Cost-effectiveness of New Surgical Treatments for Hemorrhoidal Disease: A Multicentre Randomized Controlled Trial Comparing Transanal Doppler-guided Hemorrhoidal Artery Ligation With Mucopexy and Circular Stapled Hemorrhoidopexy.

PubMed

Lehur, Paul A; Didnée, Anne S; Faucheron, Jean-Luc; Meurette, Guillaume; Zerbib, Philippe; Siproudhis, Laurent; Vinson-Bonnet, Béatrice; Dubois, Anne; Casa, Christine; Hardouin, Jean-Benoit; Durand-Zaleski, Isabelle

2016-11-01

To compare Doppler-guided hemorrhoidal artery ligation (DGHAL) with circular stapled hemorrhoidopexy (SH) in the treatment of grade II/III hemorrhoidal disease (HD). DGHAL is a treatment option for symptomatic HD; existing studies report limited risk and satisfactory outcomes. DGHAL has never before been compared with SH in a large-scale multi-institutional randomized clinical trial. Three hundred ninety-three grade II/III HD patients recruited in 22 centers from 2010 to 2013 were randomized to DGHAL (n = 197) or SH (n = 196). The primary endpoint was operative-related morbidity at 3 months (D.90) based on the Clavien-Dindo surgical complications grading. Total cost, cost-effectiveness, and clinical outcome were assessed at 1 year. At D.90, operative-related adverse events occurred after DGHAL and SH, respectively, in 47 (24%) and 50 (26%) patients (P = 0.70). DGHAL resulted in longer mean operating time (44±16 vs 30±14 min; P < 0.001), less pain (postoperative and at 2 wks visual analogic scale: 2.2 vs 2.8; 1.3 vs 1.9; P = 0.03; P = 0.013) and shorter sick leave (12.3 vs 14.8 d; P = 0.045). At 1 year, DGHAL led to more residual grade III HD (15% vs 5%) and a higher reoperation rate (8% vs 4%). Patient satisfaction was >90% for both procedures. Total cost at 1 year was greater for DGHAL [&OV0556;2806 (&OV0556;2670; 2967) vs &OV0556;2538 (&OV0556;2386; 2737)]. The D.90, incremental cost-effectiveness ratio (ICER) was &OV0556;7192 per averted complication. At 1 year DGHAL strategy was dominated. DGHAL and SH are viable options in grade II/III HD with no significant difference in operative-related risk. Although resulting in less postoperative pain and shorter sick leave, DGHAL was more expensive, took longer, and provided a possible inferior anatomical correction suggesting an increased risk of recurrence.

Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials.

PubMed

Xu, L; Chen, H; Lin, G; Ge, Q; Qi, H; He, X

2016-12-01

The aim of this study was to analyse the outcomes of transanal hemorrhoidal dearterialization with mucopexy (THDm) versus open hemorrhoidectomy (OH) in the management of hemorrhoids. Randomized controlled trials in English were found by searching PubMed, Web of science, EMBASE, and the Cochrane Library database. Trials that compared THDm with OH were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random effects models. Four trials, including 316 patients, met the inclusion criteria. No statistically significant differences were noted in either total complications or postoperative bleeding, incontinence, recurrent prolapse, and urinary retention rate. Operative time was significantly longer for THDm with Doppler guidance than for THDm without Doppler guidance. Patients returned to normal activities faster after THDm than after OH. No statistically significant differences between THDm and OH were noted with regard to recurrence and reoperation rates. Our meta-analysis shows that THDm and OH are equally effective and can be attempted for the management of hemorrhoids. However, for THDm with Doppler guidance, more instruments and a longer operative time are required. Future large-scale, high-quality, multicenter trials with long-term outcomes are needed to prove these results and determine whether Doppler guidance in THD is truly necessary or not.

Hemorrhoidal artery ligation (HAL) and rectoanal repair (RAR): retrospective analysis of 408 patients in a single center.

PubMed

Scheyer, M; Antonietti, E; Rollinger, G; Lancee, S; Pokorny, H

2015-01-01

Rectoanal repair (RAR), which combines doppler-guided hemorrhoidal artery ligation (HAL) and mucopexy via lifting of the hemorrhoidal prolapse, offers a minimally invasive alternative to conventional hemorrhoidectomy. Patients with grade II hemorrhoids were treated with HAL, and patients with grade III and IV hemorrhoids were treated with the RAR procedure by two surgeons. Postoperative follow-up was performed clinically and by proctoscopy after 8 weeks routinely, and long-term follow-up was performed using a standardized postal questionnaire. The overall complication rate was 29% (n = 118). After short-term follow-up, 26% (n = 106) of patients reported recurrent or persistent prolapsing piles, while 21% (n = 86) of patients had recurrent bleeding. After long-term follow-up, 24% (n = 98) of patients reported prolapsing piles, 3% (n = 12) bleeding, 3% (n = 12) pruritus, and 2% (n = 8) anal pain, while 20% (n = 82) complained of persistent mixed symptoms. HAL and RAR provide prolonged relief for patients with hemorrhoidal disease whose main symptoms are bleeding, pruritus and pain but not for patients with prolapse as an initial indication.

Hemorrhoid laser procedure for second- and third-degree hemorrhoids: results from a multicenter prospective study.

PubMed

De Nardi, P; Tamburini, A M; Gazzetta, P G; Lemma, M; Pascariello, A; Asteria, C R

2016-07-01

The aim of our study was to assess the outcome of hemorrhoidal dearterialization, achieved by a dedicated laser energy device. From November 2012 to December 2014, 51 patients with second- or third-degree hemorrhoids were studied. The primary end point was a reduction in the bleeding rate; secondary end points were: postoperative complications, reduction in pain and prolapse, resolution of symptoms, and degree of patient's perception of improvement. The procedure was carried out as 1-day surgery. A diode laser device was employed to seal the terminal branches of the hemorrhoidal arteries, detected by a Doppler-equipped proctoscope. Follow-up was scheduled at 1 and 4 weeks, 3, 12, and 24 months. The rate and degree of symptoms was assessed with a four-point verbal rating scale. The rate of subjective symptomatic improvement was also evaluated with the Patient Global Improvement (PGI) Scale. Mean bleeding and pain scores at baseline were 2 and 0.57. All the patients were discharged on the day of surgery. Postoperative complications were bleeding (n = 4) and external hemorrhoidal thrombosis (n = 4). Mean bleeding and pain scores at 3, 12, and 24 months were significatively reduced. After 24 months, complete resolution of bleeding was observed in 28/29 patients (96.7 %), resolution of pain in all patients, and resolution of the mucosal prolapse in 15/18 patients (76.9 %). At 12-month follow-up, 86.3 % of patients reported improvement with the PGI Scale. The hemorrhoid laser procedure was effective in improving bleeding and pain symptoms in patients with grade II and III hemorrhoids.

A randomized trial of transanal hemorrhoidal dearterialization with anopexy compared with open hemorrhoidectomy in the treatment of hemorrhoids.

PubMed

Elmér, Solveig E; Nygren, Jonas O; Lenander, Claes E

2013-04-01

Doppler guidance in hemorrhoidal surgery has become more frequent during the past decade. The method is mainly studied in nonrandomized trials. Data from randomized controlled trials are lacking. The aim of this study was to compare early and midterm results of transanal hemorrhoidal dearterialization with anopexy to open hemorrhoidectomy. DESIGN, SETTINGS, PATIENTS, AND INTERVENTIONS: Forty patients with grade 2 to 3 hemorrhoids were randomly assigned to transanal hemorrhoidal dearterialization with anopexy (group A, n = 20) or open hemorrhoidectomy (group B, n = 20). A diary was used during the first 2 postoperative weeks. A self-reported symptom questionnaire was answered, and a clinical examination was performed preoperatively, after 2 to 4 months, and after 1 year. The main outcome measure was postoperative pain. Postoperative peak pain was lower in group A during the first week than in group B (p < 0.05), whereas no difference in overall pain was noted. More patients expressed normal well-being in group A (p = 0.045). Pain, bleeding, and the need for manual reduction of the hemorrhoids were all improved in both groups after 1 year (p < 0.05). Soiling had decreased after both methods at early follow-up. After 1 year, soiling was significantly decreased only after open hemorrhoidectomy. The grade of hemorrhoids was significantly reduced after 1 year for both methods, but there was a trend to more patients with remaining grade 2 hemorrhoids in group A (p = 0.06). There was no blinding, the sample size was small, and follow-up was for only 1 year. The questionnaire was not validated. The difference in postoperative pain between transanal hemorrhoidal dearterialization with anopexy and open hemorrhoidectomy may be less than expected based on previous literature.

Emborrhoid: A New Concept for the Treatment of Hemorrhoids with Arterial Embolization: The First 14 Cases

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

Vidal, V., E-mail: vincent.vidal@ap-hm.fr; Sapoval, M., E-mail: marc.sapoval@gmail.com; Sielezneff, Y., E-mail: igor.sielezneff@ap-hm.fr

2015-02-15

PurposeThe ‘emborrhoid’ technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique.Materials and MethodsFourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment wasmore » decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018).ResultsTechnical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction.ConclusionOur case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new ‘emborrhoid’ technique in the management of hemorrhoidal disease.« less

Hemorrhoids.

PubMed

Mounsey, Anne L; Halladay, Jacqueline; Sadiq, Timothy S

2011-07-15

Most patients with hemorrhoids experience only mild symptoms that can be treated with nonprescription topical preparations. Patients usually seek treatment when symptoms increase. Internal hemorrhoids typically present with prolapse or painless rectal bleeding. External hemorrhoids also bleed and can cause acute pain if thrombosed. Medical therapy should be initiated with stool softeners plus local therapy to relieve swelling and symptoms. If medical therapy is inadequate, surgical intervention is warranted. Rubber band ligation is the treatment of choice for grades 1 and 2 hemorrhoids. Rubber band ligation, excisional hemorrhoidectomy, or stapled hemorrhoidopexy can be performed in patients with grade 3 hemorrhoids. Rubber band ligation causes less postoperative pain and fewer complications than excisional hemorrhoidectomy and stapled hemorrhoidopexy, but has a higher recurrence rate. Excisional hemorrhoidectomy or stapled hemorrhoidopexy is recommended for treatment of grade 4 hemorrhoids. Stapled hemorrhoidopexy has a faster postoperative recovery, but a higher recurrence rate. Postoperative pain from excisional hemorrhoidectomy can be treated with nonsteroidal anti-inflammatory drugs, narcotics, fiber supplements, and topical antispasmodics. Thrombosed external hemorrhoids can be treated conservatively or excised.

Hemorrhoids

PubMed Central

Sanchez, Caroline; Chinn, Bertram T.

2011-01-01

Hemorrhoid disease is the most common reason patients seek evaluation by a colon and rectal surgeon. The majority of hemorrhoids can be managed nonoperatively with medical management or office-based procedures. The authors review the anatomy, pathophysiology, presentation, and management of hemorrhoids. PMID:22379400

Symptomatic hemorrhoids.

PubMed

Gearhart, Susan L

2004-01-01

The most important aspect in the diagnosis of hemorrhoidal disease is the exclusion of other, more life-threatening conditions. Hemorrhoidal banding remains the most successful method to manage hemorrhoids in the outpatient clinic. Chronic application of local medications to the perineum may result in dermatologic conditions. It is safe to manage acutely inflamed hemorrhoids surgically. Table 1 is a summary of the various methods for the surgical management of symptomatic prolapsing hemorrhoids. Dietary manipulation, including fiber supplementation, should always accompany surgical

Hemorrhoids.

PubMed

Sardinha, T Cristina; Corman, Marvin L

2002-12-01

Technologic advances have contributed to numerous diverse approaches to the management of hemorrhoid disease over the past centuries. Better understanding of the pathophysiology and anatomy of the anal canal has also added to the increased success in the treatment of hemorrhoids. This article reviews the clinical and pathological aspects of hemorrhoid disease, emphasizing new therapeutic modalities.

Hemorrhoid surgery

MedlinePlus

... a small rubber band around a hemorrhoid to shrink it by blocking blood flow. Stapling a hemorrhoid to block blood flow, causing it to shrink. Using a knife (scalpel) to remove hemorrhoids. You ...

Anorectal conditions: hemorrhoids.

PubMed

Fox, Audralan; Tietze, Pamela H; Ramakrishnan, Kalyanakrishnan

2014-04-01

Hemorrhoids are engorged fibrovascular cushions lining the anal canal. Constipation, increased intra-abdominal pressure, and prolonged straining predispose to hemorrhoids. Approximately 1 in 20 Americans and almost one-half of individuals older than 50 years experience symptomatic hemorrhoids. Bright red, painless rectal bleeding during defecation is the most common presentation. Even if hemorrhoids are seen on examination, patients with rectal bleeding who are at risk of colorectal cancer (eg, adults older than 50 years) should still undergo colonoscopy to exclude cancer as the etiology. Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs. If nonsurgical management is unsuccessful, rubber band ligation is the most effective office-based procedure for grades I, II, and III hemorrhoids. Surgical hemorrhoidectomy is indicated after failure of nonsurgical management and office-based procedures and also as initial management for grades III and IV hemorrhoids. Several different procedures can be used. For acutely thrombosed external hemorrhoids, excision and evacuation of the clot, ideally within 72 hours of symptom onset, is the optimal management. Prolapsed and strangulated hemorrhoids are best managed with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery; residual hemorrhoids are banded or excised later.

Hemorrhoids

MedlinePlus

Hemorrhoids are swollen, inflamed veins around the anus or lower rectum. They are either inside the anus ... include pregnancy, aging and chronic constipation or diarrhea. Hemorrhoids are very common in both men and women. ...

Doppler-guided retrograde catheterization system

NASA Astrophysics Data System (ADS)

Frazin, Leon J.; Vonesh, Michael J.; Chandran, Krishnan B.; Khasho, Fouad; Lanza, George M.; Talano, James V.; McPherson, David D.

1991-05-01

The purpose of this study was to investigate a Doppler guided catheterization system as an adjunctive or alternative methodology to overcome the disadvantages of left heart catheterization and angiography. These disadvantages include the biological effects of radiation and the toxic and volume effects of iodine contrast. Doppler retrograde guidance uses a 20 MHz circular pulsed Doppler crystal incorporated into the tip of a triple lumen multipurpose catheter and is advanced retrogradely using the directional flow information provided by the Doppler waveform. The velocity detection limits are either 1 m/second or 4 m/second depending upon the instrumentation. In a physiologic flow model of the human aortic arch, multiple data points revealed a positive wave form when flow was traveling toward the catheter tip indicating proper alignment for retrograde advancement. There was a negative wave form when flow was traveling away from the catheter tip if the catheter was in a branch or bent upon itself indicating improper catheter tip position for retrograde advancement. In a series of six dogs, the catheter was able to be accurately advanced from the femoral artery to the left ventricular chamber under Doppler signal guidance without the use of x-ray. The potential applications of a Doppler guided retrograde catheterization system include decreasing time requirements and allowing safer catheter guidance in patients with atherosclerotic vascular disease and suspected aortic dissection. The Doppler system may allow left ventricular pressure monitoring in the intensive care unit without the need for x-ray and it may allow left sided contrast echocardiography. With pulse velocity detection limits of 4 m/second, this system may allow catheter direction and passage into the aortic root and left ventricle in patients with aortic stenosis. A modification of the Doppler catheter may include transponder technology which would allow precise catheter tip localization once the

[Complications after procedure for prolapse and hemorrhoids for circular hemorrhoids].

PubMed

Zhu, Jun; Ding, Jian-hua; Zhao, Ke; Zhang, Bin; Zhao, Yong; Tang, Hai-yan; Zhao, Yu-juan

2012-12-01

To investigate the perioperative and postoperative long-term complications of procedure for prolapse and hemorrhoids(PPH) for the treatment of circular internal hemorrhoids and circular mixed hemorrhoids. A retrospective study was performed in 2152 patients with circular internal hemorrhoids and circular mixed hemorrhoids eligible for PPH from January 2002 to December 2011. The perioperative and postoperative long-term complications were recorded and assessed. The median length of follow-up was 73 months. Perioperative complications and adverse events were reported including acute urinary retention(n=360, 16.7%) which was managed by temporary cathether indwelling, anastomotic bleeding(n=45, 2.1%) managed by surgical or endoscopic procedures, chronic anoperineal sustained pain(n=30, 1.4%) managed by local treatment or stapler removal, and thrombosed external hemorrhoid(n=28, 1.2%) managed by conservative treatment or resection. Long-term postoperative complications were reported including mild fecal incontinence(n=112, 6.3%), postoperative recurrence(n=82, 4.6%), anal distention and defecatory urgency(n=50, 2.8%), anastomotic stenosis(n=4, 0.2%). Postoperative recurrence developed in 82 patients(4.6%), 28 of whom were managed by repeat PPH and 54 by conservative treatment. PPH appears to be a safe technique for patients with circular internal hemorrhoids and circular mixed hemorrhoids.

Hemorrhoids

MedlinePlus

... by simply looking at the rectal area. External hemorrhoids can often be detected this way. Tests that may help diagnose the problem include: Rectal exam Sigmoidoscopy Anoscopy Treatment Treatments for hemorrhoids include: Over-the-counter corticosteroid (for example, cortisone) ...

Hemorrhoids.

PubMed

Hulme-Moir, M; Bartolo, D C

2001-03-01

Understanding of hemorrhoidal pathology and treatment has come a long way. The theory of a sliding anal canal lining and the knowledge that hemorrhoidal cushions are a normal part of the anal anatomy should encourage symptom control rather than radical removal of tissue. Techniques that fix the cushions back in position can be performed in outpatients with reasonable success rates. When required, surgery should be aimed at symptomatic hemorrhoids. It is hoped that new developments such as circular stapling and better pain management will promote increased day surgery, better pain control, and less time off work for patients.

Optimal Treatment of Symptomatic Hemorrhoids

PubMed Central

Kim, Soung-Ho

2011-01-01

Hemorrhoids are the most common anorectal complaint, and approximately 10 to 20 percent of patients with symptomatic hemorrhoids require surgery. Symptoms of hemorrhoids, such as painless rectal bleeding, tissue protrusion and mucous discharge, vary. The traditional therapeutic strategies of medicine include surgical, as well as non-surgical, treatment. To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients. Other non-surgical treatments, such as infrared photocoagulation, injection sclerotherapy and rubber band ligation have been used to fixate the hemorrhoid's cushion. If non-surgical treatment has no effect, surgical treatments, such as a hemorrhoidectomy, procedure for prolapsed hemorrhoids, and transanal hemorrhoidal dearterialization are used. PMID:22259741

[Anopexy according to Longo for hemorrhoids].

PubMed

Ruppert, R

2016-11-01

The treatment for hemorrhoids ranges from conservative management to surgical procedures. The procedures are tailored to the individual grading of hemorrhoids and the individual complaints. The standard Goligher classification of the hemorrhoids is the basis for further treatment and no differentiation is made between segmental hemorrhoids and circular hemorrhoids. In the case of advanced circular hemorrhoid disease the surgical procedure with a stapler, so-called stapler anopexy, is the procedure of choice.

Application of ‘tying, binding and fixing operation’ in surgical treatment of severe mixed hemorrhoids

PubMed Central

Huang, Hong-Xiang; Yao, Yi-Bo; Tang, Ying

2016-01-01

The aim of the present study was to examine the clinical value of ‘tying, binding and fixing operation’ in treating severe mixed hemorrhoids. A total of 160 patients with severe mixed hemorrhoids were selected and randomly divided into the experimental (n=80) and control (n=80) groups. The groups were treated using ‘tying, binding and fixing operation’ and Doppler ultrasound-guided hemorrhoidal artery ligation (DG-HAL), respectively. The results showed that the average operative time of the experimental group (35.57±6.17) was significantly higher than that of the control group (12.73±4.92). There was no significant difference of blood loss during the operation between the two groups (P>0.05). There was also no significant difference in improving the hemorrhage symptom between the two groups (P>0.05). In addition, concerning improvement of prolapse symptoms and reduction of the volume of hemorrhoids, the experimental group were significantly improved as compared to the control group. No anal function damage in the two groups was identified, and the length of stay in hospital for the two groups was not significantly different (P>0.05). However, the hospitalization cost in the experimental group (5,334.77±875.54) was significantly lower than that of the control group (8,551.81±1,806.54) and satisfaction degree was significantly higher than that of the control group. The incidences of perianal pain, anal edema and dysuria between two groups were not significantly different (P>0.05). There were 10 cases of secondary hemorrhage and 18 cases of infection in the experimental group, and 12 cases of secondary hemorrhage and 14 cases of infection in the control group, although the differences between the two groups were not statistically significant (P>0.05). The incidence rate of local hematoma in the experimental group (1.2%) was significantly lower than that in the control group (15.0%). The recurrence rate of the control group (22.5%) was also significantly

Hemorrhoid surgery - slideshow

MedlinePlus

... this page: //medlineplus.gov/ency/presentations/100026.htm Hemorrhoid surgery - series—Normal anatomy To use the sharing ... empties stool from the body through the anus. Hemorrhoids are "cushions" of tissue filled with blood vessels ...

