, 1–5 images) were required to control needle placement. Changes of the needle trajectory occurred in 9 of 46 targets (20%) and changes of needle advancement occurred in 6 of 46 targets (13%), which were statistically not related to spinal regions (P = 0.728 and P = 0.86, respectively) and cadaver sizes (P = 0.893 and P = 0.859, respectively). The mean error of the needle tip was 3.9±1.7 mm. There were no punctures of critical nontarget structures. The mean procedure length was 33±12 min. CONCLUSION 1.5 T augmented reality-navigated interventional MRI can provide accurate imaging guidance for perineural injections of the thoracic, lumbar, and hypogastric sympathetic plexus. PMID:28420598

1.5 T augmented reality navigated interventional MRI: paravertebral sympathetic plexus injections.

PubMed

Marker, David R; U Thainual, Paweena; Ungi, Tamas; Flammang, Aaron J; Fichtinger, Gabor; Iordachita, Iulian I; Carrino, John A; Fritz, Jan

2017-01-01

The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner. A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%), and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1.5 Tesla (T) MRI scanner and augmented reality navigation system. MRI-conditional needles were used. Gadolinium-DTPA-enhanced saline was injected. Outcome variables included the number of control magnetic resonance images, target error of the needle tip, punctures of critical nontarget structures, distribution of the injected fluid, and procedure length. Augmented-reality navigated MRI guidance at 1.5 T provided detailed anatomical visualization for successful targeting of the paravertebral space, needle placement, and perineural paravertebral injections in 46 of 46 targets (100%). A mean of 2 images (range, 1-5 images) were required to control needle placement. Changes of the needle trajectory occurred in 9 of 46 targets (20%) and changes of needle advancement occurred in 6 of 46 targets (13%), which were statistically not related to spinal regions (P = 0.728 and P = 0.86, respectively) and cadaver sizes (P = 0.893 and P = 0.859, respectively). The mean error of the needle tip was 3.9±1.7 mm. There were no punctures of critical nontarget structures. The mean procedure length was 33±12 min. 1.5 T augmented reality-navigated interventional MRI can provide accurate imaging guidance for perineural injections of the thoracic, lumbar, and hypogastric sympathetic plexus.

Needle position estimation from sub-sampled k-space data for MRI-guided interventions

NASA Astrophysics Data System (ADS)

Schmitt, Sebastian; Choli, Morwan; Overhoff, Heinrich M.

2015-03-01

MRI-guided interventions have gained much interest. They profit from intervention synchronous data acquisition and image visualization. Due to long data acquisition durations, ergonomic limitations may occur. For a trueFISP MRI-data acquisition sequence, a time sparing sub-sampling strategy has been developed that is adapted to amagnetic needle detection. A symmetrical and contrast rich susceptibility needle artifact, i.e. an approximately rectangular gray scale profile is assumed. The 1-D-Fourier transformed of a rectangular function is a sinc-function. Its periodicity is exploited by sampling only along a few orthogonal trajectories in k-space. Because a needle moves during intervention, its tip region resembles a rectangle in a time-difference image that is reconstructed from such sub-sampled k-spaces acquired at different time stamps. In different phantom experiments, a needle was pushed forward along a reference trajectory, which was determined from a needle holders geometric parameters. In addition, the trajectory of the needle tip was estimated by the method described above. Only ca. 4 to 5% of the entire k-space data was used for needle tip estimation. The misalignment of needle orientation and needle tip position, i.e. the differences between reference and estimated values, is small and even in its worst case less than 2 mm. The results show that the method is applicable under nearly real conditions. Next steps are addressed to the validation of the method for clinical data.

Sugar export limits size of conifer needles

NASA Astrophysics Data System (ADS)

Rademaker, Hanna; Zwieniecki, Maciej A.; Bohr, Tomas; Jensen, Kaare H.

2017-04-01

Plant leaf size varies by more than three orders of magnitude, from a few millimeters to over one meter. Conifer leaves, however, are relatively short and the majority of needles are no longer than 6 cm. The reason for the strong confinement of the trait-space is unknown. We show that sugars produced near the tip of long needles cannot be exported efficiently, because the pressure required to drive vascular flow would exceed the greatest available pressure (the osmotic pressure). This basic constraint leads to the formation of an inactive region of stagnant fluid near the needle tip, which does not contribute to sugar flow. Remarkably, we find that the size of the active part does not scale with needle length. We predict a single maximum needle size of 5 cm, in accord with data from 519 conifer species. This could help rationalize the recent observation that conifers have significantly smaller leaves than angiosperms, and provide a biophysical explanation for this intriguing difference between the two largest groups of plants.

[Academic origin of round magnetic needle and standardization operation].

PubMed

Cheng, Yan-Ting; Zhang, Tian-Sheng; Meng, Li-Qiang; Shi, Rui-Qi; Ji, Lai-Xi

2014-07-01

The origin and development of round magnetic needle was explored, and the structure of round magnetic needle was introduced in detail, including the handle, the body and the tip of the needle. The clinical opera tion of round magnetic needle were standardized from the aspects of the methods of holding needle, manipulation skill, tapping position, strength of manipulation, application scope and matters needing attention, which laid foundation for the popularization and application of round magnetic needle.

Experimental analysis of robot-assisted needle insertion into porcine liver.

PubMed

Wang, Wendong; Shi, Yikai; Goldenberg, Andrew A; Yuan, Xiaoqing; Zhang, Peng; He, Lijing; Zou, Yingjie

2015-01-01

How to improve placement accuracy of needle insertion into liver tissue is of paramount interest to physicians. A robot-assisted system was developed to experimentally demonstrate its advantages in needle insertion surgeries. Experiments of needle insertion into porcine liver tissue were performed with conic tip needle (diameter 8 mm) and bevel tip needle (diameter 1.5 mm) in this study. Manual operation was designed to compare the performance of the presented robot-assisted system. The real-time force curves show outstanding advantages of robot-assisted operation in improving the controllability and stability of needle insertion process by comparing manual operation. The statistics of maximum force and average force further demonstrates robot-assisted operation causes less oscillation. The difference of liver deformation created by manual operation and robot-assisted operation is very low, 1 mm for average deformation and 2 mm for maximum deformation. To conclude, the presented robot-assisted system can improve placement accuracy of needle by stably control insertion process.

Painless needle insertion in regional anesthesia of the eye.

PubMed

Vaalamo, M O; Paloheimo, M P; Nikki, P H

1995-04-01

We examined a new technique of applying topical anesthetic with cotton tip sticks to the conjunctiva before needle insertion in regional anesthesia of the eye. Oxybuprocaine 0.4% and lidocaine 4% were compared with balanced salt solution (BSS) as topical anesthetics of the conjunctiva in Study 1. Ninety patients were randomly assigned into three groups (n = 30) to receive one of the three topical anesthetics in a double-blind manner. Pain of the needle insertions was measured with visual analog scale score (VAS) and quantitative surface electromography (qEMG). Both oxybuprocaine and lidocaine reduced pain significantly when compared to BSS. In Study 2, with healthy volunteers, we compared our previous practice of merely applying three consecutive drops of oxybuprocaine on the conjunctiva before needle insertions to the new technique of placing additional cotton tip sticks soaked in oxybuprocaine on the conjunctiva. We found the needle insertion virtually pain free when the cotton tip sticks were added to the topical anesthesia. The use of this simple method of topical anesthesia before the eye block increases patient comfort significantly.

APOBEC3G Interacts with ssDNA by Two Modes: AFM Studies

NASA Astrophysics Data System (ADS)

Shlyakhtenko, Luda S.; Dutta, Samrat; Banga, Jaspreet; Li, Ming; Harris, Reuben S.; Lyubchenko, Yuri L.

2015-10-01

APOBEC3G (A3G) protein has antiviral activity against HIV and other pathogenic retroviruses. A3G has two domains: a catalytic C-terminal domain (CTD) that deaminates cytidine, and a N-terminal domain (NTD) that binds to ssDNA. Although abundant information exists about the biological activities of A3G protein, the interplay between sequence specific deaminase activity and A3G binding to ssDNA remains controversial. We used the topographic imaging and force spectroscopy modalities of Atomic Force Spectroscopy (AFM) to characterize the interaction of A3G protein with deaminase specific and nonspecific ssDNA substrates. AFM imaging demonstrated that A3G has elevated affinity for deaminase specific ssDNA than for nonspecific ssDNA. AFM force spectroscopy revealed two distinct binding modes by which A3G interacts with ssDNA. One mode requires sequence specificity, as demonstrated by stronger and more stable complexes with deaminase specific ssDNA than with nonspecific ssDNA. Overall these observations enforce prior studies suggesting that both domains of A3G contribute to the sequence specific binding of ssDNA.

APOBEC3G Interacts with ssDNA by Two Modes: AFM Studies.

PubMed

Shlyakhtenko, Luda S; Dutta, Samrat; Banga, Jaspreet; Li, Ming; Harris, Reuben S; Lyubchenko, Yuri L

2015-10-27

APOBEC3G (A3G) protein has antiviral activity against HIV and other pathogenic retroviruses. A3G has two domains: a catalytic C-terminal domain (CTD) that deaminates cytidine, and a N-terminal domain (NTD) that binds to ssDNA. Although abundant information exists about the biological activities of A3G protein, the interplay between sequence specific deaminase activity and A3G binding to ssDNA remains controversial. We used the topographic imaging and force spectroscopy modalities of Atomic Force Spectroscopy (AFM) to characterize the interaction of A3G protein with deaminase specific and nonspecific ssDNA substrates. AFM imaging demonstrated that A3G has elevated affinity for deaminase specific ssDNA than for nonspecific ssDNA. AFM force spectroscopy revealed two distinct binding modes by which A3G interacts with ssDNA. One mode requires sequence specificity, as demonstrated by stronger and more stable complexes with deaminase specific ssDNA than with nonspecific ssDNA. Overall these observations enforce prior studies suggesting that both domains of A3G contribute to the sequence specific binding of ssDNA.

APOBEC3G Interacts with ssDNA by Two Modes: AFM Studies

PubMed Central

Shlyakhtenko, Luda S.; Dutta, Samrat; Banga, Jaspreet; Li, Ming; Harris, Reuben S.; Lyubchenko, Yuri L.

2015-01-01

APOBEC3G (A3G) protein has antiviral activity against HIV and other pathogenic retroviruses. A3G has two domains: a catalytic C-terminal domain (CTD) that deaminates cytidine, and a N-terminal domain (NTD) that binds to ssDNA. Although abundant information exists about the biological activities of A3G protein, the interplay between sequence specific deaminase activity and A3G binding to ssDNA remains controversial. We used the topographic imaging and force spectroscopy modalities of Atomic Force Spectroscopy (AFM) to characterize the interaction of A3G protein with deaminase specific and nonspecific ssDNA substrates. AFM imaging demonstrated that A3G has elevated affinity for deaminase specific ssDNA than for nonspecific ssDNA. AFM force spectroscopy revealed two distinct binding modes by which A3G interacts with ssDNA. One mode requires sequence specificity, as demonstrated by stronger and more stable complexes with deaminase specific ssDNA than with nonspecific ssDNA. Overall these observations enforce prior studies suggesting that both domains of A3G contribute to the sequence specific binding of ssDNA. PMID:26503602

Design of an Optically Controlled MR-Compatible Active Needle

PubMed Central

Ryu, Seok Chang; Quek, Zhan Fan; Koh, Je-Sung; Renaud, Pierre; Black, Richard J.; Moslehi, Behzad; Daniel, Bruce L.; Cho, Kyu-Jin; Cutkosky, Mark R.

2015-01-01

An active needle is proposed for the development of magnetic resonance imaging (MRI)-guided percutaneous procedures. The needle uses a low-transition-temperature shape memory alloy (LT SMA) wire actuator to produce bending in the distal section of the needle. Actuation is achieved with internal optical heating using laser light transported via optical fibers and side coupled to the LT SMA. A prototype, with a size equivalent to a standard 16-gauge biopsy needle, exhibits significant bending, with a tip deflection of more than 14° in air and 5° in hard tissue. A single-ended optical sensor with a gold-coated tip is developed to measure the curvature independently of temperature. The experimental results in tissue phantoms show that human tissue causes fast heat dissipation from the wire actuator; however, the active needle can compensate for typical targeting errors during prostate biopsy. PMID:26512231

Smartphone-Guided Needle Angle Selection During CT-Guided Procedures.

PubMed

Xu, Sheng; Krishnasamy, Venkatesh; Levy, Elliot; Li, Ming; Tse, Zion Tsz Ho; Wood, Bradford John

2018-01-01

In CT-guided intervention, translation from a planned needle insertion angle to the actual insertion angle is estimated only with the physician's visuospatial abilities. An iPhone app was developed to reduce reliance on operator ability to estimate and reproduce angles. The iPhone app overlays the planned angle on the smartphone's camera display in real-time based on the smartphone's orientation. The needle's angle is selected by visually comparing the actual needle with the guideline in the display. If the smartphone's screen is perpendicular to the planned path, the smartphone shows the Bull's-Eye View mode, in which the angle is selected after the needle's hub overlaps the tip in the camera. In phantom studies, we evaluated the accuracies of the hardware, the Guideline mode, and the Bull's-Eye View mode and showed the app's clinical efficacy. A proof-of-concept clinical case was also performed. The hardware accuracy was 0.37° ± 0.27° (mean ± SD). The mean error and navigation time were 1.0° ± 0.9° and 8.7 ± 2.3 seconds for a senior radiologist with 25 years' experience and 1.5° ± 1.3° and 8.0 ± 1.6 seconds for a junior radiologist with 4 years' experience. The accuracy of the Bull's-Eye View mode was 2.9° ± 1.1°. Combined CT and smart-phone guidance was significantly more accurate than CT-only guidance for the first needle pass (p = 0.046), which led to a smaller final targeting error (mean distance from needle tip to target, 2.5 vs 7.9 mm). Mobile devices can be useful for guiding needle-based interventions. The hardware is low cost and widely available. The method is accurate, effective, and easy to implement.

Influence of oligomerization state on the structural properties of invasion plasmid antigen B from Shigella flexneri in the presence and absence of phospholipid membranes.

PubMed

Adam, Philip R; Dickenson, Nicholas E; Greenwood, Jamie C; Picking, Wendy L; Picking, William D

2014-11-01

Shigella flexneri causes bacillary dysentery, an important cause of mortality among children in the developing world. Shigella secretes effector proteins via its type III secretion system (T3SS) to promote bacterial uptake into human colonic epithelial cells. The T3SS basal body spans the bacterial cell envelope anchoring a surface-exposed needle. A pentamer of invasion plasmid antigen D lies at the nascent needle tip and invasion plasmid antigen B (IpaB) is recruited into the needle tip complex on exposure to bile salts. From here, IpaB forms a translocon pore in the host cell membrane. Although the mechanism by which IpaB inserts into the membrane is unknown, it was recently shown that recombinant IpaB can exist as either a monomer or tetramer. Both of these forms of IpaB associate with membranes, however, only the tetramer forms pores in liposomes. To reveal differences between these membrane-binding events, Cys mutations were introduced throughout IpaB, allowing site-specific fluorescence labeling. Fluorescence quenching was used to determine the influence of oligomerization and/or membrane association on the accessibility of different IpaB regions to small solutes. The data show that the hydrophobic region of tetrameric IpaB is more accessible to solvent relative to the monomer. The hydrophobic region appears to promote membrane interaction for both forms of IpaB, however, more of the hydrophobic region is protected from solvent for the tetramer after membrane association. Limited proteolysis demonstrated that changes in IpaB's oligomeric state may determine the manner by which it associates with phospholipid membranes and the subsequent outcome of this association. © 2014 Wiley Periodicals, Inc.

Influence of Oligomerization State on the Structural Properties of Invasion Plasmid Antigen B (IpaB) from Shigella flexneri in the Presence and Absence of Phospholipid Membranes†

PubMed Central

Adam, Philip R.; Dickenson, Nicholas E.; Greenwood, Jamie C.; Picking, Wendy L.; Picking, William D.

2014-01-01

Shigella flexneri causes bacillary dysentery, an important cause of mortality among children in the developing world. Shigella secretes effector proteins via its type III secretion system (T3SS) to promote bacterial uptake into human colonic epithelial cells. The T3SS basal body spans the bacterial cell envelope anchoring a surface-exposed needle. A pentamer of invasion plasmid antigen D (IpaD) lies at the nascent needle tip and IpaB is recruited into the needle tip complex upon exposure to bile salts. From here, IpaB forms a translocon pore in the host cell membrane. Although the mechanism by which IpaB inserts into the membrane is unknown, it was recently shown that recombinant IpaB can exist as either a monomer or tetramer. Both of these forms of IpaB associate with membranes, however, only the tetramer forms pores in liposomes. To reveal differences between these membrane-binding events, Cys mutations were introduced throughout IpaB, allowing site-specific fluorescence labeling. Fluorescence quenching was used to determine the influence of oligomerization and/or membrane association on the accessibility of different IpaB regions to small solutes. The data show that the hydrophobic region of tetrameric IpaB is more accessible to solvent relative to the monomer. The hydrophobic region appears to promote membrane interaction for both forms of IpaB, however, more of the hydrophobic region is protected from solvent for the tetramer after membrane association. Limited proteolysis demonstrated that changes in IpaB’s oligomeric state may determine the manner by which it associates with phospholipid membranes and the subsequent outcome of this association. PMID:25103195

A novel curvature-controllable steerable needle for percutaneous intervention.

PubMed

Bui, Van Khuyen; Park, Sukho; Park, Jong-Oh; Ko, Seong Young

2016-08-01

Over the last few decades, flexible steerable robotic needles for percutaneous intervention have been the subject of significant interest. However, there still remain issues related to (a) steering the needle's direction with less damage to surrounding tissues and (b) increasing the needle's maximum curvature for better controllability. One widely used approach is to control the fixed-angled bevel-tip needle using a "duty-cycle" algorithm. While this algorithm has shown its applicability, it can potentially damage surrounding tissue, which has prevented the widespread adoption of this technology. This situation has motivated the development of a new steerable flexible needle that can change its curvature without axial rotation, while at the same time producing a larger curvature. In this article, we propose a novel curvature-controllable steerable needle. The proposed robotic needle consists of two parts: a cannula and a stylet with a bevel-tip. The curvature of the needle's path is controlled by a control offset, defined by the offset between the bevel-tip and the cannula. As a result, the necessity of rotating the whole needle's body is decreased. The duty-cycle algorithm is utilized to a limited degree to obtain a larger radius of curvature, which is similar to a straight path. The first prototype of 0.46 mm (outer diameter) was fabricated and tested with both in vitro gelatin phantom and ex vivo cow liver tissue. The maximum curvatures measured 0.008 mm(-1) in 6 wt% gelatin phantom, 0.0139 mm(-1) in 10 wt% gelatin phantom, and 0.0038 mm(-1) in cow liver. The experimental results show a linear relationship between the curvature and the control offset, which can be utilized for future implementation of this control algorithm. © IMechE 2016.

Do Superior or Inferior Interlaminar Approach or Bevel Orientation Predispose to Nonepidural Needle Penetration?

PubMed

Koontz, Nicholas A; Wiggins, Richard H; Stoddard, Gregory J; Shah, Lubdha M

2017-10-01

There is a paucity of evidence-based literature regarding the advantages and disadvantages of the interlaminar approach and needle bevel orientation for performing a lumbar interlaminar epidural steroid injection (ESI). The purpose of this study was to determine if superior versus inferior lamina approach, needle bevel tip orientation, or both may predispose to inadvertent nonepidural penetration during lumbar interlaminar ESI. A prospective study was performed of patients with low back pain with or without radicular pain or neurogenic claudication referred for lumbar interlaminar ESI. Two hundred eleven patients were randomized by interlaminar approach (superior vs inferior) and bevel tip orientation (cranial vs caudal). Lumbar interlaminar ESI was performed by six interventionalists of varying levels of experience using fluoroscopic guidance with curved tip epidural needles, using loss-of-resistance technique and confirmation with contrast opacification. Exact Poisson regression was used to model the study outcome. Two hundred twenty-one lumbar interlaminar ESIs were performed on 211 patients, randomized to a superior (n = 121) or inferior lamina approach (n = 100) and to a cranial (n = 103) or caudal (n = 118) orientation of the bevel tip. Epidural needle placement was confirmed in 96.4% (n = 213) of cases. Nonepidural needle placement was most commonly associated with superior lamina approach and caudal bevel tip orientation, which was marginally significant (adjusted risk ratio, 6.88; 95% CI, 0.93-∞; p = 0.059). Inadvertent nonepidural needle penetration during fluoroscopically guided lumbar interlaminar ESI appears to be affected by approach, with superior lamina approach and caudal bevel tip orientation being the least favorable technique.

Brucella Rough Mutant Induce Macrophage Death via Activating IRE1α Pathway of Endoplasmic Reticulum Stress by Enhanced T4SS Secretion

PubMed Central

Li, Peng; Tian, Mingxing; Bao, Yanqing; Hu, Hai; Liu, Jiameng; Yin, Yi; Ding, Chan; Wang, Shaohui; Yu, Shengqing

2017-01-01

Brucella is a Gram-negative facultative intracellular pathogen that causes the worldwide zoonosis, known as brucellosis. Brucella virulence relies mostly on its ability to invade and replicate within phagocytic cells. The type IV secretion system (T4SS) and lipopolysaccharide are two major Brucella virulence factors. Brucella rough mutants reportedly induce the death of infected macrophages, which is T4SS dependent. However, the underlying molecular mechanism remains unclear. In this study, the T4SS secretion capacities of Brucella rough mutant and its smooth wild-type strain were comparatively investigated, by constructing the firefly luciferase fused T4SS effector, BPE123 and VceC. In addition, quantitative real-time PCR and western blotting were used to analyze the T4SS expression. The results showed that T4SS expression and secretion were enhanced significantly in the Brucella rough mutant. We also found that the activity of the T4SS virB operon promoter was notably increased in the Brucella rough mutant, which depends on quorum sensing-related regulators of VjbR upregulation. Cell infection and cell death assays revealed that deletion of vjbR in the Brucella rough mutant absolutely abolished cytotoxicity within macrophages by downregulating T4SS expression. This suggests that up-regulation of T4SS promoted by VjbR in rough mutant ΔrfbE contribute to macrophage death. In addition, we found that the Brucella rough mutant induce macrophage death via activating IRE1α pathway of endoplasmic reticulum stress. Taken together, our study provide evidence that in comparison to the Brucella smooth wild-type strain, VjbR upregulation in the Brucella rough mutant increases transcription of the virB operon, resulting in overexpression of the T4SS gene, accompanied by the over-secretion of effecter proteins, thereby causing the death of infected macrophages via activating IRE1α pathway of endoplasmic reticulum stress, suggesting novel insights into the molecular

Brucella Rough Mutant Induce Macrophage Death via Activating IRE1α Pathway of Endoplasmic Reticulum Stress by Enhanced T4SS Secretion.

PubMed

Li, Peng; Tian, Mingxing; Bao, Yanqing; Hu, Hai; Liu, Jiameng; Yin, Yi; Ding, Chan; Wang, Shaohui; Yu, Shengqing

2017-01-01

Brucella is a Gram-negative facultative intracellular pathogen that causes the worldwide zoonosis, known as brucellosis. Brucella virulence relies mostly on its ability to invade and replicate within phagocytic cells. The type IV secretion system (T4SS) and lipopolysaccharide are two major Brucella virulence factors. Brucella rough mutants reportedly induce the death of infected macrophages, which is T4SS dependent. However, the underlying molecular mechanism remains unclear. In this study, the T4SS secretion capacities of Brucella rough mutant and its smooth wild-type strain were comparatively investigated, by constructing the firefly luciferase fused T4SS effector, BPE123 and VceC. In addition, quantitative real-time PCR and western blotting were used to analyze the T4SS expression. The results showed that T4SS expression and secretion were enhanced significantly in the Brucella rough mutant. We also found that the activity of the T4SS virB operon promoter was notably increased in the Brucella rough mutant, which depends on quorum sensing-related regulators of VjbR upregulation. Cell infection and cell death assays revealed that deletion of vjbR in the Brucella rough mutant absolutely abolished cytotoxicity within macrophages by downregulating T4SS expression. This suggests that up-regulation of T4SS promoted by VjbR in rough mutant Δ rfbE contribute to macrophage death. In addition, we found that the Brucella rough mutant induce macrophage death via activating IRE1α pathway of endoplasmic reticulum stress. Taken together, our study provide evidence that in comparison to the Brucella smooth wild-type strain, VjbR upregulation in the Brucella rough mutant increases transcription of the virB operon, resulting in overexpression of the T4SS gene, accompanied by the over-secretion of effecter proteins, thereby causing the death of infected macrophages via activating IRE1α pathway of endoplasmic reticulum stress, suggesting novel insights into the molecular

The risk of capsular breakage from phacoemulsification needle contact with the lens capsule: a laboratory study.

PubMed

Meyer, Jay J; Kuo, Annie F; Olson, Randall J

2010-06-01

To determine capsular breakage risk from contact by phacoemulsification needles by machine and tip type. Experimental laboratory investigation. Infiniti (Alcon, Inc.) with Intrepid cartridges and Signature (Abbott Medical Optics, Inc.) phacoemulsification machines were tested using 19- and 20-gauge sharp and rounded tips. Actual and unoccluded flow vacuum were determined at 550 mm Hg, bottle height of 75 cm, and machine-indicated flow rate of 60 mL/minute. Breakage from brief tip contact with a capsular surrogate and human cadaveric lenses was calculated. Nineteen-gauge tips had more flow and less unoccluded flow vacuum than 20-gauge tips for both machines, with highest unoccluded flow vacuum in the Infiniti. The 19-gauge sharp tip was more likely than the 20-gauge sharp tip to cause surrogate breakage for Signature with micropulse and Ellips (Abbott Medical Optics, Inc.) ultrasound at 100% power. For Infiniti using OZil (Alcon, Inc.) ultrasound, 20-gauge sharp tips were more likely than 19-gauge sharp tips to break the membrane. For cadaveric lenses, using rounded 20-gauge tips at 100% power, breakage rates were micropulse (2.3%), Ellips (2.3%), OZil (5.3%). Breakage rates for sharp 20-gauge Ellips tips were higher than for rounded tips. Factors influencing capsular breakage may include active vacuum at the tip, flow rate, needle gauge, and sharpness. Nineteen-gauge sharp tips were more likely than 20-gauge tips to cause breakage in lower vacuum methods. For higher-vacuum methods, breakage is more likely with 20-gauge than with 19-gauge tips. Rounded-edge tips are less likely than sharp-edged tips to cause breakage. Copyright 2010 Elsevier Inc. All rights reserved.

A comparison of 25 gauge Quincke spinal needle with 26 gauge Eldor spinal needle for the elective Caesarian sections: insertion characteristics and complications.

PubMed

Tabedar, S; Maharjan, S K; Shrestha, B R; Shrestha, B M

2003-01-01

The study was designed to compare the insertion characteristics and incidence of PDPH between 25 gauge Quincke needle and 26 gauge Eldor needle for spinal anaesthesia in elective c/s. 60 pregnant women (aged 19-35 yrs and weighing 58 -67 kg) undergoing elective caesarean section were randomized into group A (Quincke spinal needle group) or group B (Eldor spinal needle group). Spinal anaesthesia was performed with 2.9 ml 0.5% heavy bupivacaine using 25 gauge Quincke spinal needle in group A and 26 Gauge Eldor spinal needle in group B. Onset, time of first identification of backflow of CSF, number of attempts, level of sensory and motor blockade, failure of anaesthesia, inadequate anaesthesia and incidence of PDPH were recorded. Quincke spinal needle was found easy at insertion, first attempt was successful in 90% of cases, whereas Eldor spinal needle was successful at first attempt in only 60% of cases. Early identification of CSF was seen in Eldor spinal needle group in 3.5 seconds vs. 5.2 seconds in Quincke spinal needle group. Blood mixed CSF was seen in 8 Quincke spinal needle group vs. none in Eldor spinal needle group. Onset was similar between both groups i.e. in 6 minutes. Failure of anaesthesia was none in Eldor spinal needle group vs. 2 in quincke spinal needle group. Height of sensory block achieved was T4 level in 26 parturients,T6 in 1 ,T8 in 1 and no anaesthesia at all in another 2 parturient as compared to T4 level in 29 and T3 in 1 parturient in Eldor spinal needle group. The degree of motor block with the use of Bromage criteria showed a motor score of 1 or 2 in 26 parturients in Quincke spinal needle group vs. same in all cases in Eldor spinal needle group. The total incidence of PDPH was 8.3 % (5 out of 60 parturient) which occurred all in Quincke spinal needle group. 2 parturient who developed severe PDPH required epidural blood patch. 26 gauge Eldor spinal needle was found to be better than 25 gauge Quincke spinal needle for caesarian sections

Examination of surface conditions and other physical properties of commonly used stainless steel acupuncture needles.

PubMed

Xie, Yi Min; Xu, Shanqing; Zhang, Claire Shuiqing; Xue, Charlie Changli

2014-04-01

The present work examined the surface conditions and various other physical properties of sterilised single-use stainless steel acupuncture needles from two of the most popular brands widely used in many countries. Scanning electron microscope (SEM) images were taken for 10 randomly chosen needles from each brand. Further SEM images were taken after each of these needles underwent a standard manipulation with an acupuncture needling practice gel. A comparison of forces and torques during the needling process was also carried out. The SEM images revealed significant surface irregularities and inconsistencies at the needle tips, especially for needles from one of the two brands. Metallic lumps and small, loosely attached pieces of material were observed on the surfaces of some needles. Some of the lumps and pieces of material seen on the needle surfaces disappeared after the acupuncture manipulation. If these needles had been used on patients, the metallic lumps and small pieces of material could have been deposited in human tissues, which could have caused adverse events such as dermatitis. Malformed needle tips might also cause other adverse effects including bleeding, haematoma/bruising, or strong pain during needling. An off-centre needle tip could result in the needle altering its direction during insertion and consequently failing to reach the intended acupuncture point or damaging adjacent tissues. These findings highlight the need for improved quality control of acupuncture needles, with a view to further enhancing the safety and comfort of acupuncture users.

CT fluoroscopy guided transpleural cutting needle biopsy of small (≤2.5 cm) subpleural pulmonary nodules.

PubMed

Prosch, Helmut; Oschatz, Elisabeth; Eisenhuber, Edith; Wohlschlager, Helmut; Mostbeck, Gerhard H

2011-01-01

Small subpleural pulmonary lesions are difficult to biopsy. While the direct, short needle path has been reported to have a lower rate of pneumothorax, the indirect path provides a higher diagnostic yield. Therefore, we tried to optimize the needle pathway and minimize the iatrogenic pneumothorax risk by evaluating a CT fluoroscopy guided direct approach to biopsy subpleural lesions. Between 01/2005 and 01/2007, CT fluoroscopy guided core biopsies were performed in 24 patients. Using our technique, the tip of the guide needle remains outside the visceral pleura (17 G coaxial guide needle, 18 G Biopsy-gun, 15 or 22 mm needle path). The position of the lesion relative to the needle tip can be optimized using CT fluoroscopy by adjusting the breathing position of the patient. The Biopty gun is fired with the needle tip still outside the pleural space. Cytological smears are analyzed by a cytopathologist on-site, and biopsies are repeated as indicated with the coaxial needle still outside the pleura. Median nodule size was 1.6 cm (0.7-2.3 cm). A definitive diagnosis was obtained in 22 patients by histology and/or cytology. In one patient, only necrotic material could be obtained. In another patient, the intervention had to be aborted as the dyspnoic patient could not follow breathing instructions. An asymptomatic pneumothorax was present in seven patients; chest tube placement was not required. The presented biopsy approach has a high diagnostic yield and is especially advantageous for biopsies of small subpleural lesions in the lower lobes. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Design and evaluation of an intraocular B-scan OCT-guided 36-gauge needle

NASA Astrophysics Data System (ADS)

Shen, Jin H.; Joos, Karen M.

2015-03-01

Optical coherence tomography imaging is widely used in ophthalmology and optometry clinics for diagnosing retinal disorders. External microscope-mounted OCT operating room systems have imaged retinal changes immediately following surgical manipulations. However, the goal is to image critical surgical maneuvers in real time. External microscope-mounted OCT systems have some limitations with problems tracking constantly moving intraocular surgical instruments, and formation of absolute shadows by the metallic surgical instruments upon the underlying tissues of interest. An intraocular OCT-imaging probe was developed to resolve these problems. A disposable 25-gauge probe tip extended beyond the handpiece, with a 36-gauge needle welded to a disposable tip with its end extending an additional 3.5 mm. A sealed 0.35 mm diameter GRIN lens protected the fiber scanner and focused the scanning beam at a 3 to 4 mm distance. The OCT engine was a very high-resolution spectral-domain optical coherence tomography (SDOCT) system (870 nm, Bioptigen, Inc. Durham, NC) which produced 2000 A-scan lines per B-scan image at a frequency of 5 Hz with the fiber optic oscillations matched to this frequency. Real-time imaging of the needle tip as it touched infrared paper was performed. The B-scan OCT-needle was capable of real-time performance and imaging of the phantom material. In the future, the B-scan OCT-guided needle will be used to perform sub-retinal injections.

Spectral signatures of viewing a needle approaching one's body when anticipating pain.