Etiology of thrombosed external hemorrhoids.

PubMed

Wronski, Konrad

2012-01-30

External hemorrhoids are located outside of the dentate line and covered by anoderm. Thrombosed external hemorrhoids are one of the frequent acute anorectal diseases which are treated successfully in the proctology outpatient room. The etiology of this disease is still unknown. Knowledge of the etiology of thrombosed external hemorrhoids could prevent recurrence of this disease and help prepare good prophylaxis. A group of 50 patients with a diagnosis of thrombosed external hemorrhoids and treated in the Mikolaj Pirogow Regional Specialist Hospital in Lodz was interviewed by means of the author's own questionnaire concerning demography and published hypothesis. The necessary statistics were conducted by means of STATISTICA 7.1 and EXCEL 2008 programs. The analysis of the survey results shows a significant relationship of thrombosed external hemorrhoids and presence of internal hemorrhoids, practice of anoreceptive sex and consumption of more alcohol products than usual. There was no statistical relationship between lifting heavy objects, eating spicy food, having hard stools or straining at toilet during motions and thrombosed external hemorrhoids. This study confirmed three hypotheses on the causes of thrombosed external hemorrhoids which were presented in medical journals available in the MEDLINE database. The author of this article believes that it is necessary to conduct a multi-center study, which would explain the exact etiology of this disease. Knowledge about the etiology of thrombosed external disease would help develop effective prevention and treatment.

The prevalence of hemorrhoids in adults.

PubMed

Riss, Stefan; Weiser, Friedrich Anton; Schwameis, Katrin; Riss, Thomas; Mittlböck, Martina; Steiner, Gottfried; Stift, Anton

2012-02-01

Exact data on the prevalence of hemorrhoids are rare. Therefore, we designed a study to investigate the prevalence of hemorrhoids and associated risk factors in an adult general population. Between 2008 and 2009, consecutive patients were included in a prospective study. They attended the Austrian national wide health care program for colorectal cancer screening at four medical institutions. A flexible colonoscopy and detailed examination were conducted in all patients. Hemorrhoids were defined according to a standardized grading system. Independent variables included baseline characteristics, sociodemographic data, and health status. Potential risk factors were calculated by univariate and multivariate analysis. Of 976 participants, 380 patients (38.93%) suffered from hemorrhoids. In 277 patients (72.89%), hemorrhoids were classified as grade I, in 70 patients (18.42%) as grade II, in 31 patients (8.16%) as grade III, and in 2 patients (0.53%) as grade IV. One hundred seventy patients (44.74%) complained about symptoms associated with hemorrhoids, whereas 210 patients (55.26%) reported no symptoms. In the univariate and multivariate analysis, body mass index (BMI) had a significant effect on the occurrence of hemorrhoids with p = 0.0391 and p = 0.0282, respectively. Even when correcting for other potential risk factors, an increase in the BMI of one increased the risk of hemorrhoids by 3.5%. Hemorrhoids occur frequently in the adult general population. Notably, a considerable number of people with hemorrhoids do not complain about symptoms. In addition, a high BMI can be regarded as an independent risk factor for hemorrhoids.

Pharmacological treatment of hemorrhoids: a narrative review.

PubMed

Altomare, Donato F; Giannini, Ivana

2013-12-01

Hemorrhoid disease is the cause of most proctologic complaints and hundreds of medical and surgical therapies have been proposed to relieve symptoms. However, the role and the correct indication of medical treatments are still controversial. Further, the utility of conservative measures are rarely scientifically supported by adequate trials. This narrative review is based on the search and analysis of full papers in English language selected from PubMed in the past 30 years using the following MeSH Editing: hemorrhoids, conservative treatment, medical treatment and hemorrhoids, pregnancy and hemorrhoids, thrombosed hemorrhoids, randomized trials and hemorrhoids, postoperative pain and hemorrhoids. Early stages (I/II degrees) of this disease could be effectively managed conservatively with several approaches as lifestyle changes, fiber supplement, topical ointments and phlebotonic drugs. The more advanced hemorrhoid stages (III/IV degrees) need some type of surgery, but medical therapy is still useful to minimize anal symptoms as a bridge-to-surgery treatment. Further, post-hemorrhoidectomy pain, hemorrhoidal crisis even in pregnancy could benefit from the adjunct of local and systemic medical treatment. This expert opinion, based also on long-lasting clinical practice, also supports the use of medical treatment in symptoms relief in patients with hemorrhoid disease.

Safety and efficacy of superior rectal artery embolization with particles and metallic coils for the treatment of hemorrhoids (Emborrhoid technique).

PubMed

Zakharchenko, A; Kaitoukov, Y; Vinnik, Y; Tradi, F; Sapoval, M; Sielezneff, I; Galkin, E; Vidal, V

2016-11-01

The purpose of this study was to comprehensively evaluate the short-term outcomes after percutaneous embolization of the superior rectal artery (SRA) with metallic coils and particles for the management of hemorrhoids. Forty patients (15 men, 25 women) with a mean age of 35±5 years (SD) (range: 25-65 years) were prospectively enrolled. All patients had symptomatic hemorrhoids. The distribution of internal hemorrhoids was as follows: grade I (n=6, 16%); grade II (n=28, 69%) and grade III (n=6; 15%). All patients had percutaneous embolization of the SRA with metallic coils and synthetic polyvinyl alcohol particles. Follow-up evaluation included clinical examination, rectoscopy, histopathological analysis of rectal mucosa, duplex Doppler blood flow quantification, electromyography, sphincterometry of the anal sphincter and analysis of patient satisfaction. No immediate complications were observed and no patients had anal pain syndrome after embolization. Hemorrhoids showed a 43% size reduction after embolization (P<0.05). Taking into account the symptom resolutions such as irritation, discomfort, bloody discharge and pain, satisfaction was observed in 5/6 (83%) patients with grade III hemorrhoids and 32/34 patients (94%) with grades I-II hemorrhoids. One month after embolization, anal sphincter contractility normalized and no changes in anal electromyography were observed. Blood flow in the hemorrhoidal plexus dropped from 109±1.2ml/min/100g (SD) before treatment to 60.2±4.4ml/min/100g (SD) (P<0.05) the day after embolization and remained unchanged one month after embolization. Our study demonstrates that embolization of SRA with particle and coils does not lead to ischemia in patients with symptomatic hemorrhoids. Short-term results with regard to symptom management for hemorrhoidal disease are very encouraging and should stimulate further prospective and multicenter studies. Copyright © 2016 Editions françaises de radiologie. Published by Elsevier Masson SAS

[Surgical treatment of hemorrhoids].

PubMed

Polovinkin, V V; Savchenko, Iu P; Khmelik, V I

2002-01-01

Since 1994 in addition to standard operations for chronic and acute hemorrhoids in Krasnodar military hospital the device for suturing in removal of internal hemorrhoids has been applied. From 1994 to 2000 examination and treatment of 240 patients with hemorrhoids were carried out. In the study group (128 patients) hemorrhoidectomy was performed by the developed method, in control (112 patients)--by standard techniques. In early postoperative period significantly smaller quantity of complications were seen in the study group (8.4%) compared with control group (29.8%). Decrease of hospital stay and out-patient treatment was also seen. Relapses of the disease were not revealed in terms from one to six years after surgery. The device may be employed in simultaneous operations when concomitant anorectal diseases are present. The above results justify one-stage operations in combination of chronic hemorrhoids with anorectal diseases. The proposed device makes this surgery easier.

Pycnogenol® in postpartum symptomatic hemorrhoids.

PubMed

Belcaro, G; Gizzi, G; Pellegrini, L; Dugall, M; Luzzi, R; Corsi, M; Ippolito, E; Ricci, A; Cesarone, M R; Ledda, A; Bottari, A; Errichi, B M

2014-02-01

The aim of this registry study was to evaluate the efficacy of Pycnogenol® (Horphag Research Ltd.), a standardized extract from the French maritime pine bark, to control signs/symptoms and prevent complications associated with hemorrhoids in the months after delivery in healthy women. Women with hemorrhoids after their second pregnancy were included within the third month after pregnancy. Pycnogenol dosage was 150 mg/day for 6 months. Symptoms for 4th and 3rd degree hemorrhoids were evaluated. The registry groups were comparable. For 4th degree hemorrhoids, main symptoms were reduced after 6 months in all patients, but the group using Pycnogenol in addition to standard best management showed more improvement. In patients with 3rd degree hemorrhoids, symptoms were reduced in both management groups at 6 months; with Pycnogenol the reduction in symptoms scores was significantly better. At 6 months 18/24 subjects (75%) in the Pycnogenol group were symptom-free in comparison with 14/25 (56%) in controls. In the 4th degree hemorrhoid group, 7/10 patients (70%) in the Pycnogenol group were symptom-free at 6 months in comparison with 4/11 subjects (36%) in the best management group. No significant side effects were observed. Pycnogenol appears to positively affect hemorrhoid signs and symptoms in the months after pregnancy.

21 CFR 884.5200 - Hemorrhoid prevention pressure wedge.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hemorrhoid prevention pressure wedge. 884.5200... Devices § 884.5200 Hemorrhoid prevention pressure wedge. (a) Identification. A hemorrhoid prevention... hemorrhoids associated with vaginal childbirth. (b) Classification. Class II (special controls). The special...

21 CFR 884.5200 - Hemorrhoid prevention pressure wedge.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hemorrhoid prevention pressure wedge. 884.5200... Devices § 884.5200 Hemorrhoid prevention pressure wedge. (a) Identification. A hemorrhoid prevention... hemorrhoids associated with vaginal childbirth. (b) Classification. Class II (special controls). The special...

21 CFR 884.5200 - Hemorrhoid prevention pressure wedge.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hemorrhoid prevention pressure wedge. 884.5200... Devices § 884.5200 Hemorrhoid prevention pressure wedge. (a) Identification. A hemorrhoid prevention... hemorrhoids associated with vaginal childbirth. (b) Classification. Class II (special controls). The special...

Clinical features of hemorrhoidal disease in renal transplant recipients.

PubMed

Tallarita, T; Gurrieri, C; Cappellani, A; Corona, D; Gagliano, M; Giuffrida, G; Caglià, P; Fiamingo, P; Giaquinta, A; Sinagra, N; Zerbo, D; Virzì, G; Veroux, P; Veroux, M

2010-05-01

Hemorrhoidal disease is a frequent cause of morbidity among the general population with a reported incidence of 4.4%, but little is known about its incidence and clinical features in kidney transplant recipients. Among 116 patients who had undergone kidney transplantation and were evaluated for hemorrhoidal disease, 82 had no hemorrhoids (70.6%), 28 (24%) had grade I hemorrhoids, and 6 (5.4%) had grade II hemorrhoids at the pretransplantation evaluation. Twenty-seven out of 116 recipients (22.4%) developed grade III or IV hemorrhoids after transplantation and underwent surgery. Hemorrhoidal disease was more frequent in patients with a pretransplantation history of hemorrhoids, with a rapid weight increase in the posttransplantation period, or who were aged between 30 and 50 years. Immunosuppressive therapy may play an important role in the worsening of hemorrhoidal disease among kidney transplant recipients. A prompt diagnosis and surgical treatment, whenever necessary, is mandatory for patients with clinical signs of worsening of hemorrhoids. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Operative management of internal hemorrhoids.

PubMed

Kline, Rochelle Paris

2015-02-01

An estimated 50% of the population over age 50 years have experienced hemorrhoidal symptoms at some point in their lives. Improved surgical techniques for internal hemorrhoids can reduce postoperative pain and facilitate a quicker recovery.

Hemorrhoids: from basic pathophysiology to clinical management.

PubMed

Lohsiriwat, Varut

2012-05-07

This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. The abnormal dilatation and distortion of the vascular channel, together with destructive changes in the supporting connective tissue within the anal cushion, is a paramount finding of hemorrhoids. It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development, and could be a potential target for medical treatment. In most instances, hemorrhoids are treated conservatively, using many methods such as lifestyle modification, fiber supplement, suppository-delivered anti-inflammatory drugs, and administration of venotonic drugs. Non-operative approaches include sclerotherapy and, preferably, rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is invariable. Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence. The applications and outcomes of each treatment are thoroughly discussed.

Rubber band ligation of hemorrhoids: A guide for complications

PubMed Central

Albuquerque, Andreia

2016-01-01

Rubber band ligation is one of the most important, cost-effective and commonly used treatments for internal hemorrhoids. Different technical approaches were developed mainly to improve efficacy and safety. The technique can be employed using an endoscope with forward-view or retroflexion or without an endoscope, using a suction elastic band ligator or a forceps ligator. Single or multiple ligations can be performed in a single session. Local anaesthetic after ligation can also be used to reduce the post-procedure pain. Mild bleeding, pain, vaso-vagal symptoms, slippage of bands, priapism, difficulty in urination, anal fissure, and chronic longitudinal ulcers are normally considered minor complications, more frequently encountered. Massive bleeding, thrombosed hemorrhoids, severe pain, urinary retention needing catheterization, pelvic sepsis and death are uncommon major complications. Mild pain after rubber band ligation is the most common complication with a high frequency in some studies. Secondary bleeding normally occurs 10 to 14 d after banding and patients taking anti-platelet and/or anti-coagulant medication have a higher risk, with some reports of massive life-threatening haemorrhage. Several infectious complications have also been reported including pelvic sepsis, Fournier’s gangrene, liver abscesses, tetanus and bacterial endocarditis. To date, seven deaths due to these infectious complications were described. Early recognition and immediate treatment of complications are fundamental for a favourable prognosis. PMID:27721924

Rubber band ligation of hemorrhoids: A guide for complications.

PubMed

Albuquerque, Andreia

2016-09-27

Rubber band ligation is one of the most important, cost-effective and commonly used treatments for internal hemorrhoids. Different technical approaches were developed mainly to improve efficacy and safety. The technique can be employed using an endoscope with forward-view or retroflexion or without an endoscope, using a suction elastic band ligator or a forceps ligator. Single or multiple ligations can be performed in a single session. Local anaesthetic after ligation can also be used to reduce the post-procedure pain. Mild bleeding, pain, vaso-vagal symptoms, slippage of bands, priapism, difficulty in urination, anal fissure, and chronic longitudinal ulcers are normally considered minor complications, more frequently encountered. Massive bleeding, thrombosed hemorrhoids, severe pain, urinary retention needing catheterization, pelvic sepsis and death are uncommon major complications. Mild pain after rubber band ligation is the most common complication with a high frequency in some studies. Secondary bleeding normally occurs 10 to 14 d after banding and patients taking anti-platelet and/or anti-coagulant medication have a higher risk, with some reports of massive life-threatening haemorrhage. Several infectious complications have also been reported including pelvic sepsis, Fournier's gangrene, liver abscesses, tetanus and bacterial endocarditis. To date, seven deaths due to these infectious complications were described. Early recognition and immediate treatment of complications are fundamental for a favourable prognosis.

Novel endoscopic delivery modality of infrared coagulation therapy for internal hemorrhoids.

PubMed

McLemore, Elisabeth C; Rai, Rudra; Siddiqui, Junaid; Basu, P Patrick; Tabbaa, Mousab; Epstein, Michael S

2012-11-01

A novel endoscopic delivery system for infrared coagulation therapy (IRC) has been designed recently. IRC is a well-established treatment for symptomatic internal hemorrhoids. Patients frequently undergo lower endoscopy before hemorrhoid treatment to eliminate other sources of bleeding. Current treatment options are difficult to perform without an anal retractor, adequate lighting, and specialized instruments. Endoscopic IRC is an attractive alternative to standard IRC, because it can be performed during the lower endoscopy. Endoscopic IRC utilizes infrared radiation generated by a control box, which is applied to the tissue through a flexible, fiber optic light guide (Precision Endoscopic Infrared Coagulator™). The light guide is placed through the colonoscope or flexible sigmoidoscope in the same chamber as other endoscopic instruments. A retrospective review was performed using a prospectively collected database. A standardized protocol was utilized in all patients. Patients graded their symptoms before and after therapy by using the visual analog symptom severity scoring system (range, 0-10). These results were analyzed by using the nonparametric Wilcoxon signed-rank test. Exact P values were computed by using the R function wilcox.exact. A total of 55 patients underwent endoscopic IRC for predominately grade II and grade III symptomatic internal hemorrhoids (71 %). There were 22 (40 %) female patients. Posttherapy results indicated a significant improvement in global symptoms (pretreatment average global score = 2.24 vs. posttreatment average global score = 0.28; P < 0.0001). There have been no adverse events reported to date. Endoscopic IRC provides improved visibility and efficiency, allowing simultaneous treatment of symptomatic internal hemorrhoids at the time of lower endoscopy. Patients experienced significant improvement in their symptoms after a single session of endoscopic IRC. There are a variety of additional endoscopic IRC therapeutic utilities

21 CFR 876.4400 - Hemorrhoidal ligator.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4400 Hemorrhoidal ligator. (a... of a ligature or band placed around the hemorrhoid. (b) Classification. Class II (performance...

Hemorrhoids: From basic pathophysiology to clinical management

PubMed Central

Lohsiriwat, Varut

2012-01-01

This review discusses the pathophysiology, epidemiology, risk factors, classification, clinical evaluation, and current non-operative and operative treatment of hemorrhoids. Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. The abnormal dilatation and distortion of the vascular channel, together with destructive changes in the supporting connective tissue within the anal cushion, is a paramount finding of hemorrhoids. It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development, and could be a potential target for medical treatment. In most instances, hemorrhoids are treated conservatively, using many methods such as lifestyle modification, fiber supplement, suppository-delivered anti-inflammatory drugs, and administration of venotonic drugs. Non-operative approaches include sclerotherapy and, preferably, rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is invariable. Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence. The applications and outcomes of each treatment are thoroughly discussed. PMID:22563187

Hemorrhoids and fistulas: new solutions to old problems.

PubMed

Rakinic, Jan; Poola, Venkateswara Prasad

2014-03-01

Symptoms thought related to hemorrhoids must be carefully considered before intervention. The first line of therapy for any hemorrhoidal complaint remains conservative management with increased fluid and fiber intake and appropriate modification of toileting behavior. Bleeding in grades 1 and 2 hemorrhoids that does not respond to this can be satisfactorily and safely managed with office-based therapies; some grade 3 hemorrhoids would also respond to this, though more treatment sessions would likely be required. Operative therapy is the best choice for management of persistently symptomatic grade 2 disease and for grades 3 and 4 symptomatic hemorrhoids as well. With proper patient selection and preparation, along with a familiarity with instrumentation and techniques, good results can be obtained with newer operative interventions for internal hemorrhoids. Outcomes must always be compared with those obtained with classic excisional hemorrhoidectomy.

Risk Factors for Hemorrhoids on Screening Colonoscopy.

PubMed

Peery, Anne F; Sandler, Robert S; Galanko, Joseph A; Bresalier, Robert S; Figueiredo, Jane C; Ahnen, Dennis J; Barry, Elizabeth L; Baron, John A

2015-01-01

Constipation, a low fiber diet, sedentary lifestyle and gravidity are commonly assumed to increase the risk of hemorrhoids. However, evidence regarding these factors is limited. We examined the association between commonly cited risk factors and the prevalence of hemorrhoids. We performed a cross sectional study of participants who underwent a colonoscopy in a colorectal adenoma prevention trial and who had a detailed assessment of bowel habits, diet and activity. The presence of hemorrhoids was extracted from the subjects' colonoscopy reports. We used logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for age and sex. The study included 2,813 participants. Of these, 1,074 had hemorrhoids recorded. Constipation was associated with an increased prevalence of hemorrhoids (OR 1.43, 95% CI 1.11, 1.86). Of the fiber subtypes, high grain fiber intake was associated with a reduced risk (OR for quartile 4 versus quartile 1 = 0.78, 95% CI 0.62, 0.98). We found no association when comparing gravid and nulligravida women (OR 0.93, 95% CI 0.62-1.40). Sedentary behavior was associated with a reduced risk (OR 0.80, 95% CI 0.65-0.98), but not physical activity (OR 0.83, 95% CI 0.66-1.03). Neither being overweight nor obese was associated with the presence of hemorrhoids (OR 0.89, 95% CI 0.72-1.09 and OR 0.86, 95% CI 0.70-1.06). Constipation is associated with an increased risk of hemorrhoids. Gravidity and physical activity do not appear to be associated. High grain fiber intake and sedentary behavior are associated with a decreased risk of hemorrhoids.

Matrix metalloproteinases in pathogenesis of hemorrhoidal disease.

PubMed

Kisli, Erol; Kemik, Ahu; Sümer, Aziz; Kemik, Özgür

2013-11-01

The aim of this study is to investigate the accuracy of serum matrix metalloproteinase (MMP) levels in an effort to find a reliable factor that may play an important role in pathogenesis of hemorrhoidal disease. Twenty control subjects and 21 Grade I, 19 Grade II, 20 Grade III, and 21 Grade IV patients with internal hemorrhoid were included in this prospective study. The mean ages of control subjects were 47.65 ± 6.71 standard deviation (SD) years (range, 37 to 60 years). The mean age of internal Grade I, Grade II, Grade III, and Grade IV patients with internal hemorrhoid were 48.85 ± 6.44, 47.20 ± 6.75, 44.90 ± 6.13, and 42.95 ± 3.49 SD years (ranges, 38 to 58, 38 to 60, 34 to 55, and 38 to 50 years), respectively. Ten milliliters of blood was taken from all subjects. Enzyme-linked immunosorbent assay (ELISA) for MMP-1, -2, -7, and -9 levels were performed using an ELISA kit (R&D Systems) following the manufacturer's instructions. There was an important difference between Grade I and Grade II groups in the serum levels of MMP-9 (P < 0.01). Patients with Grade III hemorrhoidal disease had significantly higher serum levels of all MMP than patients with Grade I and Grade II hemorrhoidal disease (P < 0.001). Also, patients with Grade 4 hemorrhoidal disease had higher serum levels of MMP-7 and -9 according to Grade I, II, and III groups (P < 0.01, 0.001). High serum levels of MMP are present in patients with hemorrhoids, suggesting the possible mechanism in the pathogenesis of hemorrhoids.

[Comparison of Doppler-assisted dearterialization with mucopexy and hemorrhoidectomy].

PubMed

Titov, A Iu; Abritsova, M V; Mudrov, A A

2016-01-01

To compare two methods of hemorrhoid treatment. This prospective study included 240 patients with hemorrhoids stage III-IVA. Stages III and IVA were diagnosed in 156 (65%) and 84 (35%) patients respectively. Randomization was performed using envelopes method in one to one distribution. In group 1 (n=120) Doppler-assisted dearterialization of internal hemorrhoids with mucopexy was performed (DDM), in group 2 (n=120) - hemorrhoidectomy using harmonic scalpel (HE). Duration of surgery was 17.9±6.1 and 34.5±10.1 minutes in DDM and HE groups respectively (p<0.01). Postoperative pain severity was higher in group 2 (4.8 compared with 2.5 scores of the first group (p<0.01). Narcotic analgesics were used less often in DDM group (1.3 doses compared with 6.1 doses in HE group (p<0.01). Disability period was 14.4±5.2 and 30.3±5.4 days in both groups respectively (p<0.01). Immediate postoperative complications occurred in 9 (7.5%) and 19 (15.8%) patients of DDM and HE groups respectively. Recurrent prolapse of internal hemorrhoids was diagnosed in 2 (1.7%) patients of the 1st group in terms of up to 45 days. DDM is reliable minimally invasive method of hemorrhoids stage III-IVA treatment and has similar efficacy with HE. DDM reduces postoperative pain severity, hospital stay and disability period.

[Latex ligation in treatment of chronic hemorrhoids].

PubMed

Ektov, V N; Somov, K A

2015-01-01

We analyzed the results of treatment of 432 patients with chronic hemorrhoids using different variants of latex ligation. New technique including ligation of mucosa and submucosa of low-ampullar rectum providing ligation of hemorrhoidalvessels, lifting and recto-anal repair is developed and suggested. This method is advisable to use in case of chronic internal hemorrhoids stages I and II. The authors recommend simultaneous combined ligation of mucosa of low-ampullar rectum and internal hemorrhoids for stages III and IV. Different variants of latex ligation with external hemorrhoids excision were used in 103 patients. Pointed variants of latex ligation preserve important advantages including mini-invasiveness, simplicity and wide availability, low cost. Good remote results were obtained after these procedures in 87.3% of observations. Suggested tactics extends use of latex ligation and increases its effectiveness in treatment of different stages and forms of chronic hemorrhoids.

Risk Factors for Hemorrhoids on Screening Colonoscopy

PubMed Central

Peery, Anne F.; Sandler, Robert S.; Galanko, Joseph A.; Bresalier, Robert S.; Figueiredo, Jane C.; Ahnen, Dennis J.; Barry, Elizabeth L.; Baron, John A.

2015-01-01

Background Constipation, a low fiber diet, sedentary lifestyle and gravidity are commonly assumed to increase the risk of hemorrhoids. However, evidence regarding these factors is limited. We examined the association between commonly cited risk factors and the prevalence of hemorrhoids. Methods We performed a cross sectional study of participants who underwent a colonoscopy in a colorectal adenoma prevention trial and who had a detailed assessment of bowel habits, diet and activity. The presence of hemorrhoids was extracted from the subjects’ colonoscopy reports. We used logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for age and sex. Results The study included 2,813 participants. Of these, 1,074 had hemorrhoids recorded. Constipation was associated with an increased prevalence of hemorrhoids (OR 1.43, 95% CI 1.11, 1.86). Of the fiber subtypes, high grain fiber intake was associated with a reduced risk (OR for quartile 4 versus quartile 1 = 0.78, 95% CI 0.62, 0.98). We found no association when comparing gravid and nulligravida women (OR 0.93, 95% CI 0.62–1.40). Sedentary behavior was associated with a reduced risk (OR 0.80, 95% CI 0.65–0.98), but not physical activity (OR 0.83, 95% CI 0.66–1.03). Neither being overweight nor obese was associated with the presence of hemorrhoids (OR 0.89, 95% CI 0.72–1.09 and OR 0.86, 95% CI 0.70–1.06). Conclusions Constipation is associated with an increased risk of hemorrhoids. Gravidity and physical activity do not appear to be associated. High grain fiber intake and sedentary behavior are associated with a decreased risk of hemorrhoids. PMID:26406337

Surgical Management of Hemorrhoids

PubMed Central

Agbo, S. P.

2011-01-01

Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids

PubMed Central

Su, Ming-Yao; Chiu, Cheng-Tang; Lin, Wei-Pin; Hsu, Chen-Ming; Chen, Pang-Chi

2011-01-01

AIM: To assess the long-term outcome of endoscopic hemorrhoid ligation (EHL) for the treatment of symptomatic internal hemorrhoids. METHODS: A total of 759 consecutive patients (415 males and 344 females) were enrolled. Clinical presentations were rectal bleeding (593 patients) and mucosal prolapse (166 patients). All patients received EHL at outpatient clinics. Hemorrhoid severity was classified by Goligher’s grading. The mean follow-up period was 55.4 mo (range, 45-92 mo). RESULTS: The number of band ligations averaged 2.35 in the first session for bleeding and 2.69 for prolapsed patients. Bleeding was controlled in 587 (98.0%) patients, while prolapse was reduced in 137 (82.5%) patients. After treatment, 93 patients experienced anal pain and 48 patients had mild bleeding. Patient subjective satisfaction was 93.6%. Repeat treatment or surgery was performed if symptoms were not relieved in the first session. In the bleeding group, the recurrence rate was 3.7% (22 patients) at 1 year, and 6.6% and 13.0% at 2 and 5 years. In the prolapsed group, the recurrence rate was 3.0%, 9.6% and 16.9% at 1, 2 and 5 years, respectively. CONCLUSION: EHL is an easy and well-tolerated procedure for the treatment of symptomatic internal hemorrhoids, with good long-term results. PMID:21633644

Feasibility and safety of endoscopic submucosal dissection for lower rectal tumors with hemorrhoids.

PubMed

Tanaka, Shinwa; Toyonaga, Takashi; Morita, Yoshinori; Hoshi, Namiko; Ishida, Tsukasa; Ohara, Yoshiko; Yoshizaki, Tetsuya; Kawara, Fumiaki; Umegaki, Eiji; Azuma, Takeshi

2016-07-21

To evaluate the feasibility and safety of endoscopic submucosal dissection (ESD) for lower rectal lesions with hemorrhoids. The outcome of ESD for 23 lesions with hemorrhoids (hemorrhoid group) was compared with that of 48 lesions without hemorrhoids extending to the dentate line (non-hemorrhoid group) during the same study period. Median operation times (ranges) in the hemorrhoid and non-hemorrhoid groups were 121 (51-390) and 130 (28-540) min. The en bloc resection rate and the curative resection rate in the hemorrhoid group were 96% and 83%, and they were 100% and 90% in the non-hemorrhoid group, respectively. In terms of adverse events, perforation and postoperative bleeding did not occur in both groups. In terms of the clinical course of hemorrhoids after ESD, the rate of complete recovery of hemorrhoids after ESD in lesions with resection of more than 90% was significantly higher than that in lesions with resection of less than 90%. ESD on lower rectal lesions with hemorrhoids could be performed safely, similarly to that on rectal lesions extending to the dentate line without hemorrhoids. In addition, all hemorrhoids after ESD improved to various degrees, depending on the resection range.

Segmentation of Dilated Hemorrhoidal Veins in Hemorrhoidal Disease.

PubMed

Díaz-Flores, Lucio; Gutiérrez, Ricardo; González-Gómez, Miriam; García, Pino; Sáez, Francisco J; Díaz-Flores, Lucio; Carrasco, José Luis; Madrid, Juan F

2018-06-18

Vein segmentation is a vascular remodeling process mainly studied in experimental conditions and linked to hemodynamic factors, with clinical implications. The aim of this work is to assess the morphologic characteristics, associated findings, and mechanisms that participate in vein segmentation in humans. To this end, we examined 156 surgically obtained cases of hemorrhoidal disease. Segmentation occurred in 65 and was most prominent in 15, which were selected for serial sections, immunohistochemistry, and immunofluorescence procedures. The dilated veins showed differently sized spaces, separated by thin septa. Findings associated with vein segmentation were: (a) vascular channels formed from the vein intima endothelial cells (ECs) and located in the vein wall and/or intraluminal fibrin, (b) vascular loops formed by interconnected vascular channels (venous-venous connections), which encircled vein wall components or fibrin and formed folds/pillars/papillae (FPPs; the encircling ECs formed the FPP cover and the encircled components formed the core), and (c) FPP splitting, remodeling, alignment, and fusion, originating septa. Thrombosis was observed in some nonsegmented veins, while the segmented veins only occasionally contained thrombi. Dense microvasculature was also present in the interstitium and around veins. In conclusion, the findings suggest that hemorrhoidal vein segmentation is an adaptive process in which a piecemeal angiogenic mechanism participates, predominantly by intussusception, giving rise to intravascular FPPs, followed by linear rearrangement, remodeling and fusion of FPPs, and septa formation. Identification of other markers, as well as the molecular bases, hemodynamic relevance, and possible therapeutic implications of vein segmentation in dilated hemorrhoidal veins require further studies. © 2018 S. Karger AG, Basel.

Myofibrotic malformation vessels: unique angiodysplasia toward the progression of hemorrhoidal disease

PubMed Central

Li, Sheng-Long; Jing, Fang-Yan; Ma, Li-Li; Guo, Li-Li; Na, Feng; An, Sheng-Li; Ye, Yan; Yang, Jun-Ming; Bao, Ming; Kang, Dong; Sun, Xiao-Lan; Deng, Yong-Jian

2015-01-01

Background The etiology and pathogenesis of hemorrhoids is unclear, although hemorrhoids are a worldwide disease in men and women, with peak prevalence at 45–65 years of age. Hemorrhoidal cushions as the anal venous plexi are normal anatomical structures from infancy. This study attempts to reveal the angiodysplasia and other pathological changes in association with different degrees of symptomatic hemorrhoids. Materials and methods A total of 281 patients with internal hemorrhoids from degree I to IV underwent hemorrhoidectomy. The vascular changes were analyzed by microscopic assessment and software analysis, with Masson’s trichrome, CD34, and smooth muscle actin. Results The hemorrhoidal tissues exhibited abnormal vessels in the mucosae and submucosae that we termed them as myofibrotic malformation vessels (MMVs). MMVs are not ascribed to arteries or veins because they exhibit enlarged and tortuous lumens with smooth muscle dysplasia and fibrotic deposition in the walls without overlying mucosal ulceration. The muscularis mucosae also showed smooth muscle dysplasia and fibrosis, even if it were interrupted by the intruding MMVs. The statistical data indicated that the severity of all the changes correlate positively with the progression of hemorrhoids (P<0.001). Hemorrhoidal patients are prone for reoccurrence even with prolapsing hemorrhoid when compared with the conventional hemorrhoidectomy. Multiple logistic regression analysis showed that MMVs in mucosal propria, mean thickness of mucosal muscularis layer, and fibrotic changes in MMV were independent risk factors for MMVs in hemorrhoidal disease. Conclusion MMVs and muscularis mucosae dysplasia reciprocally contribute to hemorrhoidal exacerbation. The novel findings of this study propose that the characteristic features of MMVs and muscularis mucosae dysplasia of the anorectal tube ultimately cause symptomatic hemorrhoids, which could affect the clinical management of hemorrhoidal disease through the

Myofibrotic malformation vessels: unique angiodysplasia toward the progression of hemorrhoidal disease.

PubMed

Li, Sheng-Long; Jing, Fang-Yan; Ma, Li-Li; Guo, Li-Li; Na, Feng; An, Sheng-Li; Ye, Yan; Yang, Jun-Ming; Bao, Ming; Kang, Dong; Sun, Xiao-Lan; Deng, Yong-Jian

2015-01-01

The etiology and pathogenesis of hemorrhoids is unclear, although hemorrhoids are a worldwide disease in men and women, with peak prevalence at 45-65 years of age. Hemorrhoidal cushions as the anal venous plexi are normal anatomical structures from infancy. This study attempts to reveal the angiodysplasia and other pathological changes in association with different degrees of symptomatic hemorrhoids. A total of 281 patients with internal hemorrhoids from degree I to IV underwent hemorrhoidectomy. The vascular changes were analyzed by microscopic assessment and software analysis, with Masson's trichrome, CD34, and smooth muscle actin. The hemorrhoidal tissues exhibited abnormal vessels in the mucosae and submucosae that we termed them as myofibrotic malformation vessels (MMVs). MMVs are not ascribed to arteries or veins because they exhibit enlarged and tortuous lumens with smooth muscle dysplasia and fibrotic deposition in the walls without overlying mucosal ulceration. The muscularis mucosae also showed smooth muscle dysplasia and fibrosis, even if it were interrupted by the intruding MMVs. The statistical data indicated that the severity of all the changes correlate positively with the progression of hemorrhoids (P<0.001). Hemorrhoidal patients are prone for reoccurrence even with prolapsing hemorrhoid when compared with the conventional hemorrhoidectomy. Multiple logistic regression analysis showed that MMVs in mucosal propria, mean thickness of mucosal muscularis layer, and fibrotic changes in MMV were independent risk factors for MMVs in hemorrhoidal disease. MMVs and muscularis mucosae dysplasia reciprocally contribute to hemorrhoidal exacerbation. The novel findings of this study propose that the characteristic features of MMVs and muscularis mucosae dysplasia of the anorectal tube ultimately cause symptomatic hemorrhoids, which could affect the clinical management of hemorrhoidal disease through the use of surgery to target the malformed vessels.

Feasibility and safety of endoscopic submucosal dissection for lower rectal tumors with hemorrhoids

PubMed Central

Tanaka, Shinwa; Toyonaga, Takashi; Morita, Yoshinori; Hoshi, Namiko; Ishida, Tsukasa; Ohara, Yoshiko; Yoshizaki, Tetsuya; Kawara, Fumiaki; Umegaki, Eiji; Azuma, Takeshi

2016-01-01

AIM: To evaluate the feasibility and safety of endoscopic submucosal dissection (ESD) for lower rectal lesions with hemorrhoids. METHODS: The outcome of ESD for 23 lesions with hemorrhoids (hemorrhoid group) was compared with that of 48 lesions without hemorrhoids extending to the dentate line (non-hemorrhoid group) during the same study period. RESULTS: Median operation times (ranges) in the hemorrhoid and non-hemorrhoid groups were 121 (51-390) and 130 (28-540) min. The en bloc resection rate and the curative resection rate in the hemorrhoid group were 96% and 83%, and they were 100% and 90% in the non-hemorrhoid group, respectively. In terms of adverse events, perforation and postoperative bleeding did not occur in both groups. In terms of the clinical course of hemorrhoids after ESD, the rate of complete recovery of hemorrhoids after ESD in lesions with resection of more than 90% was significantly higher than that in lesions with resection of less than 90%. CONCLUSION: ESD on lower rectal lesions with hemorrhoids could be performed safely, similarly to that on rectal lesions extending to the dentate line without hemorrhoids. In addition, all hemorrhoids after ESD improved to various degrees, depending on the resection range. PMID:27468216

Sonographic appearance of anal cushions of hemorrhoids

PubMed Central

Aimaiti, Adilijiang; A Ba Bai Ke Re, Ma Mu Ti Jiang; Ibrahim, Irshat; Chen, Hui; Tuerdi, Maimaitituerxun; Mayinuer

2017-01-01

AIM To evaluate the diagnostic value of different sonographic methods in hemorrhoids. METHODS Forty-two healthy volunteers and sixty-two patients with grades I-IV hemorrhoids received two different sonographic examinations from January 2013 to January 2016 at the First and Second Hospitals of Xinjiang Medical University in a prospective way. We analyzed the ultrasonographic findings of these participants and evaluated the outcomes. Resected grades III and IV hemorrhoid tissues were pathologically examined. The concordance of ultrasonographic results with pathology results was assessed with the Cohen’s kappa coefficient. RESULTS All healthy volunteers and all patients had no particular complications related to sonography. There were no statistically significant differences between the participants regarding age (P = 0.5919), gender (P = 0.4183), and persistent symptoms (P > 0.8692). All healthy control participants had no special findings. However, 30 patients with hemorrhoids showed blood signals around the dentate line on ultrasonography. When grades I and II hemorrhoids were analyzed, there were no significant differences between transrectal ultrasound (TRUS), transperianal ultrasound (TPUS), and transvaginal ultrasound (TVUS) (P > 0.05). Grades III and IV hemorrhoids revealed blood flow with different directions which could be observed as a “mosaic pattern”. In patients with grades III and IV hemorrhoids, the number of patients with “mosaic pattern” as revealed by TRUS, TPUS and TVUS was 22, 12, and 4, respectively. Patients with grades III and IV disease presented with a pathologically abnormal cushion which usually appeared as a “mosaic pattern” in TPUS and an arteriovenous fistula in pathology. Subepithelial vessels of resected grades III and IV hemorrhoid tissues were manifested by obvious structural impairment and retrograde and ruptured changes of internal elastic lamina. Some parts of the Trietz’s muscle showed hypertrophy and distortion

Sonographic appearance of anal cushions of hemorrhoids.

PubMed

Aimaiti, Adilijiang; A Ba Bai Ke Re, Ma Mu Ti Jiang; Ibrahim, Irshat; Chen, Hui; Tuerdi, Maimaitituerxun; Mayinuer

2017-05-28

To evaluate the diagnostic value of different sonographic methods in hemorrhoids. Forty-two healthy volunteers and sixty-two patients with grades I-IV hemorrhoids received two different sonographic examinations from January 2013 to January 2016 at the First and Second Hospitals of Xinjiang Medical University in a prospective way. We analyzed the ultrasonographic findings of these participants and evaluated the outcomes. Resected grades III and IV hemorrhoid tissues were pathologically examined. The concordance of ultrasonographic results with pathology results was assessed with the Cohen's kappa coefficient. All healthy volunteers and all patients had no particular complications related to sonography. There were no statistically significant differences between the participants regarding age ( P = 0.5919), gender ( P = 0.4183), and persistent symptoms ( P > 0.8692). All healthy control participants had no special findings. However, 30 patients with hemorrhoids showed blood signals around the dentate line on ultrasonography. When grades I and II hemorrhoids were analyzed, there were no significant differences between transrectal ultrasound (TRUS), transperianal ultrasound (TPUS), and transvaginal ultrasound (TVUS) ( P > 0.05). Grades III and IV hemorrhoids revealed blood flow with different directions which could be observed as a "mosaic pattern". In patients with grades III and IV hemorrhoids, the number of patients with "mosaic pattern" as revealed by TRUS, TPUS and TVUS was 22, 12, and 4, respectively. Patients with grades III and IV disease presented with a pathologically abnormal cushion which usually appeared as a "mosaic pattern" in TPUS and an arteriovenous fistula in pathology. Subepithelial vessels of resected grades III and IV hemorrhoid tissues were manifested by obvious structural impairment and retrograde and ruptured changes of internal elastic lamina. Some parts of the Trietz's muscle showed hypertrophy and distortion. Arteriovenous fistulas and

Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?