PubMed

Höfle, Marion; Pomper, Ulrich; Hauck, Michael; Engel, Andreas K; Senkowski, Daniel

2013-10-01

When viewing the needle of a syringe approaching your skin, anticipation of a painful prick may lead to increased arousal. How this anticipation is reflected in neural oscillatory activity and how it relates to activity within the autonomic nervous system is thus far unknown. Recently, we found that viewing needle pricks compared with Q-tip touches increases the pupil dilation response (PDR) and perceived unpleasantness of electrical stimuli. Here, we used high-density electroencephalography to investigate whether anticipatory oscillatory activity predicts the unpleasantness of electrical stimuli and PDR while viewing a needle approaching a hand that is perceived as one's own. We presented video clips of needle pricks and Q-tip touches, and delivered spatiotemporally aligned painful and nonpainful intracutaneous electrical stimuli. The perceived unpleasantness of electrical stimuli and the PDR were enhanced when participants viewed needle pricks compared with Q-tip touches. Source reconstruction using linear beamforming revealed reduced alpha-band activity in the posterior cingulate cortex (PCC) and fusiform gyrus before the onset of electrical stimuli when participants viewed needle pricks compared with Q-tip touches. Moreover, alpha-band activity in the PCC predicted PDR on a single trial level. The anticipatory reduction of alpha-band activity in the PCC may reflect a neural mechanism that serves to protect the body from forthcoming harm by facilitating the preparation of adequate defense responses. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Radiofrequency Cauterization with Biopsy Introducer Needle

PubMed Central

Pritchard, William F.; Wray-Cahen, Diane; Karanian, John W.; Hilbert, Stephen; Wood, Bradford J.

2014-01-01

PURPOSE The principal risks of needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. This study compared hemorrhage after liver and kidney biopsy with and without radiofrequency (RF) ablation of the needle tract. MATERIALS AND METHODS Biopsies of liver and kidney were performed in swine through introducer needles modified to allow RF ablation with the distal 2 cm of the needle. After each biopsy, randomization determined whether the site was to undergo RF ablation during withdrawal of the introducer needle. Temperature was measured with a thermistor stylet near the needle tip, with a target temperature of 70°C–100°C with RF ablation. Blood loss was measured as grams of blood absorbed in gauze at the puncture site for 2 minutes after needle withdrawal. Selected specimens were cut for gross examination. RESULTS RF ablation reduced bleeding compared with absence of RF ablation in liver and kidney (P < .01), with mean blood loss reduced 63% and 97%, respectively. Mean amounts of blood loss (±SD) in the liver in the RF and no-RF groups were 2.03 g ± 4.03 (CI, 0.53–3.54 g) and 5.50 g ± 5.58 (CI, 3.33–7.66 g), respectively. Mean amounts of blood loss in the kidney in the RF and no-RF groups were 0.26 g ± 0.32 (CI, −0.01 to 0.53 g) and 8.79 g ± 7.72 (CI, 2.34–15.24 g), respectively. With RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed. CONCLUSION RF ablation of needle biopsy tracts reduced hemorrhage after biopsy in the liver and kidney and may reduce complications of hemorrhage as well as implantation of tumor cells in the tract. PMID:14963187

The Structures of Coiled-Coil Domains from Type III Secretion System Translocators Reveal Homology to Pore-Forming Toxins

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barta, Michael L.; Dickenson, Nicholas E.; Patil, Mrinalini

2012-03-26

Many pathogenic Gram-negative bacteria utilize type III secretion systems (T3SSs) to alter the normal functions of target cells. Shigella flexneri uses its T3SS to invade human intestinal cells to cause bacillary dysentery (shigellosis) that is responsible for over one million deaths per year. The Shigella type III secretion apparatus is composed of a basal body spanning both bacterial membranes and an exposed oligomeric needle. Host altering effectors are secreted through this energized unidirectional conduit to promote bacterial invasion. The active needle tip complex of S. flexneri is composed of a tip protein, IpaD, and two pore-forming translocators, IpaB and IpaC.more » While the atomic structure of IpaD has been elucidated and studied, structural data on the hydrophobic translocators from the T3SS family remain elusive. We present here the crystal structures of a protease-stable fragment identified within the N-terminal regions of IpaB from S. flexneri and SipB from Salmonella enterica serovar Typhimurium determined at 2.1 {angstrom} and 2.8 {angstrom} limiting resolution, respectively. These newly identified domains are composed of extended-length (114 {angstrom} in IpaB and 71 {angstrom} in SipB) coiled-coil motifs that display a high degree of structural homology to one another despite the fact that they share only 21% sequence identity. Further structural comparisons also reveal substantial similarity to the coiled-coil regions of pore-forming proteins from other Gram-negative pathogens, notably, colicin Ia. This suggests that these mechanistically separate and functionally distinct membrane-targeting proteins may have diverged from a common ancestor during the course of pathogen-specific evolutionary events.« less

Evolutionarily Conserved nodE, nodO, T1SS, and Hydrogenase System in Rhizobia of Astragalus membranaceus and Caragana intermedia.

PubMed

Yan, Hui; Xie, Jian Bo; Ji, Zhao Jun; Yuan, Na; Tian, Chang Fu; Ji, Shou Kun; Wu, Zhong Yu; Zhong, Liang; Chen, Wen Xin; Du, Zheng Lin; Wang, En Tao; Chen, Wen Feng

2017-01-01

Mesorhizobium species are the main microsymbionts associated with the medicinal or sand-fixation plants Astragalus membranaceus and Caragana intermedia (AC) in temperate regions of China, while all the Mesorhizobium strains isolated from each of these plants could nodulate both of them. However, Rhizobium yanglingense strain CCBAU01603 could nodulate AC plants and it's a high efficiency symbiotic and competitive strain with Caragana . Therefore, the common features shared by these symbiotic rhizobia in genera of Mesorhizobium and Rhizobium still remained undiscovered. In order to study the genomic background influencing the host preference of these AC symbiotic strains, the whole genomes of two ( M. silamurunense CCBAU01550, M. silamurunense CCBAU45272) and five representative strains ( M. septentrionale CCBAU01583, M. amorphae CCBAU01570, M. caraganae CCBAU01502, M. temperatum CCBAU01399, and R. yanglingense CCBAU01603) originally isolated from AC plants were sequenced, respectively. As results, type III secretion systems (T3SS) of AC rhizobia evolved in an irregular pattern, while an evolutionarily specific region including nodE, nodO , T1SS, and a hydrogenase system was detected to be conserved in all these AC rhizobia. Moreover, nodO was verified to be prevalently distributed in other AC rhizobia and was presumed as a factor affecting the nodule formation process. In conclusion, this research interpreted the multifactorial features of the AC rhizobia that may be associated with their host specificity at cross-nodulation group, including nodE, nodZ , T1SS as the possible main determinants; and nodO , hydrogenase system, and T3SS as factors regulating the bacteroid formation or nitrogen fixation efficiency.

A portable integrated system to control an active needle

NASA Astrophysics Data System (ADS)

Konh, Bardia; Motalleb, Mahdi; Ashrafiuon, Hashem

2017-04-01

The primary objective of this work is to introduce an integrated portable system to operate a flexible active surgical needle with actuation capabilities. The smart needle uses the robust actuation capabilities of the shape memory alloy wires to drastically improve the accuracy of in medical procedures such as brachytherapy. This, however, requires an integrated system aimed to control the insertion of the needle via a linear motor and its deflection by the SMA wire in real-time. The integrated system includes a flexible needle prototype, a Raspberry Pi computer, a linear stage motor, an SMA wire actuator, a power supply, electromagnetic tracking system, and various communication supplies. The linear stage motor guides the needle into tissue. The power supply provides appropriate current to the SMA actuator. The tracking system measures tip movement for feedback, The Raspberry Pi is the central tool that receives the tip movement feedback and controls the linear stage motor and the SMA actuator via the power supply. The implemented algorithms required for communication and feedback control are also described. This paper demonstrates that the portable integrated system may be a viable solution for more effective procedures requiring surgical needles.

Development and evaluation of needle trap device geometry and packing methods for automated and manual analysis.

PubMed

Warren, Jamie M; Pawliszyn, Janusz

2011-12-16

For air/headspace analysis, needle trap devices (NTDs) are applicable for sampling a wide range of volatiles such as benzene, alkanes, and semi-volatile particulate bound compounds such as pyrene. This paper describes a new NTD that is simpler to produce and improves performance relative to previous NTD designs. A NTD utilizing a side-hole needle used a modified tip, which removed the need to use epoxy glue to hold sorbent particles inside the NTD. This design also improved the seal between the NTD and narrow neck liner of the GC injector; therefore, improving the desorption efficiency. A new packing method has been developed and evaluated using solvent to pack the device, and is compared to NTDs prepared using the previous vacuum aspiration method. The slurry packing method reduced preparation time and improved reproducibility between NTDs. To evaluate the NTDs, automated headspace extraction was completed using benzene, toluene, ethylbenzene, p-xylene (BTEX), anthracene, and pyrene (PAH). NTD geometries evaluated include: blunt tip with side-hole needle, tapered tip with side-hole needle, slider tip with side-hole, dome tapered tip with side-hole and blunt with no side-hole needle (expanded desorptive flow). Results demonstrate that the tapered and slider tip NTDs performed with improved desorption efficiency. Copyright © 2011 Elsevier B.V. All rights reserved.

Comparison of Spinal Needle Deflection in a Ballistic Gel Model.

PubMed

Rand, Ethan; Christolias, George; Visco, Christopher; R Singh, Jaspal

2016-10-01

Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a ballistic gel tissue simulant. Six needles commonly used in spinal procedures (Quincke, Short Bevel, Chiba, Tuohy, Hustead, Whitacre) were selected for use in this study. Ballistic gel samples were made in molds of two depths, 40mm and 80 mm. Each needle was mounted in a drill press to ensure an accurate needle trajectory. Distance of deflection was recorded for each needle. In comparing the mean deflection of 22 gauge needles of all types at 80 mm of depth, deflection was greatest among beveled needles [Short Bevel (9.96 ± 0.77 mm), Quincke (8.89 ± 0.17 mm), Chiba (7.71 ± 1.16 mm)], moderate among epidural needles [Tuohy (7.64 ± 0.16 mm) and least among the pencil-point needles [Whitacre (0.73 ± 0.34 mm)]. Increased gauge (25 g) led to a significant increase in deflection among beveled needles. The direction of deflection was away from the bevel with Quincke, Chiba and Short Beveled needles and toward the bevel of the Tuohy and Hustead needles. Deflection of the Whitacre pencil-point needle was minimal. There is clinical utility in knowing the relative deflection of various needle tips. When a procedure requires a needle to be steered around obstacles, or along non-collinear targets, the predictable and large amount of deflection obtained through use of a beveled spinal needle may prove beneficial.

Comparison of Spinal Needle Deflection in a Ballistic Gel Model

PubMed Central

Rand, Ethan; Christolias, George; Visco, Christopher; R. Singh, Jaspal

2016-01-01

Background Percutaneous diagnostic and therapeutic procedures are commonly used in the treatment of spinal pain. The success of these procedures depends on the accuracy of needle placement, which is influenced by needle size and shape. Objectives The purpose of this study is to examine and quantify the deviation of commonly used spinal needles based on needle tip design and gauge, using a ballistic gel tissue simulant. Materials and Methods Six needles commonly used in spinal procedures (Quincke, Short Bevel, Chiba, Tuohy, Hustead, Whitacre) were selected for use in this study. Ballistic gel samples were made in molds of two depths, 40mm and 80 mm. Each needle was mounted in a drill press to ensure an accurate needle trajectory. Distance of deflection was recorded for each needle. Results In comparing the mean deflection of 22 gauge needles of all types at 80 mm of depth, deflection was greatest among beveled needles [Short Bevel (9.96 ± 0.77 mm), Quincke (8.89 ± 0.17 mm), Chiba (7.71 ± 1.16 mm)], moderate among epidural needles [Tuohy (7.64 ± 0.16 mm) and least among the pencil-point needles [Whitacre (0.73 ± 0.34 mm)]. Increased gauge (25 g) led to a significant increase in deflection among beveled needles. The direction of deflection was away from the bevel with Quincke, Chiba and Short Beveled needles and toward the bevel of the Tuohy and Hustead needles. Deflection of the Whitacre pencil-point needle was minimal. Conclusions There is clinical utility in knowing the relative deflection of various needle tips. When a procedure requires a needle to be steered around obstacles, or along non-collinear targets, the predictable and large amount of deflection obtained through use of a beveled spinal needle may prove beneficial. PMID:27847693

The Type IX Secretion System (T9SS): Highlights and Recent Insights into Its Structure and Function

PubMed Central

Lasica, Anna M.; Ksiazek, Miroslaw; Madej, Mariusz; Potempa, Jan

2017-01-01

Protein secretion systems are vital for prokaryotic life, as they enable bacteria to acquire nutrients, communicate with other species, defend against biological and chemical agents, and facilitate disease through the delivery of virulence factors. In this review, we will focus on the recently discovered type IX secretion system (T9SS), a complex translocon found only in some species of the Bacteroidetes phylum. T9SS plays two roles, depending on the lifestyle of the bacteria. It provides either a means of movement (called gliding motility) for peace-loving environmental bacteria or a weapon for pathogens. The best-studied members of these two groups are Flavobacterium johnsoniae, a commensal microorganism often found in water and soil, and Porphyromonas gingivalis, a human oral pathogen that is a major causative agent of periodontitis. In P. gingivalis and some other periodontopathogens, T9SS translocates proteins, especially virulence factors, across the outer membrane (OM). Proteins destined for secretion bear a conserved C-terminal domain (CTD) that directs the cargo to the OM translocon. At least 18 proteins are involved in this still enigmatic process, with some engaged in the post-translational modification of T9SS cargo proteins. Upon translocation across the OM, the CTD is removed by a protease with sortase-like activity and an anionic LPS is attached to the newly formed C-terminus. As a result, a cargo protein could be secreted into the extracellular milieu or covalently attached to the bacterial surface. T9SS is regulated by a two-component system; however, the precise environmental signal that triggers it has not been identified. Exploring unknown systems contributing to bacterial virulence is exciting, as it may eventually lead to new therapeutic strategies. During the past decade, the major components of T9SS were identified, as well as hints suggesting the possible mechanism of action. In addition, the list of characterized cargo proteins is

Evaluation of the safety and efficiency of novel metallic implant scaler tips manufactured by the powder injection molding technique.

PubMed

Chun, Kyung A; Kum, Kee-Yeon; Lee, Woo-Cheol; Baek, Seung-Ho; Choi, Hae-Won; Shon, Won-Jun

2017-07-11

Although many studies have compared the properties of ultrasonic scaling instruments, it remains controversial as to which is most suitable for implant scaling. This study evaluated the safety and efficiency of novel metallic ultrasonic scaler tips made by the powder injection molding (PIM) technique on titanium surfaces. Mechanical instrumentation was carried out using four types of metal scaler tips consisting of copper (CU), bronze (BR), 316 L stainless steel (316 L), and conventional stainless steel (SS) tips. The instrumented surface alteration image of samples was viewed with scanning electron microscope (SEM) and surface profile of the each sample was investigated with confocal laser scanning microscopy (CLSM). Arithmetic mean roughness (Ra) and maximum height roughness (Rmax) of titanium samples were measured and dissipated power of the scaler tip was estimated for scaling efficiency. The average Ra values caused by the 316 L and SS tip were about two times higher than those of the CU and BR tips (p < 0.05). The Rmax value showed similar results. The efficiency of the SS tip was about 3 times higher than that of CU tip, the 316 L tip is about 2.7 times higher than that of CU tip, and the BR tip is about 1.2 times higher than that of CU tip. Novel metallic bronze alloy ultrasonic scaler tip minimally damages titanium surfaces, similar to copper alloy tip. Therefore, this bronze alloy scaler tip may be promising instrument for implant maintenance therapy.

[The effect of needle type and immobilization on postspinal headache].

PubMed

Hafer, J; Rupp, D; Wollbrück, M; Engel, J; Hempelmann, G

1997-10-01

Post-dural puncture headache (PDPH) is a significant complication of spinal anaesthesia. Diameter and tip of the needle as well as the patient's age have been proven to be important determinants. The question of whether post-operative recumbency can reduce the risk of PDPH has not been answered uniformly. And besides, some studies referring to this subject reveal methodical failures, for example, as to clear definition and exact documentation of post-operative immobilization. Furthermore, fine-gauge needles (26G or more) have not been investigated yet. The first aim of our study was therefore to examine the role of recumbency in the prevention of PDPH under controlled conditions using thin needles. Secondly, we wanted to confirm the reported prophylactic effect of needles with a modified, atraumatic tip (Whitacre and Atraucan) by comparing them to Quincke needles of identical diameter. Most of the former investigators compared Quincke with atraumatic needles of different size regardless of the known influence of the diameter on PDPH. In a prospective study we included 481 consecutive patients undergoing a total of 500 orthopaedic operations under spinal anaesthesia. The latter was performed in a standardized manner (patient sitting, midline approach, needle with parallel bevel direction), using four different needles allocated randomly (26-gauge and 27-gauge needles with Quincke tip, 26-gauge Atraucan and 27-gauge Whitacre cannula). Half of the patients were instructed to stay in bed for 24 h (horizontal position without raising head), the others to get up as early as possible. An anaesthesiologist visited the patients on the fourth postoperative day or later and questioned them about headache and duration of recumbency. Additionally, the patients had to fill out a questionnaire 1 week after surgery. Any postural headache was considered as PDPH. The four groups of different needles had homogeneous demographic characteristics (see Table 1). A total of 47 patients (9

Automatic needle segmentation in 3D ultrasound images using 3D Hough transform

NASA Astrophysics Data System (ADS)

Zhou, Hua; Qiu, Wu; Ding, Mingyue; Zhang, Songgeng

2007-12-01

3D ultrasound (US) is a new technology that can be used for a variety of diagnostic applications, such as obstetrical, vascular, and urological imaging, and has been explored greatly potential in the applications of image-guided surgery and therapy. Uterine adenoma and uterine bleeding are the two most prevalent diseases in Chinese woman, and a minimally invasive ablation system using an RF button electrode which is needle-like is being used to destroy tumor cells or stop bleeding currently. Now a 3D US guidance system has been developed to avoid accidents or death of the patient by inaccurate localizations of the electrode and the tumor position during treatment. In this paper, we described two automated techniques, the 3D Hough Transform (3DHT) and the 3D Randomized Hough Transform (3DRHT), which is potentially fast, accurate, and robust to provide needle segmentation in 3D US image for use of 3D US imaging guidance. Based on the representation (Φ , θ , ρ , α ) of straight lines in 3D space, we used the 3DHT algorithm to segment needles successfully assumed that the approximate needle position and orientation are known in priori. The 3DRHT algorithm was developed to detect needles quickly without any information of the 3D US images. The needle segmentation techniques were evaluated using the 3D US images acquired by scanning water phantoms. The experiments demonstrated the feasibility of two 3D needle segmentation algorithms described in this paper.

The use of a Colapinto TIPS Needle under cone-beam computed tomography guidance for true lumen re-entry in subintimal recanalization of chronic iliac artery occlusion.

PubMed

Liang, Huei-Lung; Li, Ming-Feng; Chiang, Chia-Ling; Chen, Matt Chiung-Yu; Wu, Chieh-Jen; Pan, Huay-Ben

2017-06-01

To report the technique and clinical outcome of subintimal re-entry in chronic iliac artery occlusion by using a Colapinto transjugular intrahepatic portosystemic shunt (TIPS) needle under rotational angiography (cone-beam computed tomography; CT) imaging guidance. Patients with chronic iliac artery occlusion with earlier failed attempts at conventional percutaneous recanalization during the past 5 years were enrolled in our study. In these patients, an ipsilateral femoral access route was routinely utilized in a retrograde fashion. A Colapinto TIPS Needle was used to aid the true lumen re-entry after failed conventional intraluminal or subintimal guidewire and catheter-based techniques. The puncture was directed under rotational angiography cone-beam CT guidance to re-enter the abdominal aorta. Bare metallic stents 8-10 mm in diameter were deployed in the common iliac artery, and followed by balloon dilation. Ten patients (9 male; median age, 75 years) were included in our investigation. The average occlusion length was 10.2 cm (range, 4-15 cm). According to the Trans-Atlantic Inter-Society Consensus (TASC) II classification, there were five patients each with Class B and D lesions. Successful re-entry was achieved in all patients without procedure-related complications. The ankle-brachial index (ABI) values increased from 0.38-0.79 to 0.75-1.28 after the procedure. Imaging follow-up (> 6 months) was available in six patients with patency of all stented iliac artery. Thereafter, no complaints of recurrent clinical symptoms occurred during the follow-up period. The use of Colapinto TIPS needle, especially under cone-beam CT image guidance, appears to be safe and effective to re-enter the true lumen in a subintimal angioplasty for a difficult chronic total iliac occlusion. Copyright © 2017. Published by Elsevier Taiwan LLC.

MLESAC Based Localization of Needle Insertion Using 2D Ultrasound Images

NASA Astrophysics Data System (ADS)

Xu, Fei; Gao, Dedong; Wang, Shan; Zhanwen, A.

2018-04-01

In the 2D ultrasound image of ultrasound-guided percutaneous needle insertions, it is difficult to determine the positions of needle axis and tip because of the existence of artifacts and other noises. In this work the speckle is regarded as the noise of an ultrasound image, and a novel algorithm is presented to detect the needle in a 2D ultrasound image. Firstly, the wavelet soft thresholding technique based on BayesShrink rule is used to denoise the speckle of ultrasound image. Secondly, we add Otsu’s thresholding method and morphologic operations to pre-process the ultrasound image. Finally, the localization of the needle is identified and positioned in the 2D ultrasound image based on the maximum likelihood estimation sample consensus (MLESAC) algorithm. The experimental results show that it is valid for estimating the position of needle axis and tip in the ultrasound images with the proposed algorithm. The research work is hopeful to be used in the path planning and robot-assisted needle insertion procedures.

Is Skin-Touch Sham Needle Not Placebo? A Double-Blind Crossover Study on Pain Alleviation

PubMed Central

Homma, Ikuo; Izumizaki, Masahiko

2015-01-01

It remains an open question whether placebo/sham acupuncture, in which the needle tip presses the skin, can be used as a placebo device for research on pain. We compare the analgesic effect of the skin-touch placebo needle with that of the no-touch placebo needle, in which the needle tip does not touch the skin, in a double-blind crossover manner including no-treatment control in 23 healthy volunteers. The subjects received painful electrical stimulation in the forearm before and during needle retention to the LI 4 acupoint and after the removal of the needle and rated pain intensity using a visual analogue scale. We found no significant difference in analgesic effects among the skin-touch placebo needle, no-touch placebo needle, and no-treatment control at every point before, during, and after the treatments (p > 0.05). The results indicate that the skin-touch placebo needle can be used as a placebo device in clinical studies on pain. PMID:26064153

Impact of needle insertion depth on the removal of hard-tissue debris.

PubMed

Perez, R; Neves, A A; Belladonna, F G; Silva, E J N L; Souza, E M; Fidel, S; Versiani, M A; Lima, I; Carvalho, C; De-Deus, G

2017-06-01

To evaluate the effect of depth of insertion of an irrigation needle tip on the removal of hard-tissue debris using micro-computed tomographic (micro-CT) imaging. Twenty isthmus-containing mesial roots of mandibular molars were anatomically matched based on similar morphological dimensions using micro-CT evaluation and assigned to two groups (n = 10), according to the depth of the irrigation needle tip during biomechanical preparation: 1 or 5 mm short of the working length (WL). The preparation was performed with Reciproc R25 file (tip size 25, .08 taper) and 5.25% NaOCl as irrigant. The final rinse was 17% EDTA followed by bidistilled water. Then, specimens were scanned again, and the matched images of the canals, before and after preparation, were examined to quantify the amount of hard-tissue debris, expressed as the percentage volume of the initial root canal volume. Data were compared statistically using the Mann-Whitney U-test. None of the tested needle insertion depths yielded root canals completely free from hard-tissue debris. The insertion depth exerted a significant influence on debris removal, with a significant reduction in the percentage volume of hard-tissue debris when the needle was inserted 1 mm short of the WL (P < 0.05). The insertion depth of irrigation needles significantly influenced the removal of hard-tissue debris. A needle tip positioned 1 mm short of the WL resulted in percentage levels of hard-tissue debris removal almost three times higher than when positioned 5 mm from the WL. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Postmyelography headache rates with Whitacre versus Quincke 22-gauge spinal needles.

PubMed

Peterman, S B

1996-09-01

To compare the postdural puncture headache (PDPH) rates after myelography with use of 22-gauge Whitacre (blunt tip) versus standard 22-gauge Quincke (bevel-tip) spinal needles. At myelography, 340 patients were randomly assigned to one of two groups in which either the Whitacre (167 patients) or the Quincke (173 patients) needle was used. Follow-up was at 48 hours and at 4 days after the procedure. Crude and adjusted Whitacre/PDPH odds ratios and risk ratios were calculated. The crude Whitacre needle PDPH risk was 9.6%, and the crude Quincke needle PDPH risk was 15.6%. The absolute risk difference was 6.0% with a 95% confidence interval of -0.98% and 13.04%. The adjusted Whitacre/PDPH odds ratio was 0.492 with a 95% confidence interval of 0.241 and 1.003. The Whitacre needle group had a statistically significantly lower PDPH severity grade (P = .0151), similar PDPH duration, and more technical difficulty with the needle. The Whitacre needle is associated with an equal or lower PDPH risk; the lack of statistical significance is most likely related to sample size. Further study is necessary to determine whether the decreased PDPH rate justifies the added difficulty associated with use of the Whitacre needle.

An ultrasound needle insertion guide in a porcine phantom model.

PubMed

Whittaker, S; Lethbridge, G; Kim, C; Keon Cohen, Z; Ng, I

2013-08-01

We compared nerve blockade with and without the Infiniti(TM) needle guide in an ultrasound in-plane porcine simulation. We recruited 30 anaesthetists with varying blockade experience. Using the guide, the needle tip was more visible (for a median (IQR [range]) of 67 (56-100]) % of the time; and invisible for 2 (1-4 [0-19]) s) than when the guide was not used (respectively 23 (13-43 [0-80]) % and 25 (9-52 [1-198]) s; both p < 0.001). The corresponding block times were 8 (6-10 [3-28]) s and 32 (15-67 [5-225]) s, respectively; p < 0.001. The needle guide reduced the block time and the time that the needle was invisible, irrespective of anaesthetist experience. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Influence of needle position on lumbar segmental nerve root block selectivity.

PubMed

Wolff, André P; Groen, Gerbrand J; Wilder-Smith, Oliver H

2006-01-01

In patients with chronic low back pain radiating to the leg, segmental nerve root blocks (SNRBs) are performed to predict surgical outcome and identify the putative symptomatic spinal nerve. Epidural spread may lead to false interpretation, affecting clinical decision making. Systematic fluoroscopic analysis of epidural local anesthetic spread and its relationship to needle tip location has not been published to date. Study aims include assessment of epidural local anesthetic spread and its relationship to needle position during fluoroscopy-assisted blocks. Patients scheduled for L4, L5, and S1 blocks were included in this prospective observational study. Under fluoroscopy and electrostimulation, they received 0.5 mL of a mixture containing lidocaine 5 mg and iohexol 75 mg. X-rays with needle tip and contrast were scored for no epidural spread (grade 0), local spread epidurally (grade 1), or to adjacent nerve roots (grade 2). Sixty-five patients were analyzed for epidural spread, 62 for needle position. Grade 1 epidural spread occurred in 47% of L4 and 28% of L5 blocks and grade 2 spread in 3 blocks (5%; L5 n = 1, S1 n = 2). For lumbar blocks, the needle was most frequently found in the lateral upper half of the intervertebral foramen. Epidural spread occurred more frequently with medial needle positions (P = .06). The findings suggest (P = .06) that the risk of grade 1 and 2 lumbar epidural spread, which results in decreased SNRB selectivity, is greater with medial needle positions in the intervertebral foramen. The variability in anatomic position of the dorsal root ganglion necessitates electrostimulation to guide SNRB in addition to fluoroscopy.

Convolution neural networks for real-time needle detection and localization in 2D ultrasound.

PubMed

Mwikirize, Cosmas; Nosher, John L; Hacihaliloglu, Ilker

2018-05-01

We propose a framework for automatic and accurate detection of steeply inserted needles in 2D ultrasound data using convolution neural networks. We demonstrate its application in needle trajectory estimation and tip localization. Our approach consists of a unified network, comprising a fully convolutional network (FCN) and a fast region-based convolutional neural network (R-CNN). The FCN proposes candidate regions, which are then fed to a fast R-CNN for finer needle detection. We leverage a transfer learning paradigm, where the network weights are initialized by training with non-medical images, and fine-tuned with ex vivo ultrasound scans collected during insertion of a 17G epidural needle into freshly excised porcine and bovine tissue at depth settings up to 9 cm and [Formula: see text]-[Formula: see text] insertion angles. Needle detection results are used to accurately estimate needle trajectory from intensity invariant needle features and perform needle tip localization from an intensity search along the needle trajectory. Our needle detection model was trained and validated on 2500 ex vivo ultrasound scans. The detection system has a frame rate of 25 fps on a GPU and achieves 99.6% precision, 99.78% recall rate and an [Formula: see text] score of 0.99. Validation for needle localization was performed on 400 scans collected using a different imaging platform, over a bovine/porcine lumbosacral spine phantom. Shaft localization error of [Formula: see text], tip localization error of [Formula: see text] mm, and a total processing time of 0.58 s were achieved. The proposed method is fully automatic and provides robust needle localization results in challenging scanning conditions. The accurate and robust results coupled with real-time detection and sub-second total processing make the proposed method promising in applications for needle detection and localization during challenging minimally invasive ultrasound-guided procedures.

Intra-operative navigation of a 3-dimensional needle localization system for precision of irreversible electroporation needles in locally advanced pancreatic cancer.

PubMed

Bond, L; Schulz, B; VanMeter, T; Martin, R C G

2017-02-01

Irreversible electroporation (IRE) uses multiple needles and a series of electrical pulses to create pores in cell membranes and cause cell apoptosis. One of the demands of IRE is the precise needle spacing required. Two-dimensional intraoperative ultrasound (2-D iUS) is currently used to measure inter-needle distances but requires significant expertise. This study evaluates the potential of three-dimensional (3-D) image guidance for placing IRE needles and calculating needle spacing. A prospective clinical evaluation of a 3-D needle localization system (Explorer™) was evaluated in consecutive patients from April 2012 through June 2013 for unresectable pancreatic adenocarcinoma. 3-D reconstructions of patients' anatomy were generated from preoperative CT images, which were aligned to the intraoperative space. Thirty consecutive patients with locally advanced pancreatic cancer were treated with IRE. The needle localization system setup added an average of 6.5 min to each procedure. The 3-D needle localization system increased surgeon confidence and ultimately reduced needle placement time. IRE treatment efficacy is highly dependent on accurate needle spacing. The needle localization system evaluated in this study aims to mitigate these issues by providing the surgeon with additional visualization and data in 3-D. The Explorer™ system provides valuable guidance information and inter-needle distance calculations. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

The effects of needle deformation during lumbar puncture

PubMed Central

Özdemir, Hasan Hüseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

2015-01-01

Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH. PMID:25883480

The effects of needle deformation during lumbar puncture.

PubMed

Özdemir, Hasan Hüseyin; Demir, Caner F; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

2015-01-01

The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

Design and evaluation of a computed tomography (CT)-compatible needle insertion device using an electromagnetic tracking system and CT images.

PubMed

Shahriari, Navid; Hekman, Edsko; Oudkerk, Matthijs; Misra, Sarthak

2015-11-01

Percutaneous needle insertion procedures are commonly used for diagnostic and therapeutic purposes. Although current technology allows accurate localization of lesions, they cannot yet be precisely targeted. Lung cancer is the most common cause of cancer-related death, and early detection reduces the mortality rate. Therefore, suspicious lesions are tested for diagnosis by performing needle biopsy. In this paper, we have presented a novel computed tomography (CT)-compatible needle insertion device (NID). The NID is used to steer a flexible needle (φ0.55 mm) with a bevel at the tip in biological tissue. CT images and an electromagnetic (EM) tracking system are used in two separate scenarios to track the needle tip in three-dimensional space during the procedure. Our system uses a control algorithm to steer the needle through a combination of insertion and minimal number of rotations. Noise analysis of CT images has demonstrated the compatibility of the device. The results for three experimental cases (case 1: open-loop control, case 2: closed-loop control using EM tracking system and case 3: closed-loop control using CT images) are presented. Each experimental case is performed five times, and average targeting errors are 2.86 ± 1.14, 1.11 ± 0.14 and 1.94 ± 0.63 mm for case 1, case 2 and case 3, respectively. The achieved results show that our device is CT-compatible and it is able to steer a bevel-tipped needle toward a target. We are able to use intermittent CT images and EM tracking data to control the needle path in a closed-loop manner. These results are promising and suggest that it is possible to accurately target the lesions in real clinical procedures in the future.

Effect of spinal needle characteristics on measurement of spinal canal opening pressure.

PubMed

Bellamkonda, Venkatesh R; Wright, Thomas C; Lohse, Christine M; Keaveny, Virginia R; Funk, Eric C; Olson, Michael D; Laack, Torrey A

2017-05-01

A wide variety of spinal needles are used in clinical practice. Little is currently known regarding the impact of needle length, gauge, and tip type on the needle's ability to measure spinal canal opening pressure. This study aimed to investigate the relationship between these factors and the opening-pressure measurement or time to obtain an opening pressure. Thirteen distinct spinal needles, chosen to isolate the effects of length, gauge, and needle-point type, were prospectively tested on a lumbar puncture simulator. The key outcomes were the opening-pressure measurement and the time required to obtain that measure. Pressures were recorded at 10-s intervals until 3 consecutive, identical readings were observed. Time to measure opening pressure increased with increasing spinal needle length, increasing gauge, and the Quincke-type (cutting) point (P<0.001 for all). The time to measurement ranged from 30s to 530s, yet all needle types were able to obtain a consistent opening pressure measure. Although opening pressure estimates are unlikely to vary markedly by needle type, the time required to obtain the measurement increased with increasing needle length and gauge and with Quincke-type needles. Copyright © 2017 Elsevier Inc. All rights reserved.

Identification of minor inner-membrane components of the Shigella type III secretion system 'needle complex'.