PubMed

Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong; Jung, Yoon Suk

2017-01-01

False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results. Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24-3.40; p<0.001). Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs.

Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?

PubMed Central

Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong

2017-01-01

Purpose False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. Materials and Methods A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results. Results Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24–3.40; p<0.001). Conclusion Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs. PMID:27873508

Curative effect of Amorphophallus paeoniifolius tuber on experimental hemorrhoids in rats.

PubMed

Dey, Yadu Nandan; Wanjari, Manish M; Kumar, Dharmendra; Lomash, Vinay; Jadhav, Ankush D

2016-11-04

Amorphophallus paeoniifolius (Dennst.) Nicolson (Family- Araceae) is a crop of south East Asian origin. In India, its tuber is widely used in ethnomedicinal practices by different tribes for the treatment of piles (hemorrhoids). The present study evaluated the effect of methanolic and aqueous extract of Amorphophallus paeoniifolius tuber on croton oil induced hemorrhoids in rats. The methanolic extract was standardized with the major phenolic compound, betulinic acid, by HPLC. The hemorrhoids were induced by applying 6% croton oil preparation in the ano-rectal region. Rats were orally administered methanolic and aqueous extract at doses of 250 and 500mg/kg, each for 7 days. Pilex (200mg/kg) was used as reference anti-hemorrhoidal drug. Hemorrhoids were assessed on eighth day by measuring hemorrhoidal and biochemical parameters along with histology of ano-rectal tissue. Croton oil application caused induction of hemorrhoids as indicated by significant (p<0.001) increase in plasma exudation of Evans blue in ano-rectal tissue, macroscopic severity score and ano-rectal coefficient as compared to normal rats. It significantly (p<0.001) elevated lactate dehydrogenase and cytokines (TNF-α and IL-6) levels in serum and increased myeloperoxidase activity and lipid peroxidation in ano-rectal tissue along with marked histological damage as compared to normal rats. Treatment with tuber extracts and pilex significantly (p<0.05-p<0.001) ameliorated Evans blue exudation, hemorrhoidal parameters and other biochemical parameters with attenuation of tissue damage compared to hemorrhoid control rats. The results indicate that tuber extracts exhibited curative action on hemorrhoids. The aqueous extract showed more pronounced effect than methanolic extract. The effects may be attributed to anti-inflammatory and antioxidant properties. Results indicate that tuber of Amorphophallus paeoniifolius exhibited curative action on hemorrhoids through anti-inflammatory and antioxidant

Doppler-guided transanal haemorrhoidal dearterialization for haemorrhoids: results from a multicentre trial.

PubMed

Ratto, C; Parello, A; Veronese, E; Cudazzo, E; D'Agostino, E; Pagano, C; Cavazzoni, E; Brugnano, L; Litta, F

2015-01-01

This multicentre study, based on the largest patient population ever published, aims to evaluate the efficacy of Doppler-guided transanal haemorrhoidal dearterialization (THD Doppler) in the treatment of symptomatic haemorrhoids and to identify the factors predicting failure for an effective mid-term outcome. Eight hundred and three patients affected by Grade II (137, 17.1%), III (548, 68.2%) and IV (118, 14.7%) symptomatic haemorrhoidal disease underwent THD Doppler, with a rectal mucopexy in patients with haemorrhoidal prolapse. The disease was assessed through a specifically designed symptom questionnaire and scoring system. A uni- and multivariate analyses of the potential predictive factors for failure were performed. The morbidity rate was 18.0%, represented mainly by pain or tenesmus (106 patients, 13.0%). Acute bleeding requiring surgical haemostasis occurred in seven patients (0.9%). No serious or life-threatening complications occurred. After a mean follow-up period of 11.1 ± 9.2 months, the overall success rate was 90.7% (728 patients), with a recurrence of haemorrhoidal prolapse, bleeding, and both symptoms in 51 (6.3%), 19 (2.4%) and 5 (0.6%) patients, respectively. Sixteen out of 47 patients undergoing re-operation had a conventional haemorrhoidectomy. All the symptoms were significantly improved in each domain of the score (P < 0.0001). At multivariate analysis the absence of morbidity and performance of a distal Doppler-guided dearterialization were associated with a better outcome. THD Doppler is a safe and effective therapy for haemorrhoidal disease. If this technique is to be employed, an accurate distal Doppler-guided dearterialization and a tailored mucopexy are mandatory to contain and reduce the symptoms. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

[Efficacy comparison of tissue selecting therapy stapler and procedure for prolapse and hemorrhoids in the treatment of severe hemorrhoids].

PubMed

Ruan, Ning; Chen, Zhi-hua; Lin, Xia-bing

2013-07-01

To compare the efficacy and complication of tissue selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) in the treatment of severe hemorrhoids. Clinical data of 542 cases of severe hemorrhoids undergoing TST (258 cases) or PPH (284 cases) in The First Affiliated Hospital of Fujian Medical University from November 2010 to January 2012 were analyzed retrospectively. Operative parameters, efficacy and complication 3 months after operation were assessed and compared. No significant difference in cure rate between TST and PPH (96.5% vs. 95.4%) was found, while the operation time and hospital stay after operation in TST group were significantly shorter urgency [(20.6±4.7) vs. (26.4±6.3) min, (2.9±0.5) vs. (3.5±0.7) d, both P<0.05]. Incidences of postoperative pain, bleeding, anal urgency and urinary retention in TST group were significantly lower than those in PPH group (all P<0.01). No anal stenosis was observed in TST group, and 5 cases developed anal stenosis in PPH group (P<0.05). Hemorrhoid recurrence did not differ significantly between the two groups. The efficacy of TST and PPH is comparable for severe hemorrhoids patients, while TST is associated with faster postoperative recovery and less complications.

Hemorrhoids.

PubMed

Hussain, J N

1999-03-01

Hemorrhoids are one of the most frequent anorectal disorders encountered in the primary care setting. They are the most common cause of hematochezia, and are responsible for considerable patient suffering and disability. With the techniques of diagnosis and office-based interventions described in this article, the primary care provider can effectively relieve most patients' symptoms and ensure that more significant bowel disease is not overlooked.

[Necessary and unnecessary treatment options for hemorrhoids].

PubMed

Zindel, Joel; Inglin, Roman; Brügger, Lukas

2014-12-01

Up to one third of the general population suffers from symptoms caused by hemorrhoids. Conservative treatment comes first unless the patient presents with an acute hemorrhoidal prolapse or a thrombosis. A fiber enriched diet is the primary treatment option, recommended in the perioperative period as well as a long-term prophylaxis. A timely limited application of topical ointments or suppositories and/or flavonoids are further treatment options. When symptoms persist interventional procedures for grade I-II hemorrhoids, and surgery for grade III-IV hemorrhoids should be considered. Rubber band ligation is the interventional treatment of choice. A comparable efficacy using sclerosing or infrared therapy has not yet been demonstrated. We therefore do not recommend these treatment options for the cure of hemorrhoids. Self-treatment by anal insertion of bougies is of lowrisk and may be successful, particularly in the setting of an elevated sphincter pressure. Anal dilation, sphincterotomy, cryosurgery, bipolar diathermy, galvanic electrotherapy, and heat therapy should be regarded as obsolete given the poor or missing data reported for these methods. For a long time, the classic excisional hemorrhoidectomy was considered to be the gold standard as far as surgical procedures are concerned. Primary closure (Ferguson) seems to be superior compared to the "open" version (Milligan Morgan) with respect to postoperative pain and wound healing. The more recently proposed stapled hemorrhoidopexy (Longo) is particularly advisable for circular hemorrhoids. Compared to excisional hemorrhoidectomy the Longo-operation is associated with reduced postoperative pain, shorter operation time and hospital stay as well as a faster recovery, with the disadvantage though of a higher recurrence rate. Data from Hemorrhoidal Artery Ligation (HAL)-, if appropriate in combination with a Recto-Anal Repair (HAL/RAR)-, demonstrates a similar trend towards a better tolerance of the procedure at the

Distal Hemorrhoidectomy With ALTA Injection: A New Method for Hemorrhoid Surgery

PubMed Central

Abe, Tatsuya; Hachiro, Yoshikazu; Ebisawa, Yoshiaki; Hishiyama, Houhei; Kunimoto, Masao

2014-01-01

Aluminum potassium sulfate and tannic acid injection (ALTA) is a useful and less-invasive treatment for internal hemorrhoids. However, it is not a treatment option for external hemorrhoidal diseases, including mixed hemorrhoids. Distal hemorrhoidectomy with ALTA injection involves surgical resection of external piles, followed by injection therapy on internal piles. We report technical details and the short-term results of this procedure in patients with mixed hemorrhoids. Seventy-two patients with mixed hemorrhoids treated between 2010 and 2011 were included. The main outcome measures were the short-term response and complication rates. At 28 days after surgery, the disappearance rate of prolapse was 100%. Three patients (4%) had postoperative complications, all minor in nature. No prolapse recurrence was observed within a median follow-up period of 6 months. Distal hemorrhoidectomy with ALTA injection appears to be a promising treatment option for patients with mixed hemorrhoids. PMID:24833156

[Study on the tectology change of rectum wall above the hemorrhoids].

PubMed

Zhang, Li; Yang, Bin; Zhang, Yu-Chao; Fu, Yu-Ru; Chen, Shuang

2009-06-15

To investigate the histomorphological characteristics and its significance of rectum wall above hemorrhoids. Tissues of rectum wall above hemorrhoids were obtained after stapled hemorrhoidopexy from 21 patients with grade III-IV internal hemorrhoids. Seven macroscopically normal rectal tissues collected from upper rectal cancer patients without a history of hemorrhoids served as control. Masson trichrome staining was performed for detecting smooth muscles and collagen in the tissues. The expression of type III collagen was detected by using immunohistochemical staining in the two groups. Morphological abnormalities, such as fragment, rupture, disorganization were found in smooth muscle of proximal rectal tissues above the piles, and it was statistically different from the distal rectal tissues above the piles and control tissues (all P < 0.05). Moreover, hyperplasia of type III collagen in both muscularis mucosa and rectum wall in tissues above hemorrhoids were observed, no such changes was found in the control tissues. The range of pathological changes in hemorrhoids is beyond the anal cushions. The pathological changes of the smooth muscle and the type III collagen in the tissues above the piles are the pathological basis of hemorrhoids.

ALTA injection sclerosing therapy:non-excisional treatment of internal hemorrhoids.

PubMed

Miyamoto, Hidenori; Asanoma, Michihito; Miyamoto, Hideyuki; Shimada, Mitsuo

2012-01-01

Aluminum potassium sulfate and tannic acid (ALTA) is a new sclerosing therapy for internal hemorrhoids. This injection therapy is a four-step direct injection sclerosing procedure intended to shrink and harden internal hemorrhoids to eliminate hemorrhoidal prolapse and bleeding. The aim of this study was to assess the short term efficacy of this treatment. The procedure was conducted using a four-step injection process under perianal local anesthesia. The entry point for the four-step injection of ALTA is the submucosa of the superior pole, the submucosa in the central part, the mucous lamina propria in the central part and the submucosa at the inferior pole of hemorrhoid. From January 2009 to March 2010, we performed the ALTA sclerosing therapy on 28 patients (14 men and 14 women; mean age, 64.6 years), including 5 second-degree, 16 third-degree and 7 fourth-degree hemorrhoids. There were 6 postoperative complications (2 cases of low grade fever, 2 anal pains, 1 necrosis at injection site and 1 perianal dermatitis). All symptoms of prolapse or bleeding disappeared after 29 postoperative days. There were 3 recurrent cases (10.7%). ALTA sclerosing therapy is a useful and less invasive treatment for internal hemorrhoids.

Infrared coagulation: a new treatment for hemorrhoids

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

Leicester, R.J.; Nicholls, R.J.; Mann, C.V.

Many methods, which have effectively reduced the number of patients requiring hospital admission, have been described for the outpatient treatment of hemorrhoids. However, complications have been reported, and the methods are often associated with unpleasant side effects. In 1977 Neiger et al. described a new method that used infrared coagulation, which produced minimal side effects. The authors have conducted a prospective, randomized trial to evaluate infrared coagulation compared with more traditional methods of treatment. The authors' results show that it may be more effective than injection sclerotherapy in treating non-prolapsing hemorrhoids and that it compares favorably with rubber band ligationmore » in most prolapsing hemorrhoids. No complications occurred, and significantly fewer patients experienced pain after infrared coagulation (P . less than 0.001).« less

Transanal anopexy with HemorPex System (HPS) is effective in treating grade II and III hemorrhoids: medium-term follow-up.

PubMed

Basile, M; Di Resta, V; Ranieri, E

2016-06-01

Hemorrhoidal disease is a common proctologic disorder. The HemorPex System(®) (HPS) (Angiologica, S. Martino Siccomario PV, Italy) is an innovative surgical technique based on muco-hemorrhoidopexy without Doppler guidance. The aim of this study was to evaluate the efficacy of HPS in on the treatment of grade II and III hemorrhoids. One hundred patients with grade II and III hemorrhoidal disease were included in the study and operated on using HPS without Doppler guidance. The procedure consists of a mucopexy carried out by means of a dedicated rotating anoscope in the 6 relatively constant positions of the terminal branches of the superior hemorrhoidal artery. A direct follow-up was carried out on 100 patients for up to 3 months. A late analysis (>12 months postoperatively) was conducted by telephone interview. At follow-up the following parameters were considered: pain, bleeding, prolapse, difficulties with hygiene and patient satisfaction with treatment. Operative time was 16 ± 5 min. Three-month follow-up showed significant improvement of symptoms: pain was present in 10 (10 %) patients versus 45 (45 %) preoperatively; bleeding in 13 (13 %) of patients versus 57 (57 %) preoperatively; prolapse in 13 (13 %) of patients versus 45 (45 %) preoperatively and difficulties with hygiene in 1 (1 %) versus 24 (24 %) preoperatively (all p < 0.05). At longer follow-up which was available in 67 patients, 5 patients (7.5 %) had recurrence and were reoperated on at 8, 10, 24, 26 and 36 months, respectively after the first procedure. As regards patient satisfaction, complete satisfaction was reported by 95/100 patients (95 %) at 3 months, 62/67 (92.5 %) at 12 months and 8/56 (85.7 %) at 24 months; partial satisfaction was reported by 3/100 patients (3 %) with intermittent bleeding at 3 months, 3/67 (4.4 %) patients at 12 months and 6/56 (10.7 %) patients at 24 months, all with either intermittent bleeding or prolapse. Dissatisfaction with the

[Therapy of hemorrhoidal disease].

PubMed

Herold, A

2006-08-01

Hemorrhoidal disease is one of the most frequent disorders in western countries. The aim of individual therapy is freedom from symptoms achieved by normalisation of anatomy and physiology. Treatment is orientated to the stage of disease: haemorrhoids 1 are treated conservatively. In addition to high-fibre diet, sclerotherapy is used. Haemorrhoids 2 prolapse during defecation and return spontaneously. First-line treatment is rubber band ligation. Haemorrhoids 3 that prolapse during defecation have to be digitally reduced, and the majority need surgery. For segmental disorders, haemorrhoidectomy according to Milligan-Morgan or Ferguson is recommended. In circular disease, Stapler hemorrhoidopexy is now the procedure of choice. Using a therapeutic regime according to the hemorrhoidal disease classification offers high healing rates and low rates of complications and recurrence.

[Rubber band ligation in treatment of hemorrhoids: our experience].

PubMed

Gaj, F; Biviano, I; Sportelli, G; Candeloro, L

2015-01-01

Hemorrhoids are a very common condition. The treatment depends upon persistence and severity of symptoms. For hemorrhoids of II and III grade the rubber band ligation may be therapeutic. Our aim is to report the outcomes of rubber band ligation of hemorrhoids, with a follow up of 6 months. A total of 50 patients underwent rubber band ligation for symptomatic hemorrhoids (grade II and III) without prolapse, between June 2012 and June 2014. All patients underwent plug test to rule out presence of rectal mucosal prolapse and were classified according to PATE classification (1). Each hemorrhoid was ligated with one rubber band through a ligator. All patients were evaluated immediately at the end of the procedure, after ten days and six months after the treatment. Patient's demographic and operative data were collected and analyzed. The mean patients age was 47.6±12.3 years (range 24-72). All procedures were performed without complications. Before rubber band ligation, 42 patients had rectal bleeding, 38 had perineal discomfort and 27 had itching. Ten days after the treatment, 12 patients presented self-limited rectal bleeding, but 10 of these had more hemorrhoids and underwent a second rubber band ligation. No patients complained perineal discomfort, and 8 patients had itching; 78% and 16% of patients respectively, experienced feeling of a foreign body inside the canal anal and anal pain. After 6 months, only 13 patients were occasionally symptomatic: 4 patients had rectal bleeding, 2 had perineal discomfort and 4 had itching. Three more patients presented both perineal discomfort and hitching. None had the feeling of a foreign body in anal canal or anal pain. Rubber band ligation is an efficacious, cost-effective and simple treatment for the second and third degree hemorrhoids without rectal mucosal prolapsed. In our hands, no severe complications developed and minor complications could be handled with ease.

Partial stapled hemorrhoidopexy: a minimally invasive technique for hemorrhoids.

PubMed

Lin, Hong-Cheng; He, Qiu-Lan; Ren, Dong-Lin; Peng, Hui; Xie, Shang-Kui; Su, Dan; Wang, Xiao-Xue

2012-09-01

This study was designed to assess the safety, efficacy, and postoperative outcomes of partial stapled hemorrhoidopexy (PSH). A prospective study was conducted between February and March 2010. PSH was performed with single-window anoscopes for single isolated hemorrhoids, bi-window anoscopes for two isolated hemorrhoids, and tri-window anoscopes for three isolated hemorrhoids or circumferential hemorrhoids. The data pertaining to demographics, preoperative characteristics and postoperative outcomes were collected and analyzed. Forty-four eligible patients underwent PSH. Single-window anoscopes were used in 2 patients, and bi- and tri-window anoscopes in 6 and 36 patients. The blood loss in patients with single-window, bi-window, and tri-window anoscopes was 6.0 ml (range 5.0-7.0 ml), 5.0 ml (range 5.0-6.5 ml), and 5.0 ml (4.5-14.5 ml) (P = 0.332). The mean postoperative visual analog scale score for pain was 3 (range, 1-4), 2 (range 1-4), 3 (range 2-6), 1 (range 0-3), 1 (range 0-2) and 2 (range 2-4) at 12 h, days 1, 2, 3, and 7, and at first defecation. The rate of urgency was 9.1%. No patients developed anal incontinence or stenosis. The 1-year recurrence rate of prolapsing hemorrhoids was 2.3%. Partial stapled hemorrhoidopexy appears to be a safe and effective technique for grade III-IV hemorrhoids. Encouragingly, PSH is associated with mild postoperative pain, few urgency episodes, and no stenosis or anal incontinence.

Hemorrhoids and varicose veins: a review of treatment options.

PubMed

MacKay, D

2001-04-01

Hemorrhoids and varicose veins are common conditions seen by general practitioners. Both conditions have several treatment modalities for the physician to choose from. Varicose veins are treated with mechanical compression stockings. There are several over-the-counter topical agents available for hemorrhoids. Conservative therapies for both conditions include diet, lifestyle changes, and hydrotherapy which require a high degree of patient compliance to be effective. When conservative hemorrhoid therapy is ineffective, many physicians may choose other non-surgical modalities: injection sclerotherapy, cryotherapy, manual dilation of the anus, infrared photocoagulation, bipolar diathermy, direct current electrocoagulation, or rubber band ligation. Injection sclerotherapy is the non-surgical treatment for primary varicose veins. Non-surgical modalities require physicians to be specially trained, own specialized equipment, and assume associated risks. If a non-surgical approach fails, the patient is often referred to a surgeon. The costly and uncomfortable nature of treatment options often lead a patient to postpone evaluation until aggressive intervention is necessary. Oral dietary supplementation is an attractive addition to the traditional treatment of hemorrhoids and varicose veins. The loss of vascular integrity is associated with the pathogenesis of both hemorrhoids and varicose veins. Several botanical extracts have been shown to improve microcirculation, capillary flow, and vascular tone, and to strengthen the connective tissue of the perivascular amorphous substrate. Oral supplementation with Aesculus hippocastanum, Ruscus aculeatus, Centella asiatica, Hamamelis virginiana, and bioflavonoids may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids.