PubMed

Zenk, Sebastian F; Stabat, David; Hodgkinson, Julie L; Veenendaal, Andreas K J; Johnson, Steven; Blocker, Ariel J

2007-08-01

Type III secretion systems (T3SSs or secretons) are central virulence factors of many Gram-negative bacteria, used to inject protein effectors of virulence into eukaryotic host cells. Their overall morphology, consisting of a cytoplasmic region, an inner- and outer-membrane section and an extracellular needle, is conserved in various species. A portion of the secreton, containing the transmembrane regions and needle, has been isolated biochemically and termed the 'needle complex' (NC). However, there are still unsolved questions concerning the nature and relative arrangement of the proteins assembling the NC. Until these are resolved, the mode of function of the NC cannot be clarified. This paper describes an affinity purification method that enables highly efficient purification of Shigella NCs under near-physiological conditions. Using this method, three new minor components of the NC were identified by mass spectrometry: IpaD, a known component of the needle tip complex, and two predicted components of its central inner-membrane export apparatus, Spa40 and Spa24. A further minor component of the NC, MxiM, is only detected by immunoblotting. MxiM is a 'pilotin'-type protein for the outer-membrane 'secretin' ring formed of MxiD. As expected, it localized to the outer rim of the upper ring of NCs, validating the other findings.

Autonomic Responses to Ultrasound-Guided Percutaneous Needle Electrolysis: Effect of Needle Puncture or Electrical Current?

PubMed

García Bermejo, Paula; De La Cruz Torres, Blanca; Naranjo Orellana, José; Albornoz Cabello, Manuel

2018-01-01

The aim of this study was to establish if the changes in sympathetic and parasympathetic activity (analyzed through heart-rate variability [HRV]) during ultrasound (US)-guided percutaneous needle electrolysis (PNE) is due to the effect of needle puncture only or of the PNE technique per se where the puncture and galvanic current are combined. This was an experimental, case-control study that took place at the University of Seville. Subjects were 36 male footballers who were randomly allocated to three groups: a control group (CG; 12 players), for whom HRV was recorded for 10 min, both at rest and during an exhaustive US examination of the patellar tendon and adjacent structures; a first experimental group (PNE group; 12 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE in the patellar tendon; and a second experimental group (needle group; 12 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE without electrical current in the patellar tendon. The outcome measures were the diameters of the Poincaré plot (SD1, SD2), stress score, and sympathetic/parasympathetic ratio. There were no differences between groups in any baseline measurements, nor were there any significant differences between CG measurements (baseline vs. intervention). The PNE group exhibited statistically significant increases in SD1 (p = 0.01) and SD2 (p = 0.004) and statistically significant decreases in SS and S/PS ratio (p = 0.03), indicating increased parasympathetic and decreased sympathetic activity, respectively. The needle group exhibited statistically significant increases in SD2 (p = 0.02) and statistically significant decreases in SS (p = 0.02), indicating decreased sympathetic activity. The application of the US-guided PNE technique caused a measurable increase in parasympathetic activity (detected by HRV), which was due to the combination of needle puncture and

New Coaxial Transseptal Needle for Creation of Atrial Septal Defects in Adult Sheep

DOE Office of Scientific and Technical Information (OSTI.GOV)

Uchida, Barry T.; Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu; Shimohira, Masashi

Objectives: To introduce a new transseptal (TS) needle assembled in our laboratory-the coaxial TS (CTS) needle-and describe our experience with it in creating experimental atrial septal defects (ASD) in adult sheep.BackgroundWith commercially available TS needles, we were not able to consistently perform TS puncture at the fossa ovalis in adult sheep.Material and MethodsTen adult sheep with a mean weight of 63.5 kg were used. The CTS needle consists of four components: a 9F Teflon catheter, a 14-gauge blunt curved-tip metal cannula, a 4F tapered catheter, and a 20-gauge open needle. A transjugular 5F pigtail catheter was used to display themore » septal anatomy by angiocardiography and was left in place to mark the level of the fossa ovalis. The septum was then probed by a transfemoral 5F curved-tip end-hole catheter. The CTS needle was aligned with the tip of the transjugular catheter, and the TS puncture was performed under fluoroscopic guidance. After documenting a left atrial position, a balloon angioplasty catheter was used for creation of the ASD. Results: A small patent foramen ovale was discovered by septal probing in one sheep. All sheep underwent successful TS punctures without complications. The ASD size ranged from 13 to 15 mm. In eight sheep, the ASD was in fossa ovalis. In the first two sheep where the needle was not well aligned with the marking catheter, the ASD was in the septum secundum. No damage to the atrial or other heart structures was found at necropsy. Conclusion: The CTS needle is a suitable needle for TS puncture and ASD creation in adult sheep. Proper alignment of the CTS needle with a catheter marking the fossa ovalis is essential for successful puncture.« less

Structural characterization of the Yersinia pestis type III secretion system needle protein YscF in complex with its heterodimeric chaperone YscE/YscG

PubMed Central

Sun, Ping; Tropea, Joseph E.; Austin, Brian P.; Cherry, Scott; Waugh, David S.

2008-01-01

Summary The plague-causing bacterium Yersinia pestis utilizes a Type III Secretion System (T3SS) to deliver effector proteins into mammalian cells where they interfere with signal transduction pathways that mediate phagocytosis and the inflammatory response. Effector proteins are injected through a hollow needle structure composed of the protein YscF. YscG and YscE act as "chaperones" to prevent premature polymerization of YscF in the cytosol of the bacterium prior to assembly of the needle. Here, we report the crystal structure of the YscEFG protein complex at 1.8 Å resolution. Overall, the structure is similar to that of the analogous PscEFG complex from the Pseudomonas aeruginosa T3SS, but there are noteworthy differences. The structure confirms that, like PscG, YscG is a member of the tetratricopeptide repeat (TPR) family of proteins. YscG binds tightly to the C-terminal half of YscF, implying that it is this region of YscF that controls its polymerization into the needle structure. YscE interacts with the N-terminal TPR motif of YscG but makes very little direct contact with YscF. Its function may be to stabilize the structure of YscG and/or to participate in recruiting the complex to the secretion apparatus. No electron density could be observed for the N-terminal 49 residues of YscF. This and additional evidence suggest that the N-terminus of YscF is disordered in the complex with YscE and YscG. As expected, conserved residues in the C-terminal half of YscF mediate important intra- and intermolecular interactions in the complex. Moreover, the phenotypes of some previously characterized mutations in the C-terminal half of YscF can be rationalized in terms of the structure of the heterotrimeric YscEFG complex. PMID:18281060

Characteristics of nanosecond pulse needle-to-plane discharges at high pressure: a particle-in-cell Monte Carlo collision simulation

NASA Astrophysics Data System (ADS)

Sang, Chaofeng; Sun, Jizhong; Ren, Chunsheng; Wang, Dezhen

2009-02-01

A model of one dimensional in position and three dimensional in velocity space self-consistent particle in cell with Monte Carlo collision technique was employed to simulate the argon discharge between the needle and plane electrodes at high pressure, in which a nanosecond rectangular pulse was applied to the needle electrode. The work focused on the investigation of the spatiotemporal evolution of the discharge versus the needle tip size and working gas pressure. The simulation results showed that the discharge occurred mainly in the region near the needle tip at atmospheric pressure, and that the small radius of the needle tip led to easy discharge. Reducing the gas pressure gave rise to a transition from a corona discharge to a glowlike discharge along the needle-to-plane direction. The microscopic mechanism for the transition can arguably be attributed to the peak of high-energy electrons occurring before the breakdown; the magnitude of the number of these electrons determined whether the breakdown can take place.

Cadaveric and Ultrasonographic Validation of Needling Placement in the Cervical Multifidus Muscle.

PubMed

Fernández-de-Las-Peñas, César; Mesa-Jiménez, Juan A; Paredes-Mancilla, Jose A; Koppenhaver, Shane L; Fernández-Carnero, Samuel

2017-06-01

The aim of this study was to determine if a needle is able to reach the cervical multifidus during the application of dry needling or acupuncture. Dry needling and ultrasound imaging of cervical multifidi was conducted on 5 patients (age: 32 ± 5 years) with mechanical neck pain and on 2 fresh cadavers (age: 64 ± 1 years). Dry needling was done using a needle of 40 mm in length inserted perpendicular to the skin about 1 cm lateral to the spinous process at C3-C4. The needle was advanced from a posterior to anterior direction into the cervical multifidus with a slight inferior-medial angle (approximately 10°) to reach the vertebra lamina. For the cadaveric study, the multifidus was isolated by carefully resecting the superficial posterior cervical muscles: trapezius, splenius, and semispinalis. For the ultrasonographic study, a convex transducer was placed transversely over C3-C4 after the insertion of the needle into the muscle. The results of both the cadaveric and ultrasonic studies found that the needle does pierce the cervical multifidus muscle during insertion and that the tip of the needle rests properly against the vertebral laminae, thereby guarding the sensitive underlying spinal structures from damage. This anatomical and ultrasound imaging study supports that dry needling of the cervical multifidus could be conducted clinically. Copyright © 2017. Published by Elsevier Inc.

[Percutaneous needle aponeurotomy for Dupuytren's disease].

PubMed

Spies, C K; Müller, L P; Skouras, E; Bassemir, D; Hahn, P; Unglaub, F

2016-02-01

Percutaneous transverse aponeurotomy of the cord by using a hypodermic needle as a scalpel blade in order to improve function of the hand. Symptomatic flexion contracture with positive table top test caused by a single, palpable cord within the palm (primarily Tubiana stages I and II). Multiple, infiltrating or broad-based cords within the palm; irritated skin conditions; exclusive digital cord localization; recurrence after aponeurectomy; previous surgical intervention at the site of interest, digital nerve lesions; lack of patient compliance. Pinpoint surface anesthesia is obtained by injecting each portal area subdermally with 0.1 ml of local anesthetic. These applications start from distally to proximally within the palm while the most distal injection site is located proximal to the distal palm crease. Then the needle tip is introduced perpendicular to the cord. Sawing movements through the cord are performed transversely. While passively extending the contracted finger, the cord is held under tension which guarantees safe cutting. Patients are encouraged to report immediate pain sensation or numbness in order to prevent injuries to neurovascular structures and active finger flexion excludes tendon lesions during the procedure. Introducing the needle tip may be performed at several sites along the cord, if necessary, from distal to proximal at least 5 mm apart with prior pinpoint surface anesthesia. Finally, cautious passive stretching may be done after each release. Bandaging allowing immediate motion; application of a hand-based extension splint-glove during the night for 3-6 months. Recurrence rate was 53% in 15 retrospectively examined patients after a mean interval of 40 months postoperatively.

Small-molecule type III secretion system inhibitors block assembly of the Shigella type III secreton.

PubMed

Veenendaal, Andreas K J; Sundin, Charlotta; Blocker, Ariel J

2009-01-01

Type III secretion systems (T3SSs) are essential virulence devices for many gram-negative bacteria that are pathogenic for plants, animals, and humans. They serve to translocate virulence effector proteins directly into eukaryotic host cells. T3SSs are composed of a large cytoplasmic bulb and a transmembrane region into which a needle is embedded, protruding above the bacterial surface. The emerging antibiotic resistance of bacterial pathogens urges the development of novel strategies to fight bacterial infections. Therapeutics that rather than kill bacteria only attenuate their virulence may reduce the frequency or progress of resistance emergence. Recently, a group of salicylidene acylhydrazides were identified as inhibitors of T3SSs in Yersinia, Chlamydia, and Salmonella species. Here we show that these are also effective on the T3SS of Shigella flexneri, where they block all related forms of protein secretion so far known, as well as the epithelial cell invasion and induction of macrophage apoptosis usually demonstrated by this bacterium. Furthermore, we show the first evidence for the detrimental effect of these compounds on T3SS needle assembly, as demonstrated by increased numbers of T3S apparatuses without needles or with shorter needles. Therefore, the compounds generate a phenocopy of T3SS export apparatus mutants but with incomplete penetrance. We discuss why this would be sufficient to almost completely block the later secretion of effector proteins and how this begins to narrow the search for the molecular target of these compounds.

Needle segmentation using 3D Hough transform in 3D TRUS guided prostate transperineal therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qiu Wu; Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario N6A 5K8; Yuchi Ming

Purpose: Prostate adenocarcinoma is the most common noncutaneous malignancy in American men with over 200 000 new cases diagnosed each year. Prostate interventional therapy, such as cryotherapy and brachytherapy, is an effective treatment for prostate cancer. Its success relies on the correct needle implant position. This paper proposes a robust and efficient needle segmentation method, which acts as an aid to localize the needle in three-dimensional (3D) transrectal ultrasound (TRUS) guided prostate therapy. Methods: The procedure of locating the needle in a 3D TRUS image is a three-step process. First, the original 3D ultrasound image containing a needle is cropped;more » the cropped image is then converted to a binary format based on its histogram. Second, a 3D Hough transform based needle segmentation method is applied to the 3D binary image in order to locate the needle axis. The position of the needle endpoint is finally determined by an optimal threshold based analysis of the intensity probability distribution. The overall efficiency is improved through implementing a coarse-fine searching strategy. The proposed method was validated in tissue-mimicking agar phantoms, chicken breast phantoms, and 3D TRUS patient images from prostate brachytherapy and cryotherapy procedures by comparison to the manual segmentation. The robustness of the proposed approach was tested by means of varying parameters such as needle insertion angle, needle insertion length, binarization threshold level, and cropping size. Results: The validation results indicate that the proposed Hough transform based method is accurate and robust, with an achieved endpoint localization accuracy of 0.5 mm for agar phantom images, 0.7 mm for chicken breast phantom images, and 1 mm for in vivo patient cryotherapy and brachytherapy images. The mean execution time of needle segmentation algorithm was 2 s for a 3D TRUS image with size of 264 Multiplication-Sign 376 Multiplication-Sign 630 voxels

XopN-T3SS effector of Xanthomonas axonopodis pv. punicae localizes to the plasma membrane and modulates ROS accumulation events during blight pathogenesis in pomegranate.

PubMed

Kumar, Rishikesh; Soni, Madhvi; Mondal, Kalyan K

2016-12-01

Bacterial blight caused by Xanthomonas axonopodis pv. punicae (Xap) is a major disease of pomegranate. Xap secretes effector proteins via type III secretion system (T3SS) to suppress pathogen-associated molecular pattern (PAMP)-triggered plant immunity (PTI). Previously we reported that XopN, a conserved effector of Xap, modulate in planta bacterial growth, and blight disease. In continuation to that here we report the deletion of XopN from Xap caused higher accumulation of reactive oxygen species (ROS) including H 2 O 2 and O 2 - . We quantitatively assessed the higher accumulation of H 2 O 2 in pomegranate leaves infiltrated with Xap ΔxopN compared to Xap wild-type. We analysed that 1.5 to 3.3 fold increase in transcript expression of ROS and flg22-inducible genes, namely FRK1, GST1, WRKY29, PR1, PR2 and PR5 in Arabidopsis when challenged with Xap ΔxopN; contrary, the up-regulation of all the genes were compromised when challenged with either Xap wild-type or Xap ΔxopN+xopN. Further, we demonstrated the plasma-membrane based localization of XopN protein both in its natural and experimental hosts. All together, the present study suggested that XopN-T3SS effector of Xap gets localized in the plasma membrane and suppresses ROS-mediated early defense responses during blight pathogenesis in pomegranate. Copyright © 2016 Elsevier GmbH. All rights reserved.

A novel actuator for simulation of epidural anesthesia and other needle insertion procedures.

PubMed

Magill, John C; Byl, Marten F; Hinds, Michael F; Agassounon, William; Pratt, Stephen D; Hess, Philip E

2010-06-01

When navigating a needle from skin to epidural space, a skilled clinician maintains a mental model of the anatomy and uses the various forms of haptic and visual feedback to track the location of the needle tip. Simulating the procedure requires an actuator that can produce the feel of tissue layers even as the needle direction changes from the ideal path. A new actuator and algorithm architecture simulate forces associated with passing a needle through varying tissue layers. The actuator uses a set of cables to suspend a needle holder. The cables are wound onto spools controlled by brushless motors. An electromagnetic tracker is used to monitor the position of the needle tip. Novice and expert clinicians simulated epidural insertion with the simulator. Preliminary depth-time curves show that the user responds to changes in tissue properties as the needle is advanced. Some discrepancy in clinician response indicates that the feel of the simulator is sensitive to technique, thus perfect tissue property simulation has not been achieved. The new simulator is able to approximately reproduce properties of complex multilayer tissue structures, including fine-scale texture. Methods for improving fidelity of the simulation are identified.

Electrolytic echo enhancement: a novel method to make needles more reflective to ultrasound.

PubMed

Cockburn, John F; Khosh, Stefan K

2014-04-01

This study examines the effect of augmenting the ultrasound reflectivity of needles using a novel electrolytic echo enhancement method. Needles were connected by a lead to the negative terminal of a 4.5 V direct current source. A grounding pad, connected to the positive terminal, was positioned on the undersurface of an ex vivo ox liver phantom. During needle insertion into the liver, electrolysis was induced creating a layer of gas on the needle electrode. Analysis of images showed a significant increase in needle brightness using electrolytic echo enhancement. Brightness was found to increase by a factor of ×3.6 compared with controls (P < 0.001). Electrolytic echo enhancement has the potential to make ultrasound-guided procedures safer and quicker for patients and increase the confidence of operators in their ability to see the whole needle including its tip. © 2014 The Royal Australian and New Zealand College of Radiologists.

Binding Affects the Tertiary and Quaternary Structures of the Shigella Translocator Protein IpaB and its Chaperone IpgC†

PubMed Central

Adam, Philip R.; Patil, Mrinalini K.; Dickenson, Nicholas E.; Choudhari, Shyamal; Barta, Michael; Geisbrecht, Brian V.; Picking, Wendy L.; Picking, William D.

2012-01-01

Shigella flexneri uses its type III secretion system (T3SS) to promote invasion of human intestinal epithelial cells as the first step in causing shigellosis, a life threatening form of dysentery. The Shigella type III secretion apparatus (T3SA) consists of a basal body that spans the bacterial envelope and an exposed needle that injects effector proteins into target cells. The nascent Shigella T3SA needle is topped with a pentamer of the needle tip protein invasion plasmid antigen D (IpaD). Bile salts trigger recruitment of the first hydrophobic translocator protein, IpaB, to the tip complex where it senses contact with a host membrane. In the bacterial cytoplasm, IpaB exists in a complex with its chaperone IpgC. Several structures of IpgC have been solved and we recently reported the 2.1-Å crystal structure of the N-terminal domain (IpaB74.224) of IpaB. Like IpgC, the IpaB N-terminal domain exists as a homodimer in solution. We now report that when the two are mixed, these homodimers dissociate and form heterodimers having a nanomolar dissociation constant. This is consistent with the equivalent complexes co-purified after being co-expressed in E. coli. Fluorescence data presented here also indicate that the N-terminal domain of IpaB possesses two regions that appear to contribute additively to chaperone binding. It is also likely that the IpaB N terminus adopts an alternative conformation as a result of chaperone binding. The importance of these findings within the functional context of these proteins is discussed. PMID:22497344

A variable stiffness mechanism for steerable percutaneous instruments: integration in a needle.

PubMed

De Falco, Iris; Culmone, Costanza; Menciassi, Arianna; Dankelman, Jenny; van den Dobbelsteen, John J

2018-06-04

Needles are advanced tools commonly used in minimally invasive medical procedures. The accurate manoeuvrability of flexible needles through soft tissues is strongly determined by variations in tissue stiffness, which affects the needle-tissue interaction and thus causes needle deflection. This work presents a variable stiffness mechanism for percutaneous needles capable of compensating for variations in tissue stiffness and undesirable trajectory changes. It is composed of compliant segments and rigid plates alternately connected in series and longitudinally crossed by four cables. The tensioning of the cables allows the omnidirectional steering of the tip and the stiffness tuning of the needle. The mechanism was tested separately under different working conditions, demonstrating a capability to exert up to 3.6 N. Afterwards, the mechanism was integrated into a needle, and the overall device was tested in gelatine phantoms simulating the stiffness of biological tissues. The needle demonstrated the capability to vary deflection (from 11.6 to 4.4 mm) and adapt to the inhomogeneity of the phantoms (from 21 to 80 kPa) depending on the activation of the variable stiffness mechanism. Graphical abstract ᅟ.

The sensitivity of motor response to needle nerve stimulation during ultrasound guided interscalene catheter placement.

PubMed

Fredrickson, Michael J

2008-01-01

Neurostimulation during single shot interscalene block has a significant false negative motor response rate. Compared with tangential needle approaches for single shot block, interscalene catheter (ISC) placement commonly involves Tuohy needles inserted longitudinally to the brachial plexus. This study aimed to determine the sensitivity of neurostimulation during ultrasound-guided ISC needle placement, and the feasibility of an ultrasound-guided ISC needle endpoint. One hundred fifty-five consecutive nonstimulating ISCs were placed with the needle tip position confirmed by the sonographic spread of 5 mL dextrose 5%. Catheter advancement was then blind 2 to 3 cm past the needle tip. A 0.8 mA electrical stimulus at 2 Hz was applied throughout. When a satisfactory image was obtained, neurostimulation was ignored and the minimum motor response amplitude noted. If imaging was equivocal, a brief appropriate motor response at 0.8 mA was sought. A sustained response at <0.5 mA was only sought if imaging was suboptimal. Prior to surgery conducted under general anesthesia, 30 mL ropivacaine 0.5% was administered through the ISC. Catheter success was defined as a recovery room numerical rating pain score of needle endpoint was used in 92% of ISC placements, of which 96% were successful. Sustained twitches at <0.5 mA were obtained in 12 (8%) patients, 6 (4%) of these deliberately sought because of suboptimal imaging. Catheter success overall was 95%. This study suggests that the false negative motor response rate for longitudinal ISC needle placement is higher than the false negative response rate associated with tangential needle approach interscalene block. An ultrasound guided ISC needle endpoint is a feasible alternative to a neurostimulation endpoint.

CalR is required for the expression of T6SS2 and the adhesion of Vibrio parahaemolyticus to HeLa cells.

PubMed

Zhang, Lingyu; Osei-Adjei, George; Zhang, Ying; Gao, He; Yang, Wenhui; Zhou, Dongsheng; Huang, Xinxiang; Yang, Huiying; Zhang, Yiquan

2017-08-01

Vibrio parahaemolyticus expresses one major virulence determinant T6SS2, which is constituted into three putative operons, i.e., VPA1027-1024, VPA1043-1028, and VPA1044-1046. CalR, a LysR-type transcriptional regulator, was originally identified as a repressor of the swarming motility and T3SS1 gene expression. As shown in this study, CalR binds to the promoter-proximal region of each of the three operons to activate their transcription, and moreover, CalR activates the adhesion of V. parahaemolyticus to HeLa cells. In addition, competitive EMSAs demonstrated that CalR acts as an antagonist of H-NS in V. parahaemolyticus. Collectively, these studies confirmed a new physiological role for CalR in V. parahaemolyticus.

Small-Molecule Type III Secretion System Inhibitors Block Assembly of the Shigella Type III Secreton▿ †

PubMed Central

Veenendaal, Andreas K. J.; Sundin, Charlotta; Blocker, Ariel J.

2009-01-01

Type III secretion systems (T3SSs) are essential virulence devices for many gram-negative bacteria that are pathogenic for plants, animals, and humans. They serve to translocate virulence effector proteins directly into eukaryotic host cells. T3SSs are composed of a large cytoplasmic bulb and a transmembrane region into which a needle is embedded, protruding above the bacterial surface. The emerging antibiotic resistance of bacterial pathogens urges the development of novel strategies to fight bacterial infections. Therapeutics that rather than kill bacteria only attenuate their virulence may reduce the frequency or progress of resistance emergence. Recently, a group of salicylidene acylhydrazides were identified as inhibitors of T3SSs in Yersinia, Chlamydia, and Salmonella species. Here we show that these are also effective on the T3SS of Shigella flexneri, where they block all related forms of protein secretion so far known, as well as the epithelial cell invasion and induction of macrophage apoptosis usually demonstrated by this bacterium. Furthermore, we show the first evidence for the detrimental effect of these compounds on T3SS needle assembly, as demonstrated by increased numbers of T3S apparatuses without needles or with shorter needles. Therefore, the compounds generate a phenocopy of T3SS export apparatus mutants but with incomplete penetrance. We discuss why this would be sufficient to almost completely block the later secretion of effector proteins and how this begins to narrow the search for the molecular target of these compounds. PMID:18996990

An Optical Actuation System and Curvature Sensor for a MR-compatible Active Needle

PubMed Central

Ryu, Seok Chang; Quek, Zhan Fan; Renaud, Pierre; Black, Richard J.; Daniel, Bruce L.; Cutkosky, Mark R.

2015-01-01

A side optical actuation method is presented for a slender MR-compatible active needle. The needle includes an active region with a shape memory alloy (SMA) wire actuator, where the wire generates a contraction force when optically heated by a laser delivered though optical fibers, producing needle tip bending. A prototype, with multiple side heating spots, demonstrates twice as fast an initial response compared to fiber tip heating when 0.8 W of optical power is applied. A single-ended optical sensor with a gold reflector is also presented to measure the curvature as a function of optical transmission loss. Preliminary tests with the sensor prototype demonstrate approximately linear response and a repeatable signal, independent of the bending history. PMID:26509099

Real-time MRI-guided needle intervention for cryoablation: a phantom study

NASA Astrophysics Data System (ADS)

Gao, Wenpeng; Jiang, Baichuan; Kacher, Dan F.; Fetics, Barry; Nevo, Erez; Lee, Thomas C.; Jayender, Jagadeesan

2017-03-01

MRI-guided needle intervention for cryoablation is a promising way to relieve the pain and treat the cancer. However, the limited size of MRI bore makes it impossible for clinicians to perform the operation in the bore. The patients had to be moved into the bore for scanning to verify the position of the needle's tip and out for adjusting the needle's trajectory. Real-time needle tracking and shown in MR images is of importance for clinicians to perform the operation more efficiently. In this paper, we have instrumented the cryotherapy needle with a MRI-safe electromagnetic (EM) sensor and optical sensor to measure the needle's position and orientation. To overcome the limitation of line-of-sight for optical sensor and the poor dynamic performance of the EM sensor, Kalman filter based data fusion is developed. Further, we developed a navigation system in open-source software, 3D Slicer, to provide accurate visualization of the needle and the surrounding anatomy. Experiment of simulation the needle intervention at the entrance was performed with a realistic spine phantom to quantify the accuracy of the navigation using the retrospective analysis method. Eleven trials of needle insertion were performed independently. The target accuracy with the navigation using only EM sensor, only optical sensor and data fusion are 2.27 +/-1.60 mm, 4.11 +/- 1.77 mm and 1.91 - 1.10 mm, respectively.

A Novel Actuator for Simulation of Epidural Anesthesia and Other Needle Insertion Procedures

PubMed Central

Magill, John C.; Byl, Marten F.; Hinds, Michael F.; Agassounon, William; Pratt, Stephen D.; Hess, Philip E.

2010-01-01

Introduction When navigating a needle from skin to epidural space, a skilled clinician maintains a mental model of the anatomy and uses the various forms of haptic and visual feedback to track the location of the needle tip. Simulating the procedure requires an actuator that can produce the feel of tissue layers even as the needle direction changes from the ideal path. Methods A new actuator and algorithm architecture simulate forces associated with passing a needle through varying tissue layers. The actuator uses a set of cables to suspend a needle holder. The cables are wound onto spools controlled by brushless motors. An electromagnetic tracker is used to monitor the position of the needle tip. Results Novice and expert clinicians simulated epidural insertion with the simulator. Preliminary depth-time curves show that the user responds to changes in tissue properties as the needle is advanced. Some discrepancy in clinician response indicates that the feel of the simulator is sensitive to technique, thus perfect tissue property simulation has not been achieved. Conclusions The new simulator is able to approximately reproduce properties of complex multilayer tissue structures, including fine-scale texture. Methods for improving fidelity of the simulation are identified. PMID:20651481

Day surgery for vocal fold lesions using a double-bent 60-mm Cathelin needle.

PubMed

Toyomura, Fumimasa; Tokashiki, Ryoji; Hiramatsu, Hiroyuki; Tsukahara, Kiyoaki; Motohashi, Ray; Sakurai, Eriko; Nomoto, Masaki; Suzuki, Mamoru

2014-11-01

Day surgery for vocal cord lesions overcomes the disadvantages of laryngomicrosurgery under general anesthesia. We present our experience with treatment of vocal fold lesions using a long double-bend Cathelin needle that can access all parts of the vocal cords. A 23G, 60-mm-long Cathelin needle was bent twice by 45(o) at a distance of 1 and 2 cm from the tip, and was attached to a syringe. Under topical anesthesia and nasal endoscopy of the laryngopharynx, the needle was inserted percutaneously perpendicular to the skin, the direction of insertion being altered when the bends in the needle reached the skin surface. This allows the tip of the needle to access all parts of the glottis, allowing the performance of procedures such as biopsies, excision of lesions, and injection into the vocal folds. Between January 2011 and December 2013, we used this technique to perform vocal fold procedures in 566 patients presenting for treatment of spasmodic dysphonia (412 cases, 73 %) and other vocal fold lesions. Only minor complications, such as hematoma (3 patients, 0.5 %) and slight bleeding from the puncture site in the epiglottic vallecula (all patients, 100 %), which ceased spontaneously within 10 min, were seen. Erroneous puncture occurred in three patients (0.5 %) and the puncture had to be repeated in 38 patients (6.7 %). The procedure was completed successfully in all cases (100 %). Surgery for vocal fold lesions under topical anesthesia using our double-bend Cathelin needle technique is simple, safe, and useful.

Modelling and characterisation of a ultrasound-actuated needle for improved visibility in ultrasound-guided regional anaesthesia and tissue biopsy.

PubMed

Kuang, Y; Hilgers, A; Sadiq, M; Cochran, S; Corner, G; Huang, Z

2016-07-01

Clear needle visualisation is recognised as an unmet need for ultrasound guided percutaneous needle procedures including regional anaesthesia and tissue biopsy. With inadequate needle visibility, these procedures may result in serious complications or a failed operation. This paper reports analysis of the modal behaviour of a previously proposed ultrasound-actuated needle configuration, which may overcome this problem by improving needle visibility in colour Doppler imaging. It uses a piezoelectric transducer to actuate longitudinal resonant modes in needles (outer diameter 0.8-1.2mm, length>65mm). The factors that affect the needle's vibration mode are identified, including the needle length, the transducer's resonance frequency and the gripping position. Their effects are investigated using finite element modelling, with the conclusions validated experimentally. The actuated needle was inserted into porcine tissue up to 30mm depth and its visibility was observed under colour Doppler imaging. The piezoelectric transducer is able to generate longitudinal vibration with peak-to-peak amplitude up to 4μm at the needle tip with an actuating voltage of 20Vpp. Actuated in longitudinal vibration modes (distal mode at 27.6kHz and transducer mode at 42.2kHz) with a drive amplitude of 12-14Vpp, a 120mm needle is delineated as a coloured line in colour Doppler images, with both needle tip and shaft visualised. The improved needle visibility is maintained while the needle is advanced into the tissue, thus allowing tracking of the needle position in real time. Moreover, the needle tip is highlighted by strong coloured artefacts around the actuated needle generated by its flexural vibration. A limitation of the technique is that the transducer mode requires needles of specific lengths so that the needle's resonance frequency matches the transducer. This may restrict the choice of needle lengths in clinical applications. Copyright © 2016 The Authors. Published by Elsevier B

Discrimination accuracy between real and sham press needles in the hands.

PubMed

Kim, Sungha; Lee, Sanghun; Choi, Sunmi; Park, Jeonghwan; Kim, Sungchul

2015-08-01

To evaluate the blinding effectiveness of a modified blunt sham press needle on the basis of the ability of subjects to discriminate between real and sham acupuncture needles compared with their discrimination ability based on pure guessing, and to define differences between senses (touch and vision) in the rates of correctly identified needles. Sixty-three healthy students and staff members were recruited through convenience sampling. First, real or sham acupuncture was randomly administered to the left LI4 point while subjects could not observe the needle tip. A real or sham needle tip was then shown to the subjects. Finally, a random combination of real or sham acupuncture needles were randomly administered to the left and right LI4 points, this time with the subjects observing the procedure. In all conditions the subjects gave their judgement as Yes or No in response to questions asking them to identify the needle type. The proportion of correct judgements (P(C)) was computed for the last part of the trial in left and right LI4 points, and the rates of correctly identified needles for each trial were obtained. The subjects' accuracy of discrimination between the real and sham acupuncture needles in left and right LI4 points was not significantly different from that based on pure guess (P(C)=0.50 (chance level)), which indicates complete inability to discriminate between needles. The rates of correctly identified needles using touch, vision and a combination of both senses were not significantly different (p=0.807). The findings from this study show that this sham acupuncture device successfully blinded subjects to real and sham press needles, suggesting that it is effective for subject blinding in studies on acupuncture using press needles, and facilitating evaluation of the effects of acupuncture in placebo-controlled trials using a rigorous scientific research methodology. Published by the BMJ Publishing Group Limited. For permission to use (where not already

Corona-glow transition in the atmospheric pressure RF-excited plasma needle

NASA Astrophysics Data System (ADS)

Sakiyama, Y.; Graves, D. B.

2006-08-01

We present clear evidence of two different discharge modes of the atmospheric pressure RF-excited plasma needle and the transition mechanism by the finite element method. The gas used is helium with 0.1% nitrogen addition. The needle has a point-to-plane geometry with a radius of 30 µm at the tip, 150 µm at the base and an inter-electrode gap of 1 mm. We employ the one-moment fluid model with the local field approximation. Our simulation results indicate that the plasma needle operates as a corona discharge at low power and that the discharge mode transitions to a glow discharge at a critical power. The discharge power increases but the discharge voltage drops abruptly by a factor of about 2 in the corona-glow transition. The plasma density and ionization is confined near the needle tip in corona-mode while it spreads back along the needle surface in glow-mode. The corona-glow transition is also characterized by a dramatic decrease in sheath thickness and an order of magnitude increase in plasma density and volume-averaged ionization. The transition is observed whether or not secondary electron emission is included in the model, and therefore we suggest that this is not an α -γ transition.