Aluminum Potassium Sulfate and Tannic Acid Injection for Hemorrhoids

PubMed Central

2012-01-01

A quick hemostatic effect, as well as sclerosing and shrinkage of hemorrhoids, can be attained when internal hemorrhoids are treated by using injection therapy with aluminum potassium sulfate and tannic acid (ALTA), the outcomes of treatment may be similar to those of a hemorrhoidectomy. However, if the type of hemorrhoid or the method of injection is not appropriate for ALTA treatment, complications peculiar to ALTA or recurrence may develop. Accordingly, sufficient understanding of the treatment mechanism of ALTA injection and repeated training for injection are required for effective use of the ALTA treatment. PMID:22606645

Effectiveness of hemorrhoidal treatment by rubber band ligation and infrared photocoagulation.

PubMed

Linares Santiago, E; Gómez Parra, M; Mendoza Olivares, F J; Pellicer Bautista, F J; Herrerías Gutiérrez, J M

2001-04-01

To demonstrate the effectiveness of the treatment of internal hemorrhoids with rubber band ligation (RBL) and infrared photocoagulation (IRC). From march 1996 to december 1999, we prospectively studied 358 patients with a total of 817 hemorrhoid groups and a follow-up period of 36 months. Distribution according to gender and age was: 210 men with a mean age of 46 years and 148 women with a mean age 45.8 years. The mean number of hemorrhoids treated per patients was 2.3. All of them had complete a follow-up protocol at 15, 30, 60 and 180 days and at 12, 24 and 36 months. Rubber band ligation was performed with McGown ligator and suction pump, placing the band at the base of the hemorrhoid. For the infrared coagulation we used a Lumatec coagulation system, applying at least four shoots around each hemorrhoid, with an exposition time ranging between 1 and 1.5 seconds. Treatment was considered effective when patients became asymptomatic (relief of pain, bleeding or anal itching) and the obliteration of hemorrhoids after the treatment was confirmed by anal inspection and anoscopy. Two hundred ninety five of 358 patients were treated with RBL (82.4%), this treatment being effective in 98% of the patients after 180 days and very good after 36 months. There were 6/295 relapses at 36 months (2%). All minor and major complications were observed within the first 15 days of treatment: rectal tenesmus in 96/295 patients (32.5%), mild anal pain in 115/295 (38.9%), self-limited and mild bleeding after the detachment of the bands in 30/295 (10%), and febricula in one patient. Sixty three of 358 patients were treated with IRC (17.6%). In this group, relapses were observed in 6/63 patients (9.5%) at 36 months, all of them with grade III hemorrhoids that required additional treatment with RBL. All the complications (inherent to the technique) were observed within the first days: mild anal pain in 40/63 patients (63.4%) and mild bleeding in 1/63 (1.6%). The treatment with RBL or IRC

Findings of 2-fluoro-2-deoxy-d-glucose positron emission tomography in hemorrhoids.

PubMed

Tsai, Shih-Chuan; Jeng, Long-Bin; Yeh, Jun-Jun; Lin, Cheng-Chieh; Chen, Jin-Hua; Lin, Wan-Yu; Kao, Chia-Hung

2011-10-01

Hemorrhoids are very common in adults. The data regarding the incidence of high 2-fluoro-2-deoxy-D: -glucose (FDG) uptake in hemorrhoids is incomplete. In this study, we evaluated FDG uptake in hemorrhoids and calculated the rate of high FDG uptake in these lesions. One hundred and seventy six subjects who undertook whole body FDG-PET for health screening examination were investigated retrospectively. All patients had colonoscopy and 156 subjects were found to have hemorrhoids and 20 had no hemorrhoids. Quantitative analysis of FDG uptake in the anal region was performed by calculating the maximum standard uptake value (SUV(max)). The SUV(max) ranged from 1.8 to 4.1 (2.8 ± 0.6) for normal subjects and ranged from 1.4 to 8.3 (2.9 ± 0.8) for patients with hemorrhoids. No statistical difference was noted between these two groups using a Student's t-tests. If the highest SUV(max), which was 4.1 in normal subjects, was used as a cutoff, 5.1% (8/156) hemorrhoid patients had a SUV(max) greater than 4.1. Hemorrhoids can be one possible cause of focal high FDG uptake in the rectum.

YAG laser in the treatment of hemorrhoids: a report of 700 cases

NASA Astrophysics Data System (ADS)

Liu, Jian-xun; Zhang, Xinrong

1993-03-01

The results of treating hemorrhoids in 700 cases with a YAG laser knife is reported. Since 1988, the author introduced the YAG laser into the treatment of various kinds of hemorrhoids. The satisfactory results were achieved with 100% cure rate. Some related problems also are discussed in this paper. Hemorrhoid is a kind of common disease. It usually appears in the superior or inferior rectal venous plexus covered with mucosa. The hemorrhoids are divided into internal, external, and mixed types according to their location and origination. The internal hemorrhoid is superior to the dentate line and caused by varicosity of superior rectal venous plexus covered with mucosa, the most common presentation is a bleeding and prolapse mass out of the anus. The external hemorrhoid arises from varicosity of inferior rectal venous plexus, the most important clinical finding is a painful mass covered with skin of the anal canal. The characteristics of mixed type are the combination of the two types as mentioned above.

Nonsurgical treatment of actively bleeding internal hemorrhoids with a novel endoscopic device (with video).

PubMed

Kantsevoy, Sergey V; Bitner, Marianne

2013-10-01

Internal hemorrhoids often present with bleeding, prolapse, and other symptoms. Currently used nonsurgical treatment modalities have limited effectiveness and usually require several treatment sessions. To evaluate effectiveness and safety of a novel endoscopic device for nonsurgical treatment of internal hemorrhoids. Retrospective study. Single center. This study involved 23 patients with actively bleeding internal hemorrhoids. The HET Bipolar System is a modified anoscope, with a treatment window, light source, and tissue temperature monitor. The device is inserted into the rectum under direct observation. The tissue carrying superior hemorrhoidal branches and the apex of the internal hemorrhoid is positioned inside the treatment window, clamped with incorporated tissue forceps, and treated with bipolar energy to ligate hemorrhoidal feeding vessels. Rate of hemorrhoidal bleeding after the treatment. The mean age of the patients was 64.3 ± 9.9 years (range 44-79 years). Eleven patients (47.8%) had grade I hemorrhoids and 12 patients (52.2%) had grade II hemorrhoids. In 18 patients (78.3%), treatment with the HET System was performed with the patient under conscious sedation. Five patients (21.7%) were treated without sedation. All patients tolerated treatment without complaints. The average follow-up period was 11.2 ± 4.7 months. No bleeding or prolapse occurred after the procedure in any of the treated patients. Retrospective study. The newly developed HET System is easy to use, safe, and highly effective in eliminating bleeding in grade I and II internal hemorrhoids and prolapse in grade II internal hemorrhoids. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Single session treatment for bleeding hemorrhoids

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

Weinstein, S.J.; Rypins, E.B.; Houck, J.

1987-12-01

Fifty consecutive outpatients with bleeding internal hemorrhoids were prospectively treated with a single application of rubber band ligation or infrared coagulation. Complete follow-up observation was obtained in 48 patients (23 underwent rubber band ligation and 25 underwent infrared coagulation). At one month after treatment, 22 patients who underwent rubber band ligation and 16 who underwent infrared coagulation, were symptomatically improved (p less than 0.05). At six months, 15 patients who had undergone rubber band ligation and ten who had infrared coagulation treatment, remained improved (p less than 0.05). There was no statistical difference in the discomfort experienced by either groupmore » during or after the procedure as determined by a self-assessment scale. Two patients who underwent rubber band ligation experienced complications--a thrombosed external hemorrhoid developed in one patient and another had delayed rectal bleeding. Although associated with occasional complications after treatment, rubber band ligation is more effective than in infrared coagulation for single session treatment of bleeding internal hemorrhoids.« less

Surgical treatment of hemorrhoids: a critical appraisal of the current options.

PubMed

Cerato, Marlise Mello; Cerato, Nilo Luiz; Passos, Patrícia; Treigue, Alberto; Damin, Daniel C

2014-01-01

Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results.

PubMed

van Turenhout, Sietze T; Oort, Frank A; Terhaar sive Droste, Jochim S; Coupé, Veerle M H; van der Hulst, Rene W; Loffeld, Ruud J; Scholten, Pieter; Depla, Annekatrien C T M; Bouman, Anneke A; Meijer, Gerrit A; Mulder, Chris J J; van Rossum, Leo G M

2012-07-01

Colorectal cancer screening by fecal immunochemical tests (FITs) is hampered by frequent false-positive (FP) results and thereby the risk of complications and strain on colonoscopy capacity. Hemorrhoids might be a plausible cause of FP results. To determine the contribution of hemorrhoids to the frequency of FP FIT results. Retrospective analysis from prospective cohort study. Five large teaching hospitals, including 1 academic hospital. All subjects scheduled for elective colonoscopy. FIT before bowel preparation. Frequency of FP FIT results in subjects with hemorrhoids as the only relevant abnormality compared with FP FIT results in subjects with no relevant abnormalities. Logistic regression analysis to determine colonic abnormalities influencing FP results. In 2855 patients, 434 had positive FIT results: 213 had advanced neoplasia and 221 had FP results. In 9 individuals (4.1%; 95% CI, 1.4-6.8) with an FP FIT result, hemorrhoids were the only abnormality. In univariate unadjusted analysis, subjects with hemorrhoids as the only abnormality did not have more positive results (9/134; 6.7%) compared with subjects without any abnormalities (43/886; 4.9%; P = .396). Logistic regression identified hemorrhoids, nonadvanced polyps, and a group of miscellaneous abnormalities, all significantly influencing false positivity. Of 1000 subjects with hemorrhoids, 67 would have FP results, of whom 18 would have FP results because of hemorrhoids only. Potential underreporting of hemorrhoids; high-risk individuals. Hemorrhoids in individuals participating in colorectal cancer screening will probably not lead to a substantial number of false-positive test results. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Factors Associated with Hemorrhoids in Korean Adults: Korean National Health and Nutrition Examination Survey

PubMed Central

Lee, Jong-Hyun; Kim, Hyo-Eun; Kang, Ji-Hun

2014-01-01

Background Although hemorrhoids are one of the most common anal diseases among Koreans, risk factors for hemorrhoids have not been well identified. Methods We analyzed the data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2009. Study subjects were 17,228 participants of KNHANES who were aged 19 years or older. Logistic regression analysis was conducted to evaluate associations between hemorrhoids and probable risk factors. Results Overall prevalence of hemorrhoids among study subjects was 14.4%, being more prevalent among women (15.7%) than among men (13.0%). Obesity and abdominal obesity were associated with a higher risk of hemorrhoids with odds ratio (OR) (95% confidence intervals, 95% CI) of 1.13 (1.01 to 1.26) and 1.16 (1.04 to 1.30), respectively. Both self-reported depression (OR, 1.83; 95% CI, 1.62 to 2.08) and physician diagnosed depression (OR, 1.71; 95% CI, 1.35 to 2.17) were associated with significantly higher risk of hemorrhoids. No regular walking (OR, 1.11; 95% CI, 1.00 to 1.23) and experience of pregnancy (OR, 1.62; 95% CI, 1.17 to 2.25) for women were also associated with higher risk of hemorrhoids. However, educational level, alcohol consumption, physical activities, diabetes mellitus, hypertension, fiber, fat intake, and energy intake were not associated with a risk of hemorrhoids. Low quality of life assessed with EuroQol-5 Dimension and EuroQol-Visual Analogue Scale was significantly associated with hemorrhoids. Conclusion This nationwide cross-sectional study of Korean adults suggests that obesity, abdominal obesity, depression, and past pregnancy may be risk factors for hemorrhoids and hemorrhoids affect quality of life negatively. PMID:25309703

SURGICAL TREATMENT OF HEMORRHOIDS: A CRITICAL APPRAISAL OF THE CURRENT OPTIONS

PubMed Central

CERATO, Marlise Mello; CERATO, Nilo Luiz; PASSOS, Patrícia; TREIGUE, Alberto; DAMIN, Daniel C.

2014-01-01

Introduction Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results. PMID:24676303

Hemorrhoids and matrix metalloproteinases: A multicenter study on the predictive role of biomarkers.

PubMed

Serra, Raffaele; Gallelli, Luca; Grande, Raffaele; Amato, Bruno; De Caridi, Giovanni; Sammarco, Giuseppe; Ferrari, Francesco; Butrico, Lucia; Gallo, Gaetano; Rizzuto, Antonia; de Franciscis, Stefano; Sacco, Rosario

2016-02-01

An association between hemorrhoidal disease and matrix metalloproteinases (MMPs) has been described previously. MMPs regulate extracellular structural proteins and tissue remodeling. Neutrophil gelatinase-associated lipocalin (NGAL) is involved in the regulation of MMP activity. The aim of this work was to study the relationship between tissue immunoreactive levels of MMPs and NGAL and different stages of hemorrhoids. In a multicenter, open-label, prospective study, the population under investigation consisted of 2 groups: group I (with symptomatic hemorrhoids; Goligher grade I-IV) and group II (healthy volunteers). We enrolled 97 patients with hemorrhoids: 21 with grade I hemorrhoids, 37 with grade II, 14 with grade III, and 25 with grade IV. Finally, 90 healthy volunteers (53 males and 37 females; age range, 19-70 years; median, 56) were enrolled in group II. Enzyme-linked immunosorbent assay and Western blot analysis revealed greater levels of immunoreactive MMPs and NGAL in all patients with hemorrhoids. We recorded significantly greater levels of MMP-1 and MMP-3 in grade I and II patients compared with control, and greater levels of MMP-3, MMP-7, MMP-8, and MMP-9 in grade III compared with grade II. MMP-9 and NGAL were particularly increased in patients with grade IV especially in case of thrombosed hemorrhoids. These results provide potentially important insights into the understanding of the natural history of hemorrhoids. MMPs and NGAL play a role in development of disease and may represent molecular markers for the complications such as hemorrhoidal thrombosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Banding hemorrhoids using the O'Regan Disposable Bander. Single center experience.

PubMed

Paikos, Dimitrios; Gatopoulou, Anthie; Moschos, John; Koulaouzidis, Anastasios; Bhat, Shivram; Tzilves, Dimitrios; Soufleris, Konstantinos; Tragiannidis, Dimitrios; Katsos, Ioannis; Tarpagos, Anestis

2007-06-01

Hemorrhoids are the most common anorectal disorder in the Western World and are a major cause of active, relapsing or chronic rectal bleeding. Many treatment options have been proposed and tried for early-stage hemorrhoids. There is general agreement that rubber banding ligation (RBL) is safe and effective. To evaluate the effectiveness and complications associated with RBL performed in outpatients for symptomatic hemorrhoids using the O'Regan Disposable Bander device. Sixty consecutive patients underwent hemorrhoid banding with the O'Regan Disposable Bander. The mean time required for one session was 6.2 min; the longest was 10 min. No major complications were noted. Minor early and late bleeding was reported in 10% and 6.7% respectively, but none was severe. Pain occurred in 6.7% but was not severe. In all cases, clinical and endoscopic (range and form scores) improvement was observed and patients of all ages, including the elderly, were found to be tolerant to the procedure. RBL performed in outpatients for symptomatic hemorrhoids using the O'Regan Disposable Bander device is associated with a good response and low complication rate. We recommend the technique as a safe and reliable treatment option.

LigaSure Hemorrhoidectomy for Symptomatic Hemorrhoids: First Pediatric Experience.

PubMed

Grossmann, Ole; Soccorso, Giampiero; Murthi, Govind

2015-08-01

Hemorrhoids are uncommon in children. Third and fourth degree symptomatic hemorrhoids may be surgically excised. We describe the first experience of using LigaSure (Covidien, Mansfield, Massachusetts, United States) to perform hemorrhoidectomies in children. LigaSure hemorrhoidectomy has been well described in adults and is found to be superior in patient tolerance as compared with conventional hemorrhoidectomy. Georg Thieme Verlag KG Stuttgart · New York.

Efficacy and safety of a polyherbal formulation in hemorrhoids

PubMed Central

Tripathi, Raakhi K.; Bolegave, Somesh S.; Shetty, Parvan A.; Uchil, Dinesh A.; Rege, Nirmala N.; Chawda, Mukesh B.; Rege, Sameer A.

2015-01-01

Background: The medical management of hemorrhoids should include an integrated approach. This integrated approach can be achieved by polyherbal formulations containing anti-inflammatory, styptics, analgesics, and laxative effect which reduce inflammation, pain, and bleeding, and increase gastro-intestinal motility and soften stools. One such polyherbal kit is “Arshkeyt™, a 7 day kit,” which consists of oral tablets and powder along with topical cream. Objective: Efficacy and safety of Arshkeyt™, a 7 day kit, a marketed polyherbal formulation was evaluated in comparison with conventional therapy practiced in surgery outpatient departments. Materials and Methods: Patients (n = 90) with hemorrhoids were randomly allocated to receive either Arshkeyt™ or standard therapy (combination of oral Isabgul powder and 2% lidocaine gel) for 14 days. Assessment on the basis of rectal symptoms and proctoscopic examination was done on day 0, 7, and 14 to derive a “composite score” which ranged from 0 to 25 by a blinded evaluator. The primary endpoint was number of patients achieving composite score 0 at the end of therapy (day 14). Inter-group analysis was done using Chi-square test. Results: On day 14, the composite score of 0 was achieved in 15 patients of Arshkeyt™ group versus 6 patients receiving standard therapy. The symptoms and signs which showed significant improvement in Arshkeyt™ group compared to standard treatment group were the tenesmus (visual analog score) score (P = 0.047), anal sphincter spasm (P = 0.0495) and a decrease in the grade of hemorrhoids (P = 0.0205) on day 14. Arshkeyt™ was also more beneficial in case of bleeding hemorrhoids as compared to nonbleeding hemorrhoids (P < 0.05). The incidence of adverse drug reactions in both groups was comparable and no patient required any treatment for the same. Conclusion: “Arshkeyt™, a 7 day kit,” was effective in the treatment of hemorrhoids and had a good safety profile. PMID:26834421

Diagnosis and treatment of haemorrhoids.

PubMed

Buntzen, Steen; Christensen, Peter; Khalid, Ali; Ljungmann, Ken; Lindholt, Jan; Lundby, Lilli; Walker, Line Rossell; Raahave, Dennis; Qvist, Niels

2013-12-01

These guidelines provide a review of diagnosis, conservative and surgical treatment of haemorrhoids with primary focus on the surgical treatment. In symptomatic hemorrhoids it is recommended, that conservative treatment is used as basic treatment regardless of grading. The vast majority of grade II haemorrhoids are treated conservatively, but surgery may be considered in a few cases with pronounced symptoms. In these cases chirurgia minor, Doppler guided dearterilization procedures or stapled haemorrhoidopexy are recommended. In grade III and IV Doppler guided dearterilization procedures, stapled haemorrhoidopexy (Grade III) or conventional Milligan Morgan haemorrhoidectomy are recommended.

[First experience in surgical treatment of hemorrhoidal disease using the PPH stapler].

PubMed

Morales-Olivera, José Martín; Velasco, Liliana; Bada-Yllán, Orlando; Vergara-Fernández, Omar; Takahashi-Monroy, Takeshi

2007-01-01

Haemorrhoidal disease is a frequent entity worldwide. The surgical management is indicated in third or fourth degree internal hemorrhoidal disease. The conventional hemorrhoidectomy has showed good results but the severe postoperative pain is an important complain. Currently diverse surgical alternatives have been described, mainly to avoid the postoperative pain that follows surgical hemorrhoidectomy. One of these new options is the stapled hemorrhoidectomy using the PPH stapler. This procedure may produce less postoperative pain, with a shorter inpatient stay and faster return to work. The aim of this paper is to analyze the results of using the Procedure for Prolapsed Hemorrhoids (PPH) as treatment in Hemorrhoidal Disease. This is an observational and descriptive study, where 17 patients underwent stapled hemorrhoidectomy with PPH procedure, between March 2000 and August 2003. 52.8% of this patients presented grade three internal hemorrhoids and 47.2% grade four; 52.9% presented mild postoperative pain; 41.2% moderate and 5.9% severe pain. In a short and median follow up, due to the persistence of hemorrhoidal disease symptoms two patients required surgical re-intervention. Two more patients presented incontinency. One patient presented stenosis in the line of staples treated satisfactory with an anal dilatation session. The use of PPH is a feasible and safe procedure and it could be a surgical alternative in the treatment of hemorrhoidal disease, even before than conventional hemorrhoidectomy.

The Evaluation and Office Management of Hemorrhoids for the Gastroenterologist.

PubMed

Guttenplan, Mitchel

2017-07-01

Hemorrhoid disease is extremely common, and seldom requires surgical intervention. The vast majority of patients can be cared for in the office setting and by the gastroenterologist. This piece aims to summarize the epidemiology and pathophysiology of hemorrhoid disease, along with the proper evaluation and office-based treatment of these patients. Most GI fellowship training programs spend little time on these topics, and the recommendation has been made to include anorectal care in the GI's "core curriculum." The use of the anoscope and a proper anorectal examination are keys to evaluating these patients, and the techniques available to treat these patients are described. Often overlooked in these patients are other anorectal issues that occur alongside hemorrhoidal issues very commonly-the most common being anal fissure. Comprehensive management of all of these issues will allow all but the most severely affected patients to avoid the expense and morbidity of surgical intervention. The anatomy, etiology, pathophysiology, diagnosis, and non-surgical treatment of hemorrhoid disease are presented with the gastroenterologist in mind.

Bilateral Deep Peroneal Nerve Paralysis Following Kerosene Self-Injection into External Hemorrhoids

PubMed Central

Rostami, Khalil; Farzaneh, Esmaeil; Abolhassani, Hassan

2010-01-01

Along with conventional therapies, some abrogated traditional treatment had been used for hemorrhoids like local Kerosene injection especially for extremely irritated external hemorrhoids. We report a rare case of Kerosene self-injection into the hemorrhoid. Despite antibiotics therapy, extent debridement, and colostomy, the patient died after 24 hours because of heart attack. Moreover, we discuss here the case with contact or injection of hydrocarbon materials and early care action to decrease the extensions of injury and side effects. PMID:20936130

Hemorrhoids and anal fissures in inflammatory bowel disease.

PubMed

D'Ugo, S; Stasi, E; Gaspari, A L; Sileri, P

2015-12-01

Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Hemorrhoids and anal fissures in patients with IBD have been overlooked, although they can represent a challenging problem. The management of hemorrhoids and fissures in IBD patients may be difficult and may significantly differ compared to the non-affected population. Historically surgery was firmly obstructed, and hemorrhoidectomy or sphincterotomy in patients with associated diagnosis of IBD was considered harmful, although literature data is scant and based on small series. Various authors reported an incidence of postoperative complications higher in IBD than in the general populations, with potential severe events. Considering that a spontaneous healing is possible, the first line management should be a medical therapy. In patients non-responding to conservative measures it is possible a judicious choice of surgical options on a highly selective basis; this can lead to acceptable results, but the risk of possible complications needs to be considered. In this review it is analyzed the current literature on the incidence, symptoms and treatment options of hemorrhoids and anal fissures in patients with Crohn's disease and ulcerative colitis.

High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy.

PubMed

van Iersel, J J; Formijne Jonkers, H A; Verheijen, P M; Draaisma, W A; Consten, E C J; Broeders, I A M J

2016-04-01

To describe patients developing grade III and IV hemorrhoids requiring surgery after laparoscopic ventral mesh rectopexy (LVMR) and to explore the relationship between developing such hemorrhoids and recurrence of rectal prolapse after LVMR. All consecutive patients receiving LVMR at the Meander Medical Centre, Amersfoort, the Netherlands, between 2004 and 2013 were analyzed. Kaplan-Meier estimates were calculated for recurrences. A total of 420 patients underwent LVMR. Sixty-five of these patients (actuarial 5-year incidence 24.3, 95 % confidence interval (CI) 18.6-30.0) developed symptomatic grade III/IV hemorrhoids requiring stapled or excisional hemorrhoidectomy. Re-do surgery for recurrent grade III/IV hemorrhoids was required for 15 of the 65 patients (actuarial 5-year recurrence rate 40.6, 95 % CI 23.2-58.0) after the primary hemorrhoidectomy. Three of the 65 patients developed an external rectal prolapse (ERP) recurrence and eight an internal rectal prolapse (IRP) recurrence. This generated a 5-year recurrence rate of 25.3 % (95 % CI 0-53.9) for ERP recurrence and 24.4 % (95 % CI 9.1-39.7) for IRP recurrence. The rest of the LVMR cohort not receiving additional surgery for hemorrhoids (n = 355) showed significantly lower actuarial 5-year ERP (0.8 %, p = 0.011) and IRP (11 %, p = 0.020) recurrence rates. High-grade hemorrhoids requiring surgery may be common after LVMR. The development of high-grade hemorrhoids after LVMR might be considered a predictor of rectal prolapse recurrence.

Association of chronic obstructive pulmonary disease and hemorrhoids

PubMed Central

Lin, Lih-Hwa; Siu, Justin Ji-Yuen; Liao, Po-Chi; Chiang, Jen-Huai; Chou, Pei-Chi; Chen, Huey-Yi; Ho, Tsung-Jung; Tsai, Ming-Yen; Chen, Yung-Hsiang; Chen, Wen-Chi

2017-01-01

Abstract According to traditional Chinese medicine (TCM) theory, a specific physiological and pathological relationship exists between the lungs and the large intestine. The aim of this study is to delineate the association of chronic obstructive pulmonary disease (COPD) and hemorrhoids in order to verify the “interior–exterior” relationship between the lungs and the large intestine. A retrospective cohort study is conceived from the National Health Insurance Research Database, Taiwan. The 2 samples (COPD cohort and non-COPD cohort) were selected from the 2000 to 2003 beneficiaries of the NHI, representing patients age 20 and older in Taiwan, with the follow-up ending on December 31, 2011. The COPD cohort (n = 51,506) includes every patient newly diagnosed as having Chronic Obstructive Pulmonary Disease (COPD, ICD-9-CM: 490–492, 494, 496), who have made at least 2 confirmed visits to the hospital/clinic. The non-COPD cohort (n = 103,012) includes patients without COPD and is selected via a 1:2 (COPD: non-COPD) matching by age group (per 5 years), gender, and index date (diagnosis date of COPD for the COPD cohort). Compared with non-COPD cohorts, patients with COPD have a higher likelihood of having hemorrhoids and the age-, gender- and comorbidies-adjusted hazard ratio (HR) for hemorrhoids is 1.56 (95% confidence intervals [CI]:1.50–1.62). The adjusted HR of hemorrhoids for females is 0.79 (95% CI: 0.77–0.83), which is significantly less than that for males. The elderly groups, 40 to 59 years and aged 60 or above, have higher adjusted HRs than younger age groups (20–39 years), 1.19 (95% CI: 1.14–1.26), and 1.18 (95% CI: 1.12–1.24), respectively. Patients with COPD may have a higher likelihood to have hemorrhoids in this retrospective cohort study. This study verifies the fundamental theorem of TCM that there is a definite pathogenic association between the lungs and large intestine. PMID:28272246

Adequate dietary fiber supplement and TONE can help avoid surgery in most patients with advanced hemorrhoids.

PubMed

Garg, Pankaj; Singh, Pratiksha

2017-06-01

The root cause of hemorrhoids resides in three deranged defecation habits (DDH), namely increased straining, prolonged defecation-time, and frequent bowel-motions. These DDH are responsible for the development of new hemorrhoids, progression of existing one and hemorrhoidal rupture (bleeding). DDH can be corrected with the help of the "TONE" mnemonic. TONE entails specifying exact treatment goals: T, three minutes at defecation; O, once-a-day defecation frequency; N, no straining during passing motions; E, enough fiber. TONE can be implemented by proper counseling and by prescribing fiber supplement appropriately (5-6 teaspoonfuls of psyllium husk with 600 mL of water daily. Corrected DDH would prevent the progression of hemorrhoids and bleeding episodes. An office procedure may be done to further downgrade the hemorrhoids. Patients with advanced hemorrhoids (grades III and IV) who were referred for surgery were prescribed fiber supplement and were counseled to follow TONE. The outcome parameters evaluated were improvement in prolapse, bleeding episodes, satisfaction levels. A total of 102 patients (75 males and 10 females, mean age 46.0±13.5 years, 17 lost to follow-up) with advanced hemorrhoids (41 with early grade III, 38 with late grade III, and 6 with grade IV) were included in the study. All patients had symptoms of prolapsed hemorrhoids and bleeding episodes were present in 71.8% (61/85) of patients. After the follow-up of 40 (12-96) months, 68.2% (58/85) patients were highly satisfied, 12.9% (11/85) were moderately satisfied and 18.9% (16/85) were not satisfied with treatment. Prolapse improved in 56.5% (48/85), did not progress over time in 25.9 (22/85) and continued to progress in 4.7% (4/85) patients. 12.9% (11/85) underwent operation for hemorrhoids. Bleeding episodes decreased from 71.8% (61/85) to 29.4% (25/85) (P<0.0001). Adequate fiber supplement combined with the TONE method can correct DDH, thus stopping the progression of hemorrhoids and

Coronary CT Angiography Incorporating Doppler-Guided Prospective ECG Gating in Patients with High Heart Rate: Comparison with Results of Traditional Prospective ECG Gating

PubMed Central

Li, Min; Yu, Bing-bing; Wu, Jian-hua; Xu, Lin; Sun, Gang

2013-01-01

Purpose As Doppler ultrasound has been proven to be an effective tool to predict and compress the optimal pulsing windows, we evaluated the effective dose and diagnostic accuracy of coronary CT angiography (CTA) incorporating Doppler-guided prospective electrocardiograph (ECG) gating, which presets pulsing windows according to Doppler analysis, in patients with a heart rate >65 bpm. Materials and Methods 119 patients with a heart rate >65 bpm who were scheduled for invasive coronary angiography were prospectively studied, and patients were randomly divided into traditional prospective (n = 61) and Doppler-guided prospective (n = 58) ECG gating groups. The exposure window of traditional prospective ECG gating was set at 30%–80% of the cardiac cycle. For the Doppler group, the length of diastasis was analyzed by Doppler. For lengths greater than 90 ms, the pulsing window was preset during diastole (during 60%–80%); otherwise, the optimal pulsing intervals were moved from diastole to systole (during 30%–50%). Results The mean heart rates of the traditional ECG and the Doppler-guided group during CT scanning were 75.0±7.7 bpm (range, 66–96 bpm) and 76.5±5.4 bpm (range: 66–105 bpm), respectively. The results indicated that whereas the image quality showed no significant difference between the traditional and Doppler groups (P = 0.42), the radiation dose of the Doppler group was significantly lower than that of the traditional group (5.2±3.4mSv vs. 9.3±4.5mSv, P<0.001). The sensitivities of CTA applying traditional and Doppler-guided prospective ECG gating to diagnose stenosis on a segment level were 95.5% and 94.3%, respectively; specificities 98.0% and 97.1%, respectively; positive predictive values 90.7% and 88.2%, respectively; negative predictive values 99.0% and 98.7%, respectively. There was no statistical difference in concordance between the traditional and Doppler groups (P = 0.22). Conclusion Doppler-guided prospective ECG gating

Recurrent epistaxis from Kiesselbach area syndrome in patients suffering from hemorrhoids: fact or fiction?

PubMed

Mladina, Ranko; Cavcic, Josip; Subaric, Marin

2002-01-01

It has been found that >90% of patients suffering from recurrent epistaxis from Kiesselbach area syndrome (REKAS) simultaneously suffered from hemorrhoids. To clarify this, the authors decided to investigate in the opposite direction, i.e., to find out whether or not REKAS occurs in patients suffering primarily from hemorrhoids. The study group included 53 randomly selected hospitalized patients with hemorrhoidal disorder (31 males and 22 females: age range 18-57 years). A search for essential clinical signs of REKAS was performed in each patient. Incidence was not high, although all clinical parameters were nearly the same: dilated vessels in Kiesselbach venous plexus (83.01%) and a positive hereditary factor (92.7%). The only missing factor in patients with hemorrhoids was anterior septal deformity, so frequent in REKAS patients. CONCLUSIONS; The authors conclude that REKAS and hemorrhoidal syndrome are separate clinical entities that are characterized by dilated vessels of similar venous plexus and simultaneous appearance in the same patient or close relatives.

[Pathologic change of elastic fibers with difference of microvessel density and expression of angiogenesis-related proteins in internal hemorrhoid tissues].

PubMed

Han, Wei; Wang, Zhen-jun; Zhao, Bo; Yang, Xin-qing; Wang, Dong; Wang, Jian-pin; Tang, Xiu-ying; Zhao, Fa; Hung, Yan-ting

2005-01-01

To investigate the pathological variations in internal hemorrhoid and evaluate the expression of nitric- oxide synthase(NOS),vascular endothelial growth factor(VEGF),matrix metalloproteinase- 2(MMP2) and MMP9. Normal anal cushion and internal hemorrhoids tissue samples were obtained from 24 patients with iii degree hemorrhoids after procedure for prolapse and hemorrhoids(PPH) procedure. The expression of NOS, VEGF, MMP2, MMP9 and CD34 were detected by immunohistochemical staining; the microvessel density (MVD) was counted by anti- CD34 antibody; the elastic fibers were detected by orcein staining. There were statistically significant differences in the expression of MVD, VEGF, MMP9 between internal hemorrhoid tissue and normal anal cushions(P< 0.05). iNOS was significantly increased in hemorrhoid tissue, but no significant difference between normal anal cushions and hemorrhoid tissue. Morphological abnormalities such as breaking, distortion, mortality, hyaline degeneration were found in elastic fibers of internal hemorrhoid tissue, but not in normal anal cushions. Angiogenesis is evident in hemorrhoid tissue, suggesting the possible mechanism in the pathogenesis of hemorrhoids. The direct degeneration effect of MMP9 on supporting structure elastic fibers in anal cushion is another important mechanism. The high expression of iNOS suggests the inflammatory factors involve in the pathogenesis of hemorrhoids, and NO may be involve in pathological effect on hemorrhoids.

An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia

PubMed Central

Hashempur, Mohammad Hashem; Khademi, Fatemeh; Rahmanifard, Maryam; Zarshenas, Mohammad M.

2017-01-01

Hemorrhoids is one of the most common gastrointestinal diseases. There are several therapeutic options associated with some complications. Therefore, researchers look for traditional medicines as a potential resource for introduction of new natural drugs. The current study reports an evidence-based review of herbal remedies for hemorrhoids in traditional Persian medicine. A comprehensive survey about hemorrhoids on the most important manuscripts of traditional Persian medicine was done. Then, scientific data banks were searched for possible related properties of each herb in the conventional medicine. We reported some historical aspects of traditional Persian medicine view on classification, examination, and predisposing factors of hemorrhoids. In addition, we have reported 105 medicinal plants belonging to 51 families. More than half of the reported herbs exhibited anti-inflammatory and analgesic effects. Although lack of human studies regarding the mentioned herbs is noted, positive results from experimental findings can be considered for new drug discovery supported by traditional and medieval experiences. PMID:29228790

Cap-assisted endoscopic sclerotherapy for hemorrhoids: Methods, feasibility and efficacy

PubMed Central

Zhang, Ting; Xu, Li-Juan; Xiang, Jie; He, Zhi; Peng, Zhao-Yuan; Huang, Guang-Ming; Ji, Guo-Zhong; Zhang, Fa-Ming

2015-01-01

AIM: To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy (CAES) for internal hemorrhoids. METHODS: A pilot study on CAES for grade I to III internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent. RESULTS: A total of 30 patients with grade I to III internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One (3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma. CONCLUSION: CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids. PMID:26722615

[Efficacy of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids].

PubMed

Zheng, Chenguo; Jin, Chun; Lian, Shaoxiong; Jin, Dingguo

2014-12-01

To evaluate the efficacy and necessity of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids (PPH). Clinical data of 260 cases with severe hemorrhoids in our hospital from January 2010 to May 2012 were analyzed retrospectively. A total of 132 cases with severe hemorrhoids excluding in rectal posterior wall were enrolled in retained rectal posterior mucosa in PPH (improvement group), other 128 cases of severe hemorrhoids were assigned to PPH (conventional group). Operative parameters, efficacy and complication after operation were compared. Two groups of patients received successful operations. Postoperative pain duration, frequency of analgesic drugs and postoperative hospital stay in improvement group were significantly reduced [(1.3 ± 0.5) d vs. (4.8 ± 0.7) d, 1.1 ± 0.3 vs. 5.9 ± 0.6, (5.2 ± 0.8) d vs. (5.8 ± 0.5) d, all P<0.01]. Incidence of anastomotic stenosis, heavy feeling in the anus and delayed bleeding in improvement group were significantly lower than those in conventional group (0 vs. 7.8%, 0.8% vs. 14.1%, 0 vs.7.8%, all P<0.01). The application of retained rectal posterior mucosa in PPH to patients with severe hemorrhoids excluding in rectal posterior wall can significantly reduce postoperative complications. But long-term efficacy needs further observation.

Tribenoside and lidocaine in the local treatment of hemorrhoids: an overview of clinical evidence.

PubMed

Lorenc, Z; Gökçe, Ö

2016-06-01

The combination of tribenoside+lidocaine (Procto-Glyvenol®) is a medical preparation for the local treatment of hemorrhoids, delivered as a suppository or rectal cream. This product has been used for decades in the therapy of hemorrhoids. This review discusses available evidence on the use of tribenoside/lidocaine in clinical practice. Papers were retrieved by a PubMed search, using different combinations of pertinent keywords (e.g. tribenoside AND hemorrhoids), without any limitations in terms of publication date and language. Documents from Authors' personal collection of literature could also be considered. Papers were selected for inclusion according to their relevance for the topic, as judged by the Authors. The efficacy of the combination of tribenoside+lidocaine in relieving symptoms caused by hemorrhoids and its safety have been assessed in several clinical studies on patients of either gender, either versus its two individual components (tribenoside and lidocaine) or versus steroids in the same setting. Five studies compared the combination treatment with each of its single components, and of these, three studies compared tribenoside+ lidocaine with a tribenoside-free semi-placebo preparation containing only lidocaine, and two studies compared this combination with lidocaine-free preparations containing only tribenoside. Tribenoside+lidocaine was compared with steroid-containing preparations in six studies. Last, two studies evaluated the efficacy and tolerability of the tribenoside+lidocaine combination in women with hemorrhoids as a consequence of pregnancy or delivery. All the above-mentioned studies were well-conducted and can provide a comprehensive evaluation of tribenoside+lidocaine in the treatment of hemorrhoids. Enough evidence exists to recommend the use of this combination therapy as a fast, effective and safe option for the local treatment of low-grade hemorrhoids.

The efficacy of Euphorbia prostrata in early grades of symptomatic hemorrhoids--a pilot study.

PubMed

Gupta, P J

2011-02-01

The medical treatment for hemorrhoids has undergone significant changes on introduction of new pharmaceutical agents in the last decade. Euphorbia Prostrata is a new molecule used for grade I and II hemorrhoids. Beneficial effects of the Euphorbia prostrata in hemorrhoids have multiple mechanisms that are due to its active constituents flavonoids, tannins and phenolic acid. This pilot study was performed to assess the effectiveness of this molecule in early grades of symptomatic hemorrhoids. In the present retrospective study, the effect of Euphorbia prostrata on patients with hemorrhoids was observed over a follow up period of 12 weeks. In all, 120 patients were studied. This included 63 males and 57 females. Patients with grade 1 and 2 were prescribed with one tablet of Euphorbia prostrata (Tab Sitcom, Panacea Biotec, India) to be consumed on empty stomach every morning for two weeks. Follow-up was carried out at 2, 4 and 12 weeks after commencement of treatment. The primary end point of the study was control of bleeding and secondary end points were regression of hemorrhoid mass, pruritus and discomfort in the anus. Ninty-nine patients (82%) had complete cessation of bleeding at the end of two weeks. Six patients needed another 2 week's treatment to achieve complete relief, amounting to a success rate of 87%. Anal itch was relieved in 73% of patients, while anal discomfort subsided in 90% of patients. None of the patient had reported any adversity with consumption of the drug. At the follow-up after 3 months of treatment, no patient reported with symptomatic recurrence. However, 37 of the 79 patients (46%) still had residual hemorrhoids on anoscopic examination. This pilot study shows that Euphorbia prostrata can be used as an effective and well-tolerated pharmaceutical agent in the treatment of early grades of hemorrhoids. Long-term follow-up and randomized control trials by comparing with other established formulations is necessary to justify reliance on this

[Clinical study of Ruiyun procedure for hemorrhoids combined with Xiaozhiling injections in treatment of hemorrhoids complicated with human immunodeficiency virus infection].

PubMed

Wei, Guo; Hua, Xin; Zhao, Yong; Hu, Minghui; Gou, Fang; Liu, Lin; Cai, Lin; He, Yong; He, Shenghua

2014-12-01

To explore the efficacy of Ruiyun procedure for hemorrhoids (RPH) combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with human immunodeficiency virus (HIV) infection and its influence on cellular immune function. Clinical data of 76 hemorrhoid patients, including 36 positive HIV and 40 negative HIV, undergoing RPH combined with Xiaozhiling injections in our center from January 2010 to December 2012 were retrospectively analyzed. Clinical efficacy and cellular immune function preoperative day 1, postoperative day 7, 30 were compared between positive and negative groups. Recurrence rates of positive group and negative group postoperative 6 months were 22.2% (8/36) and 22.5% (9/40), postoperative 1 year were 30.6% (11/36) and 30.0% (12/40) without significant differences (all P>0.05). Morbidity of postoperative complication was also not significantly different between two groups (P>0.05). According to HIV classification, peripheral lymph cell ratio, CD4 count, CD4/CD8, white blood cell count and neutrophil ratio were not significantly different between preoperative day 1 and postoperative day 7 in both groups (all P>0.05). Decreasing velocity and amplitude of CD4 in both groups from high to low was HIV III, HIV II, HIV I, HIV-, while after 30 days the increase of CD4 from high to low was HIV-, HIV I, HIV II, HIV III, which were significantly different as compared to postoperative day 7 (all P<0.05). RPH combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with HIV infection is effective and safe. Postoperative inhibited cellular immune function can recover quickly.