A needle guidance system for biopsy and therapy using two-dimensional ultrasound

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bluvol, Nathan; Sheikh, Allison; Kornecki, Anat

2008-02-15

Image-guided needle biopsies are currently used to provide a definitive diagnosis of breast cancer; however, difficulties in tumor targeting exist as the ultrasound (United States) scan plane and biopsy needle must remain coplanar throughout the procedure to display the actual needle tip position. The additional time associated with aligning and maintaining this coplanar relationship results in increased patient discomfort. Biopsy procedural efficiency is further hindered since needle pathway interpretation is often difficult, especially for needle insertions at large depths that usually require multiple reinsertions. The authors developed a system that would increase the speed and accuracy of current breast biopsymore » procedures using readily available two-dimensional (2D) US technology. This system is composed of a passive articulated mechanical arm that attaches to a 2D US transducer. The arm is connected to a computer through custom electronics and software, which were developed as an interface for tracking the positioning of the mechanical components in real time. The arm couples to the biopsy needle and provides visual guidance for the physician performing the procedure in the form of a real-time projected needle pathway overlay on an US image of the breast. An agar test phantom, with stainless steel targets interspersed randomly throughout, was used to validate needle trajectory positioning accuracy. The biopsy needle was guided by both the software and hardware components to the targets. The phantom, with the needle inserted and device decoupled, was placed in an x-ray stereotactic mammography (SM) machine. The needle trajectory and bead target locations were determined in three dimensions from the SM images. Results indicated a mean needle trajectory accuracy error of 0.75{+-}0.42 mm. This is adequate to sample lesions that are <2 mm in diameter. Chicken tissue test phantoms were used to compare core needle biopsy procedure times between experienced

Precision grid and hand motion for accurate needle insertion in brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.

2011-08-15

Purpose: In prostate brachytherapy, a grid is used to guide a needle tip toward a preplanned location within the tissue. During insertion, the needle deflects en route resulting in target misplacement. In this paper, 18-gauge needle insertion experiments into phantom were performed to test effects of three parameters, which include the clearance between the grid hole and needle, the thickness of the grid, and the needle insertion speed. Measurement apparatus that consisted of two datum surfaces and digital depth gauge was developed to quantify needle deflections. Methods: The gauge repeatability and reproducibility (GR and R) test was performed on themore » measurement apparatus, and it proved to be capable of measuring a 2 mm tolerance from the target. Replicated experiments were performed on a 2{sup 3} factorial design (three parameters at two levels) and analysis included averages and standard deviation along with an analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: Results showed that grid with tight clearance hole and slow needle speed increased precision and accuracy of needle insertion. The tight grid was vital to enhance precision and accuracy of needle insertion for both slow and fast insertion speed; additionally, at slow speed the tight, thick grid improved needle precision and accuracy. Conclusions: In summary, the tight grid is important, regardless of speed. The grid design, which shows the capability to reduce the needle deflection in brachytherapy procedures, can potentially be implemented in the brachytherapy procedure.« less

Transillumination for needle localization in the larynx.

PubMed

Hoffman, Henry T; Dailey, Seth H; Bock, Jonathan M; Thibeault, Susan L; McCulloch, Timothy M

2015-10-01

Transillumination through laryngeal soft tissue may be used to direct percutaneous transcricothyroid membrane subepithelial needle placement in the larynx. Cadaver simulation (canine and human). Lighted devices, including sialendoscopes and fiberoptic cables, were tested as transilluminating obturators in trocars and needles through multiple studies to identify appropriate illumination, monitoring, and equipment for successful localization of needle/trocar tips placed within laryngeal tissue. Lighted 250-micron fiberoptic cables within 23-gauge needles were successfully placed percutaneously through the cricothyroid membrane and maneuvered submucosally into Reinke's space, the midlateral vocal fold, and through the thyroarytenoid gap with monitoring via flexible transnasal laryngoscopy. Technical adaptations in the course of study permitted successful simulation of clinical use in full cadaver study for accurate injection laryngoplasty, confirmed by laryngeal dissection following collagen injection. Small caliber fiberoptic cables are useful as transilluminating obturators to accurately direct needle position within laryngeal tissue. Clinical application of this new technique is anticipated to improve the accuracy of percutaneous needle localization in the larynx, as well as to assist in directed instrumentation of the larynx from an external approach. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

DIY guide-needle-assisted conjunctivodacryocystorhinostomy (CDCR).

PubMed

Paik, Ji-Sun; Kim, Su-Ah; Doh, Sang-Hee

2013-01-01

In this study, we introduce DIY guide-needle-assisted conjunctivodacryocystorhinostomy (CDCR), in which a guide needle helps in measuring the initial Jones tube length for insertion and reduces unnecessary handling for tube changes. Three CDCR procedures were conducted in which the length of the Jones tube was calculated using a 22-gauge DIY guide needle, and a prospective study of tube position change and migration, (a major cause of CDCR failure) was done. Wound healing was almost complete within 4 weeks postoperatively in the osteotomy site, but in cases of partial middle turbinectomy, a little more time was necessary. There was a slight change in Jones tube position in the nasal cavity compared with the expected position of original tube tip, but no tube migration from the caruncle fixation position had occurred by the final follow-up time. This guide-needle-assisted CDCR has multiple advantages, such as easy measurement of the proper initial tube size, utilization of the initial needle path, and easy replacement of tubes. Finally, this approach to CDCR can be readily applied because it uses materials ordinarily found in hospitals to create the devices needed for the procedure, so there is no additional cost.

Negative ion formation and evolution in atmospheric pressure corona discharges between point-to-plane electrodes with arbitrary needle angle

NASA Astrophysics Data System (ADS)

Sekimoto, K.; Takayama, M.

2010-12-01

The change in the distribution pattern of negative ions HO-, NOx- and COx- observed on arbitrary point-to-plane electrode configuration has been investigated by varying the angle of needle to the plane electrode, under atmospheric pressure corona discharge conditions. The stationary inhomogeneous electric field distributions between the point-to-plane electrodes with arbitrary needle angle were calculated. The experimental and theoretical results obtained suggested that the negative ion evolutions progress along field lines established between the electrodes with arbitrary configurations and the resulting terminal ion formation on a given field line is attributable to the electric field strength on the needle tip surface where the field line arose. The NOx- and COx- ions were dominantly produced on the field lines arising from the needle tip apex region with the highest electric field strength, while the field lines emanating from the tip peripheral regions with lower field strength resulted in the formation of the HO- ion.

Automated real-time needle-guide tracking for fast 3-T MR-guided transrectal prostate biopsy: a feasibility study.

PubMed

Zamecnik, Patrik; Schouten, Martijn G; Krafft, Axel J; Maier, Florian; Schlemmer, Heinz-Peter; Barentsz, Jelle O; Bock, Michael; Fütterer, Jurgen J

2014-12-01

To assess the feasibility of automatic needle-guide tracking by using a real-time phase-only cross correlation ( POCC phase-only cross correlation ) algorithm-based sequence for transrectal 3-T in-bore magnetic resonance (MR)-guided prostate biopsies. This study was approved by the ethics review board, and written informed consent was obtained from all patients. Eleven patients with a prostate-specific antigen level of at least 4 ng/mL (4 μg/L) and at least one transrectal ultrasonography-guided biopsy session with negative findings were enrolled. Regions suspicious for cancer were identified on 3-T multiparametric MR images. During a subsequent MR-guided biopsy, the regions suspicious for cancer were reidentified and targeted by using the POCC phase-only cross correlation -based tracking sequence. Besides testing a general technical feasibility of the biopsy procedure by using the POCC phase-only cross correlation -based tracking sequence, the procedure times were measured, and a pathologic analysis of the biopsy cores was performed. Thirty-eight core samples were obtained from 25 regions suspicious for cancer. It was technically feasible to perform the POCC phase-only cross correlation -based biopsies in all regions suspicious for cancer in each patient, with adequate biopsy samples obtained with each biopsy attempt. The median size of the region suspicious for cancer was 8 mm (range, 4-13 mm). In each region suspicious for cancer (median number per patient, two; range, 1-4), a median of one core sample per region was obtained (range, 1-3). The median time for guidance per target was 1.5 minutes (range, 0.7-5 minutes). Nineteen of 38 core biopsy samples contained cancer. This study shows that it is feasible to perform transrectal 3-T MR-guided biopsies by using a POCC phase-only cross correlation algorithm-based real-time tracking sequence. © RSNA, 2014.

What's the point of the type III secretion system needle?

PubMed Central

Blocker, Ariel J.; Deane, Janet E.; Veenendaal, Andreas K. J.; Roversi, Pietro; Hodgkinson, Julie L.; Johnson, Steven; Lea, Susan M.

2008-01-01

Recent work by several groups has significantly expanded our knowledge of the structure, regulation of assembly, and function of components of the extracellular portion of the type III secretion system (T3SS) of Gram-negative bacteria. This perspective presents a structure-informed analysis of functional data and discusses three nonmutually exclusive models of how a key aspect of T3SS biology, the sensing of host cells, may be performed. PMID:18458349

Comparative proteomic analysis reveals that T3SS, Tfp, and xanthan gum are key factors in initial stages of Citrus sinensis infection by Xanthomonas citri subsp. citri.

PubMed

Facincani, Agda P; Moreira, Leandro M; Soares, Márcia R; Ferreira, Cristiano B; Ferreira, Rafael M; Ferro, Maria I T; Ferro, Jesus A; Gozzo, Fabio C; de Oliveira, Julio C F

2014-03-01

The bacteria Xanthomonas citri subsp. citri (Xac) is the causal agent of citrus canker. The disease symptoms are characterized by localized host cell hyperplasia followed by tissue necrosis at the infected area. An arsenal of bacterial pathogenicity- and virulence-related proteins is expressed to ensure a successful infection process. At the post-genomic stage of Xac, we used a proteomic approach to analyze the proteins that are displayed differentially over time when the pathogen attacks the host plant. Protein extracts were prepared from infectious Xac grown in inducing medium (XAM1) for 24 h or from host citrus plants for 3 or 5 days after infection, detached times to evaluate the adaptation and virulence of the pathogen. The protein extracts were proteolyzed, and the peptides derived from tryptic digestion were investigated using liquid chromatography and tandem mass spectrometry. Changes in the protein expression profile were compared with the Xac genome and the proteome recently described under non-infectious conditions. An analysis of the proteome of Xac under infectious conditions revealed proteins directly involved in virulence such as the type III secretion system (T3SS) and effector proteins (T3SS-e), the type IV pilus (Tfp), and xanthan gum biosynthesis. Moreover, four new mutants related to proteins detected in the proteome and with different functions exhibited reduced virulence relative to the wild-type proteins. The results of the proteome analysis of infectious Xac define the processes of adaptation to the host and demonstrate the induction of the virulence factors of Xac involved in plant-pathogen interactions.

Mechanics of anesthetic needle penetration into human sciatic nerve.

PubMed

Pichamuthu, Joseph E; Maiti, Spandan; Gan, Maria G; Verdecchia, Nicole M; Orebaugh, Steven L; Vorp, David A

2018-06-06

Nerve blocks are frequently performed by anesthesiologists to control pain. For sciatic nerve blocks, the optimal placement of the needle tip between its paraneural sheath and epineurial covering is challenging, even under ultrasound guidance, and frequently results in nerve puncture. We performed needle penetration tests on cadaveric isolated paraneural sheath (IPS), isolated nerve (IN), and the nerve with overlying paraneural sheath (NPS), and quantified puncture force requirement and fracture toughness of these specimens to assess their role in determining the clinical risk of nerve puncture. We found that puncture force (123 ± 17 mN) and fracture toughness (45.48 ± 9.72 J m -2 ) of IPS was significantly lower than those for NPS (1440 ± 161 mN and 1317.46 ± 212.45 Jm -2 , respectively), suggesting that it is not possible to push the tip of the block needle through the paraneural sheath only, without pushing it into the nerve directly, when the sheath is lying directly over the nerve. Results of this study provide a physical basis for tangential placement of the needle as the ideal situation for local anesthetic deposition, as it allows for the penetration of the sheath along the edge of the nerve without entering the epineurium. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multi-resolution Gabor wavelet feature extraction for needle detection in 3D ultrasound

NASA Astrophysics Data System (ADS)

Pourtaherian, Arash; Zinger, Svitlana; Mihajlovic, Nenad; de With, Peter H. N.; Huang, Jinfeng; Ng, Gary C.; Korsten, Hendrikus H. M.

2015-12-01

Ultrasound imaging is employed for needle guidance in various minimally invasive procedures such as biopsy guidance, regional anesthesia and brachytherapy. Unfortunately, a needle guidance using 2D ultrasound is very challenging, due to a poor needle visibility and a limited field of view. Nowadays, 3D ultrasound systems are available and more widely used. Consequently, with an appropriate 3D image-based needle detection technique, needle guidance and interventions may significantly be improved and simplified. In this paper, we present a multi-resolution Gabor transformation for an automated and reliable extraction of the needle-like structures in a 3D ultrasound volume. We study and identify the best combination of the Gabor wavelet frequencies. High precision in detecting the needle voxels leads to a robust and accurate localization of the needle for the intervention support. Evaluation in several ex-vivo cases shows that the multi-resolution analysis significantly improves the precision of the needle voxel detection from 0.23 to 0.32 at a high recall rate of 0.75 (gain 40%), where a better robustness and confidence were confirmed in the practical experiments.

A 30 mK, 13.5 T scanning tunneling microscope with two independent tips

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roychowdhury, Anita; Center for Nanophysics and Advanced Materials, Department of Physics, University of Maryland, College Park, Maryland 20740; Gubrud, M. A.

We describe the design, construction, and performance of an ultra-low temperature, high-field scanning tunneling microscope (STM) with two independent tips. The STM is mounted on a dilution refrigerator and operates at a base temperature of 30 mK with magnetic fields of up to 13.5 T. We focus on the design of the two-tip STM head, as well as the sample transfer mechanism, which allows in situ transfer from an ultra high vacuum preparation chamber while the STM is at 1.5 K. Other design details such as the vibration isolation and rf-filtered wiring are also described. Their effectiveness is demonstrated viamore » spectral current noise characteristics and the root mean square roughness of atomic resolution images. The high-field capability is shown by the magnetic field dependence of the superconducting gap of Cu{sub x}Bi{sub 2}Se{sub 3}. Finally, we present images and spectroscopy taken with superconducting Nb tips with the refrigerator at 35 mK that indicate that the effective temperature of our tips/sample is approximately 184 mK, corresponding to an energy resolution of 16 μeV.« less

A 30 mK, 13.5 T scanning tunneling microscope with two independent tips.

PubMed

Roychowdhury, Anita; Gubrud, M A; Dana, R; Anderson, J R; Lobb, C J; Wellstood, F C; Dreyer, M

2014-04-01

We describe the design, construction, and performance of an ultra-low temperature, high-field scanning tunneling microscope (STM) with two independent tips. The STM is mounted on a dilution refrigerator and operates at a base temperature of 30 mK with magnetic fields of up to 13.5 T. We focus on the design of the two-tip STM head, as well as the sample transfer mechanism, which allows in situ transfer from an ultra high vacuum preparation chamber while the STM is at 1.5 K. Other design details such as the vibration isolation and rf-filtered wiring are also described. Their effectiveness is demonstrated via spectral current noise characteristics and the root mean square roughness of atomic resolution images. The high-field capability is shown by the magnetic field dependence of the superconducting gap of CuxBi2Se3. Finally, we present images and spectroscopy taken with superconducting Nb tips with the refrigerator at 35 mK that indicate that the effective temperature of our tips/sample is approximately 184 mK, corresponding to an energy resolution of 16 μeV.

Regulation of Histone Acetyltransferase TIP60 Function by Histone Deacetylase 3

PubMed Central

Yi, Jingjie; Huang, Xiangyang; Yang, Yuxia; Zhu, Wei-Guo; Gu, Wei; Luo, Jianyuan

2014-01-01

The key member of the MOZ (monocyticleukaemia zinc finger protein), Ybf2/Sas3, Sas2, and TIP60 acetyltransferases family, Tat-interactive protein, 60 kD (TIP60), tightly modulates a wide array of cellular processes, including chromatin remodeling, gene transcription, apoptosis, DNA repair, and cell cycle arrest. The function of TIP60 can be regulated by SIRT1 through deacetylation. Here we found that TIP60 can also be functionally regulated by HDAC3. We identified six lysine residues as its autoacetylation sites. Mutagenesis of these lysines to arginines completely abolishes the autoacetylation of TIP60. Overexpression of HDAC3 increases TIP60 ubiquitination levels. However, unlike SIRT1, HDAC3 increased the half-life of TIP60. Further study found that HDAC3 colocalized with TIP60 both in the nucleus and the cytoplasm, which could be the reason why HDAC3 can stabilize TIP60. The deacetylation of TIP60 by both SIRT1 and HDAC3 reduces apoptosis induced by DNA damage. Knockdown of HDAC3 in cells increased TIP60 acetylation levels and increased apoptosis after DNA damage. Together, our findings provide a better understanding of TIP60 regulation mechanisms, which is a significant basis for further studies of its cellular functions. PMID:25301942

[A comparison of three different needles used for spinal anesthesia in terms of squamous epithelial cell transport risk].

PubMed

Çiğdem, Ünal Kantekin; Sevinç, Şahin; Esef, Bolat; Süreyya, Öztürk; Muzaffer, Gencer; Akif, Demirel

To investigate the differences in the number of squamous epithelial cells carried to the spinal canal by three different types of spinal needle tip of the same size. Patients were allocated into three groups (Group I, Group II, Group III). Spinal anesthesia was administered to Group I (n=50) using a 25G Quincke needle, to Group II (n=50) using a 25G pencil point spinal needle, and to Group III (n=50) using a non-cutting atraumatic needle with special bending. The first and third drops of cerebral spinal fluid (CSF) samples were taken from each patient and each drop was placed on a slide for cytological examination. Nucleated and non-nucleated squamous epithelial cells on the smear preparations were counted. There was statistically significant difference between the groups in respect to the number of squamous epithelial cells in the first drop (p<0.05). Group III had lower number of squamous epithelial cells in the first drop compared to that of Group I and Group II. Mean while Group I had higher number of squamous epithelial cells in the third drop compared to the other groups. The number of squamous epithelial cells in the first and third drops was statistically similar in each group respectively (p>0.05 for each group). In this study of different needle tips, it was seen that with atraumatic needle with special bending a significantly smaller number of cells were transported when compared to the Quincke tip needles, and with pencil point needles. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Modulating p56Lck in T-Cells by a Chimeric Peptide Comprising Two Functionally Different Motifs of Tip from Herpesvirus saimiri

PubMed Central

Vernot, Jean-Paul; Perdomo-Arciniegas, Ana María; Pérez-Quintero, Luis Alberto; Martínez, Diego Fernando

2015-01-01

The Lck interacting protein Tip of Herpesvirus saimiri is responsible for T-cell transformation both in vitro and in vivo. Here we designed the chimeric peptide hTip-CSKH, comprising the Lck specific interacting motif CSKH of Tip and its hydrophobic transmembrane sequence (hTip), the latter as a vector targeting lipid rafts. We found that hTip-CSKH can induce a fivefold increase in proliferation of human and Aotus sp. T-cells. Costimulation with PMA did not enhance this proliferation rate, suggesting that hTip-CSKH is sufficient and independent of further PKC stimulation. We also found that human Lck phosphorylation was increased earlier after stimulation when T-cells were incubated previously with hTip-CSKH, supporting a strong signalling and proliferative effect of the chimeric peptide. Additionally, Lck downstream signalling was evident with hTip-CSKH but not with control peptides. Importantly, hTip-CSKH could be identified in heavy lipid rafts membrane fractions, a compartment where important T-cell signalling molecules (LAT, Ras, and Lck) are present during T-cell activation. Interestingly, hTip-CSKH was inhibitory to Jurkat cells, in total agreement with the different signalling pathways and activation requirements of this leukemic cell line. These results provide the basis for the development of new compounds capable of modulating therapeutic targets present in lipid rafts. PMID:26539553

Modulating p56Lck in T-Cells by a Chimeric Peptide Comprising Two Functionally Different Motifs of Tip from Herpesvirus saimiri.

PubMed

Vernot, Jean-Paul; Perdomo-Arciniegas, Ana María; Pérez-Quintero, Luis Alberto; Martínez, Diego Fernando

2015-01-01

The Lck interacting protein Tip of Herpesvirus saimiri is responsible for T-cell transformation both in vitro and in vivo. Here we designed the chimeric peptide hTip-CSKH, comprising the Lck specific interacting motif CSKH of Tip and its hydrophobic transmembrane sequence (hTip), the latter as a vector targeting lipid rafts. We found that hTip-CSKH can induce a fivefold increase in proliferation of human and Aotus sp. T-cells. Costimulation with PMA did not enhance this proliferation rate, suggesting that hTip-CSKH is sufficient and independent of further PKC stimulation. We also found that human Lck phosphorylation was increased earlier after stimulation when T-cells were incubated previously with hTip-CSKH, supporting a strong signalling and proliferative effect of the chimeric peptide. Additionally, Lck downstream signalling was evident with hTip-CSKH but not with control peptides. Importantly, hTip-CSKH could be identified in heavy lipid rafts membrane fractions, a compartment where important T-cell signalling molecules (LAT, Ras, and Lck) are present during T-cell activation. Interestingly, hTip-CSKH was inhibitory to Jurkat cells, in total agreement with the different signalling pathways and activation requirements of this leukemic cell line. These results provide the basis for the development of new compounds capable of modulating therapeutic targets present in lipid rafts.

Semicircular thermocouple needle depth gauge for cryoprocedures.

PubMed

Pappenfort, R B

1981-06-01

A semicircular thermocouple needle depth gauge made of an aluminum alloy drilled with tracks at different angles to place thermocouple needles at various depths below the surface is described herein. Its shape offers definite advantages over circular jigs (templates) when doing cryoexperimentation and when used clinically. The material of which it is made is more durable than plastic. Grommets that firmly snap in place within the inner rim of the instrument permit accurate placement of liquid gas spray, cryoprobes, and other applicators directly over the thermocouple needle tips. This is of special importance when doing cryoexperiments. Furthermore, with this design, the advancing ice front and possible liquid gas runoff are more easily seen. By using both halves it is suitable for monitoring the temperature when freezing large tumors at two different sites and a different depths.

Structural insights into the T6SS effector protein Tse3 and the Tse3-Tsi3 complex from Pseudomonas aeruginosa reveal a calcium-dependent membrane-binding mechanism.

PubMed

Lu, Defen; Shang, Guijun; Zhang, Heqiao; Yu, Qian; Cong, Xiaoyan; Yuan, Jupeng; He, Fengjuan; Zhu, Chunyuan; Zhao, Yanyu; Yin, Kun; Chen, Yuanyuan; Hu, Junqiang; Zhang, Xiaodan; Yuan, Zenglin; Xu, Sujuan; Hu, Wei; Cang, Huaixing; Gu, Lichuan

2014-06-01

The opportunistic pathogen Pseudomonas aeruginosa uses the type VI secretion system (T6SS) to deliver the muramidase Tse3 into the periplasm of rival bacteria to degrade their peptidoglycan (PG). Concomitantly, P. aeruginosa uses the periplasm-localized immunity protein Tsi3 to prevent potential self-intoxication caused by Tse3, and thus gains an edge over rival bacteria in fierce niche competition. Here, we report the crystal structures of Tse3 and the Tse3-Tsi3 complex. Tse3 contains an annexin repeat-like fold at the N-terminus and a G-type lysozyme fold at the C-terminus. One loop in the N-terminal domain (Loop 12) and one helix (α9) from the C-terminal domain together anchor Tse3 and the Tse3-Tsi3 complex to membrane in a calcium-dependent manner in vitro, and this membrane-binding ability is essential for Tse3's activity. In the C-terminal domain, a Y-shaped groove present on the surface likely serves as the PG binding site. Two calcium-binding motifs are also observed in the groove and these are necessary for Tse3 activity. In the Tse3-Tsi3 structure, three loops of Tsi3 insert into the substrate-binding groove of Tse3, and three calcium ions present at the interface of the complex are indispensable for the formation of the Tse3-Tsi3 complex. © 2014 John Wiley & Sons Ltd.

Intravascular Ultrasound in the Creation of Transhepatic Portosystemic Shunts Reduces Needle Passes, Radiation Dose, and Procedure Time: A Retrospective Study of a Single-Institution Experience.

PubMed

Kao, Steven D; Morshedi, Maud M; Narsinh, Kazim H; Kinney, Thomas B; Minocha, Jeet; Picel, Andrew C; Newton, Isabel; Rose, Steven C; Roberts, Anne C; Kuo, Alexander; Aryafar, Hamed

2016-08-01

To assess whether intravascular ultrasound (US) guidance impacts number of needle passes, contrast usage, radiation dose, and procedure time during creation of transjugular intrahepatic portosystemic shunts (TIPS). Intravascular US-guided creation of TIPS in 40 patients was retrospectively compared with conventional TIPS in 49 patients between February 2010 and November 2015 at a single tertiary care institution. Patient sex and age, etiology of liver disease (hepatitis C virus, alcohol abuse, nonalcoholic steatohepatitis), severity of liver disease (mean Model for End-Stage Liver Disease score), and indications for TIPS (variceal bleeding, refractory ascites, refractory hydrothorax) in conventional and intravascular US-guided cases were recorded. The two groups were well matched by sex, age, etiology of liver disease, Child-Pugh class, Model for End-Stage Liver Disease scores, and indication for TIPS (P range = .19-.94). Fewer intrahepatic needle passes were required in intravascular US-guided TIPS creation compared with conventional TIPS (2 passes vs 6 passes, P < .01). Less iodinated contrast material was used in intravascular US cases (57 mL vs 140 mL, P < .01). Radiation exposure, as measured by cumulative dose, dose area product, and fluoroscopy time, was reduced with intravascular US (174 mGy vs 981 mGy, P < .01; 3,793 μGy * m(2) vs 21,414 μGy * m(2), P < .01; 19 min vs 34 min, P < .01). Procedure time was shortened with intravascular US (86 min vs 125 min, P < .01). Intravascular US guidance resulted in fewer intrahepatic needle passes, decreased contrast medium usage, decreased radiation dosage, and shortened procedure time in TIPS creation. Copyright © 2016 SIR. All rights reserved.

Reduced variability and execution time to reach a target with a needle GPS system: Comparison between physicians, residents and nurse anaesthetists.

PubMed

Fevre, Marie-Cécile; Vincent, Caroline; Picard, Julien; Vighetti, Arnaud; Chapuis, Claire; Detavernier, Maxime; Allenet, Benoît; Payen, Jean-François; Bosson, Jean-Luc; Albaladejo, Pierre

2018-02-01

Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand-eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle guidance positioning systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety. Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS. We measured execution times to perform the tasks, hand-eye coordination and the number of repositioning occurrences or errors in handling the needle or the probe. Without the GPS system, we observed a significant inter-individual difference for execution time (P<0.05), hand-eye coordination and the number of errors/needle repositioning between physicians, residents and nurse anaesthetists. US training and video gaming were found to be independent factors associated with a shorter execution time. Use of GPS attenuated the inter-individual and group variability. We observed a reduced execution time and improved hand-eye coordination in all groups as compared to US without GPS. Neither US training, video gaming nor demographic personal or professional factors were found to be significantly associated with reduced execution time when GPS was used. US associated with GPS systems may improve safety and decrease execution time by reducing inter-individual variability between professionals for needle-handling procedures. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Characterisation of a fibre optic Raman probe within a hypodermic needle.

PubMed

Iping Petterson, Ingeborg E; Day, John C C; Fullwood, Leanne M; Gardner, Benjamin; Stone, Nick

2015-11-01

We demonstrate the first use of a multifibre Raman probe that fits inside the bore of a hypodermic needle. A Raman probe containing multiple collection fibres provides improved signal collection efficiency in biological samples compared with a previous two-fibre design. Furthermore, probe performance (signal-to-noise ratios) compared favourably with the performance achieved in previous Raman microscope experiments able to distinguish between benign lymph nodes, primary malignancies in lymph nodes and secondary malignancies in lymph nodes. The experimental measurements presented here give an indication of the sampling volume of the Raman needle probe in lymphoid tissues. Liquid tissue phantoms were used that contained scattering medium encompassing a range of scattering properties similar to those of a variety of tissue types, including lymph node tissues. To validate the appropriateness of the phantoms, the sampling depth of the probe was also measured in excised lymph node tissue. More than 50 % of Raman photons collected were found to originate from between the tip of the needle and a depth of 500 μm into the tissue. The needle probe presented here achieves spectral quality comparable to that in numerous studies previously demonstrating Raman disease discrimination. It is expected that this approach could achieve targeted subcutaneous tissue measurements and be viable for use for the in vivo Raman diagnostics of solid organs located within a few centimetres below the skin's surface. Graphical Abstract Schematic of multi-fibre Raman needle probe with disposible tips and proximal optical filtration.

[Needling technique of Professor Li Yan-Fang].

PubMed

Li, Li-Jun

2014-01-01

Experiences of needling techniques of Professor LI Ya- fang is introduced in this article. Gentle and superficial insertion is adopted by Professor LI in clinic. Emphases are put on the qi regulation function, needling sensation to the affected region and insertion with both hands, especially the function of the left hand as pressing hand. The gentle and superficial insertion should be done as the follows: hold the needle with the right hand, press gently along the running course of meridians with the left hand to promote qi circulation, hard pressing should be applied at acupoints to disperse the local qi and blood, insert the needle gently and quickly into the subcutaneous region with the right hand, and stop the insertion when patient has the needling sensation. While the fast needling is characterized with shallow insertion and swift manipulation: the left hand of the manipulator should press first along the running course of the meridian, and fix the local skin, hold the needle with the right hand and insert the needle quickly into the acupoint. Withdrawal of the needle should be done immediately after the reinforcing and reducing manipulations. Professor LI is accomplished in qi regulation. It is held by him that regulating qi circulation is essence of acupuncture, letting the patient get the needling sensation is the most important task of needling. Lifting, thrusting and rotation manipulations should be applied to do reinforcing or reducing. The tissue around the tip of the needle should not be too contracted or too relaxed, and the resistance should not be too strong or too weak. The feeling of the insertion hand of the practitioner should not be too smooth or too hesitant. Needle should be inserted into the skin quickly at the moment of hard pressing by the left hand. And then, slow rotation and gentle lifting and thrusting can be applied to promote the needling sensation like electric current pass through and to reach the affected region along the

Production of atmospheric-pressure glow discharge in nitrogen using needle-array electrode

NASA Astrophysics Data System (ADS)

Takaki, K.; Hosokawa, M.; Sasaki, T.; Mukaigawa, S.; Fujiwara, T.

2005-04-01

An atmospheric pressure glow discharge was generated using a needle-array electrode in nitrogen, and the voltage-current characteristics of the glow discharge were obtained in a range from 1 mA to 60 A. A pulsed high voltage with short rise time under 10 ns was employed to generate streamer discharges simultaneously at all needle tips. The large number of streamer discharges prevented the glow-to-arc transition caused by inhomogeneous thermalization. Semiconductor opening switch diodes were employed as an opening switch to shorten the rise time. The glow voltage was almost constant until the discharge current became 0.3 A, whereas the voltage increased with the current higher than 0.3 A. Electron density and temperature in a positive column of the glow discharge at 60 A were obtained to 1.4×1012cm-3 and 1.3 eV from calculation based on nitrogen swarm data.

Effect of beam steering on the visibility of echogenic and non-echogenic needles: a laboratory study.

PubMed

Uppal, Vishal; Sondekoppam, Rakesh V; Ganapathy, Sugantha

2014-10-01

During peripheral nerve block procedures, needle visibility decreases as the angle of needle insertion relative to skin increases due to loss of reflective signals. The primary aim of our study was to compare the effect of beam steering on the visibility of echogenic and non-echogenic block needles. PAJUNK non-echogenic and echogenic needles were inserted into pork meat at 20°, 40°, 60°, and 70° angles, and electronic beam steering was applied at three different angles (shallow, medium, and steep) to obtain the best possible needle images. Eleven anesthesiologists blinded to the type of needle or use of beam steering scored the images obtained (0 = needle not visible; 10 = excellent needle shaft and tip visibility). Mean scores were used to classify the needles as poor visibility (mean score 0-3.3), intermediate visibility (mean score 3.4-6.6), or good visibility (mean score 6.7-10). At 20°, the visibility scores were intermediate to good in all groups. At 40°, the mean (SD) visibility score for the non-echogenic needle improved significantly from 3.1 (1.4) to 7.9 (1.8) with application of beam steering (difference = 4.8; 95% confidence interval [CI]: 3.1 to 6.6; P < 0.001). At 60°, the mean (SD) visibility score for the non-echogenic needle was poor 0.6 (0.7) and remained poor 2.4 (1.1) with beam steering. One the other hand, the echogenic needle without beam steering 6.5 (1.8) scored significantly better than the non-echogenic needle with beam steering 2.4 (1.1) (difference = 4.2; 95% CI: 2.7 to 5.6; P < 0.001). At 70°, the mean needle visibility score was poor for the non-echogenic needle with or without beam steering. In contrast, the echogenic needle attained an intermediate visibility score with or without beam steering. Beam steering did not significantly change the visibility scores of either the echogenic or the non-echogenic needle (P = 0.088 and 0.056, respectively) at a 70° angle. The PAJUNK echogenic needle, with or without beam steering, was

Type-IVC Secretion System: A Novel Subclass of Type IV Secretion System (T4SS) Common Existing in Gram-Positive Genus Streptococcus

PubMed Central

Chen, Chen; Gao, George F.

2012-01-01

A growing number of pathogens are being found to possess specialized secretion systems which they use in various ways to subvert host defenses. Type IV secretion system (T4SS) is one of versatile secretion systems essential for the virulence and even survival of some bacteria species, and they enable the secretion of protein and DNA substrates across the cell envelope. T4SS was once believed to be present only in Gram-negative bacteria. In this study, we present evidence of a new subclass of T4SS, Type-IVC secretion system and indicate its common existence in the Gram-positive bacterial genus Streptococcus. We further identified that VirB1, VirB4, VirB6 and VirD4 are the minimal key components of this system. Using genome comparisons and evolutionary relationship analysis, we proposed that Type-IVC secretion system is movable via transposon factors and mediates the conjugative transfer of DNA, enhances bacterial pathogenicity, and could cause large-scale outbreaks of infections in humans. PMID:23056296

Smart surgical needle actuated by shape memory alloys for percutaneous procedures

NASA Astrophysics Data System (ADS)

Konh, Bardia

Background: Majority of cancer interventions today are performed percutaneously using needle-based procedures, i.e. through the skin and soft tissue. Insufficient accuracy using conventional surgical needles motivated researchers to provide actuation forces to the needle's body for compensating the possible errors of surgeons/physicians. Therefore, active needles were proposed recently where actuation forces provided by shape memory alloys (SMAs) are utilized to assist the maneuverability and accuracy of surgical needles. This work also aims to introduce a novel needle insertion simulation to predict the deflection of a bevel tip needle inside the tissue. Methods: In this work first, the actuation capability of a single SMA wire was studied. The complex response of SMAs was investigated via a MATLAB implementation of the Brinson model and verified via experimental tests. The material characteristics of SMAs were simulated by defining multilinear elastic isothermal stress-strain curves. Rigorous experiments with SMA wires were performed to determine the material properties as well as to show the capability of the code to predict a stabilized SMA transformation behavior with sufficient accuracy. The isothermal stress-strain curves of SMAs were simulated and defined as a material model for the Finite Element Analysis of the active needle. In the second part of this work, a three-dimensional finite element (FE) model of the active steerable needle was developed to demonstrate the feasibility of using SMA wires as actuators to bend the surgical needle. In the FE model, birth and death method of defining boundary conditions, available in ANSYS, was used to achieve the pre-strain condition on SMA wire prior to actuation. This numerical model was validated with needle deflection experiments with developed prototypes of the active needle. The third part of this work describes the design optimization of the active using genetic algorithm aiming for its maximum flexibility

The keys to successful TIPS in patients with portal vein thrombosis and cavernous transformation.

PubMed

Lombardo, S; Espejo, J J; Pérez-Montilla, M E; Zurera, L J; González-Galilea, Á

Portal vein thrombosis is a common complication in patients with cirrhosis. Anticoagulation involves a high risk of bleeding secondary to portal hypertension, so placing transjugular intrahepatic portosystemic shunts (TIPS) has become an alternative treatment for portal vein thrombosis. Three strategies for TIPS placement have been reported: 1) portal recanalization and conventional implantation of the TIPS through the jugular vein; 2) portal recanalization through percutaneous transhepatic/transsplenic) access; and (3) insertion of the TIPS between the suprahepatic vein and a periportal collateral vessel without portal recanalization. We describe different materials that can be used as fluoroscopic targets for the TIPS needle and for portal recanalization. This article aims to show the success of TIPS implantation using different combinations of the techniques listed above, which is a good treatment alternative in these patients whose clinical condition makes them difficult to manage, and to show that portal vein thrombosis/cavernous transformation should not be considered a contraindication for TIPS. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

A data-driven soft sensor for needle deflection in heterogeneous tissue using just-in-time modelling.

PubMed

Rossa, Carlos; Lehmann, Thomas; Sloboda, Ronald; Usmani, Nawaid; Tavakoli, Mahdi

2017-08-01

Global modelling has traditionally been the approach taken to estimate needle deflection in soft tissue. In this paper, we propose a new method based on local data-driven modelling of needle deflection. External measurement of needle-tissue interactions is collected from several insertions in ex vivo tissue to form a cloud of data. Inputs to the system are the needle insertion depth, axial rotations, and the forces and torques measured at the needle base by a force sensor. When a new insertion is performed, the just-in-time learning method estimates the model outputs given the current inputs to the needle-tissue system and the historical database. The query is compared to every observation in the database and is given weights according to some similarity criteria. Only a subset of historical data that is most relevant to the query is selected and a local linear model is fit to the selected points to estimate the query output. The model outputs the 3D deflection of the needle tip and the needle insertion force. The proposed approach is validated in ex vivo multilayered biological tissue in different needle insertion scenarios. Experimental results in five different case studies indicate an accuracy in predicting needle deflection of 0.81 and 1.24 mm in the horizontal and vertical lanes, respectively, and an accuracy of 0.5 N in predicting the needle insertion force over 216 needle insertions.

Needle-Free Inhalable Vaccine and Antibiotic Powder Aerosols

DTIC Science & Technology

2004-11-15

NEEDLE-FREE INHALABLE VACCINE AND ANTIBIOTIC POWDER AEROSOLS R. E. Sievers, J.L. Burger,, S. P. Cape, E.T.S. Huang, J.A. Best, J.A. Madsen and...currently valid OMB control number. 1. REPORT DATE 15 NOV 2004 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Needle-Free Inhalable ...soluble drugs: naproxen, budesonide, betamethsone, amphotericin B, cyclosporin, DPPC Sugars: lactose, sucrose, trehalose , mannitol Polymers: PLA, PLGA

Oligomeric states of the Shigella translocator protein IpaB provide structural insights into formation of the type III secretion translocon

PubMed Central

Dickenson, Nicholas E; Choudhari, Shyamal P; Adam, Philip R; Kramer, Ryan M; Joshi, Sangeeta B; Middaugh, C Russell; Picking, Wendy L; Picking, William D

2013-01-01

The Shigella flexneri Type III secretion system (T3SS) senses contact with human intestinal cells and injects effector proteins that promote pathogen entry as the first step in causing life threatening bacillary dysentery (shigellosis). The Shigella Type III secretion apparatus (T3SA) consists of an anchoring basal body, an exposed needle, and a temporally assembled tip complex. Exposure to environmental small molecules recruits IpaB, the first hydrophobic translocator protein, to the maturing tip complex. IpaB then senses contact with a host cell membrane, forming the translocon pore through which effectors are delivered to the host cytoplasm. Within the bacterium, IpaB exists as a heterodimer with its chaperone IpgC; however, IpaB's structural state following secretion is unknown due to difficulties isolating stable protein. We have overcome this by coexpressing the IpaB/IpgC heterodimer and isolating IpaB by incubating the complex in mild detergents. Interestingly, preparation of IpaB with n-octyl-oligo-oxyethylene (OPOE) results in the assembly of discrete oligomers while purification in N,N-dimethyldodecylamine N-oxide (LDAO) maintains IpaB as a monomer. In this study, we demonstrate that IpaB tetramers penetrate phospholipid membranes to allow a size-dependent release of small molecules, suggesting the formation of discrete pores. Monomeric IpaB also interacts with liposomes but fails to disrupt them. From these and additional findings, we propose that IpaB can exist as a tetramer having inherent flexibility, which allows it to cooperatively interact with and insert into host cell membranes. This event may then lay the foundation for formation of the Shigella T3SS translocon pore. PMID:23456854

Comparison of a GPS needle-tracking system, multiplanar imaging and 2D imaging for real-time ultrasound-guided epidural anaesthesia: A randomized, comparative, observer-blinded study on phantoms.

PubMed

Menacé, Cécilia; Choquet, Olivier; Abbal, Bertrand; Bringuier, Sophie; Capdevila, Xavier

2017-04-01

The real-time ultrasound-guided paramedian sagittal oblique approach for neuraxial blockade is technically demanding. Innovative technologies have been developed to improve nerve identification and the accuracy of needle placement. The aim of this study was to evaluate three types of ultrasound scans during ultrasound-guided epidural lumbar punctures in a spine phantom. Eleven sets of 20 ultrasound-guided epidural punctures were performed with 2D, GPS, and multiplanar ultrasound machines (660 punctures) on a spine phantom using an in-plane approach. For all punctures, execution time, number of attempts, bone contacts, and needle redirections were noted by an independent physician. Operator comfort and visibility of the needle (tip and shaft) were measured using a numerical scale. The use of GPS significantly decreased the number of punctures, needle repositionings, and bone contacts. Comfort of the physician was also significantly improved with the GPS system compared with the 2D and multiplanar systems. With the multiplanar system, the procedure was not facilitated and execution time was longer compared with 2D imaging after Bonferroni correction but interaction between the type of ultrasound system and mean execution time was not significant in a linear mixed model. There were no significant differences regarding needle tip and shaft visibility between the systems. Multiplanar and GPS needle-tracking systems do not reduce execution time compared with 2D imaging using a real-time ultrasound-guided paramedian sagittal oblique approach in spine phantoms. The GPS needle-tracking system can improve performance in terms of operator comfort, the number of attempts, needle redirections and bone contacts. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

The extracellular matrix of the oleolytic biofilms of Marinobacter hydrocarbonoclasticus comprises cytoplasmic proteins and T2SS effectors that promote growth on hydrocarbons and lipids.

PubMed

Ennouri, Habiba; d'Abzac, Paul; Hakil, Florence; Branchu, Priscilla; Naïtali, Murielle; Lomenech, Anne-Marie; Oueslati, Ridha; Desbrières, Jacques; Sivadon, Pierre; Grimaud, Régis

2017-01-01

The assimilation of the nearly water insoluble substrates hydrocarbons and lipids by bacteria entails specific adaptations such as the formation of oleolytic biofilms. The present article reports that the extracellular matrix of an oleolytic biofilm formed by Marinobacter hydrocarbonoclasticus at n-hexadecane-water interfaces is largely composed of proteins typically cytoplasmic such as translation factors and chaperones, and a lesser amount of proteins of unknown function that are predicted extra-cytoplasmic. Matrix proteins appear to form a structured film on hydrophobic interfaces and were found mandatory for the development of biofilms on lipids, alkanes and polystyrene. Exo-proteins secreted through the type-2 secretion system (T2SS) were shown to be essential for the formation of oleolytic biofilms on both alkanes and triglycerides. The T2SS effector involved in biofilm formation on triglycerides was identified as a lipase. In the case of biofilm formation on n-hexadecane, the T2SS effector is likely involved in the mass transfer, capture or transport of alkanes. We propose that M. hydrocarbonoclasticus uses cytoplasmic proteins released by cell lysis to form a proteinaceous matrix and dedicated proteins secreted through the T2SS to act specifically in the assimilation pathways of hydrophobic substrates. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.

Influence of electrical properties of treated surface on RF-excited plasma needle at atmospheric pressure

NASA Astrophysics Data System (ADS)

Sakiyama, Y.; Graves, D. B.; Stoffels, E.

2008-05-01

We present a comparison of a finite element analysis of the atmospheric pressure RF-excited plasma needle interacting with different surfaces with corresponding experimental observations of light emission spatial profiles. The gas used is helium with 1 ppm nitrogen as an impurity. The needle has a point-to-plane geometry with a radius of 30 µm at the tip and an inter-electrode gap of 1 mm. We employ a fluid model in two-dimensional axisymmetric coordinates. Our simulation results indicate that the plasma structure strongly depends on the electrical properties of the treated surface as well as the discharge mode. In the lower power corona mode with a dielectric surface, the plasma is confined near the needle tip. As a result, particle fluxes to the dielectric surface are relatively low and follow a Gaussian-like radial profile. In the higher power glow mode with a dielectric surface, the particle fluxes to the surface are orders of magnitude higher and the spatial distribution of the particle fluxes becomes radially more uniform due to a uniform ionization layer just above the treated surface. When a conductive plate replaces the dielectric surface in the glow mode, a quite intense ionization spot appears near the surface closest to the needle tip. Consequently, the particle fluxes to the surface peak near the symmetry axis under these conditions. These simulation results are validated by experimental observation of light emission spatial profiles.

Structural and regulatory mutations in Vibrio parahaemolyticus type III secretion systems display variable effects on virulence.

PubMed

Calder, Thomas; de Souza Santos, Marcela; Attah, Victoria; Klimko, John; Fernandez, Jessie; Salomon, Dor; Krachler, Anne-Marie; Orth, Kim

2014-12-01

The Gram-negative bacterium, Vibrio parahaemolyticus, is a major cause of seafood-derived food poisoning throughout the world. The pathogenicity of V. parahaemolyticus is attributed to several virulence factors, including two type III secretion systems (T3SS), T3SS1 and T3SS2. Herein, we compare the virulence of V. parahaemolyticus POR strains, which harbor a mutation in the T3SS needle apparatus of either system, to V. parahaemolyticus CAB strains, which harbor mutations in positive transcriptional regulators of either system. These strains are derived from the clinical RIMD 2210633 strain. We demonstrate that each mutation affects the virulence of the bacterium in a different manner. POR and CAB strains exhibited similar levels of swarming motility and T3SS effector production and secretion, but the CAB3 and CAB4 strains, which harbor a mutation in the T3SS2 master regulator gene, formed reduced biofilm growth under T3SS2 inducing conditions. Additionally, while the cytotoxicity of the POR and CAB strains was similar, the CAB2 (T3SS1 regulatory mutant) strain was strikingly more invasive than the comparable POR2 (T3SS1 structural mutant) strain. In summary, creating structural or regulatory mutations in either T3SS1 or T3SS2 causes differential downstream effects on other virulence systems. Understanding the biological differences of strains created from a clinical isolate is critical for interpreting and understanding the pathogenic nature of V. parahaemolyticus. © 2014 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

Design of a Teleoperated Needle Steering System for MRI-guided Prostate Interventions

PubMed Central

Seifabadi, Reza; Iordachita, Iulian; Fichtinger, Gabor

2013-01-01

Accurate needle placement plays a key role in success of prostate biopsy and brachytherapy. During percutaneous interventions, the prostate gland rotates and deforms which may cause significant target displacement. In these cases straight needle trajectory is not sufficient for precise targeting. Although needle spinning and fast insertion may be helpful, they do not entirely resolve the issue. We propose robot-assisted bevel-tip needle steering under MRI guidance as a potential solution to compensate for the target displacement. MRI is chosen for its superior soft tissue contrast in prostate imaging. Due to the confined workspace of the MRI scanner and the requirement for the clinician to be present inside the MRI room during the procedure, we designed a MRI-compatible 2-DOF haptic device to command the needle steering slave robot which operates inside the scanner. The needle steering slave robot was designed to be integrated with a previously developed pneumatically actuated transperineal robot for MRI-guided prostate needle placement. We describe design challenges and present the conceptual design of the master and slave robots and the associated controller. PMID:24649480

Fast 3-T MR-guided transrectal prostate biopsy using an in-room tablet device for needle guide alignment: a feasibility study.

PubMed

Overduin, Christiaan G; Heidkamp, Jan; Rothgang, Eva; Barentsz, Jelle O; de Lange, Frank; Fütterer, Jurgen J

2018-05-22

To assess the feasibility of adding a tablet device inside the scanner room to assist needle-guide alignment during magnetic resonance (MR)-guided transrectal prostate biopsy. Twenty patients with one cancer-suspicious region (CSR) with PI-RADS score ≥ 4 on diagnostic multiparametric MRI were prospectively enrolled. Two orthogonal scan planes of an MR fluoroscopy sequence (~3 images/s) were aligned to the CSR and needle-guide pivoting point. Targeting was achieved by manipulating the needle-guide under MR fluoroscopy feedback on the in-room tablet device. Technical feasibility and targeting success were assessed. Complications and biopsy procedure times were also recorded. Needle-guide alignment with the in-room tablet device was technically successful in all patients and allowed sampling after a single alignment step in 19/20 (95%) CSRs (median size 14 mm, range: 4-45). Biopsy cores contained cancer in 18/20 patients. There were no per-procedural or post-biopsy complications. Using the tablet device, the mean time to first biopsy was 5.8 ± 1.0 min and the mean total procedure time was 23.7 ± 4.1 min. Use of an in-room tablet device to assist needle-guide alignment was feasible and safe during MR-guided transrectal prostate biopsy. Initial experience indicates potential for procedure time reduction. • Performing MR-guided prostate biopsy using an in-room tablet device is feasible. • CSRs could be sampled after a single alignment step in 19/20 patients. • The mean procedure time for biopsy with the tablet device was 23.7 min.

Combined frequency modulated atomic force microscopy and scanning tunneling microscopy detection for multi-tip scanning probe microscopy applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morawski, Ireneusz; Institute of Experimental Physics, University of Wrocław, pl. M. Borna 9, 50-204 Wrocław; Spiegelberg, Richard

A method which allows scanning tunneling microscopy (STM) tip biasing independent of the sample bias during frequency modulated atomic force microscopy (AFM) operation is presented. The AFM sensor is supplied by an electronic circuit combining both a frequency shift signal and a tunneling current signal by means of an inductive coupling. This solution enables a control of the tip potential independent of the sample potential. Individual tip biasing is specifically important in order to implement multi-tip STM/AFM applications. An extensional quartz sensor (needle sensor) with a conductive tip is applied to record simultaneously topography and conductivity of the sample. Themore » high resonance frequency of the needle sensor (1 MHz) allows scanning of a large area of the surface being investigated in a reasonably short time. A recipe for the amplitude calibration which is based only on the frequency shift signal and does not require the tip being in contact is presented. Additionally, we show spectral measurements of the mechanical vibration noise of the scanning system used in the investigations.« less

Design of an actively controlled steerable needle with tendon actuation and FBG-based shape sensing.

PubMed

van de Berg, Nick J; Dankelman, Jenny; van den Dobbelsteen, John J

2015-06-01

This work presents a new steerable needle to facilitate active steering toward predefined target locations. It focuses on mechanical aspects and design choices in relation to the observed response in a tissue phantom. Tip steering with two rotational degrees of freedom was achieved by a tendon actuated ball joint mechanism. During insertion, the flexible cannula bends as a result of asymmetric tip-tissue interaction forces. The stylet was equipped with fiber Bragg gratings to measure the needle shape and tip position during use. A PI-controller was implemented to facilitate steering to predefined targets. During the validation study, nine targets were defined at a depth of 100 mm below the gelatin surface. One was located below the insertion point, the others at a radial offset of 30 mm in each of the eight principle steering directions. Per location, six repetitions were performed. The targeting accuracy was 6.2 ± 1.4 mm (mean ± std). The steering precision was 2.6 ± 1.1 mm. The ability to steer with this new needle steering approach is presented and the mechanical characteristics are discussed for this representative subset of steering directions. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Dynamic analysis of a needle insertion for soft materials: Arbitrary Lagrangian-Eulerian-based three-dimensional finite element analysis.

PubMed

Yamaguchi, Satoshi; Tsutsui, Kihei; Satake, Koji; Morikawa, Shigehiro; Shirai, Yoshiaki; Tanaka, Hiromi T

2014-10-01

Our goal was to develop a three-dimensional finite element model that enables dynamic analysis of needle insertion for soft materials. To demonstrate large deformation and fracture, we used the arbitrary Lagrangian-Eulerian (ALE) method for fluid analysis. We performed ALE-based finite element analysis for 3% agar gel and three types of copper needle with bevel tips. To evaluate simulation results, we compared the needle deflection and insertion force with corresponding experimental results acquired with a uniaxial manipulator. We studied the shear stress distribution of agar gel on various time scales. For 30°, 45°, and 60°, differences in deflections of each needle between both sets of results were 2.424, 2.981, and 3.737mm, respectively. For the insertion force, there was no significant difference for mismatching area error (p<0.05) between simulation and experimental results. Our results have the potential to be a stepping stone to develop pre-operative surgical planning to estimate an optimal needle insertion path for MR image-guided microwave coagulation therapy and for analyzing large deformation and fracture in biological tissues. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ultrasound-guided three-dimensional needle steering in biological tissue with curved surfaces

PubMed Central

Abayazid, Momen; Moreira, Pedro; Shahriari, Navid; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

In this paper, we present a system capable of automatically steering a bevel-tipped flexible needle under ultrasound guidance toward a physical target while avoiding a physical obstacle embedded in gelatin phantoms and biological tissue with curved surfaces. An ultrasound pre-operative scan is performed for three-dimensional (3D) target localization and shape reconstruction. A controller based on implicit force control is developed to align the transducer with curved surfaces to assure the maximum contact area, and thus obtain an image of sufficient quality. We experimentally investigate the effect of needle insertion system parameters such as insertion speed, needle diameter and bevel angle on target motion to adjust the parameters that minimize the target motion during insertion. A fast sampling-based path planner is used to compute and periodically update a feasible path to the target that avoids obstacles. We present experimental results for target reconstruction and needle insertion procedures in gelatin-based phantoms and biological tissue. Mean targeting errors of 1.46 ± 0.37 mm, 1.29 ± 0.29 mm and 1.82 ± 0.58 mm are obtained for phantoms with inclined, curved and combined (inclined and curved) surfaces, respectively, for insertion distance of 86–103 mm. The achieved targeting errors suggest that our approach is sufficient for targeting lesions of 3 mm radius that can be detected using clinical ultrasound imaging systems. PMID:25455165

A Bacterial Pathogen uses Distinct Type III Secretion Systems to Alternate between Host Kingdom

USDA-ARS?s Scientific Manuscript database

Gram-negative bacterial pathogens of eukaryotes often secrete proteins directly into host cells via a needle-like protein channel called a ‘type III secretion system’ (T3SS). Bacteria that are adapted to either animal or plant hosts use phylogenetically distinct T3SSs for secreting proteins. Here, ...

Accurate real-time sensing tip for aqueous NO with optical fibers embedded in active hydrogel waveguide

NASA Astrophysics Data System (ADS)

Chung, Chieh-Wen; Tsai, May-Jywan; Lin, Peng-Wei; Huang, Ding-Wen; Wang, Kuan-Hsun; Chen, Yu-An; Meng, Hsin-Fei; Zan, Hsiao-Wen; Cheng, Henrich; Tong, Limin; Zhang, Lei; Horng, Sheng-Fu; Hung, Cheng-Hsiung

2018-02-01

A NO sensing tip is made by inserting two parallel optical fibers inside a poly 2-hydroxyethyl methacrylate (PolyHEMA) hydrogel waveguide mixed with the probe molecule 1, 2-Diaminoanthraquinone (DAQ). There is a length difference of 1 mm between the two fibers, and the light has to propagate through the difference from the short fiber to the long fiber. The total cross section area of the active hydrogel waveguide embedded with the fibers is only 3mm x 1.2 mm. For practical use the tip is housed in a needle for mechanical protection and the sensing tip is able to detect aqueous NO concentration around 1 μM with time resolution about 5 minutes. Such a sensing tip can be used to monitor the medical conditions inside the brain after a stroke or a brain injury.

Comparison of design features and mechanical properties of commercially available Veress needles.

PubMed

Schramel, Johannes P; Kindslehner, Angelika; Bockstahler, Barbara A; Dupré, Gilles P

2017-10-01

To compare design features and mechanical properties of 13 commercially available Veress needles (VN). In vitro biomechanical study. Veress needles from 9 manufacturers (6 reusable, 6 disposable, and 1 with a reusable stylet combined with a disposable cannula) were included in the study. Veress needles are designed with a spring-loaded stylet to protect the tip of the cannula following insertion into the abdomen. Stylet forces were measured with a scale in a test jig by moving the stylet in 0.5 mm steps into the hollow cannula. Forces and spring rates were derived from force-displacement plots. Mass, mechanical dimensions, and the bevel angle and geometry were assessed. Differences between VN models were analyzed with a univariate analysis of variance. Results are reported as mean ± SD or median (range). Physical and mechanical parameters differed between models. The exposed stylet length was 3.5 mm (2-7). Three bevel geometries (bias, lancet type, and back-cut) with angles between 20° and 40° were identified. Reusable VN weigh more (24.9 ± 2.2 g) than disposable designs (6.0 ± 2.3 g). The mean values for the spring rate and the residual stylet force were 0.23 ± 0.08 Nmm -1 and 0.94 ± 0.28 N, respectively. The mean force required to move the stylet to the cannula tip was 1.81 ± 0.29 N and 2.77 ± 0.54 N to move to the proximal end of the bevel. Commercially available VN use diverse bevel geometries and have different mechanical characteristics. Studies investigating laparoscopic entry complications should explicitly report the type of VN model used. © 2017 The American College of Veterinary Surgeons.

Development of a fine thermocouple-needle system for real-time feedback of thermal tumour ablation margin

PubMed Central

Ishizaka, H; Shiraishi, A; Awata, S; Shimizu, A; Hirasawa, S

2011-01-01

Thermal tumour ablation techniques such as radiofrequency (RF) ablation are applied for radical removal of local tumours as an easier, less invasive alternative to surgical resection. A serious drawback of thermal ablation, however, is that the ablation area cannot be accurately assessed during the procedure. To achieve real-time feedback and exact and safe ablation, a superfine thermocouple-needle system (TNS) comprising a 0.25-mm diameter thermocouple embedded in a 22-G, 15-cm-long needle was devised and efficacy was tested in vitro using porcine livers (n = 15) and in vivo using rabbit back muscles (n = 2) and livers (n = 3). A 17-gauge RF electrode with a 2 cm active tip was used for ablation. The TNS was inserted 1 cm from the active tip of the RF electrode and liver temperature around the electrode was measured concurrently. The RF current was cut off when the temperature reached 60°C or after 5 min at ≥50°C. Porcine livers and rabbit back muscles were then cut along a plane passing through the axes of the electrode and the TNS. In rabbit livers, contrast-enhanced CT was performed to evaluate ablation areas. Ablation areas in cut surfaces of porcine livers exhibited well-defined discoloured regions and the TNS tip precisely pinpointed the margin of the ablation area. Contrast-enhanced CT of rabbit livers showed the TNS tip accurately located at the margin of areas without contrast enhancement. These results indicate that the TNS can accurately show ablation margins and that placing the TNS tip at the intended ablation margin permits exact thermal ablation. PMID:21937618

Numerical Analysis of the Elastic Properties of 3D Needled Carbon/Carbon Composites

NASA Astrophysics Data System (ADS)

Tan, Y.; Yan, Y.; Li, X.; Guo, F.

2017-09-01

Based on the observation of microstructures of 3D needled carbon/carbon (C/C) composites, a model of their representative volume element (RVE) considering the true distribution of fibers is established. Using the theories of mesoscopic mechanics and introducing periodic boundary conditions for displacements, their elastic properties, with account of porosity, are determined by finite-element methods. Quasi-static tensile tests were carried out, and the numerical predictions were found to be in good agreement with test results. This means that the RVE model of 3D needled C/C composites can predict their elastic properties efficiently. The effects of needling density, radius of needled fibers, and thickness ratio of a short-cut fiber web and a weftless ply on the elastic constants of the composites are analyzed.

Cardiac MOLLI T1 mapping at 3.0 T: comparison of patient-adaptive dual-source RF and conventional RF transmission.

PubMed

Rasper, Michael; Nadjiri, Jonathan; Sträter, Alexandra S; Settles, Marcus; Laugwitz, Karl-Ludwig; Rummeny, Ernst J; Huber, Armin M

2017-06-01

To prospectively compare image quality and myocardial T 1 relaxation times of modified Look-Locker inversion recovery (MOLLI) imaging at 3.0 T (T) acquired with patient-adaptive dual-source (DS) and conventional single-source (SS) radiofrequency (RF) transmission. Pre- and post-contrast MOLLI T 1 mapping using SS and DS was acquired in 27 patients. Patient wise and segment wise analysis of T 1 times was performed. The correlation of DS MOLLI measurements with a reference spin echo sequence was analysed in phantom experiments. DS MOLLI imaging reduced T 1 standard deviation in 14 out of 16 myocardial segments (87.5%). Significant reduction of T 1 variance could be obtained in 7 segments (43.8%). DS significantly reduced myocardial T 1 variance in 16 out of 25 patients (64.0%). With conventional RF transmission, dielectric shading artefacts occurred in six patients causing diagnostic uncertainty. No according artefacts were found on DS images. DS image findings were in accordance with conventional T 1 mapping and late gadolinium enhancement (LGE) imaging. Phantom experiments demonstrated good correlation of myocardial T 1 time between DS MOLLI and spin echo imaging. Dual-source RF transmission enhances myocardial T 1 homogeneity in MOLLI imaging at 3.0 T. The reduction of signal inhomogeneities and artefacts due to dielectric shading is likely to enhance diagnostic confidence.

The ACUSITT ultrasonic ablator: the first steerable needle with an integrated interventional tool

NASA Astrophysics Data System (ADS)

Burdette, E. Clif; Rucker, D. Caleb; Prakash, Punit; Diederich, Chris J.; Croom, Jordon M.; Clarke, Clyde; Stolka, Philipp; Juang, Titania; Boctor, Emad M.; Webster, Robert J., III

2010-03-01

Steerability in percutaneous medical devices is highly desirable, enabling a needle or needle-like instrument to avoid sensitive structures (e.g. nerves or blood vessels), access obstructed anatomical targets, and compensate for the inevitable errors induced by registration accuracy thresholds and tissue deformation during insertion. Thus, mechanisms for needle steering have been of great interest in the engineering community in the past few years, and several have been proposed. While many interventional applications have been hypothesized for steerable needles (essentially anything deliverable via a regular needle), none have yet been demonstrated as far as the authors are aware. Instead, prior studies have focused on model validation, control, and accuracy assessment. In this paper, we present the first integrated steerable needle-interventional device. The ACUSITT integrates a multi-tube steerable Active Cannula (AC) with an Ultrasonic Interstitial Thermal Therapy ablator (USITT) to create a steerable percutaneous device that can deliver a spatially and temporally controllable (both mechanically and electronically) thermal dose profile. We present our initial experiments toward applying the ACUSITT to treat large liver tumors through a single entry point. This involves repositioning the ablator tip to several different locations, without withdrawing it from the liver capsule, under 3D Ultrasound image guidance. In our experiments, the ACUSITT was deployed to three positions, each 2cm apart in a conical pattern to demonstrate the feasibility of ablating large liver tumors 7cm in diameter without multiple parenchyma punctures.

Veress needle insertion into the left hypochondrium for creation of pneumoperitoneum: diagnostic value of tests to determine the position of the needle in unselected patients.

PubMed

Becker, Otávio Monteiro; Azevedo, João Luiz Moreira Coutinho; de Azevedo, Otávio Cansanção; Hypólito, Octávio Henrique Mendes; Miyahira, Susana Abe; Miguel, Gustavo Peixoto Soares; Machado, Afonso Cesar Cabral Guedes

2011-01-01

To assess the effectiveness of the Veress needle puncture in the left hypochondrium and the accuracy of the tests described for the intraperitoneal correct positioning of the tip of the Veress needle in an unselected population. Ninetyone patients consecutively scheduled for Videolaparoscopy had the abdominal wall punctured in the left hypochondrium. There were no exclusion criteria. The patients received general anesthesia and mechanical ventilation according to the protocol. After puncturing five tests were used to confirm the positioning of the needle tip within the peritoneal cavity: aspiration test--AT; resistance to infusion--Pres; recovery of the infused fluid--Prec, dripping test--DT, and test of initial intraperitoneal pressure--IIPP. The test results were compared with results from literature for groups with defined exclusion criteria. The results were used for calculating sensitivity (S) specificity (E), positive predictive value (PPV) and negative predictive value (NPV). Inferential statistical methods were used to analyze the findings. There were 13 failures. AT had E = 100% and NPV 100%. Pres had S = 100%, E = 0; PPV = 85.71%; NPV does not apply. Prec: S = 100%, E = 53.84%, PPV = 92.85%, NPV = 100%. DT: S = 100%, E = 61.53%, PPV = 93.97% NPV 100%. In IIPP, S, E, PPV and NPV were 100%. The puncture in the left hypochondrium is effective and the performed tests guide the surgeon regardless of sex, BMI, or previous laparotomy.

Tilt/Tip/Piston Manipulator with Base-Mounted Actuators

NASA Technical Reports Server (NTRS)

Tahmasebi, Farhad

2006-01-01

A proposed three-degree-of-freedom (tilt/tip/piston) manipulator, suitable for aligning an optical or mechanical component, would offer several advantages over prior such manipulators: Unlike in some other manipulators, no actuator would support the weight of another actuator: All of the actuators would be mounted on a base. Hence, there would be less manipulated weight. The basic geometry of the manipulator would afford mechanical advantage: that is, actuator motions would be larger than the motions they produce in the manipulated object. Mechanical advantage inherently increases the accuracy and resolution of manipulation. Unlike in some other manipulators, it would not be necessary to route power and/or data lines through manipulator joints. The proposed manipulator (see figure) would include three prismatic actuators (T1N1, T2N2, and T3N3) mounted on the base and operating in the same plane. Examples of suitable prismatic actuators include lead-screw mechanisms, linear hydraulic motors, piezoelectric linear drives, inchworm-movement linear stepping motors, and linear flexure drives. The actuators would control the lengths of links R1T1, R2T2, and R3T3. Three spherical joints (P1, P2, and P3) would be located at the corners of an equilateral triangle of side length q on the platform holding the object to be manipulated. Three inextensible limbs (R1P1, R2P2, and R3P3) having length r would connect the spherical joints on the platform to revolute joints (R1, R2, and R3) at the ends of the actuator-controlled links R1T1, R2T2, and R3T3. By varying the lengths of these links, one could control the tilt, tip, and piston coordinates of the platform. Closed-form equations for direct or forward kinematics of the manipulator (given the lengths of the variable links, find the tilt, tip, and piston coordinates) have been derived. The equations of inverse kinematics (find the variable link lengths needed to obtain the desired tilt, tip, and piston coordinates) have also

Ultrasound-guided transhepatic puncture of the hepatic veins for TIPS placement.

PubMed

Gazzera, C; Fonio, P; Gallesio, C; Camerano, F; Doriguzzi Breatta, A; Righi, D; Veltri, A; Gandini, G

2013-04-01

This retrospective analysis was carried out to assess the feasibility and results of transjugular intrahepatic portal systemic shunt (TIPS) performed with ultrasound (US)-guided percutaneous puncture of the hepatic veins. Over a period of 3 years, 153 patients were treated with TIPS at our centre. In eight cases, a percutaneous puncture of the middle (n=7) or right (n=1) hepatic vein was required because the hepatic vein ostium was not accessible. Indications for TIPS were bleeding (n=1), Budd-Chiari syndrome (n=1), ascites (n=2), reduced portal flow (n=1) and incomplete portal thrombosis (n=3). A 0.018-in. guidewire was anterogradely introduced into the hepatic vein to the inferior vena cava (IVC) through a 21-gauge needle. In the meantime, a 25-mm snare-loop catheter was introduced through the jugular access to retrieve the guidewire, achieving through-andthrough access. Then, a Rosch-Uchida set was used to place the TIPS with the traditional technique. Technical success was achieved in all patients. There was one case of stent thrombosis. One patient died of pulmonary oedema. Three patients were eligible for liver transplantation, whereas the others were excluded due to shunt thrombosis (n=1) and previous nonhepatic neoplasms (n=3). The percutaneous approach to hepatic veins is rapid and safe and may be useful for avoiding traumatic liver injuries.