Treatment of uncomplicated hemorrhoids with a Hemor-Rite® cryotherapy device: a randomized, prospective, comparative study

PubMed Central

Guindic, Luis Charúa

2014-01-01

Hemorrhoids are one of the most common ailments known. Often described as “varicose veins of the anus and rectum”, hemorrhoids are enlarged, bulging blood vessels in, and about the anus and lower rectum. About 75% of people will have hemorrhoids at some point in their lives. This paper shares the results from the clinical evaluation conducted to study effects of cryotherapy in treating uncomplicated hemorrhoids. The device used in the study is based on topically-applied cold therapy which can produce vasoconstriction in the tissues, tissue hypoxia, analgesia, and muscle relaxation. Cryotherapy was shown to be statistically similar or superior to proctology ointment in some of the parameters studied such as reduction of pain and hemorrhage. Overall it was observed that cryotherapy device contributes to improving the quality of life of patients with hemorrhoids. PMID:24474845

Improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser

NASA Astrophysics Data System (ADS)

Bao, Xiao-qing; Zhu, Jing; Shi, Hong-Min

2005-07-01

Objective: To observe and study the improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser and evaluate the effective rate. Methods: 60 patients of internal hemorrhoids were treated with Nd:YAG laser (10-15mw) irradiating on the mucosa of the lesions. Results: Among 60 patients, 57 patients were primarily cured with one treatment, 3 patients were primarily cured with two treatments. The effective rate was 95% with one treatment, and it reached to 100% with two treatments. Conclusions: the improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser is effective and easy to operate.

Management of internal hemorrhoids by Kshara karma: An educational case report.

PubMed

Mahapatra, Anita; Srinivasan, A; Sujithra, R; Bhat, Ramesh P

2012-07-01

A 66-year-old male patient came to the anorectal clinic, Outpatient department, AVT Institute for Advanced Research, Coimbatore, Tamil Nadu, with complaints of prolapsing pile mass during defecation and bleeding while passing stool. The case was diagnosed as "Raktarsha" - 11 & 7 'o' clock position II degree internal hemorrhoids, deeply situated, projecting one and caused by pitta and rakta; with bleeding tendency. Kshara karma (application of caustic alkaline paste) intervention was done in this case to internal hemorrhoids under local anesthesia. The pile mass and per rectal bleeding resolved in 8 days and the patient was relieved from all symptoms within 21 days. No complications were reported after the procedure. The patient was followed up regularly from 2004 onward till date and proctoscopic examination did not reveal any evidence of recurrence of the hemorrhoids.

Aluminum potassium sulfate and tannic acid (ALTA) injection as the mainstay of treatment for internal hemorrhoids.

PubMed

Hachiro, Yoshikazu; Kunimoto, Masao; Abe, Tatsuya; Kitada, Masahiro; Ebisawa, Yoshiaki

2011-06-01

Aluminum potassium sulfate and tannic acid (ALTA) induce noninvasive sclerosis and the involution of hemorrhoids by initiating an inflammatory reaction. We assessed the mid-term outcome after ALTA sclerotherapy for symptomatic hemorrhoids. Between May 2006 and July 2009, 1210 patients with grade III or IV hemorrhoids underwent surgery at Kunimoto Hospital. Our treatment strategy for internal hemorrhoids is first establishing whether ALTA therapy is possible for the type of hemorrhoid, and then performing either ALTA therapy or alternatively, ligation and excision (LE) for those types unsuitable for ALTA therapy. A total of 448 patients were treated with ALTA therapy alone (Group A), 706 patients were treated with a combination of ALTA and LE therapy (Group B), and 56 patients were treated with LE alone (Group C). The overall recurrence rates were 3.6% (16/448) and 0.3% (2/706) in Groups A and B, respectively. There was no recurrence in Group C. Rectal ulcers developed at the injection site in four (0.9%) patients from Group A, but they healed within a few months with conservative therapy. ALTA sclerotherapy is a simple and safe treatment for symptomatic hemorrhoids, with few complications.

Management of internal hemorrhoids by Kshara karma: An educational case report

PubMed Central

Mahapatra, Anita; Srinivasan, A.; Sujithra, R.; Bhat, Ramesh P.

2012-01-01

A 66-year-old male patient came to the anorectal clinic, Outpatient department, AVT Institute for Advanced Research, Coimbatore, Tamil Nadu, with complaints of prolapsing pile mass during defecation and bleeding while passing stool. The case was diagnosed as “Raktarsha” - 11 & 7 ‘o’ clock position II degree internal hemorrhoids, deeply situated, projecting one and caused by pitta and rakta; with bleeding tendency. Kshara karma (application of caustic alkaline paste) intervention was done in this case to internal hemorrhoids under local anesthesia. The pile mass and per rectal bleeding resolved in 8 days and the patient was relieved from all symptoms within 21 days. No complications were reported after the procedure. The patient was followed up regularly from 2004 onward till date and proctoscopic examination did not reveal any evidence of recurrence of the hemorrhoids. PMID:23125506

A comparative study of Barron's rubber band ligation with Kshar Sutra ligation in hemorrhoids

PubMed Central

Singh, Rakhi; Arya, Ramesh C.; Minhas, Satinder S.; Dutt, Anil

2010-01-01

Despite a long medical history of identification and treatment, hemorrhoids still pose a challenge to the medical fraternity in terms of finding satisfactory cure of the disease. In this study, Kshar Sutra Ligation (KSL), a modality of treatment described in Ayurveda, was compared with Barron's Rubber Band Ligation (RBL) for grade II and grade III hemorrhoids. This study was conducted in 20 adult patients of either sex with grade II and grade III hemorrhoids at two different hospitals. Patients were randomly allotted to two groups of 10 patients each. Group I patients underwent RBL, whereas patients of group II underwent KSL. Guggul-based Apamarga Kshar Sutra was prepared according to the principles laid down in ancient Ayurvedic texts and methodology standardized by IIIM, Jammu and CDRI, Lucknow. Comparative assessment of RBL and KSL was done according to 16 criteria. Although the two procedures were compared on 15 criteria, treatment outcome of grade II and grade III hemorrhoids was decided chiefly on the basis of patient satisfaction index (subjective criterion) and ability of each procedure to deal with prolapse of internal hemorrhoidal masses (objective criterion): Findings in each case were recorded over a follow-up of four weeks (postoperative days 1, 3, 7, 15 and 30). Statistical analysis was done using Student's t test for parametric data and Chi square test & Mann-Whitney test for non-parametric data. P < 0.05 was considered significant. RBL had the advantages of being an OPD procedure requiring no anesthesia and was attended by significantly lesser postoperative recumbency (P < 0.001 ) and significantly lesser pain (P < 0.005 on day 1) as compared to KSL. However, Group II (KSL) scored better in terms of treatment outcome. In Group II, there was significantly high (P < 0.05) patient satisfaction index as compared to Group I. Group II reported 100% 'cure' (absence of hemorrhoidal masses even on proctoscopy) of internal hemorrhoidal prolapse as against 80

Comparison between Ultroid and rubber band ligation in treatment of internal hemorrhoids.

PubMed

Azizi, Rasoul; Rabani-Karizi, Behzad; Taghipour, Mohammad Ali

2010-01-01

Hemorrhoid is one of the most common surgical diseases and different methods are available for its treatment. This study is a comparison between two methods of treatment of internal hemorrhoid, Monopolar low voltage instrument (Ultroid) and Rubber Band Ligation. This method has been carried out prospectively in which 50 patients who were treated with rubber band ligation and 50 patients with Ultroid were compared according to the incidence of complications, post-operative pain and treatment response. According to this study complete success rate with Ultroid was 82% and partial success rate was 10% and no response to treatment was seen in 8%. In Rubber Band method the complete response rate was 94% (P=0.2). With Ultroid, 74% of patient reported no postoperative pain, 24% reported mild and moderate pain and 2% of patients complained of severe pain. With Rubber band ligation, 72% of patients reported no post-operative pain, 26% reported mild and moderate pain and 1% complained of severe pain (P=0.00). Rubber Band ligation and Ultroid are both considered as outpatient procedures for treatment of hemorrhoids. Both methods are mostly used for grade 1, 2 and sometime grade 3 hemorrhoids. In Ultroid method the operator is required to hold the probe for a period of time, and in most cases, the surgeon should spend between 20-25 minutes for the coagulation of three piles. Some surgeons do not have patience for this modality of internal hemorrhoid treatment. In this study we achieved acceptable results comparable with those of other techniques.

Doppler ultrasound-guided percutaneous nephrolithotomy with two-step tract dilation for management of complex renal stones.

PubMed

Xu, Youming; Wu, Zhonghua; Yu, Jianhua; Wang, Shulong; Li, Fang; Chen, Jiushun; Liu, Jin; Chen, Kan

2012-06-01

To report our experience and assess the safety and efficacy of Doppler ultrasound-guided percutaneous nephrolithotomy (PCNL) with 2-step tract dilation for complex renal stones. From March 2009 to February 2011, 262 patients underwent PCNL. Eighty-three patients had a complete and 105 had partial staghorn calculus, and 74 had a renal pelvic stone of >2 cm in diameter. Thirty-five patients had renal surgical history. Doppler ultrasound-guided PCNL with 2-step tract dilation were performed. Stones were fragmented and cleared using a combination of ultrasonic and pneumatic lithotripters. All PCNL procedures were successful. Successful access to the collecting system was 100%. Although most of the cases (231/262) were managed satisfactorily by a single tract, a second tract was used in 31 cases. Mean operation time was 56 minutes (range 25-145). The primary stone-free rate of PCNL was 80.9%. There were 39 auxiliary procedures (13 second PCNL and 26 extracorporeal shock wave lithotripsy). One month after treatment, the overall stone-free rate was 92.7%. Five patients (1.9%) received blood transfusion. Eight patients (3.1%) with a postoperative fever of ≥38.5°C were cured by intravenous antibiotics. No other severe complications occurred. The mean postoperative stay was 3.8 days (range 2-12). Doppler ultrasound-guided PCNL with 2-step tract dilation for complex renal stones is safe, effective, and worthy of wider use in clinical practice. Copyright © 2012 Elsevier Inc. All rights reserved.

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study

PubMed Central

Miyamoto, Hidenori; Hada, Takenori; Ishiyama, Gentaro; Ono, Yoshito; Watanabe, Hideo

2016-01-01

AIM: To show that aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy has a high success rate for Grade II and III hemorrhoids. METHODS: This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades II and III hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy. RESULTS: One hundred and sixty-nine patients were diagnosed with Grade II hemorrhoids and 435 patients were diagnosed with Grade III hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades II and III hemorrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades II and III hemorrhoids (P = 0.09). There were forty-seven post-operative complications (low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure. CONCLUSION: ALTA sclerotherapy has had a high success rate for Grade II and III hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease. PMID:27458504

Comparison of Electrotherapy, Rubber Band Ligation and Hemorrhoidectomy in the Treatment of Hemorrhoids: A Clinical and Manometric Study

PubMed Central

Izadpanah, A; Hosseini, SV; Mahjoob, M

2010-01-01

BACKGROUND Treatment of hemorrhoid disease is one of the most challenging fields in general surgery in which different methods are used to treat this condition. In this study, we compared the manometric and clinical results of three treatment methods for hemorrhoids. METHODS A total of 150 patients with symptomatic grades II or III internal hemorrhoids were randomly assigned to three groups. Group A underwent Ferguson hemorrhoidectomy, group B were treated with rubber band ligation (RBL) and group C were treated with direct current electrotherapy. RESULTS Preoperatively, grade III hemorrhoids had significantly higher mean resting pressure and mean squeezing pressure in comparison to grade II hemorrhoids. After hemorrhoidectomy, patients in group A had a significant decrease in the maximum resting pressure (90.8 to 77.7 mmHg) and maximum squeezing pressure (130.6 to 114.8 mmHg) with a significant raise in the volume of the first sensation. However there was no significant change in manometric indexes after RBL and electrotherapy. Group A patients had more postoperative pain and itching compared to groups B and C. CONCLUSION We conclude that electrotherapy is a safe, effective and simple method of treating grades II and III uncomplicated internal hemorrhoids. This procedure is associated with little postoperative pain and complications, and has the least changes in anorectal manometric characteristics. Therefore electrotherapy may be recommended as a treatment of choice for grades II and III uncomplicated internal hemorrhoids. PMID:25197506

Efficacy of a standardized herbal preparation (Roidosanal®) in the treatment of hemorrhoids: A randomized, controlled, open-label multicentre study

PubMed Central

Aggrawal, Kapil; Satija, Naveen; Dasgupta, Gita; Dasgupta, Partha; Nain, Parul; Sahu, Aditya R.

2014-01-01

Background: Catechins and epicatechins are monomers of naturally occurring proanthocyanidins, which have been reported with free radical scavenging, antioxidant, antiinflammatory, antiallergic, and vasodilatory properties. Plant parts rich in proanthocyanidins have been used for years in treatment of various ano-rectal diseases. This study compares the efficacy of two herbal preparations, Daflon® 500 mg and Roidosanal®, in ameliorating the signs and symptoms associated with hemorrhoids. Objective: To evaluate the safety and to compare the efficacy of a herbal preparation, Roidosanal® versus Daflon® 500 mg, on signs and symptoms of hemorrhoidal disease. Materials and Methods: In this pilot, active controlled, open-labeled multicentre study, 73 patients with proctoscopy proven hemorrhoids (Grade I to III) were randomly assigned to receive either Roidosanal® (Gr R; n = 37) or Daflon® 500 mg (Gr D; n = 36), for 15 days, at three centers in India. Assessment of hemorrhoidal symptoms was carried out in all patients at different time points. Intent-to-treat analysis was performed for both primary and secondary endpoints. Results: Baseline characteristics were comparable between the two groups. Both products were found to be equally effective in improving the ano-rectal conditions in Grade I and Grade II hemorrhoids; however, Roidosanal® demonstrated better efficacy in patients with Grade III hemorrhoids. Hemorrhoids associated symptoms like bleeding, pain, etc., improved in both groups, although intergroup comparisons were comparable. Conclusion: Both Roidosanal® and Daflon® 500 mg were equally effective in resolving signs and symptoms of hemorrhoids. Roidosanal® can be tried as a safe and effective treatment option for treatment of hemorrhoids. Further randomized, double-blind and large multicentre studies are recommended. PMID:24948863

Guidelines for the treatment of hemorrhoids (short report).

PubMed

Higuero, T; Abramowitz, L; Castinel, A; Fathallah, N; Hemery, P; Laclotte Duhoux, C; Pigot, F; Pillant-Le Moult, H; Senéjoux, A; Siproudhis, L; Staumont, G; Suduca, J M; Vinson-Bonnet, B

2016-06-01

Hemorrhoids are a common medical problem that is often considered as benign. The French Society of Colo-Proctology (Société nationale française de colo-proctologie [SNFCP]) recently revised its recommendations for the management of hemorrhoids (last issued in 2001), based on the literature and consensual expert opinion. We present a short report of these recommendations. Briefly, medical treatment, including dietary fiber, should always be proposed in first intention and instrumental treatment only if medical treatment fails, except in grade ≥III prolapse. Surgery should be the last resort, and the patient well informed of the surgical alternatives, including the possibility of elective ambulatory surgery, if appropriate. Postoperative pain should be prevented by the systematic implementation of a pudendal block and multimodal use of analgesics. Copyright © 2016. Published by Elsevier Masson SAS.

A retrospective analysis of short and long term efficacy of RBL for hemorrhoids.

PubMed

Lu, L Y; Zhu, Y; Sun, Q

2013-10-01

Rubber band ligation is an effective treatment for hemorrhoids. A retrospective analysis was performed to evaluate its short and long-term efficacy. From 2000 to 2008, 254 outpatients with II- degree and 114 with III-degree hemorrhoids underwent rubber band ligation. Two or three hemorrhoids were ligated per session. Each haemorrhoid was ligated with two rubber bands through a ligator. All patients were visited after two months and followed up through a telephone after two and eleven years. Twenty-four or forty-eight hours post treatment, 41% of patients had mild-moderate pain. Four patients showed severe pain and required for haemorrhoidectomy within a few days. Only 2% of patients experienced self-limiting rectal bleeding after one week and 6% of patients had an additional ligation within two months. Two months later, 92% of II-degree patients and 76% of III-degree patients showed no residual symptoms. After two and eleven years, the history of 314 patients (85%) were obtained, of them, 70% was asymptomatic, 27% had some residual symptoms of occasional bleeding and prolapse, and 3% needed further surgery. Rubber band ligation is an efficient, cost-effective and simple outpatient procedure for the second and third degree hemorrhoids with minimal complications.

Hemorrhoids in pregnancy

PubMed Central

Staroselsky, Arthur; Nava-Ocampo, Alejandro A.; Vohra, Sabina; Koren, Gideon

2008-01-01

QUESTION One of my patients is in the third trimester of her first pregnancy. She has recently experienced spotting during her bowel movements. She has hemorrhoids. What medications are safe? ANSWER The treatment is mainly symptomatic for most patients. Most forms of the condition can be treated by increasing fibre content in the diet, administering stool softeners, increasing liquid intake, and training in toilet habits. Although none of the topical antihemorrhoidal agents commonly used have been assessed for safety in pregnancy, it is unlikely that the constituent parts (anesthetic, corticosteroids, and anti-inflammatory agents) will harm the third-trimester infant. In most women, most symptoms of the condition will resolve spontaneously soon after giving birth. PMID:18272631

Hemorrhoids in pregnancy.

PubMed

Staroselsky, Arthur; Nava-Ocampo, Alejandro A; Vohra, Sabina; Koren, Gideon

2008-02-01

One of my patients is in the third trimester of her first pregnancy. She has recently experienced spotting during her bowel movements. She has hemorrhoids. What medications are safe? The treatment is mainly symptomatic for most patients. Most forms of the condition can be treated by increasing fibre content in the diet, administering stool softeners, increasing liquid intake, and training in toilet habits. Although none of the topical antihemorrhoidal agents commonly used have been assessed for safety in pregnancy, it is unlikely that the constituent parts (anesthetic, corticosteroids, and anti-inflammatory agents) will harm the third-trimester infant. In most women, most symptoms of the condition will resolve spontaneously soon after giving birth.

Association of chronic obstructive pulmonary disease and hemorrhoids: A nationwide cohort study.

PubMed

Lin, Lih-Hwa; Siu, Justin Ji-Yuen; Liao, Po-Chi; Chiang, Jen-Huai; Chou, Pei-Chi; Chen, Huey-Yi; Ho, Tsung-Jung; Tsai, Ming-Yen; Chen, Yung-Hsiang; Chen, Wen-Chi

2017-03-01

According to traditional Chinese medicine (TCM) theory, a specific physiological and pathological relationship exists between the lungs and the large intestine. The aim of this study is to delineate the association of chronic obstructive pulmonary disease (COPD) and hemorrhoids in order to verify the "interior-exterior" relationship between the lungs and the large intestine. A retrospective cohort study is conceived from the National Health Insurance Research Database, Taiwan. The 2 samples (COPD cohort and non-COPD cohort) were selected from the 2000 to 2003 beneficiaries of the NHI, representing patients age 20 and older in Taiwan, with the follow-up ending on December 31, 2011. The COPD cohort (n = 51,506) includes every patient newly diagnosed as having Chronic Obstructive Pulmonary Disease (COPD, ICD-9-CM: 490-492, 494, 496), who have made at least 2 confirmed visits to the hospital/clinic. The non-COPD cohort (n = 103,012) includes patients without COPD and is selected via a 1:2 (COPD: non-COPD) matching by age group (per 5 years), gender, and index date (diagnosis date of COPD for the COPD cohort). Compared with non-COPD cohorts, patients with COPD have a higher likelihood of having hemorrhoids and the age-, gender- and comorbidies-adjusted hazard ratio (HR) for hemorrhoids is 1.56 (95% confidence intervals [CI]:1.50-1.62). The adjusted HR of hemorrhoids for females is 0.79 (95% CI: 0.77-0.83), which is significantly less than that for males. The elderly groups, 40 to 59 years and aged 60 or above, have higher adjusted HRs than younger age groups (20-39 years), 1.19 (95% CI: 1.14-1.26), and 1.18 (95% CI: 1.12-1.24), respectively. Patients with COPD may have a higher likelihood to have hemorrhoids in this retrospective cohort study. This study verifies the fundamental theorem of TCM that there is a definite pathogenic association between the lungs and large intestine.