An alternative local anaesthesia technique to reduce pain in paediatric patients during needle insertion.

PubMed

Lee, S H; Lee, N Y

2013-06-01

Pain control, which is necessary during most dental procedures, is administered by injecting a local anaesthetic. Because the injection itself can be painful, the procedure via which pain is reduced warrants continued investigation. Only a few studies regarding the reaction of children to dental needle insertion without the use of topical anaesthetics have been reported. This study was conducted to evaluate the efficacy of the local anaesthetic procedure without topical application as compared to the conventional insertion technique for alleviating pain in children receiving local anaesthesia injections. For the alternative injection procedure, the dentist quickly and gently pulled or pushed the clean and dried loose tissue at the injection site over the tip of the needle to a depth of 1 to 1.5 mm. When the end of the bevel of the needle tip entered the tissue, a few drops of solution were released, after which the needle was advanced to its proper and intended depth to continue anaesthetic release. There was a significant difference regarding the pain response between the alternative insertion technique (less painful) and the conventional one according to Sound, Eye, and Motor (SEM) scale ratings (P < 0.000). No significant difference was observed in the response between the maxilla and mandible, nor between boys and girls, between the conventional and alternative techniques. This alternative technique can reduce discomfort in paediatric dental patients and allow the clinician to administer a superficial local anaesthesia injection before the needle is advanced into deeper tissue. This technique is simple, quick, devoid of additional costs, and potentially more effective than the conventional needle insertion method.

A scanning electron microscopic study to evaluate the efficacy of NaviTip FX in removing the canal debris during root canal preparation: an in vitro study.

PubMed

Chandra, Vinay; Gandi, Padma; Shivanna, Anil Kumar; Srinivas, Siva; Himgiri, S; Nischith, K G

2013-07-01

To evaluate the efficacy of NaviTip FX in removing the canal debris during root canal preparation using scanning electron microscopic study. Thirty single rooted teeth with completely formed apices were used in this study. Standard endodontic access cavity preparations were performed. Then the teeth were randomly divided into two groups: groups 1 and 2 of 15 teeth each group. For group 1, NaviTip FX (brush covered needle) was used to irrigate the canal with 5.25% sodium hypochlorite after each instrument use. For group 2, NaviTip (brushless needle) was used for irrigation following each instrument use. ProTaper rotary files were used for the canal preparation. The teeth were then cleaned and dried before splitting them into two halves. The half with most visible part of the apex was used for scanning electron microscopic evaluation. The results were statistically analyzed using the Mann-Whitney U-test at significance level p < 0.005. The mean values for coronal and middle third of group 1 showed lower debris scores than group 2 and this difference was statistically significant at a p-value 0.01 and 0.05 respectively, but no significance difference between them at the apical third at a p-value of < 0.05. The NaviTip FX (brush covered needle) showed effectively better canal wall debris removal than the NaviTip (brushless needle).

A systematic approach to fabricate high aspect ratio silicon micro-needles for transdermal drug delivery

NASA Astrophysics Data System (ADS)

Ng, H. B.; Shearwood, C.

2007-12-01

The successful development of micro-needles can help transport drugs and vaccines both effectively and painlessly across the skin. However, not all micro-needles are strong enough to withstand the insertion forces and viscoelasticity of the skin. The work here focuses on the micro-fabrication of high aspect ratio needles with careful control of needle-profile using dry etching technologies. Silicon micro-needles, 150μm in length with base-diameters ranging from 90 to 240μm have been investigated in this study. A novel, multiple-sacrificial approach has been demonstrated as suited to the fabrication of long micro-needle bodies with positive profiles. The parameters that control the isotropic etching are adjusted to control the ratio of the needle-base diameter to needle length. By careful control of geometry, the needle profile can be engineered to give a suitable tip size for penetration, as well as a broad needle base to facilitate the creation of either single or multiple-through holes. This approach allows the mechanical properties of the otherwise brittle needles to be optimized. Finite element analysis indicates that the micro-needles will fracture prematurely due to buckling, with forces ranging from 10 to 30mN.

Influence of hearing of 22 G Whitacre and 22 G Quincke needles.

PubMed

Sundberg, A; Wang, L P; Fog, J

1992-11-01

Audiograms were performed pre-operatively and 2 days postoperatively in 48 patients given spinal anaesthesia for transurethral resection of the prostate. Hearing levels were examined at 1000 Hz and below. Either 22 G standard design (Quincke) needles (n = 25) or 22 G pencil-point design (Whitacre) needles (n = 23) were used. Hearing loss of 10 dB or more at two or more frequencies were observed in six of 25 patients in the Quincke group and in two of 23 patients in the Whitacre group. The mean hearing level was more reduced in the Quincke group. The shape of the tip of the spinal needle seems to be of some importance to the effects on hearing level that may occur after spinal anaesthesia.

Automatic needle segmentation in 3D ultrasound images using 3D improved Hough transform

NASA Astrophysics Data System (ADS)

Zhou, Hua; Qiu, Wu; Ding, Mingyue; Zhang, Songgen

2008-03-01

3D ultrasound (US) is a new technology that can be used for a variety of diagnostic applications, such as obstetrical, vascular, and urological imaging, and has been explored greatly potential in the applications of image-guided surgery and therapy. Uterine adenoma and uterine bleeding are the two most prevalent diseases in Chinese woman, and a minimally invasive ablation system using a needle-like RF button electrode is widely used to destroy tumor cells or stop bleeding. To avoid accidents or death of the patient by inaccurate localizations of the electrode and the tumor position during treatment, 3D US guidance system was developed. In this paper, a new automated technique, the 3D Improved Hough Transform (3DIHT) algorithm, which is potentially fast, accurate, and robust to provide needle segmentation in 3D US image for use of 3D US imaging guidance, was presented. Based on the coarse-fine search strategy and a four parameter representation of lines in 3D space, 3DIHT algorithm can segment needles quickly, accurately and robustly. The technique was evaluated using the 3D US images acquired by scanning a water phantom. The segmentation position deviation of the line was less than 2mm and angular deviation was much less than 2°. The average computational time measured on a Pentium IV 2.80GHz PC computer with a 381×381×250 image was less than 2s.

The reactivity of phosphagermaallene Tip(t-Bu)Ge=C=PMes* with doubly and triply bonded nitrogen compounds.

PubMed

Ghereg, Dumitru; Gornitzka, Heinz; Escudié, Jean; Ladeira, Sonia

2010-11-15

Phosphagermaallene Tip(t-Bu)Ge=C=PMes* (1; Mes* = 2,4,6-tri-tert-butylphenyl, Tip = 2,4,6-triisopropylphenyl) gives, with N-benzylidenemethylamine and pivalonitrile, [2+2] cycloadditions between the Ge=C double bond and the C=N and C≡N unsaturations, leading to the formation of the corresponding four-membered heterocycles 2 and 9. With N-tert-butyl-α-phenylnitrone and benzonitrile oxide, [2+3] cycloadditions occur to form the five-membered ring derivatives 6 and 7. By treatment of 1 with derivatives which possess weak acidic hydrogens in α of the C=N or C≡N multiple bond, two types of reactions were observed: an ene reaction with methyl(benzylideneamino)acetate and a 1,2 addition with acetonitrile to afford azadienyl(germyl)ether (4) and 3-germa-1-phosphapropene (8), respectively. In the case of benzonitrile, phosphagermaallene 1 behaves as a 1,3-dipole, to give, via a cyclic phosphagermacarbene intermediate, the tricyclic derivative 10.

Single-molecule FRET studies of the cooperative and non-cooperative binding kinetics of the bacteriophage T4 single-stranded DNA binding protein (gp32) to ssDNA lattices at replication fork junctions

PubMed Central

Lee, Wonbae; Gillies, John P.; Jose, Davis; Israels, Brett A.; von Hippel, Peter H.; Marcus, Andrew H.

2016-01-01

Gene 32 protein (gp32) is the single-stranded (ss) DNA binding protein of the bacteriophage T4. It binds transiently and cooperatively to ssDNA sequences exposed during the DNA replication process and regulates the interactions of the other sub-assemblies of the replication complex during the replication cycle. We here use single-molecule FRET techniques to build on previous thermodynamic studies of gp32 binding to initiate studies of the dynamics of the isolated and cooperative binding of gp32 molecules within the replication complex. DNA primer/template (p/t) constructs are used as models to determine the effects of ssDNA lattice length, gp32 concentration, salt concentration, binding cooperativity and binding polarity at p/t junctions. Hidden Markov models (HMMs) and transition density plots (TDPs) are used to characterize the dynamics of the multi-step assembly pathway of gp32 at p/t junctions of differing polarity, and show that isolated gp32 molecules bind to their ssDNA targets weakly and dissociate quickly, while cooperatively bound dimeric or trimeric clusters of gp32 bind much more tightly, can ‘slide’ on ssDNA sequences, and exhibit binding dynamics that depend on p/t junction polarities. The potential relationships of these binding dynamics to interactions with other components of the T4 DNA replication complex are discussed. PMID:27694621

T3SEdb: data warehousing of virulence effectors secreted by the bacterial Type III Secretion System.

PubMed

Tay, Daniel Ming Ming; Govindarajan, Kunde Ramamoorthy; Khan, Asif M; Ong, Terenze Yao Rui; Samad, Hanif M; Soh, Wei Wei; Tong, Minyan; Zhang, Fan; Tan, Tin Wee

2010-10-15

Effectors of Type III Secretion System (T3SS) play a pivotal role in establishing and maintaining pathogenicity in the host and therefore the identification of these effectors is important in understanding virulence. However, the effectors display high level of sequence diversity, therefore making the identification a difficult process. There is a need to collate and annotate existing effector sequences in public databases to enable systematic analyses of these sequences for development of models for screening and selection of putative novel effectors from bacterial genomes that can be validated by a smaller number of key experiments. Herein, we present T3SEdb http://effectors.bic.nus.edu.sg/T3SEdb, a specialized database of annotated T3SS effector (T3SE) sequences containing 1089 records from 46 bacterial species compiled from the literature and public protein databases. Procedures have been defined for i) comprehensive annotation of experimental status of effectors, ii) submission and curation review of records by users of the database, and iii) the regular update of T3SEdb existing and new records. Keyword fielded and sequence searches (BLAST, regular expression) are supported for both experimentally verified and hypothetical T3SEs. More than 171 clusters of T3SEs were detected based on sequence identity comparisons (intra-cluster difference up to ~60%). Owing to this high level of sequence diversity of T3SEs, the T3SEdb provides a large number of experimentally known effector sequences with wide species representation for creation of effector predictors. We created a reliable effector prediction tool, integrated into the database, to demonstrate the application of the database for such endeavours. T3SEdb is the first specialised database reported for T3SS effectors, enriched with manual annotations that facilitated systematic construction of a reliable prediction model for identification of novel effectors. The T3SEdb represents a platform for inclusion of

Optimizing EUS-guided liver biopsy sampling: comprehensive assessment of needle types and tissue acquisition techniques.

PubMed

Schulman, Allison R; Thompson, Christopher C; Odze, Robert; Chan, Walter W; Ryou, Marvin

2017-02-01

EUS-guided liver biopsy sampling using FNA and, more recently, fine-needle biopsy (FNB) needles has been reported with discrepant diagnostic accuracy, in part due to differences in methodology. We aimed to compare liver histologic yields of 4 EUS-based needles and 2 percutaneous needles to identify optimal number of needle passes and suction. Six needle types were tested on human cadaveric tissue: one 19G FNA needle, one existing 19G FNB needle, one novel 19G FNB needle, one 22G FNB needle, and two 18G percutaneous needles (18G1 and 18G2). Two needle excursion patterns (1 vs 3 fanning passes) were performed on all EUS needles. Primary outcome was number of portal tracts. Secondary outcomes were degree of fragmentation and specimen adequacy. Pairwise comparisons were performed using t tests, with a 2-sided P < .05 considered to be significant. Multivariable regression analysis was performed. In total, 288 liver biopsy samplings (48 per needle type) were performed. The novel 19G FNB needle had significantly increased mean portal tracts compared with all needle types. The 22G FNB needle had significantly increased portal tracts compared with the 18G1 needle (3.8 vs 2.5, P < .001) and was not statistically different from the 18G2 needle (3.8 vs 3.5, P = .68). FNB needles (P < .001) and 3 fanning passes (P ≤ .001) were independent predictors of the number of portal tracts. A novel 19G EUS-guided liver biopsy needle provides superior histologic yield compared with 18G percutaneous needles and existing 19G FNA and core needles. Moreover, the 22G FNB needle may be adequate for liver biopsy sampling. Investigations are underway to determine whether these results can be replicated in a clinical setting. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Effect of Needle Size in Ultrasound-guided Core Needle Breast Biopsy: Comparison of 14-, 16-, and 18-Gauge Needles.

PubMed

Giuliani, Michela; Rinaldi, Pierluigi; Rella, Rossella; Fabrizi, Gina; Petta, Federica; Carlino, Giorgio; Di Leone, Alba; Mulè, Antonino; Bufi, Enida; Romani, Maurizio; Belli, Paolo; Bonomo, Lorenzo

2017-11-01

The aim of the present study was to assess the diagnostic accuracy of ultrasound-guided core needle biopsy (US-CNB) of breast lesions, comparing smaller needles (16- and 18-gauge) with the 14-gauge needle, and to analyze the lesion characteristics influencing US-CNB diagnostic performance. All the patients provided informed consent before the biopsy procedure. The data from breast lesions that had undergone US-CNB in our institution from January 2011 to January 2015 were retrospectively reviewed. The inclusion criterion was the surgical histopathologic examination findings of the entire lesion or radiologic follow-up data for ≥ 24 months. The exclusion criterion was the use of preoperative neoadjuvant therapy. The US-CNB results were compared with the surgical pathologic results or with the follow-up findings in the 3 needle size groups (14-, 16-, and 18-gauge). The needle size- and lesion characteristic-specific diagnostic accuracy parameters were evaluated. Statistical analysis was performed using a dedicated software program, and P ≤ .01 was considered significant. A total of 1118 US-CNB cases (1042 patients) were included. Of the 1118 cases, 630 (56.3%) were in the 14-gauge group, 136 (12.2%) in the 16-gauge, and 352 (31.5%) in the 18-gauge needle group. Surgery was performed on 800 lesions (71.6%). Of these, 619 were malignant, 77 were high risk, and 104 were benign. The remaining 318 lesions (28.4%) underwent follow-up imaging studies. All the lesions were stable and, therefore, were considered benign. No differences were observed in the diagnostic accuracy parameters among the 3 needle size groups (P > .01). The false-negative rate was greater for lesions < 10 mm (7.2%) (P < .01) but without statistically significant differences among the 3 gauges (P > .01). US-CNB performed with small needles (16 and 18 gauge) had the same diagnostic accuracy as that performed with 14-gauge needles, regardless of the lesion characteristics. Copyright © 2017

Crack-tip-opening angle measurements and crack tunneling under stable tearing in thin sheet 2024-T3 aluminum alloy

NASA Technical Reports Server (NTRS)

Dawicke, D. S.; Sutton, M. A.

1993-01-01

The stable tearing behavior of thin sheets 2024-T3 aluminum alloy was studied for middle crack tension specimens having initial cracks that were: flat cracks (low fatigue stress) and 45 degrees through-thickness slant cracks (high fatigue stress). The critical crack-tip-opening angle (CTOA) values during stable tearing were measured by two independent methods, optical microscopy and digital image correlation. Results from the two methods agreed well. The CTOA measurements and observations of the fracture surfaces showed that the initial stable tearing behavior of low and high fatigue stress tests is significantly different. The cracks in the low fatigue stress tests underwent a transition from flat-to-slant crack growth, during which the CTOA values were high and significant crack tunneling occurred. After crack growth equal to about the thickness, CTOA reached a constant value of 6 deg and after crack growth equal to about twice the thickness, crack tunneling stabilized. The initial high CTOA values, in the low fatigue crack tests, coincided with large three-dimensional crack front shape changes due to a variation in the through-thickness crack tip constraint. The cracks in the high fatigue stress tests reach the same constant CTOA value after crack growth equal to about the thickness, but produced only a slightly higher CTOA value during initial crack growth. For crack growth on the 45 degree slant, the crack front and local field variables are still highly three-dimensional. However, the constant CTOA values and stable crack front shape may allow the process to be approximated with two-dimensional models.

The Symbiotic System SS73 17 seen with Suzaku

NASA Technical Reports Server (NTRS)

Smith, Randall K.; Mushotzky, Richard; Kallman, Tim; Tueller, Jack; Mukai, Koji; Markwardt, Craig

2007-01-01

We observed with Suzaku the symbiotic star SS73 17, motivated by the discovery by the INTEGRAL satellite and the Swift BAT survey that it emits hard X-rays. Our observations showed a highly-absorbed X-ray spectrum with NH > loz3 emp2, equivalent to Av > 26, although the source has B magnitude 11.3 and is also bright in UV. The source also shows strong, narrow iron lines including fluorescent Fe K as well as Fe xxv and Fe XXVI. The X-ray spectrum can be fit with a thermal model including an absorption component that partially covers the source. Most of the equivalent width of the iron fluorescent line in this model can be explained as a combination of reprocessing in a dense absorber plus reflection off a white dwarf surface, but it is likely that the continuum is partially seen in reflection as well. Unlike other symbiotic systems that show hard X-ray emission (CH Cyg, RT Cru, T CrB, GX1+4), SS73 17 is not known to have shown nova-like optical variability, X-ray flashes, or pulsations, and has always shown faint soft X-ray emission. As a result, although it is likely a white dwarf, the nature of the compact object in SS73 17 is still uncertain. SS73 17 is probably an extreme example of the recently discovered and relatively small class of hard X-ray emitting symbiotic systems.

Production of needle-type liquid-metal ion sources and their application in a scanning ion muscope

NASA Astrophysics Data System (ADS)

Knapp, Helmut; Rübesame, Detlef; Niedrig, Heinz

1991-07-01

A tungsten wire is electrochemically etched in NaOH to produce tip radii of 4-10 μm for use in liquid-metal ion sources (LMIS). To ensure complete wetting of the needle with the liquid metal (Sn, Ga), the needle has to be annealed at 800-1000°C by electron bombardment in a vacuum. It is then immediately dipped into the liquid metal in the same vacuum chamber. An anode prepared in this way is part of a triode system, followed by an octupole stigmator, an electrostatic einzel lens and the scanning unit. Upon application of a high voltage the liquid metal will form a Taylor cone at the needle tip. In the resulting high electrical field ions are extracted through field evaporation. Typical beam current and spot size values during scanning ion muscope (SIM) operation are 2.5 μA and 10 μm respectively. An Everhart-Thornley detector and a quadrupole mass spectrometer are available to allow analysis of secondary particles emitted from the target.

Short communication. Development of a fine thermocouple-needle system for real-time feedback of thermal tumour ablation margin.

PubMed

Ishizaka, H; Shiraishi, A; Awata, S; Shimizu, A; Hirasawa, S

2011-12-01

Thermal tumour ablation techniques such as radiofrequency (RF) ablation are applied for radical removal of local tumours as an easier, less invasive alternative to surgical resection. A serious drawback of thermal ablation, however, is that the ablation area cannot be accurately assessed during the procedure. To achieve real-time feedback and exact and safe ablation, a superfine thermocouple-needle system (TNS) comprising a 0.25-mm diameter thermocouple embedded in a 22-G, 15-cm-long needle was devised and efficacy was tested in vitro using porcine livers (n = 15) and in vivo using rabbit back muscles (n = 2) and livers (n = 3). A 17-gauge RF electrode with a 2 cm active tip was used for ablation. The TNS was inserted 1 cm from the active tip of the RF electrode and liver temperature around the electrode was measured concurrently. The RF current was cut off when the temperature reached 60°C or after 5 min at ≥50°C. Porcine livers and rabbit back muscles were then cut along a plane passing through the axes of the electrode and the TNS. In rabbit livers, contrast-enhanced CT was performed to evaluate ablation areas. Ablation areas in cut surfaces of porcine livers exhibited well-defined discoloured regions and the TNS tip precisely pinpointed the margin of the ablation area. Contrast-enhanced CT of rabbit livers showed the TNS tip accurately located at the margin of areas without contrast enhancement. These results indicate that the TNS can accurately show ablation margins and that placing the TNS tip at the intended ablation margin permits exact thermal ablation.

Investigating Liquid Leak from Pre-Filled Syringes upon Needle Shield Removal: Effect of Air Bubble Pressure.

PubMed

Chan, Edwin; Maa, Yuh-Fun; Overcashier, David; Hsu, Chung C

2011-01-01

This study is to investigate the effect of headspace air pressure in pre-filled syringes on liquid leak (dripping) from the syringe needle upon needle shield removal. Drip tests to measure drip quantity were performed on syringes manually filled with 0.5 or 1.0 mL of various aqueous solutions. Parameters assessed included temperature (filling and test), bulk storage conditions (tank pressure and the type of the pressurized gas), solution composition (pure water, 0.9% sodium chloride, and a monoclonal antibody formulation), and testing procedures. A headspace pressure analyzer was used to verify the drip test method. Results suggested that leakage is indeed caused by headspace pressure increase, and the temperature effect (ideal gas expansion) is a major, but not the only, factor. The dissolved gases in the liquid bulk prior to or during filling may contribute to leakage, as these gases could be released into the headspace due to solubility changes (in response to test temperature and pressure conditions) and cause pressure increase. Needle shield removal procedures were found to cause dripping, but liquid composition played little role. Overall, paying attention to the processing history (pressure and temperature) of the liquid bulk is the key to minimize leakage. The headspace pressure could be reduced by decreasing liquid bulk storage pressure, filling at a higher temperature, or employing lower solubility gas (e.g., helium) for bulk transfer and storage. Leakage could also be mitigated by simply holding the syringe needle pointing upward during needle shield removal. Substantial advances in pre-filled syringe technology development, particularly in syringe filling accuracy, have been made. However, there are factors, as subtle as how the needle shield (or tip cap) is removed, that may affect dosing accuracy. We recently found that upon removal of the tip cap from a syringe held vertically with needle pointed downwards, a small amount of solution, up to 3-4% of

Preparation of Graphene-Modified Acupuncture Needle and Its Application in Detecting Neurotransmitters

NASA Astrophysics Data System (ADS)

Tang, Lina; Du, Danxin; Yang, Fan; Liang, Zhong; Ning, Yong; Wang, Hua; Zhang, Guo-Jun

2015-06-01

We report a unique nanosensing platform by combining modern nanotechnology with traditional acupuncture needle to prepare graphene-modified acupuncture needle (G-AN), and using it for sensitive detection of neurotransmitters via electrochemistry. An electrochemical deposition method was employed to deposit Au nanoparticles (AuNPs) on the tip surface of the traditional acupuncture needle, while the other part of the needle was coated with insulation paste. Subsequently, the G-AN was obtained by cyclic voltammetry reduction of a graphene oxide solution on the surface of the AuNPs. To investigate the sensing property of the G-AN, pH dependence was measured by recording the open circuit potential in the various pH buffer solutions ranging from 2.0 to 10.0. What’s more, the G-AN was further used for detection of dopamine (DA) with a limit of detection of 0.24 μM. This novel G-AN exhibited a good sensitivity and selectivity, and could realize direct detection of DA in human serum.

Real-time ultrasound-guided spinal anesthesia using the SonixGPS® needle tracking system: a case report.

PubMed

Wong, Simon W; Niazi, Ahtsham U; Chin, Ki J; Chan, Vincent W

2013-01-01

The SonixGPS® is an electromagnetic needle tracking system for ultrasound-guided needle intervention. Both current and predicted needle tip position are displayed on the ultrasound screen in real-time, facilitating needle-beam alignment and guidance to the target. This case report illustrates the use of the SonixGPS system for successful performance of real-time ultrasound-guided spinal anesthesia in a patient with difficult spinal anatomy. A 67-yr-old male was admitted to our hospital to undergo revision of total right hip arthroplasty. His four previous arthroplasties for hip revision were performed under general anesthesia because he had undergone L3-L5 instrumentation for spinal stenosis. The L4-L5 interspace was viewed with the patient in the left lateral decubitus position. A 19G 80-mm proprietary needle (Ultrasonix Medical Corp, Richmond, BC, Canada) was inserted and directed through the paraspinal muscles to the ligamentum flavum in plane to the ultrasound beam. A 120-mm 25G Whitacre spinal needle was then inserted through the introducer needle in a conventional fashion. Successful dural puncture was achieved on the second attempt, as indicated by a flow of clear cerebrospinal fluid. The patient tolerated the procedure well, and the spinal anesthetic was adequate for the duration of the surgery. The SonixGPS is a novel technology that can reduce the technical difficulty of real-time ultrasound-guided neuraxial blockade. It may also have applications in other advanced ultrasound-guided regional anesthesia techniques where needle-beam alignment is critical.

Prom Health and Safety Tips

MedlinePlus

... Halloween Prom Tips Spring Break Valentine Tips Winter Holiday Tips 12 Ways Holiday Song Healthy Living Check-Ups are Important Check- ... Test Wash Hands Stay Warm Have a Healthy Holiday Don’t Drink and Drive Widgets Healthy People ...

Effects of insertion speed and trocar stiffness on the accuracy of needle position for brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.

2012-04-15

Purpose: In prostate brachytherapy, accurate positioning of the needle tip to place radioactive seeds at its target site is critical for successful radiation treatment. During the procedure, needle deflection leads to seed misplacement and suboptimal radiation dose to cancerous cells. In practice, radiation oncologists commonly use high-speed hand needle insertion to minimize displacement of the prostate as well as the needle deflection. Effects of speed during needle insertion and stiffness of trocar (a solid rod inside the hollow cannula) on needle deflection are studied. Methods: Needle insertion experiments into phantom were performed using a 2{sup 2} factorial design (2 parametersmore » at 2 levels), with each condition having replicates. Analysis of the deflection data included calculating the average, standard deviation, and analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: The stiffer tungsten carbide trocar is effective in reducing the average and standard deviation of needle deflection. The fast insertion speed together with the stiffer trocar generated the smallest average and standard deviation for needle deflection for almost all cases. Conclusions: The combination of stiff tungsten carbide trocar and fast needle insertion speed are important to decreasing needle deflection. The knowledge gained from this study can be used to improve the accuracy of needle insertion during brachytherapy procedures.« less

Pelton turbine Needle erosion prediction based on 3D three- phase flow simulation

NASA Astrophysics Data System (ADS)

Chongji, Z.; Yexiang, X.; Wei, Z.; Yangyang, Y.; Lei, C.; Zhengwei, W.

2014-03-01

Pelton turbine, which applied to the high water head and small flow rate, is widely used in the mountainous area. During the operation period the sediment contained in the water does not only induce the abrasion of the buckets, but also leads to the erosion at the nozzle which may damage the needle structure. The nozzle and needle structure are mainly used to form high quality cylindrical jet and increase the efficiency of energy exchange in the runner to the most. Thus the needle erosion will lead to the deformation of jet, and then may cause the efficiency loss and cavitation. The favourable prediction of abrasion characteristic of needle can effectively guide the optimization design and maintenance of needle structure. This paper simulated the unsteady three-dimensional multi-phase flow in the nozzle and injected jet flow. As the jet containing water and sediment is injected into the free atmosphere air with high velocity, the VOF model was adopted to predict the water and air flow. The sediment is simplified into round solid particle and the discrete particle model (DPM) was employed to predict the needle abrasion characteristic. The sand particle tracks were analyzed to interpret the mechanism of sand erosion on the needle surface. And the numerical result of needle abrasion was obtained and compared with the abrasion field observation. The similarity of abrasion pattern between the numerical results and field observation illustrated the validity of the 3D multi-phase flow simulation method.

Benchmarking of state-of-the-art needle detection algorithms in 3D ultrasound data volumes

NASA Astrophysics Data System (ADS)

Pourtaherian, Arash; Zinger, Svitlana; de With, Peter H. N.; Korsten, Hendrikus H. M.; Mihajlovic, Nenad

2015-03-01

Ultrasound-guided needle interventions are widely practiced in medical diagnostics and therapy, i.e. for biopsy guidance, regional anesthesia or for brachytherapy. Needle guidance using 2D ultrasound can be very challenging due to the poor needle visibility and the limited field of view. Since 3D ultrasound transducers are becoming more widely used, needle guidance can be improved and simplified with appropriate computer-aided analyses. In this paper, we compare two state-of-the-art 3D needle detection techniques: a technique based on line filtering from literature and a system employing Gabor transformation. Both algorithms utilize supervised classification to pre-select candidate needle voxels in the volume and then fit a model of the needle on the selected voxels. The major differences between the two approaches are in extracting the feature vectors for classification and selecting the criterion for fitting. We evaluate the performance of the two techniques using manually-annotated ground truth in several ex-vivo situations of different complexities, containing three different needle types with various insertion angles. This extensive evaluation provides better understanding on the limitations and advantages of each technique under different acquisition conditions, which is leading to the development of improved techniques for more reliable and accurate localization. Benchmarking results that the Gabor features are better capable of distinguishing the needle voxels in all datasets. Moreover, it is shown that the complete processing chain of the Gabor-based method outperforms the line filtering in accuracy and stability of the detection results.

Needle Biopsy

MedlinePlus

... needle biopsy procedures include fine-needle aspiration and core needle biopsy. Needle biopsy may be used to ... hollow needle to draw cells from your body. Core needle biopsy. This type of needle biopsy uses ...

Effect and Safety of Deep Needling and Shallow Needling for Functional Constipation

PubMed Central

Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

2014-01-01

Abstract Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study. SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P < 0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P > 0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P < 0.05, all compared with the lactulose group). No significant difference

Does a child's fear of needles decrease through a learning event with needles?

PubMed

Kajikawa, Natsuki; Maeno, Takami; Maeno, Tetsuhiro

2014-09-01

Most children have a fear of needles. Suitable preparation can decrease the pain and fear of needles in hospitals; however, few have examined how such preparation affects healthy children. This study examined whether learning with needles decreases fear of needles and changes motivation to get vaccinations in school-age children and the possible association between fear of needles and motivation toward vaccinations. This study included children participating in the "Let's Be Doctors" event, which was held in 4 child centers in Tsukuba city, Ibaraki, Japan. In this event, children learned about injections and how a vaccine works, and injected a vaccine (water) into skin (sponge) using a real syringe and imitation needle. Data were collected just before and after the event by anonymous self-assessment questionnaires that used a 4-point Likert scale to assess fear of needles, motivation to get vaccinations, recommendation of vaccinations, and fear toward doctors among the children. Answers were divided into two categories for statistical analysis. In total, 194 children participated in the event and 191 children answered the questionnaire (response rate 98.5%). We analyzed 180 subjects, comprising 79 boys (43.9%) and 94 girls (52.2%), mean age of 8.1 ± 1.0 years. The number of children reporting a fear of needles decreased from 69 (38.3%) before the event to 51 (28.3%) after the event, and those unwilling to get vaccinations decreased from 48 (26.7%) to 27 (15.0%). Children who reported fear of needles before the event were more unwilling to get vaccinations than those with no fear of needles (36 [52.2%] vs. 12 [10.8%]), while after the event the number of needle-fearing children unwilling to get vaccinations decreased to 19 (27.5%). Children's fear of needles and unwillingness to get vaccinations were decreased after experiencing a learning event with needles. The fear of needles is associated with a negative motivation to get vaccinations in children.

The epidural needle guidance with an intelligent and automatic identification system for epidural anesthesia

NASA Astrophysics Data System (ADS)

Kao, Meng-Chun; Ting, Chien-Kun; Kuo, Wen-Chuan

2018-02-01

Incorrect placement of the needle causes medical complications in the epidural block, such as dural puncture or spinal cord injury. This study proposes a system which combines an optical coherence tomography (OCT) imaging probe with an automatic identification (AI) system to objectively identify the position of the epidural needle tip. The automatic identification system uses three features as image parameters to distinguish the different tissue by three classifiers. Finally, we found that the support vector machine (SVM) classifier has highest accuracy, specificity, and sensitivity, which reached to 95%, 98%, and 92%, respectively.

Measurement of bio-impedance with a smart needle to confirm percutaneous kidney access.

PubMed

Hernandez, D J; Sinkov, V A; Roberts, W W; Allaf, M E; Patriciu, A; Jarrett, T W; Kavoussi, L R; Stoianovici, D

2001-10-01

The traditional method of percutaneous renal access requires freehand needle placement guided by C-arm fluoroscopy, ultrasonography, or computerized tomography. This approach provides limited objective means for verifying successful access. We developed an impedance based percutaneous Smart Needle system and successfully used it to confirm collecting system access in ex vivo porcine kidneys. The Smart Needle consists of a modified 18 gauge percutaneous access needle with the inner stylet electrically insulated from the outer sheath. Impedance is measured between the exposed stylet tip and sheath using Model 4275 LCR meter (Hewlett-Packard, Sunnyvale, California). An ex vivo porcine kidney was distended by continuous gravity infusion of 100 cm. water saline from a catheter passed through the parenchyma into the collecting system. The Smart Needle was gradually inserted into the kidney to measure depth precisely using a robotic needle placement system, while impedance was measured continuously. The Smart Needle was inserted 4 times in each of 4 kidneys. When the needle penetrated the distended collecting system in 11 of 16 attempts, a characteristic sharp drop in resistivity was noted from 1.9 to 1.1 ohm m. Entry into the collecting system was confirmed by removing the stylet and observing fluid flow from the sheath. This characteristic impedance change was observed only at successful entry into the collecting system. A characteristic sharp drop in impedance signifies successful entry into the collecting system. The Smart Needle system may prove useful for percutaneous kidney access.

Fine needle aspiration of secondary synovial sarcoma of the thyroid gland.

PubMed

Murro, Diana; Slade, Jamie Macagba; Syed, Sahr; Gattuso, Paolo

2015-11-01

Synovial sarcomas (SS) of the head and neck region are extremely rare and arise in only 5% of cases. We present a case of secondary SS of the thyroid originally diagnosed as medullary carcinoma on fine needle aspiration (FNA). A 41-year-old man presented with several weeks of dysphonia and a left thyroid mass. FNA of the thyroid nodule showed a cellular smear composed of loosely cohesive oval to spindle-shaped cells with irregular nuclear borders, finely granular chromatin, and inconspicuous nucleoli. The patient was diagnosed with medullary carcinoma and underwent a total thyroidectomy. Intro-operatively, the mass was found to arise from the tracheoesophageal groove with spread to the left thyroid. Microscopic examination of the thyroid tumor revealed a dense spindle cell proliferation with abundant mitoses, scant cords and nests of epithelial cells and foci of necrosis. The spindle cells were positive for bcl2 and vimentin and the epithelial cells were positive for cytokeratin 8/18 and epithelial membrane antigen (EMA). Both spindle and epithelial cells were negative for thyroglobulin, calcitonin, synaptophysin and chromogranin. Fluorescence in situ hybridization (FISH) demonstrated translocation (X;18)(p11;q11), confirming the diagnosis of SS. The patient underwent a total laryngopharyngoesophagectomy with subsequent adjuvant therapy and is currently disease free. Only 6 cases of histologically confirmed primary SS of the thyroid have been reported. To the best of our knowledge, this is the first case of FISH-confirmed secondary SS of the thyroid and also the first case of SS arising from the tracheoesophageal groove. © 2015 Wiley Periodicals, Inc.

Blood patch rates after lumbar puncture with Whitacre versus Quincke 22- and 20-gauge spinal needles.

PubMed

Hatfield, Malcolm K; Handrich, Stephen J; Willis, Jeffrey A; Beres, Robert A; Zaleski, George X

2008-06-01

The objective of our study was to compare the incidence of blood patch as the best objective indicator of postdural puncture headache after elective fluoroscopic lumbar puncture with the use of a 22-gauge Whitacre (pencil point) needle versus standard 22- and 20-gauge Quincke (bevel-tip) needles and to determine the best level of puncture. The records of 724 consecutive patients who were referred to St. Mary's Medical Center department of radiology for fluoroscopic lumbar puncture from January 2003 through April 2007 were retrospectively reviewed. Emergency requests (191) were discarded along with those for patients with clinical signs of pseudotumor cerebri (21), normal pressure hydrocephalus (3), and failed attempts (4). The collective total was 505 elective lumbar punctures. The blood patch rate for the 22-gauge Whitacre needle was 4.2%. The result for the 22-gauge Quincke point needle was 15.1% whereas that for the 20-gauge Quincke point needle was 29.6%. In addition, the level of puncture showed a blood patch rate that increased as the level of lumbar puncture lowered. The highest level of lumbar puncture was L1-L2 with the lowest recorded level being L5-S1. The Whitacre needle is associated with a significantly lower incidence of blood patch rate after lumbar puncture. The highest level of puncture (L1-L2) also provides the lowest level of blood patch rate.

Electron Transfer from Triplet State of TIPS-Pentacene Generated by Singlet Fission Processes to CH3NH3PbI3 Perovskite.

PubMed

Lee, Sangsu; Hwang, Daesub; Jung, Seok Il; Kim, Dongho

2017-02-16

To reveal the applicability of singlet fission processes in perovskite solar cell, we investigated electron transfer from TIPS-pentacene to CH 3 NH 3 PbI 3 (MAPbI 3 ) perovskite in film phase. Through the observation of the shorter fluorescence lifetime in TIPS-pentacene/MAPbI 3 perovskite bilayer film (5 ns) compared with pristine MAPbI 3 perovskite film (20 ns), we verified electron-transfer processes between TIPS-pentacene and MAPbI 3 perovskite. Furthermore, the observation of singlet fission processes, a faster decay rate, TIPS-pentacene cations, and the analysis of kinetic profiles of the intensity ratio between 500 and 525 nm in the TA spectra of the TIPS-pentacene/MAPbI 3 perovskite bilayer film indicate that electron transfer occurs from triplet state of TIPS-pentacene generated by singlet fission processes to MAPbI 3 perovskite conduction band. We believe that our results can provide useful information on the design of solar cells sensitized by singlet fission processes and pave the way for new types of perovskite solar cells.

Deep Needle Procedures: Improving Safety With Ultrasound Visualization

PubMed Central

Peabody, Christopher R.; Mandavia, Diku

2017-01-01

Abstract Promoting patient safety and increasing health care quality have dominated the health care landscape during the last 15 years. Health care regulators and payers are now tying patient safety outcomes and best practices to hospital reimbursement. Many health care leaders are searching for new technologies that not only make health care for patients safer but also reduce overall health care costs. New advances in ultrasonography have made this technology available to health care providers at the patient’s bedside. Point-of-care ultrasound assistance now aids providers with real-time diagnosis and with visualization for procedural guidance. This is especially true for common deep needle procedures such as central venous catheter insertion, thoracentesis, and paracentesis. There is now mounting evidence that clinician-performed point-of-care ultrasound improves patient safety, enhances health care quality, and reduces health care cost for deep needle procedures. Furthermore, the miniaturization, ease of use, and the evolving affordability of ultrasound have now made this technology widely available. The adoption of point-of-care ultrasonography has reached a tipping point and should be seriously considered the safety standard for all hospital-based deep needle procedures. PMID:24786918

Preparation of Graphene-Modified Acupuncture Needle and Its Application in Detecting Neurotransmitters

PubMed Central

Tang, Lina; Du, Danxin; Yang, Fan; Liang, Zhong; Ning, Yong; Wang, Hua; Zhang, Guo-Jun

2015-01-01

We report a unique nanosensing platform by combining modern nanotechnology with traditional acupuncture needle to prepare graphene-modified acupuncture needle (G-AN), and using it for sensitive detection of neurotransmitters via electrochemistry. An electrochemical deposition method was employed to deposit Au nanoparticles (AuNPs) on the tip surface of the traditional acupuncture needle, while the other part of the needle was coated with insulation paste. Subsequently, the G-AN was obtained by cyclic voltammetry reduction of a graphene oxide solution on the surface of the AuNPs. To investigate the sensing property of the G-AN, pH dependence was measured by recording the open circuit potential in the various pH buffer solutions ranging from 2.0 to 10.0. What’s more, the G-AN was further used for detection of dopamine (DA) with a limit of detection of 0.24 μM. This novel G-AN exhibited a good sensitivity and selectivity, and could realize direct detection of DA in human serum. PMID:26112773

Control of the Water Transport Activity of Barley HvTIP3;1 Specifically Expressed in Seeds.

PubMed

Utsugi, Shigeko; Shibasaka, Mineo; Maekawa, Masahiko; Katsuhara, Maki

2015-09-01

Tonoplast intrinsic proteins (TIPs) are involved in the transport and storage of water, and control intracellular osmotic pressure by transporting material related to the water potential of cells. In the present study, we focused on HvTIP3;1 during the periods of seed development and desiccation in barley. HvTIP3;1 was specifically expressed in seeds. An immunochemical analysis showed that HvTIP3;1 strongly accumulated in the aleurone layers and outer layers of barley seeds. The water transport activities of HvTIP3;1 and HvTIP1;2, which also accumulated in seeds, were measured in the heterologous expression system of Xenopus oocytes. When they were expressed individually, HvTIP1;2 transported water, whereas HvTIP3;1 did not. However, HvTIP3;1 exhibited water transport activity when co-expressed with HvTIP1;2 in oocytes, and this activity was higher than when HvTIP1;2 was expressed alone. This is the first report to demonstrate that the water permeability of a TIP aquaporin was activated when co-expressed with another TIP. The split-yellow fluorescent protein (YFP) system in onion cells revealed that HvTIP3;1 interacted with HvTIP1;2 to form a heterotetramer in plants. These results suggest that HvTIP3;1 functions as an active water channel to regulate water movement through tissues during the periods of seed development and desiccation. © The Author 2015. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Families with Special Needs: Caregiving Tips

MedlinePlus

... Halloween Prom Tips Spring Break Valentine Tips Winter Holiday Tips 12 Ways Holiday Song Healthy Living Check-Ups are Important Check- ... Test Wash Hands Stay Warm Have a Healthy Holiday Don’t Drink and Drive Widgets Healthy People ...

3. ONTARIO MINE. ADIT ENTRANCE WITH TIN ROOF. TIP TOP ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. ONTARIO MINE. ADIT ENTRANCE WITH TIN ROOF. TIP TOP IS LOCATED IN LINE WITH 'Y' BRANCH AND THE TAILING PILE FOR TIP TOP IS VISIBLE JUST TO RIGHT OF IT. CAMERA POINTED SOUTH-SOUTHEAST. - Florida Mountain Mining Sites, Ontario Mine, Northwest side of Florida Mountain, Silver City, Owyhee County, ID

Management of Bleeding Duodenal Varices with Combined TIPS Decompression and Trans-TIPS Transvenous Obliteration Utilizing 3% Sodium Tetradecyl Sulfate Foam Sclerosis.

PubMed

Saad, Wael E; Lippert, Allison; Schwaner, Sandra; Al-Osaimi, Abdullah; Sabri, Saher; Saad, Nael

2014-01-01

Endoscopic experience in the management of duodenal varices (DVs) is limited and challenging given the anatomic constraints and limited experience. The endovascular management of DVs is not yet established and the controversy of whether to manage them by decompression with a transjugular intrahepatic portosystemic shunt (TIPS) or by transvenous obliteration is unresolved. In the literature, the 6-12 month rebleeding rate of DVs after TIPS is 21-37% and after transvenous obliteration is 13%. The purpose of the study is to evaluate the clinical outcome of combined TIPS decompression and transvenous obliteration/sclerosis. This is a retrospective study (case series) of two institutions, evaluating patients who underwent TIPS and/or transvenous obliteration/sclerosis for bleeding DVs (from January 2009 to June 2013). TIPS was performed according to a standard procedure using covered stents. Transvenous obliteration (variceal sclerosis) from the systemic and/or portal venous circulation was performed utilizing 3% sodium tetradecyl sulfate foam. Transvenous obliteration was commonly augmented with coils and/or vascular plugs. Technical (technical success of establishing TIPS and completely obliterating the DVs) and clinical outcomes (rebleeding rate and survival) were evaluated. Five patients with liver cirrhosis presenting with bleeding DVs were included in the study with all eventually (and coincidentally) receiving TIPS and transvenous obliteration. Two of the five patients underwent concomitant TIPS and transvenous obliteration in the same procedural setting. However, three patients underwent transvenous obliteration due to bleeding despite a patent TIPS that had been previously placed. The average time from TIPS placement to transvenous obliteration was 125 days (range: 3-324 days). After having both procedures, there was no rebleeding in the patients during a mean follow-up period of 22 months (6-50 months). Coils and/or metallic vascular plugs were used to augment

Direct electrical and mechanical characterization of in situ generated DNA between the tips of silicon nanotweezers (SNT).

PubMed

Karsten, Stanislav L; Kumemura, Momoko; Jalabert, Laurent; Lafitte, Nicolas; Kudo, Lili C; Collard, Dominique; Fujita, Hiroyuki

2016-05-24

Previously, we reported the application of micromachined silicon nanotweezers (SNT) integrated with a comb-drive actuator and capacitive sensors for capturing and mechanical characterization of DNA bundles. Here, we demonstrate direct DNA amplification on such a MEMS structure with subsequent electrical and mechanical characterization of a single stranded DNA (ssDNA) bundle generated between the tips of SNT via isothermal rolling circle amplification (RCA) and dielectrophoresis (DEP). An in situ generated ssDNA bundle was visualized and evaluated via electrical conductivity (I-V) and mechanical frequency response measurements. Colloidal gold nanoparticles significantly enhanced (P < 0.01) the electrical properties of thin ssDNA bundles. The proposed technology allows direct in situ synthesis of DNA with a predefined sequence on the tips of a MEMS sensor device, such as SNT, followed by direct DNA electrical and mechanical characterization. In addition, our data provides a "proof-of-principle" for the feasibility of the on-chip label free DNA detection device that can be used for a variety of biomedical applications focused on sequence specific DNA detection.

Unveiling Singlet Fission Mediating States in TIPS-pentacene and its Aza Derivatives.

PubMed

Herz, Julia; Buckup, Tiago; Paulus, Fabian; Engelhart, Jens U; Bunz, Uwe H F; Motzkus, Marcus

2015-06-25

Femtosecond pump-depletion-probe experiments were carried out in order to shed light on the ultrafast excited-state dynamics of triisopropylsilylethynyl (TIPS)-pentacene and two nitrogen-containing derivatives, namely, diaza-TIPS-pentacene and tetraaza-TIPS-pentacene. Measurements performed in the visible and near-infrared spectral range in combination with rate model simulations reveal that singlet fission proceeds via the extremely short-lived intermediate (1)TT state, which absorbs in the near-infrared spectral region only. The T1 → T3 transition probed in the visible region shows a rise time that comprises two components according to a consecutive reaction (S1 → (1)TT → T1). The incorporation of nitrogen atoms into the acene structure leads to shorter dynamics, but the overall triplet formation follows the same kinetic model. This is of particular importance, since experiments on tetraaza-TIPS-pentacene allow for investigation of the triplet state in the visible range without an overlapping singlet contribution. In addition, the pump-depletion-probe experiments show that the triplet absorption in the visible (T1 → T3) and near-infrared (T1 → T2) regions occurs from the same initial state, which was questioned in previous studies. Furthermore, an additional ultrafast transfer between the excited triplet states (T3 → T2) is identified, which is also in agreement with the rate model simulation. By applying depletion pulses, which are resonant with higher vibrational levels, we gain insight into internal vibrational energy redistribution processes within the triplet manifold. This additional information is of great relevance regarding the study of loss channels within these materials.

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Using 19-G Needle for Sarcoidosis.

PubMed

Balwan, Akshu

2018-05-16

Flexible bronchoscopy with endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is increasingly being used to obtain pathology specimens for diagnosis of sarcoidosis. There is wide variation in reported diagnostic yield in literature. New TBNA needles are available in the market but data are lacking about their diagnostic yield especially for sarcoidosis. This study reports the diagnostic yield of bronchoscopy with EBUS-TBNA using ViziShot FLEX 19-G needle in a series of patients with suspected sarcoidosis. This is a retrospective chart review for diagnostic yield of the 19-G EBUS-TBNA needle for suspected sarcoidosis. Eighty-six EBUS bronchoscopies were performed, 15 were done with clinical suspicion of sarcoidosis. The 19-G needle was used for all cases of suspected sarcoidosis. The procedure was diagnostic of sarcoidosis in 14 (93.3%) patients by TBNA with 1 nondiagnostic bronchoscopy. Procedural diagnostic yield was 93.3%. Eighty-five percent (28/33) of sampled lymph nodes were positive for noncaseating granulomas. The yield of transbronchial lung biopsy (TBLB) and endobronchial lung biopsy was 38% (5/13) and 43% (6/14), respectively. TBLB and endobronchial lung biopsy did not add to the diagnostic yield of the procedure. No significant adverse events were noted. This series reports a higher diagnostic yield than most other published studies and opens platform for direct comparison of each available needle. It also adds to the safety data for this larger needle. In addition, it raises doubt into utility of TBLB for diagnosis of sarcoidosis, which can increase the procedural complications.

[The Huber needle as a special cannula for the puncture of implanted ports and pumps--a mistake in multiple variations].

PubMed

Müller, H; Zierski, J

1988-10-03

Huber-point needles, which are thought to be noncoring, are usually recommended for puncture of implanted drug-delivery devices, such as ports and pumps. Nevertheless, we found occlusion by silicone chips deriving from the silicone inlet septum to be a major technical complication. Electron microscopic investigations demonstrated substantial loss of material from the port membrane after repeated puncture with this type of needle. During an in vitro test, multiple puncture with Huber-type cannulas led to a pressure-dependent leakage of a port after only 150 to 750 insertions of a needle. In addition, the forces necessary for puncture or for withdrawal of the needle were increased with Huber-point needles, possibly due to a coring effect. Another disadvantage of the available port needles is the formation of a hook at the tip, which may lead to additional lesion of the port or pump membrane. In our opinion, resterilization of Huber needles, recommended by the manufactures, is not advisable, because it is well known that safe sterilization of small lumina, e.g., the lumen of the needle, is impossible.

Management of Bleeding Duodenal Varices with Combined TIPS Decompression and Trans-TIPS Transvenous Obliteration Utilizing 3% Sodium Tetradecyl Sulfate Foam Sclerosis

PubMed Central

Saad, Wael E; Lippert, Allison; Schwaner, Sandra; Al-Osaimi, Abdullah; Sabri, Saher; Saad, Nael

2014-01-01

Objectives: Endoscopic experience in the management of duodenal varices (DVs) is limited and challenging given the anatomic constraints and limited experience. The endovascular management of DVs is not yet established and the controversy of whether to manage them by decompression with a transjugular intrahepatic portosystemic shunt (TIPS) or by transvenous obliteration is unresolved. In the literature, the 6–12 month rebleeding rate of DVs after TIPS is 21-37% and after transvenous obliteration is 13%. The purpose of the study is to evaluate the clinical outcome of combined TIPS decompression and transvenous obliteration/sclerosis. Materials and Methods: This is a retrospective study (case series) of two institutions, evaluating patients who underwent TIPS and/or transvenous obliteration/sclerosis for bleeding DVs (from January 2009 to June 2013). TIPS was performed according to a standard procedure using covered stents. Transvenous obliteration (variceal sclerosis) from the systemic and/or portal venous circulation was performed utilizing 3% sodium tetradecyl sulfate foam. Transvenous obliteration was commonly augmented with coils and/or vascular plugs. Technical (technical success of establishing TIPS and completely obliterating the DVs) and clinical outcomes (rebleeding rate and survival) were evaluated. Results: Five patients with liver cirrhosis presenting with bleeding DVs were included in the study with all eventually (and coincidentally) receiving TIPS and transvenous obliteration. Two of the five patients underwent concomitant TIPS and transvenous obliteration in the same procedural setting. However, three patients underwent transvenous obliteration due to bleeding despite a patent TIPS that had been previously placed. The average time from TIPS placement to transvenous obliteration was 125 days (range: 3-324 days). After having both procedures, there was no rebleeding in the patients during a mean follow-up period of 22 months (6–50 months). Coils and

Noncontact Viscoelastic Imaging of Living Cells Using a Long-Needle Atomic Force Microscope with Dual-Frequency Modulation

NASA Astrophysics Data System (ADS)

Guan, Dongshi; Charlaix, Elisabeth; Qi, Robert Z.; Tong, Penger

2017-10-01

Imaging of surface topography and elasticity of living cells can provide insight into the roles played by the cells' volumetric and mechanical properties and their response to external forces in regulating the essential cellular events and functions. Here, we report a unique technique of noncontact viscoelastic imaging of live cells using atomic force microscopy (AFM) with a long-needle glass probe. Because only the probe tip is placed in a liquid medium near the cell surface, the AFM cantilever in air functions well under dual-frequency modulation, retaining its high-quality resonant modes. The probe tip interacts with the cell surface through a minute hydrodynamic flow in the nanometer-thin gap region between them without physical contact. Quantitative measurements of the cell height, volume, and Young's modulus are conducted simultaneously. The experiment demonstrates that the long-needle AFM has a wide range of applications in the study of cell mechanics.

Assessment of suturing in the vertical plane shows the efficacy of the multi-degree-of-freedom needle driver for neonatal laparoscopy.

PubMed

Takazawa, Shinya; Ishimaru, Tetsuya; Fujii, Masahiro; Harada, Kanako; Sugita, Naohiko; Mitsuishi, Mamoru; Iwanaka, Tadashi

2013-11-01

We have developed a thin needle driver with multiple degrees-of-freedom (DOFs) for neonatal laparoscopic surgery. The tip of this needle driver has three DOFs for grasp, deflection and rotation. Our aim was to evaluate the performance of the multi-DOF needle driver in vertical plane suturing. Six pediatric surgeons performed four directional suturing tasks in the vertical plane using the multi-DOF needle driver and a conventional one. Assessed parameters were the accuracy of insertion and exit, the depth of suture, the inclination angle of the needle and the force applied on the model. In left and right direction sutures, the inclination angle of the needle with the multi-DOF needle driver was significantly smaller than that with the conventional one (p = 0.014, 0.042, respectively). In left and right direction sutures, the force for pulling the model with the multi-DOF needle driver was smaller than that with the conventional one (p = 0.036, 0.010, respectively). This study showed that multi-directional suturing on a vertical plane using the multi-DOF needle driver had better needle trajectories and was less invasive as compared to a conventional needle driver.

Finite element analyses of a dual actuated prototype of a smart needle

NASA Astrophysics Data System (ADS)

Konh, Bardia; Podder, Tarun K.

2017-04-01

Brachytherapy is one of the most effective modalities for treating early stage prostate cancer. In this procedure, radioactive seeds are being placed in the prostate to kill the tumorous cells. Inaccurate placement of seeds can underdose the tumor and dangerously overdose the critical structures (urethra, rectum, bladder) and adjacent healthy tissues. It is very difficult, if not impossible, for the surgeons to compensate the needle misplacement errors while using the conventional passive straight needles. The smart needles actuated by shape memory alloy (SMA) wires are being developed to provide more actuation and control for the surgeons to achieve more geometric conformity. In our recent work, a prototype of a smart needle was developed where not only the actuation of SMA wires were incorporated, but also shape memory polymers (SMPs) were included in the design introducing a soft joint element to further assist the flexibility of the active surgical needles. The additional actuation of shape memory polymers provided the capability of reaching much high flexibility that was not achievable before. However, there are some disadvantages using this active SMP component compared to a passive Nylon joint component that are discussed in this work. The utilization of a heated SMP as a soft joint showed about 20% improvement in the final needle tip deflection. This work presents the finite element studies of the developed prototype. A finite element model that could accurately predict the behavior of the smart needle could be very valuable in analyzing and optimizing the future novel designs.

Noncontact viscoelastic measurement of polymer thin films in a liquid medium using a long-needle AFM

NASA Astrophysics Data System (ADS)

Guan, Dongshi; Barraud, Chloe; Charlaix, Elisabeth; Tong, Penger

We report noncontact measurement of the viscoelastic property of polymer thin films in a liquid medium using frequency-modulation atomic force microscopy (FM-AFM) with a newly developed long-needle probe. The probe contains a long vertical glass fiber with one end adhered to a cantilever beam and the other end with a sharp tip placed near the liquid-film interface. The nanoscale flow generated by the resonant oscillation of the needle tip provides a precise hydrodynamic force acting on the soft surface of the thin film. By accurately measuring the mechanical response of the thin film, we obtain the elastic and loss moduli of the thin film using the linear response theory of elasto-hydrodynamics. The experiment verifies the theory and demonstrates its applications. The technique can be used to accurately measure the viscoelastic property of soft surfaces, such as those made of polymers, nano-bubbles, live cells and tissues. This work was supported by the Research Grants Council of Hong Kong SAR.

Exploring optimization parameters to increase ssDNA recombineering in Lactococcus lactis and Lactobacillus reuteri

PubMed Central

van Pijkeren, Jan-Peter; Neoh, Kar Mun; Sirias, Denise; Findley, Anthony S.; Britton, Robert A.

2012-01-01

Single-stranded DNA (ssDNA) recombineering is a technology which is used to make subtle changes in the chromosome of several bacterial genera. Cells which express a single-stranded DNA binding protein (RecT or Bet) are transformed with an oligonucleotide which is incorporated via an annealing and replication-dependent mechanism. By in silico analysis we identified ssDNA binding protein homologs in the genus Lactobacillus and Lactococcus lactis. To assess whether we could further improve the recombineering efficiency in Lactobacillus reuteri ATCC PTA 6475 we expressed several RecT homologs in this strain. RecT derived from Enterococcus faecalis CRMEN 19 yielded comparable efficiencies compared with a native RecT protein, but none of the other proteins further increased the recombineering efficiency. We successfully improved recombineering efficiency 10-fold in L. lactis by increasing oligonucleotide concentration combined with the use of oligonucleotides containing phosphorothioate-linkages (PTOs). Surprisingly, neither increased oligonucleotide concentration nor PTO linkages enhanced recombineering in L. reuteri 6475. To emphasize the utility of this technology in improving probiotic features we modified six bases in a transcriptional regulatory element region of the pdu-operon of L. reuteri 6475, yielding a 3-fold increase in the production of the antimicrobial compound reuterin. Directed genetic modification of lactic acid bacteria through ssDNA recombineering will simplify strain improvement in a way that, when mutating a single base, is genetically indistinguishable from strains obtained through directed evolution. PMID:22750793

High-Temperature Nonequilibrium Bose Condensation Induced by a Hot Needle.

PubMed

Schnell, Alexander; Vorberg, Daniel; Ketzmerick, Roland; Eckardt, André

2017-10-06

We investigate theoretically a one-dimensional ideal Bose gas that is driven into a steady state far from equilibrium via the coupling to two heat baths: a global bath of temperature T and a "hot needle," a bath of temperature T_{h}≫T with localized coupling to the system. Remarkably, this system features a crossover to finite-size Bose condensation at temperatures T that are orders of magnitude larger than the equilibrium condensation temperature. This counterintuitive effect is explained by a suppression of long-wavelength excitations resulting from the competition between both baths. Moreover, for sufficiently large needle temperatures ground-state condensation is superseded by condensation into an excited state, which is favored by its weaker coupling to the hot needle. Our results suggest a general strategy for the preparation of quantum degenerate nonequilibrium steady states with unconventional properties and at large temperatures.

Radiocesium distribution in sugi (Cryptomeria japonica) in eastern Japan: translocation from needles to pollen.

PubMed

Kanasashi, Tsutomu; Sugiura, Yuki; Takenaka, Chisato; Hijii, Naoki; Umemura, Mitsutoshi

2015-01-01

We assessed the radiocesium contamination of sugi (Cryptomeria japonica) forests in eastern Japan from November 2012 to February 2013, including 80 sites in Fukushima and 35 sites in other regions (Tohoku and Kanto-Koshinetsu), by measuring the (137)Cs concentrations in needles of different ages, male flowers, and pollen. Over a wide geographic area, needles that were present at the time of the Fukushima Dai-ichi Nuclear Power Plant accident contained much higher (137)Cs concentrations than needles that emerged after the accident. This result, together with visual analysis of (137)Cs distribution using autoradiography, indicated that some of the (137)Cs derived from direct fallout remained on the surface of the older needles. Since we also detected (137)Cs in younger needles and male flowers, we concluded that (137)Cs was translocated toward the tips of sugi needles. The (137)Cs concentration in male flowers was higher than and positively correlated with that in the currently growing (2012) needles. Also, a positive relationship was observed between the (137)Cs concentration of male flowers and pollen, and they were found to be nearly identical (137)Cs concentration. These results indicate the occurrence of acropetal translocation of (137)Cs from old needles to young needles, male flowers and pollen. However, the results as related to (137)Cs concentration in the needles of three different ages differed from the results of similar studies conducted more than 4 y after the Chernobyl accident. This suggests that, 2 y after the Fukushima Dai-ichi NPP accident, the distribution of (137)Cs in the sugi forests has not yet reached a steady state. Copyright © 2014 Elsevier Ltd. All rights reserved.

An in vitro study of dural lesions produced by 25-gauge Quincke and Whitacre needles evaluated by scanning electron microscopy.

PubMed

Reina, M A; de Leon-Casasola, O A; Lopez, A; De Andres, J; Martin, S; Mora, M

2000-01-01

external aspect (epidural surface) and 0.034 mm2 (CI 95%, 0.018 to 0.051) in the internal aspect (arachnoid surface) of the dural sac. The area of the lesions produced by the 25-gauge Whitacre needles was 0.026 mm2 (CI 95%, 0.019 to 0.032) and 0.030 mm2 (CI 95%, 0.025 to 0.036) in the external and internal surfaces of the dural sac, respectively. There were no significant differences in the cross-sectional areas of the punctures produced by the 25-gauge Whitacre or 25-gauge Quincke needles. Moreover, with Quincke needles the dural lesions closed in an 88.3% (CI 95%, 86.3 to 92.4) and 82.7% (CI 95%, 74.1 to 90.9) of their original sizes in the epidural and arachnoid surfaces, respectively. With Whitacre needles, the closure occurred in an 86.8% (CI 95%, 83.8 to 90.3) and 84.8% (CI 95% 81.7 to 87.3) in the dural and arachnoid surfaces, respectively. However, there were differences in the morphology of the lesions. The Whitacre needles produced coarse lesions with significant destruction in the dura's fibers while the Quincke needles produced a 'U'-shaped lesion (flap) that mimics the opened lid of a tin can, regardless of the tip's direction. The needles produced lesions in the dura with different morphology and characteristics. Lesions with the Quincke needles resulted in a clean-cut opening in the dural membrane while the Whitacre needle produced a more traumatic opening with tearing and severe disruption of the collagen fibers. Thus, we hypothesized that the lower incidence of PDPH seen with the Whitacre needles may be explained, in part, by the inflammatory reaction produced by the tearing of the collagen fibers after dural penetration. This inflammatory reaction may result in a significant edema which may act as a plug limiting the leakage of cerebrospinal fluid.

Pleuroscopic punch biopsy using insulated-tip diathermic knife-2 for the diagnosis of desmoplastic malignant mesothelioma.

PubMed

Masai, Kyohei; Sasada, Shinji; Izumo, Takehiro; Taniyama, Tomoko; Nakamura, Yukiko; Chavez, Christine; Sakurai, Hiroyuki; Tsuta, Koji; Tsuchida, Takaaki

2013-10-01

Desmoplastic malignant mesothelioma (DMM) is a rare subtype of malignant pleural mesothelioma (MPM) and is often difficult to distinguish from pleural fibrosis and reactive mesothelial hyperplasia, especially if the biopsy samples are small. We performed full-thickness pleural biopsy on a lesion suspected to be DMM using an insulated-tip diathermic knife-2 (IT knife-2) during flex-rigid pleuroscopy. IT knife-2 is a novel electrosurgical device for endoscopic submucosal dissection in the early gastrointestinal cancer. It consists of a needle knife with 3 short blades at the distal end attached to an insulated ceramic tip. A 54-year-old man presenting with chest wall mass and thickened pleura, in whom a computed tomography-guided percutaneous needle aspiration had remained negative, underwent flex-rigid pleuroscopy for definitive diagnosis. While applying electric current, we used the IT knife-2 to incise the pleura in a circular shape just above the endothoracic fascia. The incised pleura was removed by forceps and examined pathologically. The microscopic examination was compatible with DMM. We discovered that pleuroscopic punch biopsy using IT knife-2 can diagnose DMM. Use of IT knife-2 during flex-rigid pleuroscopy can obtain sufficient samples from densely thickened pleura, which is difficult to diagnose with small biopsies.

RFA-cut: Semi-automatic segmentation of radiofrequency ablation zones with and without needles via optimal s-t-cuts.

PubMed

Egger, Jan; Busse, Harald; Brandmaier, Philipp; Seider, Daniel; Gawlitza, Matthias; Strocka, Steffen; Voglreiter, Philip; Dokter, Mark; Hofmann, Michael; Kainz, Bernhard; Chen, Xiaojun; Hann, Alexander; Boechat, Pedro; Yu, Wei; Freisleben, Bernd; Alhonnoro, Tuomas; Pollari, Mika; Moche, Michael; Schmalstieg, Dieter

2015-01-01

In this contribution, we present a semi-automatic segmentation algorithm for radiofrequency ablation (RFA) zones via optimal s-t-cuts. Our interactive graph-based approach builds upon a polyhedron to construct the graph and was specifically designed for computed tomography (CT) acquisitions from patients that had RFA treatments of Hepatocellular Carcinomas (HCC). For evaluation, we used twelve post-interventional CT datasets from the clinical routine and as evaluation metric we utilized the Dice Similarity Coefficient (DSC), which is commonly accepted for judging computer aided medical segmentation tasks. Compared with pure manual slice-by-slice expert segmentations from interventional radiologists, we were able to achieve a DSC of about eighty percent, which is sufficient for our clinical needs. Moreover, our approach was able to handle images containing (DSC=75.9%) and not containing (78.1%) the RFA needles still in place. Additionally, we found no statistically significant difference (p<;0.423) between the segmentation results of the subgroups for a Mann-Whitney test. Finally, to the best of our knowledge, this is the first time a segmentation approach for CT scans including the RFA needles is reported and we show why another state-of-the-art segmentation method fails for these cases. Intraoperative scans including an RFA probe are very critical in the clinical practice and need a very careful segmentation and inspection to avoid under-treatment, which may result in tumor recurrence (up to 40%). If the decision can be made during the intervention, an additional ablation can be performed without removing the entire needle. This decreases the patient stress and associated risks and costs of a separate intervention at a later date. Ultimately, the segmented ablation zone containing the RFA needle can be used for a precise ablation simulation as the real needle position is known.

LES of cavitating flow inside a Diesel injector including dynamic needle movement

NASA Astrophysics Data System (ADS)

Örley, F.; Hickel, S.; Schmidt, S. J.; Adams, N. A.

2015-12-01

We perform large-eddy simulations (LES) of the turbulent, cavitating flow inside a 9-hole solenoid common-rail injector including jet injection into gas during a full injection cycle. The liquid fuel, vapor, and gas phases are modelled by a homogeneous mixture approach. The cavitation model is based on a thermodynamic equilibrium assumption. The geometry of the injector is represented on a Cartesian grid by a conservative cut-element immersed boundary method. The strategy allows for the simulation of complex, moving geometries with sub-cell resolution. We evaluate the effects of needle movement on the cavitation characteristics in the needle seat and tip region during opening and closing of the injector. Moreover, we study the effect of cavitation inside the injector nozzles on primary jet break-up.

[Infraoccipital needle-knife for cervical vertigo].

PubMed

Li, Shaofang; Huang, Manhua; Lin, Zhuopeng; Chen, Xinze; Lin, Dongna; Lu, Peng; Lu, Qu

2017-03-12

To observe the clinical effect differences between infraoccipital needle-knife and massage for cervical vertigo. A total of 366 patients with cervical vertigo were randomly assigned into a needle-knife group (186 cases) and a massage group (180 cases). With cases dropping excluded, 183 cases in the needle-knife group and 176 cases in the massage group were included. Needle-knife was used at Fengchi (GB 20), infraoccipital ashi point, etc. in the needle-knife group. The treatment was given for one course, once three days, 5 times as one course. The traditional massage was applied in the massage group for one course, including systematic stroking, kneading, and the application of pressure and plucking, etc., once every two days and 7 times as one course. The dizziness handicap inventory (DHI) score was observed before and after treatment, as well as 3, 6, and 12 months after treatment. The effects were also evaluated. The total effective rate was 92.3% (169/183) in the needle-knife group, which was better than 85.2% (150/176) in the massage group ( P <0.05). Compared with those before treatment, the DHI scores at all the observation time points after treatment were improved in the two groups (all P <0.05), with better improvements after treatment as well as 3 and 6 months after treatment in the needle-knife group (all P <0.05). There was no significant difference in the improvement of DHI scores between the two groups 12 months after treatment ( P >0.05). The recurrence rate was 10.3% (12/117) in the needle-knife group, and it was 10.7% (11/103) in the massage group 12 months after treatment ( P >0.05). Infraoccipital needle-knife achieves apparent effect for cervical vertigo, which is superior to massage in short period.

Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow.

PubMed

McShane, John M; Nazarian, Levon N; Harwood, Marc I

2006-10-01

Chronic tendinosis of the common extensor tendon of the lateral elbow can be a difficult problem to treat. We report our experience with sonographically guided percutaneous needle tenotomy to relieve pain and improve function in patients with this condition. We performed sonographically guided percutaneous needle tenotomy on 58 consecutive patients who had persistent pain and disability resulting from common extensor tendinosis. Under a local anesthetic and sonographic guidance, a needle was advanced into the common extensor tendon, and the tip of the needle was used to repeatedly fenestrate the tendinotic tissue. Calcifications, if present, were mechanically fragmented, and the adjacent bony surface of the apex and face of the epicondyle were abraded. Finally, the fenestrated tendon was infiltrated with a solution containing corticosteroid mixed with bupivacaine. After the procedure, patients were instructed to perform passive stretches and to undergo physical therapy. During a subsequent telephone interview, patients answered questions about their experience, their functioning level, and their perceptions of procedure outcome. Fifty-five (95%) of 58 patients were contacted by telephone and agreed to participate in the study. Thirty-five (63.6%) of 55 respondents reported excellent outcomes, 16.4% good, 7.3% fair, and 12.7% poor. The average follow-up time from the date of the procedure to the date of the interview was 28 months (range, 17-44 months). No adverse events were reported; 85.5% stated that they would refer a friend or close relative for the procedure. Sonographically guided percutaneous needle tenotomy for lateral elbow tendinosis is a safe, effective, and viable alternative for patients in whom all other nonsurgical treatments failed.

Effects of the Tongue-in-Groove Maneuver on Nasal Tip Rotation.

PubMed

Antunes, Marcelo B; Quatela, Vito C

2018-03-27

Changes in nasal tip rotation is a very common maneuver performed during rhinoplasty. Among the many techniques used to achieve this goal is the tongue-in-groove (TIG). This study addresses the long-term effect of the TIG on the nasal tip rotation 1 year after rhinoplasty. The authors prospectively identified patients who were submitted to a rhinoplasty with a TIG maneuver over a period of 1 year. The angle of rotation was measured along the nostril axis angle. The data was analyzed using the t-test and a linear regression model. Seventeen patients were included. The average preoperative tip rotation was 93.95° (SD, 3.12°). Immediate postoperative tip rotation averaged 114.47° (SD, 3.79°). At the 1-year follow-up appointment, the tip rotation averaged 106.55° (SD, 3.54°). There was a significant loss of rotation at the 1-year postoperative visit (p<0.0001), with an average loss of 7.9° (SD, 3.25°), which amounted to 6.8%. The preoperative rotation didn't affect the amount of loss of rotation (p=0.04). It can be estimated that, for every degree of rotation that is changed at surgery it can be expected to lose 0.35 degrees over the first year. TIG is a more dependable technique than the ones that rely on healing and contraction to obtain rotation. Our data demonstrated a significant loss of rotation during the first year. This suggests that the surgeon needs to slightly overcorrect the tip rotation to account for this loss.

Virtual remote center of motion control for needle placement robots.

PubMed

Boctor, Emad M; Webster, Robert J; Mathieu, Herve; Okamura, Allison M; Fichtinger, Gabor

2004-01-01

We present an algorithm that enables percutaneous needle-placement procedures to be performed with unencoded, unregistered, minimally calibrated robots while removing the constraint of placing the needle tip on a mechanically enforced Remote Center of Motion (RCM). The algorithm requires only online tracking of the surgical tool and a five-degree-of-freedom (5-DOF) robot comprising three prismatic DOF and two rotational DOF. An incremental adaptive motion control cycle guides the needle to the insertion point and also orients it to align with the target-entry-point line. The robot executes RCM motion without having a physically constrained fulcrum point. The proof-of-concept prototype system achieved 0.78 mm translation accuracy and 1.4 degrees rotational accuracy (this is within the tracker accuracy) within 17 iterative steps (0.5-1 s). This research enables robotic assistant systems for image-guided percutaneous procedures to be prototyped/constructed more quickly and less expensively than has been previously possible. Since the clinical utility of such systems is clear and has been demonstrated in the literature, our work may help promote widespread clinical adoption of this technology by lowering system cost and complexity.

Pneumatically Operated MRI-Compatible Needle Placement Robot for Prostate Interventions.

PubMed

Fischer, Gregory S; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; Mewes, Philip W; Tempany, Clare M; Hata, Nobuhiko; Fichtinger, Gabor

2008-06-13

Magnetic Resonance Imaging (MRI) has potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. The strong magnetic field prevents the use of conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intra-prostatic needle placement inside closed high-field MRI scanners. The robot performs needle insertion under real-time 3T MR image guidance; workspace requirements, MR compatibility, and workflow have been evaluated on phantoms. The paper explains the robot mechanism and controller design and presents results of preliminary evaluation of the system.

Lactic acid bacteria increase antiallergic effect of Artemisia princeps pampanini SS-1.

PubMed

Lee, Seung-Hoon; Shin, Yong-Wook; Bae, Eun-Ah; Lee, Bomi; Min, Sungwon; Baek, Nam-In; Chung, Hae-Gon; Kim, Nam-Jae; Kim, Dong-Hyun

2006-09-01

Artemisia princeps Pampanini, which is called Ssajuarissuk in Korean (SS-1), was fermented with lactic acid bacteria (LAB) and their passive cutaneous anaphylaxis reaction-inhibitory activity was investigated. Of these fermented agents, SS-1 extract fermented with Bifidobacterium infantis K-525 (F-SS-1) most effectively inhibited the release of P-hexosamindase from RBL-2H3 cells induced IgE. In IgE-induced RBL-2H3 cells, F-SS-1 inhibited proinflammatory cytokines IL-6 and TNF-alpha mRNA expression. Oral administration of SS-1 and F-SS-1 to mice inhibited passive cutaneous anaphylaxis (PCA) reaction induced by IgE and scratching behaviors induced by compound 48/80. The inhibitory activity of F-SS-1 against scratching behaviors was more effective than that of SS-1. These findings suggest that the fermentation of SS-1 with LAB can increase its antiallergic activity.

A numerical study of crack tip constraint in ductile single crystals

NASA Astrophysics Data System (ADS)

Patil, Swapnil D.; Narasimhan, R.; Mishra, R. K.

In this work, the effect of crack tip constraint on near-tip stress and deformation fields in a ductile FCC single crystal is studied under mode I, plane strain conditions. To this end, modified boundary layer simulations within crystal plasticity framework are performed, neglecting elastic anisotropy. The first and second terms of the isotropic elastic crack tip field, which are governed by the stress intensity factor K and T-stress, are prescribed as remote boundary conditions and solutions pertaining to different levels of T-stress are generated. It is found that the near-tip deformation field, especially, the development of kink or slip shear bands, is sensitive to the constraint level. The stress distribution and the size and shape of the plastic zone near the crack tip are also strongly influenced by the level of T-stress, with progressive loss of crack tip constraint occurring as T-stress becomes more negative. A family of near-tip fields is obtained which are characterized by two terms (such as K and T or J and a constraint parameter Q) as in isotropic plastic solids.

Coded excitation ultrasonic needle tracking: An in vivo study.

PubMed

Xia, Wenfeng; Ginsberg, Yuval; West, Simeon J; Nikitichev, Daniil I; Ourselin, Sebastien; David, Anna L; Desjardins, Adrien E

2016-07-01

Accurate and efficient guidance of medical devices to procedural targets lies at the heart of interventional procedures. Ultrasound imaging is commonly used for device guidance, but determining the location of the device tip can be challenging. Various methods have been proposed to track medical devices during ultrasound-guided procedures, but widespread clinical adoption has remained elusive. With ultrasonic tracking, the location of a medical device is determined by ultrasonic communication between the ultrasound imaging probe and a transducer integrated into the medical device. The signal-to-noise ratio (SNR) of the transducer data is an important determinant of the depth in tissue at which tracking can be performed. In this paper, the authors present a new generation of ultrasonic tracking in which coded excitation is used to improve the SNR without spatial averaging. A fiber optic hydrophone was integrated into the cannula of a 20 gauge insertion needle. This transducer received transmissions from the ultrasound imaging probe, and the data were processed to obtain a tracking image of the needle tip. Excitation using Barker or Golay codes was performed to improve the SNR, and conventional bipolar excitation was performed for comparison. The performance of the coded excitation ultrasonic tracking system was evaluated in an in vivo ovine model with insertions to the brachial plexus and the uterine cavity. Coded excitation significantly increased the SNRs of the tracking images, as compared with bipolar excitation. During an insertion to the brachial plexus, the SNR was increased by factors of 3.5 for Barker coding and 7.1 for Golay coding. During insertions into the uterine cavity, these factors ranged from 2.9 to 4.2 for Barker coding and 5.4 to 8.5 for Golay coding. The maximum SNR was 670, which was obtained with Golay coding during needle withdrawal from the brachial plexus. Range sidelobe artifacts were observed in tracking images obtained with Barker coded

WE-G-204-08: Optimized Digital Radiographic Technique for Lost Surgical Devices/Needle Identification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gorman, A; Seabrook, G; Brakken, A

Purpose: Small surgical devices and needles are used in many surgical procedures. Conventionally, an x-ray film is taken to identify missing devices/needles if post procedure count is incorrect. There is no data to indicate smallest surgical devices/needles that can be identified with digital radiography (DR), and its optimized acquisition technique. Methods: In this study, the DR equipment used is a Canon RadPro mobile with CXDI-70c wireless DR plate, and the same DR plate on a fixed Siemens Multix unit. Small surgical devices and needles tested include Rubber Shod, Bulldog, Fogarty Hydrogrip, and needles with sizes 3-0 C-T1 through 8-0 BV175-6.more » They are imaged with PMMA block phantoms with thickness of 2–8 inch, and an abdomen phantom. Various DR techniques are used. Images are reviewed on the portable x-ray acquisition display, a clinical workstation, and a diagnostic workstation. Results: all small surgical devices and needles are visible in portable DR images with 2–8 inch of PMMA. However, when they are imaged with the abdomen phantom plus 2 inch of PMMA, needles smaller than 9.3 mm length can not be visualized at the optimized technique of 81 kV and 16 mAs. There is no significant difference in visualization with various techniques, or between mobile and fixed radiography unit. However, there is noticeable difference in visualizing the smallest needle on a diagnostic reading workstation compared to the acquisition display on a portable x-ray unit. Conclusion: DR images should be reviewed on a diagnostic reading workstation. Using optimized DR techniques, the smallest needle that can be identified on all phantom studies is 9.3 mm. Sample DR images of various small surgical devices/needles available on diagnostic workstation for comparison may improve their identification. Further in vivo study is needed to confirm the optimized digital radiography technique for identification of lost small surgical devices and needles.« less

Linkage of T3 and Cpa pilins in the Streptococcus pyogenes M3 pilus.

PubMed

Quigley, Bernard R; Zähner, Dorothea; Hatkoff, Matthew; Thanassi, David G; Scott, June R

2009-06-01

The important human pathogen Streptococcus pyogenes (group A streptococcus, GAS) initiates infection by pilus-mediated attachment to host tissue. Thus, the pilus is an excellent target for design of anti-infective strategies. The T3 pilus of GAS is composed of multiple covalently linked subunits of the T3 protein to which the two minor pilins, Cpa and OrfB, are covalently attached. Because the proteins of GAS pili do not contain either of the motifs required for pilus polymerization in other Gram-positive bacteria, we investigated the residues involved in their linkage. We show that linkage of Cpa to T3 by the sortase family transpeptidase SrtC2 requires the VPPTG motif in the cell wall-sorting signal of Cpa. We also demonstrate that K173 of T3 is required both for T3 polymerization and for attachment of Cpa to T3. Therefore, attachment of Cpa to K173 of a T3 subunit would block further addition of T3 subunits to this end of the growing pilus. This implies that Cpa is located exclusively at the pilus tip, a location supported by immunogold electron microscopy, and suggests that, as for well-studied pili on Gram-negative bacteria, the role of the pilus is to present the adhesin external to the bacterial capsule.

Use of standard hypodermic needles for accessing laparoscopic adjustable gastric band ports.

PubMed

Bewsher, Samuel Mark; Azzi, Anthony; Wright, Timothy

2010-06-01

Laparoscopic adjustable gastric banding is a common and successful method of surgically treating morbid obesity. A recipient will have to attend their surgeon's rooms a number of times to optimally adjust the amount of fluid in the band and hence the amount of restriction. Manufacturers suggest that the ports should be accessed with special non-coring needles that may not always be available in regional or remote centers, and this could create a safety risk in cases where urgent band deflation is required. Ports of two different brands were repeatedly accessed over 100 times in the same location while containing fluid under pressure, using a standard beveled 21 g hypodermic needle (SN) and a 20 g Huber tipped non-coring needle (NCN). The path the needles types took through the port septum was also examined. There was no leakage of fluid from any of the ports tested. Neither SN nor NCN passed through the port septum down their axis, but rather in a direction closer to that of their beveled surface. There is no more risk of "coring" the septum with a SN than with a NCN. SN can be used safely and routinely to access laparoscopic adjustable gastric band ports.

Estimation of Nasal Tip Support Using Computer-Aided Design and 3-Dimensional Printed Models

PubMed Central

Gray, Eric; Maducdoc, Marlon; Manuel, Cyrus; Wong, Brian J. F.

2016-01-01

IMPORTANCE Palpation of the nasal tip is an essential component of the preoperative rhinoplasty examination. Measuring tip support is challenging, and the forces that correspond to ideal tip support are unknown. OBJECTIVE To identify the integrated reaction force and the minimum and ideal mechanical properties associated with nasal tip support. DESIGN, SETTING, AND PARTICIPANTS Three-dimensional (3-D) printed anatomic silicone nasal models were created using a computed tomographic scan and computer-aided design software. From this model, 3-D printing and casting methods were used to create 5 anatomically correct nasal models of varying constitutive Young moduli (0.042, 0.086, 0.098, 0.252, and 0.302 MPa) from silicone. Thirty rhinoplasty surgeons who attended a regional rhinoplasty course evaluated the reaction force (nasal tip recoil) of each model by palpation and selected the model that satisfied their requirements for minimum and ideal tip support. Data were collected from May 3 to 4, 2014. RESULTS Of the 30 respondents, 4 surgeons had been in practice for 1 to 5 years; 9 surgeons, 6 to 15 years; 7 surgeons, 16 to 25 years; and 10 surgeons, 26 or more years. Seventeen surgeons considered themselves in the advanced to expert skill competency levels. Logistic regression estimated the minimum threshold for the Young moduli for adequate and ideal tip support to be 0.096 and 0.154 MPa, respectively. Logistic regression estimated the thresholds for the reaction force associated with the absolute minimum and ideal requirements for good tip recoil to be 0.26 to 4.74 N and 0.37 to 7.19 N during 1- to 8-mm displacement, respectively. CONCLUSIONS AND RELEVANCE This study presents a method to estimate clinically relevant nasal tip reaction forces, which serve as a proxy for nasal tip support. This information will become increasingly important in computational modeling of nasal tip mechanics and ultimately will enhance surgical planning for rhinoplasty. LEVEL OF EVIDENCE

Needle-tissue interactive mechanism and steering control in image-guided robot-assisted minimally invasive surgery: a review.

PubMed

Li, Pan; Yang, Zhiyong; Jiang, Shan

2018-06-01

Image-guided robot-assisted minimally invasive surgery is an important medicine procedure used for biopsy or local target therapy. In order to reach the target region not accessible using traditional techniques, long and thin flexible needles are inserted into the soft tissue which has large deformation and nonlinear characteristics. However, the detection results and therapeutic effect are directly influenced by the targeting accuracy of needle steering. For this reason, the needle-tissue interactive mechanism, path planning, and steering control are investigated in this review by searching literatures in the last 10 years, which results in a comprehensive overview of the existing techniques with the main accomplishments, limitations, and recommendations. Through comprehensive analyses, surgical simulation for insertion into multi-layer inhomogeneous tissue is verified as a primary and propositional aspect to be explored, which accurately predicts the nonlinear needle deflection and tissue deformation. Investigation of the path planning of flexible needles is recommended to an anatomical or a deformable environment which has characteristics of the tissue deformation. Nonholonomic modeling combined with duty-cycled spinning for needle steering, which tracks the tip position in real time and compensates for the deviation error, is recommended as a future research focus in the steering control in anatomical and deformable environments. Graphical abstract a Insertion force when the needle is inserted into soft tissue. b Needle deflection model when the needle is inserted into soft tissue [68]. c Path planning in anatomical environments [92]. d Duty-cycled spinning incorporated in nonholonomic needle steering [64].

Cannula Versus Sharp Needle for Placement of Soft Tissue Fillers: An Observational Cadaver Study.

PubMed

van Loghem, Jani A J; Humzah, Dalvi; Kerscher, Martina

2017-12-13

Soft-tissue fillers have become important products for facial rejuvenation. Deep fat compartments and facial bones lose volume during the natural aging process. For the most natural-looking results, deep volumetric injections at strategic sites are therefore preferred. Supraperiosteal placement is performed with a sharp needle or a non-traumatic cannula. The primary objective was to determine whether there is a difference in precision between supraperiosteal placement with a sharp needle compared with a non-traumatic cannula in cadaver specimens. A secondary objective was to analyze the safety profiles of both injection techniques. Cadaver heads were injected with dye material and soft-tissue fillers at multiple aesthetic facial sites on the supraperiosteum and subsequently dissected for observation of dye and filler placement. The non-traumatic cannula technique resulted in product being confined to the deep anatomic layers. In contrast, with the sharp needle technique, material was placed in multiple anatomic layers, from the periosteum to more superficial skin layers. For both techniques results were consistent for all facial sites. Although direct extrapolation from cadavers to the in vivo situation cannot be made, cannulae showed more precision in placement of product. With the sharp needle, the material was injected on the periosteum, and then migrated in a retrograde direction along the trajectory of the needle path, ending up in multiple anatomic layers. The sharp needle technique also showed a higher complication risk with intra-arterial injection occurring, even though the needle tip was positioned on the periosteum and the product was injected with the needle in constant contact with the periosteum. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

MRI-Compatible Pneumatic Robot for Transperineal Prostate Needle Placement.

PubMed

Fischer, Gregory S; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; Dimaio, Simon P; Tempany, Clare M; Hata, Nobuhiko; Fichtinger, Gabor

2008-06-01

Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of prostate and surrounding tissue, thus granting potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. However, the benefits cannot be readily harnessed for interventional procedures due to difficulties that surround the use of high-field (1.5T or greater) MRI. The inability to use conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intraprostatic needle placement inside closed high-field MRI scanners. MRI compatibility of the robot has been evaluated under 3T MRI using standard prostate imaging sequences and average SNR loss is limited to 5%. Needle alignment accuracy of the robot under servo pneumatic control is better than 0.94 mm rms per axis. The complete system workflow has been evaluated in phantom studies with accurate visualization and targeting of five out of five 1 cm targets. The paper explains the robot mechanism and controller design, the system integration, and presents results of preliminary evaluation of the system.

MRI-Compatible Pneumatic Robot for Transperineal Prostate Needle Placement

PubMed Central

Fischer, Gregory S.; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; DiMaio, Simon P.; Tempany, Clare M.; Hata, Nobuhiko; Fichtinger, Gabor

2010-01-01

Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of prostate and surrounding tissue, thus granting potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. However, the benefits cannot be readily harnessed for interventional procedures due to difficulties that surround the use of high-field (1.5T or greater) MRI. The inability to use conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intraprostatic needle placement inside closed high-field MRI scanners. MRI compatibility of the robot has been evaluated under 3T MRI using standard prostate imaging sequences and average SNR loss is limited to 5%. Needle alignment accuracy of the robot under servo pneumatic control is better than 0.94 mm rms per axis. The complete system workflow has been evaluated in phantom studies with accurate visualization and targeting of five out of five 1 cm targets. The paper explains the robot mechanism and controller design, the system integration, and presents results of preliminary evaluation of the system. PMID:21057608

Succession of splicing regulatory elements determines cryptic 5΄ss functionality

PubMed Central

Brillen, Anna-Lena; Schöneweis, Katrin; Walotka, Lara; Hartmann, Linda; Müller, Lisa; Ptok, Johannes; Kaisers, Wolfgang; Poschmann, Gereon; Stühler, Kai; Buratti, Emanuele

2017-01-01

Abstract A critical step in exon definition is the recognition of a proper splice donor (5΄ss) by the 5’ end of U1 snRNA. In the selection of appropriate 5΄ss, cis-acting splicing regulatory elements (SREs) are indispensable. As a model for 5΄ss recognition, we investigated cryptic 5΄ss selection within the human fibrinogen Bβ-chain gene (FGB) exon 7, where we identified several exonic SREs that simultaneously acted on up- and downstream cryptic 5΄ss. In the FGB exon 7 model system, 5΄ss selection iteratively proceeded along an alternating sequence of U1 snRNA binding sites and interleaved SREs which in principle supported different 3’ exon ends. Like in a relay race, SREs either suppressed a potential 5΄ss and passed the splicing baton on or splicing actually occurred. From RNA-Seq data, we systematically selected 19 genes containing exons with silent U1 snRNA binding sites competing with nearby highly used 5΄ss. Extensive SRE analysis by different algorithms found authentic 5΄ss significantly more supported by SREs than silent U1 snRNA binding sites, indicating that our concept may permit generalization to a model for 5΄ss selection and 3’ exon end definition. PMID:28039323

Effect and safety of deep needling and shallow needling for functional constipation: a multicenter, randomized controlled trial.

PubMed

Wu, Jiani; Liu, Baoyan; Li, Ning; Sun, Jianhua; Wang, Lingling; Wang, Liping; Cai, Yuying; Ye, Yongming; Liu, Jun; Wang, Yang; Liu, Zhishun

2014-12-01

Aupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study.SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P<0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P>0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P<0.05, all compared with the lactulose group). No significant difference was observed among the 3

Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules.

PubMed

Arias, Sixto; Lee, Hans; Semaan, Roy; Frimpong, Bernice; Ortiz, Ricardo; Feller-Kopman, David; Oakjones-Burgess, Karen; Yarmus, Lonny

2015-05-23

Lung nodule evaluation represents a clinical challenge especially in patients with intermediate risk for malignancy. Multiple technologies are presently available to sample nodules for pathological diagnosis. Those technologies can be divided into bronchoscopic and non-bronchoscopic interventions. Electromagnetic navigational bronchoscopy is being extensively used for the endobronchial approach to peripheral lung nodules but has been hindered by anatomic challenges resulting in a 70% diagnostic yield. Electromagnetic navigational guided transthoracic needle lung biopsy is novel non-bronchoscopic method that uses a percutaneous electromagnetic tip tracked needle to obtain core biopsy specimens. Electromagnetic navigational transthoracic needle aspiration complements bronchoscopic techniques potentially allowing the provider to maximize the diagnostic yield during one single procedure. This article describes a novel integrated diagnostic approach to pulmonary lung nodules. We propose the use of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) for mediastinal staging; radial EBUS, navigational bronchoscopy and E-TTNA during one single procedure to maximize diagnostic yield and minimize the number of invasive procedures needed to obtain a diagnosis. This manuscript describes in detail how the navigation transthoracic procedure is performed. Additional clinical studies are needed to determine the clinical utility of this novel technology.

Safe and effective error rate monitors for SS7 signaling links

NASA Astrophysics Data System (ADS)

Schmidt, Douglas C.

1994-04-01

This paper describes SS7 error monitor characteristics, discusses the existing SUERM (Signal Unit Error Rate Monitor), and develops the recently proposed EIM (Error Interval Monitor) for higher speed SS7 links. A SS7 error monitor is considered safe if it ensures acceptable link quality and is considered effective if it is tolerant to short-term phenomena. Formal criteria for safe and effective error monitors are formulated in this paper. This paper develops models of changeover transients, the unstable component of queue length resulting from errors. These models are in the form of recursive digital filters. Time is divided into sequential intervals. The filter's input is the number of errors which have occurred in each interval. The output is the corresponding change in transmit queue length. Engineered EIM's are constructed by comparing an estimated changeover transient with a threshold T using a transient model modified to enforce SS7 standards. When this estimate exceeds T, a changeover will be initiated and the link will be removed from service. EIM's can be differentiated from SUERM by the fact that EIM's monitor errors over an interval while SUERM's count errored messages. EIM's offer several advantages over SUERM's, including the fact that they are safe and effective, impose uniform standards in link quality, are easily implemented, and make minimal use of real-time resources.

Clinical evaluation of single-shot and readout-segmented diffusion-weighted imaging in stroke patients at 3 T.

PubMed

Morelli, John; Porter, David; Ai, Fei; Gerdes, Clint; Saettele, Megan; Feiweier, Thorsten; Padua, Abraham; Dix, James; Marra, Michael; Rangaswamy, Rajesh; Runge, Val

2013-04-01

Diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) is most commonly performed utilizing a single-shot echo-planar imaging technique (ss-EPI). Susceptibility artifact and image blur are severe when this sequence is utilized at 3 T. To evaluate a readout-segmented approach to DWI MR in comparison with single-shot echo planar imaging for brain MRI. Eleven healthy volunteers and 14 patients with acute and early subacute infarctions underwent DWI MR examinations at 1.5 and 3T with ss-EPI and readout-segmented echo-planar (rs-EPI) DWI at equal nominal spatial resolutions. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculations were made, and two blinded readers ranked the scans in terms of high signal intensity bulk susceptibility artifact, spatial distortions, image blur, overall preference, and motion artifact. SNR and CNR were greatest with rs-EPI (8.1 ± 0.2 SNR vs. 6.0 ± 0.2; P <10(-4) at 3T). Spatial distortions were greater with single-shot (0.23 ± 0.03 at 3T; P <0.001) than with rs-EPI (0.12 ± 0.02 at 3T). Combined with blur and artifact reduction, this resulted in a qualitative preference for the readout-segmented scans overall. Substantial image quality improvements are possible with readout-segmented vs. single-shot EPI - the current clinical standard for DWI - regardless of field strength (1.5 or 3 T). This results in improved image quality secondary to greater real spatial resolution and reduced artifacts from susceptibility in MR imaging of the brain.

Pneumatically Operated MRI-Compatible Needle Placement Robot for Prostate Interventions

PubMed Central

Fischer, Gregory S.; Iordachita, Iulian; Csoma, Csaba; Tokuda, Junichi; Mewes, Philip W.; Tempany, Clare M.; Hata, Nobuhiko; Fichtinger, Gabor

2011-01-01

Magnetic Resonance Imaging (MRI) has potential to be a superior medical imaging modality for guiding and monitoring prostatic interventions. The strong magnetic field prevents the use of conventional mechatronics and the confined physical space makes it extremely challenging to access the patient. We have designed a robotic assistant system that overcomes these difficulties and promises safe and reliable intra-prostatic needle placement inside closed high-field MRI scanners. The robot performs needle insertion under real-time 3T MR image guidance; workspace requirements, MR compatibility, and workflow have been evaluated on phantoms. The paper explains the robot mechanism and controller design and presents results of preliminary evaluation of the system. PMID:21686038

Apical Extrusion of Irrigants in Immature Permanent Teeth by Using EndoVac and Needle Irrigation: An In Vitro Study

PubMed Central

Velmurugan, N; Sooriaprakas, C; Jain, Preetham

2014-01-01

Objective: Immature teeth have a large apical opening and thin divergent or parallel dentinal walls; hence, with conventional needle irrigation there is a very high possibility of extrusion. This study was done to compare the apical extrusion of NaOCl in an immature root delivered using EndoVac and needle irrigation. Materials and Methods: Eighty freshly extracted maxillary central incisors were decoronated followed by access cavity preparation. Modified organotypic protocol was performed to create an open apex; then, the samples were divided into four groups (n=20): EndoVac Microcannula (group I), EndoVac Macrocannula (group II), NaviTip irrigation needle (group III) and Max-i-Probe Irrigating needle (group IV); 9.0 ml of 3% sodium hypochlorite was delivered slowly over a period of 60 seconds. Extruded irrigants were collected in a vial and analysed statistically. Results: Group I, group III and group IV showed 100% extrusion (20/20) but group II showed only 40% extrusion (8/20). The difference in this respect between group II and other groups was statistically significant (P<0.001). With regards to the volume of extrusion, group II had only 0.23 ml of extruded irrigant. Group I extruded 7.53ml of the irrigant. Group III and group IV extruded the entire volume of irrigant delivered. Conclusion: EndoVac Macrocannula resulted in the least extrusion of irrigant in immature teeth when compared to EndoVac Microcannula and conventional needle irrigation. PMID:25584055

Needle thoracostomy in the treatment of a tension pneumothorax in trauma patients: what size needle?

PubMed

Zengerink, Imme; Brink, Peter R; Laupland, Kevin B; Raber, Earl L; Zygun, Dave; Kortbeek, John B

2008-01-01

A tension pneumothorax requires immediate decompression using a needle thoracostomy. According to advanced trauma life support guidelines this procedure is performed in the second intercostal space (ICS) in the midclavicular line (MCL), using a 4.5-cm (2-inch) catheter (5-cm needle). Previous studies have shown a failure rate of up to 40% using this technique. Case reports have suggested that this high failure rate could be because of insufficient length of the needle. To analyze the average chest wall thickness (CWT) at the second ICS in the MCL in a trauma population and to evaluate the length of the needle used in needle thoracostomy for emergency decompression of tension pneumothoraces. Retrospective review of major trauma admissions (Injury Severity Score >12) at the Foothills Medical Centre in Calgary, Canada, who underwent a computed tomography chest scan admitted in the period from October 2001 until March 2004. Subgroup analysis on men and women, <40 years of age and >/=40 years of age was defined a priori. CWT was measured to the nearest 0.01 cm at the second ICS in the MCL. The mean CWT in the 604 male patients and 170 female patients studied averaged 3.50 cm at the left second ICS MCL and 3.51 cm on the right. The mean CWT was significantly higher for women than men (p < 0.0001). About 9.9% to 19.3% of the men had a CWT >4.5 cm and 24.1% to 35.4% of the women studied. A catheter length of 4.5 cm may not penetrate the chest wall of a substantial amount (9.9%-35.4%) of the population, depending on age and gender. This study demonstrates the need for a variable needle length for relief of a tension pneumothorax in certain population groups to improve effectiveness of needle thoracostomy.

Comparison of 21-Gauge and 22-Gauge Aspiration Needle in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

PubMed Central

Akulian, Jason; Lechtzin, Noah; Yasin, Faiza; Kamdar, Biren; Ernst, Armin; Ost, David E.; Ray, Cynthia; Greenhill, Sarah R.; Jimenez, Carlos A.; Filner, Joshua; Feller-Kopman, David

2013-01-01

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure originally performed using a 22-gauge (22G) needle. A recently introduced 21-gauge (21G) needle may improve the diagnostic yield and sample adequacy of EBUS-TBNA, but prior smaller studies have shown conflicting results. To our knowledge, this is the largest study undertaken to date to determine whether the 21G needle adds diagnostic benefit. Methods: We retrospectively evaluated the results of 1,299 patients from the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation (AQuIRE) Diagnostic Registry who underwent EBUS-TBNA between February 2009 and September 2010 at six centers throughout the United States. Data collection included patient demographics, sample adequacy, and diagnostic yield. Analysis consisted of univariate and multivariate hierarchical logistic regression comparing diagnostic yield and sample adequacy of EBUS-TBNA specimens by needle gauge. Results: A total of 1,235 patients met inclusion criteria. Sample adequacy was obtained in 94.9% of the 22G needle group and in 94.6% of the 21G needle group (P = .81). A diagnosis was made in 51.4% of the 22G and 51.3% of the 21G groups (P = .98). Multivariate hierarchical logistic regression showed no statistical difference in sample adequacy or diagnostic yield between the two groups. The presence of rapid onsite cytologic evaluation was associated with significantly fewer needle passes per procedure when using the 21G needle (P < .001). Conclusions: There is no difference in specimen adequacy or diagnostic yield between the 21G and 22G needle groups. EBUS-TBNA in conjunction with rapid onsite cytologic evaluation and a 21G needle is associated with fewer needle passes compared with a 22G needle. PMID:23632441

The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection.

PubMed

Taghavi Zenouz, Ali; Ebrahimi, Hooman; Mahdipour, Masoumeh; Pourshahidi, Sara; Amini, Parisa; Vatankhah, Mahdi

2008-01-01