Comparing topical hydrocortisone cream with Hai's Perianal Support in managing symptomatic hemorrhoids in pregnancy: a preliminary trial.

PubMed

Lim, Soo Soo; Yu, Chye Wah; Aw, Lin Da

2015-02-01

The prevalence of hemorrhoids among pregnant women is high in late pregnancy. This study was to evaluate the efficacy between drug treatment with Procort (topical hydrocortisone cream 1%) and mechanical treatment with a Hai's Perianal Support (HPS) toilet seat device in managing symptomatic hemorrhoids during the third trimester of pregnancy. A prospective randomized controlled study was conducted on 23 pregnant women with gestation above the 28th week and presented with symptomatic hemorrhoids. Pre- and post-interventional assessment was carried out to obtain data on symptoms of pain, itching, swelling, discomfort and bleeding associated with hemorrhoids. The control group was treated with topical hydrocortisone cream 1% and the test group was provided and taught to use a HPS, a posterior perineal support toilet seat device (Colorec). The results showed improvement in symptoms of pain, swelling, bleeding, itching and discomfort in both the test and control groups. However, statistically significant differences were found on symptoms of pain, swelling and discomfort between the test and control groups. There was also a statistically significant difference in well-being and overall improvement between the test and control groups. HPS has to a certain extent significantly reduced the symptoms of hemorrhoids in pregnancy and improved the well-being of pregnant women in comparison with topical treatment with hydrocortisone cream. However, more clinical trials need to be carried out to recomfirm the role of HPS in hemorrhoids in pregnancy. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Protocol for the development of a Core Outcome Set (COS) for hemorrhoidal disease: an international Delphi study.

PubMed

van Tol, R R; Melenhorst, J; Dirksen, C D; Stassen, L P S; Breukink, S O

2017-07-01

Over the last decade, many studies were performed regarding treatment options for hemorrhoidal disease. Randomised controlled trials (RCTs) should have well-defined primary and secondary outcomes. However, the reported outcome measures are numerous and diverse. The heterogeneity of outcome definition in clinical trials limits transparency and paves the way for bias. The development of a core outcome set (COS) helps minimizing this problem. A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease. The aim of this project is to generate a COS regarding the outcome of treatment after hemorrhoidal disease. A Delphi study will be performed by an international steering group healthcare professionals and patients with the intention to create a standard outcome set for future clinical trials for the treatment of hemorrhoidal disease. First, a literature review will be conducted to establish which outcomes are used in clinical trials for hemorrhoidal disease. Secondly, both healthcare professionals and patients will participate in several consecutive rounds of online questionnaires and a face-to-face meeting to refine the content of the COS. Development of a COS for hemorrhoidal disease defines a minimum outcome-reporting standard and will improve the quality of research in the future.

Conventional (CH) vs. stapled hemorrhoidectomy (SH) in surgical treatment of hemorrhoids. Ten years experience.

PubMed

Manfredelli, Simone; Montalto, Gioacchino; Leonetti, Giovanni; Covotta, Marco; Amatucci, Chiara; Covotta, Alfredo; Forte, Angelo

2012-01-01

Interest about hemorrhoids is related to its high incidence and elevated social costs that derive from its treatment. Several comparative studies are reported in Literature to define a standard for ideal treatment of hemorrhoidal disease. Radical surgery is the only therapeutic option in case of III and IV stage haemorrhoids. Hemorrhoids surgical techniques are classified as Open, Closed and Stapled ones. We report our decennial experience on surgical treatment focusing on early, middle and late complications, indications and contraindications, satisfaction level of each surgical procedure for hemorrhoids. Four hundred forty-eight patients have been hospitalized in our department fom 1st January to 31st December 2008. Of these 241 underwent surgery with traditional open or closed technique and 207 with the SH technique according to Longo. This retrospective study includes only patients with symptomatic hemorrhoids at III or IV stage. There were no differences between CH and SH about both pre and post surgery hospitalization and intraoperative length. Pain is the most frequently observed early complication with a statistically significant difference in favour of SH. We obtain good results in CH group using anoderma sparing and perianal anaesthetic infiltration at the end of the surgery. In all cases, pain relief was obtained only with standard analgesic drugs (NSAIDs). We also observed that pain level influences the outcome after surgical treatment. No chronic pain cases were observed in both groups. Bleeding is another relevant early complication in particular after SH: we reported 2 cases of immediate surgical reintenvention and 2 cases treated with blood transfusion. Only in SH group we report also 5 cases of thrombosis of external haemorrhoids and 7 perianal hematoma both solved with medical therapy There were no statistical significant differences between two groups about fever, incontinence to flatus, urinary retention, fecal incontinence, substenosis and anal

An optimal painless treatment for early hemorrhoids; our experience in Government Medical College and Hospital

PubMed Central

Singal, R; Gupta, S; Dalal, AK; Dalal, U; Attri, AK

2013-01-01

Objective - To evaluate the efficacy of Infrared Coagulation Therapy (IRC) for hemorrhoids. IRC is a painless, safe and successful procedure. Place and duration of study - Department of Surgery, Government Medical College and Hospital, Sector-32, Chandigarh, India, from August 2006 to October 2008. The choice of procedure depends on the patient's symptoms, the extent of the hemorrhoidal disease, and the experience of the surgeon along with the availability of the techniques/instruments. Materials and methods - This is a prospective study done from August 2006 to October 2008. Total number of 155 patients was included in the study. Infrared Coagulation Therapy (IRC) was performed through a special designed proctoscope. Patients excluded were with coagulopathy disorders, fissure in ano, and anal ulcers. Results - It is an outpatient Department (OPD), non-surgical, ambulatory, painless and bloodless procedure, without any hospital stay. Early recovery and minimal recurrence of hemorrhoids were noted without any morbidity or mortality. We have studied 155 patients, treated with IRC on OPD basis. Surgery was required in few patients in whom IRC failed or was contraindicated. Out of the total 155 patients, 127 came for follow up. After the 1st sitting of IRC therapy: out of 127; 43 patients got a total relief, mass shrinkage was of > 75% in 57 cases and < 50% in 14 cases. Twenty-eight cases did not come for follow-up. In the 2nd sitting, out of 84/127; 58 patients got a total relief, >75% relief in 15 cases and >50 % relief in 11 patients. In the 3rd sitting out of 26/84 cases: 13 cases got a total relief and 13 cases refused to take the third sitting; however, in 7 cases the hemorrhoidal mass shrank up to 50% after the two sittings. These 14 were operated as there was no relief from bleeding after giving two sittings of IRC. Our opinion is that, in the above 14 cases, the patient might have not followed the instructions properly for dietary habits. Conclusion - IRC is a

An optimal painless treatment for early hemorrhoids; our experience in Government Medical College and Hospital.

PubMed

Singal, R; Gupta, S; Dalal, A K; Dalal, U; Attri, A K

2013-09-15

To evaluate the efficacy of Infrared Coagulation Therapy (IRC) for hemorrhoids. IRC is a painless, safe and successful procedure. Department of Surgery, Government Medical College and Hospital, Sector-32, Chandigarh, India, from August 2006 to October 2008. The choice of procedure depends on the patient's symptoms, the extent of the hemorrhoidal disease, and the experience of the surgeon along with the availability of the techniques/instruments. This is a prospective study done from August 2006 to October 2008. Total number of 155 patients was included in the study. Infrared Coagulation Therapy (IRC) was performed through a special designed proctoscope. Patients excluded were with coagulopathy disorders, fissure in ano, and anal ulcers. Results - It is an outpatient Department (OPD), non-surgical, ambulatory, painless and bloodless procedure, without any hospital stay. Early recovery and minimal recurrence of hemorrhoids were noted without any morbidity or mortality. We have studied 155 patients, treated with IRC on OPD basis. Surgery was required in few patients in whom IRC failed or was contraindicated. Out of the total 155 patients, 127 came for follow up. After the 1st sitting of IRC therapy: out of 127; 43 patients got a total relief, mass shrinkage was of > 75% in 57 cases and < 50% in 14 cases. Twenty-eight cases did not come for follow-up. In the 2nd sitting, out of 84/127; 58 patients got a total relief, >75% relief in 15 cases and >50 % relief in 11 patients. In the 3rd sitting out of 26/84 cases: 13 cases got a total relief and 13 cases refused to take the third sitting; however, in 7 cases the hemorrhoidal mass shrank up to 50% after the two sittings. These 14 were operated as there was no relief from bleeding after giving two sittings of IRC. Our opinion is that, in the above 14 cases, the patient might have not followed the instructions properly for dietary habits. IRC is a safe, simple and effective procedure for early hemorrhoids without any

Quantification of gastric emptying and duodenogastric reflux stroke volumes using three-dimensional guided digital color Doppler imaging.

PubMed

Hausken, T; Li, X N; Goldman, B; Leotta, D; Ødegaard, S; Martin, R W

2001-07-01

To develop a non-invasive method for evaluating gastric emptying and duodenogastric reflux stroke volumes using three-dimensional (3D) guided digital color Doppler imaging. The technique involved color Doppler digital images of transpyloric flow in which the 3D position and orientation of the images were known by using a magnetic location system. In vitro, the system was found to slightly underestimate the reference flow (by average 8.8%). In vivo (five volunteers), stroke volume of gastric emptying episodes lasted on average only 0.69 s with a volume on average of 4.3 ml (range 1.1-7.4 ml), and duodenogastric reflux episodes on average 1.4 s with a volume of 8.3 ml (range 1.3-14.1 ml). With the appropriate instrument settings, orientation determined color Doppler can be used for stroke volume quantification of gastric emptying and duodenogastric reflux episodes.

Early Experience With a Partial Stapled Hemorrhoidopexy for Treating Patients With Grades III–IV Prolapsing Hemorrhoids

PubMed Central

Jeong, Hyeonseok; Ryu, Kil O; Lim, Jiyong; Kim, Hyun Tae; Yu, Hye Mi; Yoon, Jihoon; Lee, Ju-Young; Kim, Hyoung Rae; Choi, Young Gil

2017-01-01

Purpose Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III–IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH. Methods We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler. Results Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur. Conclusion PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III–IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids. PMID:28289661

Prospective Case Series of a Novel Minimally Invasive Bipolar Coagulation System in the Treatment of Grade I and II Internal Hemorrhoids.

PubMed

Crawshaw, Benjamin P; Russ, Andrew J; Ermlich, Bridget O; Delaney, Conor P; Champagne, Bradley J

2016-12-01

Background Existing nonsurgical procedures for the treatment of grade I and II internal hemorrhoids are often painful, technically demanding, and often necessitate multiple applications. This study prospectively assessed the safety and efficacy of the HET Bipolar System, a novel minimally invasive device, in the treatment of symptomatic grade I and II internal hemorrhoids. Methods Patients with symptomatic grade I or II internal hemorrhoids despite medical management underwent hemorrhoidal ligation with the HET Bipolar System. Endpoints included resolution or improvement of hemorrhoidal bleeding and/or prolapse from baseline, recurrent or refractory symptoms, and pain. Results Twenty patients were treated with the HET Bipolar System. Two were lost to follow-up. Refractory or recurrent bleeding was present in 8 of 18 (44.4%), 4 of 11 (36.4%), and 4 of 8 (50.0%) patients, and prolapse was reported by 1 of 18 (5.6%), 4 of 11 (36.4%), and 1/7 (14.3%) of patients at 1, 3, and 6 months, respectively. Bleeding improved from baseline in 88.2%, 81.8%, and 87.5% of patients, and resolution of baseline prolapse was seen in 11 of 11 (100%), 4 of 7 (57.1%), and 5 of 5 (100%) patients at the same intervals. Thirteen of 18 (72.2%) patients did not require additional treatment for their symptoms. Conclusions The HET Bipolar System is safe and easy to use with short-term effectiveness comparable to that of currently used techniques for the treatment of symptomatic grade I and II internal hemorrhoids. It may be an effective alternative to rubber band ligation in patients with larger internal hemorrhoids and those with hemorrhoids close to the dentate line in which banding may produce debilitating pain. © The Author(s) 2016.

Clinical Evaluation of Commiphora Mukul, a Botanical resin, in the Management of Hemorrhoids: A randomized controlled trial

PubMed Central

Yousefi, Mahdi; Mahdavi, Mohammad Reza Vaez; Hosseini, Seyed Mousalreza; Bahrami, Abdollah; Davati, Ali; Kamalinejad, Mohammad; Faghihzadeh, Sograt

2013-01-01

Background: Hemorrhoids complaint is one of the most common problems in most society, especially in Asian countries. Current drug treatment protocols cannot cure the disease, and they are palliative. According to Persian traditional medicine, Commiphora Mukul (CM) resin is a medication choice. Aim: This randomized study was undertaken to evaluate the efficacy and safety of crude CM resin compared to a combination of lactolose and anti-hemorrhoid (LandA) in patients with uncomplicated hemorrhoids grade 1 and 2. Materials and Methods: This trial was carried out on 99 patients with hemorrhoids, in Ghaem and Imam Reaza Hospitals of the Mashhad University of Medical Sciences, Iran. They randomly received CM 3 g/d for 4 weeks (as study group) or LandA (Lactolose syrup in laxative dose for 1 month and anti-hemorrhoid suppository daily for 10 days) as control group. Subjective and objectives variables including painful defecation, flatulence, constipation, gastro-esophageal reflux (GER), dyspepsia, proctorrhagia, anal protrusion, and colonoscopic grading were assessed before, immediately after, and 4 weeks after the treatment period. An intent-to-treat analysis was used. Safety was assessed with evaluation of clinical adverse effects by common toxicity criteria version 4.0. Forty-nine patients were assigned randomly to receive LandA and 50 to receive CM. After 4 weeks, flatulence, dyspepsia, GER, and colonoscopic grading scores significantly decreased in study group, whereas in control group constipation, painful defecation, and proctorrhagia showed better but not significant improvement. After 4-weak follow-up, the rate of constipation, and proctorrhagia also showed significantly improvement in study group. Constipation and proctorrhagia in control group recurred significantly in 4-week follow-up than after the treatment, whereas this recurrence in test group was not seen. Conclusion: CM was more effective than LandA in 4-week treatment of patients with uncomplicated

[A multicenter, randomized controlled trial of wheat cellulose particles in the treatment of internal hemorrhoids].

PubMed

Peng, Yunhua; Yang, Wei; Wang, Yehuang; Fan, Xiaohua; Zheng, Xueping; Gai, Juanjuan

2017-07-25

To evaluate the efficacy and safety of wheat cellulose particles (testa triticum tricum purify, Fiberform) in the treatment of internal hemorrhoid. A multicenter randomized controlled clinical trial was adopted. From October 2015 to July 2016, 60 patients with internal hemorrhoid were enrolled from three medical centers, including Department of Anorectum, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Department of Anorectum, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Anorectum, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine. Enrollment criteria: Patients aging from 18 to 65 years old; being diagnosed with the second or third grade internal hemorrhoid; having good communication skills and being able to complete the records and follow-ups according to the research program requirements. Patients combined with other anal diseases, or whose anus tube or rectum suffering occupying lesions; patients currently using other methods and defecation drugs in the treatment of their hemorrhoids; patients in pregnancy or with diseases of heart, liver, kidney or metabolic disorders; patients suffering from constipation due to other diseases and drugs, and long-term laxatives abusers. According to the random number table method, 60 patients were randomly divided into the combined treatment group [30 cases, wheat cellulose particles 1 bag each time, 2 times per day; Diosmin tablet 2 pills, 2 times per day] and the single treatment group [30 cases, Diosmin tablet 2 pills, 2 times per day]. The treatment courses for both groups were 7 days. According to the four-grade scoring method, the efficacy evaluation would be made on six indicators, which were the degree of hematochezia or bleeding, the degree of pain, hemorrhoid prolapse, the shapes and properties of stool, the defecation frequency and the defecation duration. The higher the score a participant got, the more severe the symptom

[Meta-analysis of randomized controlled trials comparing procedure for prolapse and hemorrhoids with Milligan-Morgan hemorrhoidectomy in the treatment of prolapsed hemorrhoids].

PubMed

He, Ping; Chen, Hongliang

2015-12-01

To compare the safety and efficacy of procedure for prolapse and hemorrhoids (PPH) with Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of prolapsed hemorrhoids. All the randomized controlled trials (RCT) comparing PPH with MMH in the treatment of prolapsed hemorrhoids published between January 1998 and January 2015 were retrieved from PubMed, Embase, Cochrane Library, CBM, CNKI, Wangfang, VIP databases. Hand search was applied in Chinese Journal of Gastrointestinal Surgery, Chinese Journal of Coloproctology and Journal of Colorectal and Anal Surgery from the library of Chengdu University of Traditional Chinese Medicine. Associated reference documents in enrolled trials were reviewed. The methodological quality of enrolled trials was evaluated according to the Cochrane handbook for systematic reviews of interventions. Meta-analysis was performed using RevMan 5.3 software. Sixteen RCTs recruiting 1411 patients were identified. Among them, 702 patients underwent PPH, and other 709 patients MMH. Meta-analysis showed that as compared to MMH, PPH had shorter operating time(WMD=-12.34, 95% CI:-17.87 to -6.80, P=0.000], shorter hospital stay (WMD=-1.48, 95% CI: -1.81 to -1.14, P=0.000) and shorter time to recover normal activity (WMD=-14.11, 95% CI: -24.51 to -3.70, P=0.008). Patients in PPH group experienced less pain at postoperative 24 h, postoperative 1 week and the first postoperative bowel movement (all P<0.01). PPH was more ascendant in terms of the requirement for analgesics(P<0.01). PPH group had higher ratio of wound-healing 2 weeks after surgery (RR=0.19, 95% CI: 0.07 to 0.51, P=0.001), lower ratio of postoperative anal stenosis (RR=0.39, 95% CI: 0.15 to 0.99, P=0.050) and lower ratio of anal incontinence (RR=0.62, 95% CI: 0.38 to 1.01, P=0.050), but higher ratio of recurrent disease after 1 year (RR=2.54, 95% CI: 1.21 to 5.31, P=0.010). No significant differences in ratios of postoperative bleeding, urinary retention, and postoperative morbidity of

Excisional hemorrhoidal surgery and its effect on anal continence

PubMed Central

Li, Yan-Dong; Xu, Jia-He; Lin, Jian-Jiang; Zhu, Wei-Fang

2012-01-01

AIM: To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients. METHODS: Seventy-six consecutive patients (33 men and 43 women) with a mean age of 44 years were included. They underwent Milligan-Morgan hemorrhoidectomy because of symptomatic third- and fourth-degree hemorrhoids and failure in conservative treatment for years. Wexner score was recorded and liquid continence test was performed for each patient before and two months after operation using the techniques described in our previous work. The speed-constant rectal lavage apparatus was prepared in our laboratory. The device could output a pulsed and speed-constant saline stream with a high pressure, which is capable of overcoming any rectal resistance change. The patients were divided into three groups, group A (< 900 mL), group B (900-1200 mL) and group C (> 1200 mL) according to the results of the preoperative liquid continence test. RESULTS: All the patients completed the study. The average number of hemorrhoidal masses excised was 2.4. Most patients presented with hemorrhoidal symptoms for more than one year, including a mean duration of incontinence of 5.2 years. The most common symptoms before surgery were anal bleeding (n = 55), prolapsed lesion (n = 34), anal pain (n = 12) and constipation (n = 17). There were grade III hemorrhoids in 39 (51.3%) patients, and grade IV in 37 (48.7%) patients according to Goligher classification. Five patients had experienced hemorrhoid surgery at least once. Compared with postoperative results, the retained volume in the preoperative liquid continence test was higher in 40 patients, lower in 27 patients, and similar in the other 9 patients. The overall preoperative retained volume in the liquid continence test was 1130.61 ± 78.35 mL, and postoperative volume was slightly decreased (991.27 ± 42.77 mL), but there was no significant difference (P = 0.057). Difference was significant in the test value before and

[A case of laparoscopic surgery for a rectal carcinoid after ALTA therapy for an internal hemorrhoid].

PubMed

Aomatsu, Naoki; Nakamura, Masanori; Hasegawa, Tsuyoshi; Nakao, Shigetomi; Uchima, Yasutake; Aomatsu, Keiho

2014-11-01

We report a case of laparoscopic surgery for a rectal carcinoid after aluminum potassium and tannic acid (ALTA) therapy for an internal hemorrhoid. A 66-year-old man was admitted to our hospital because of bleeding during defecation. He was diagnosed via anoscopy with Goligher grade II internal hemorrhoids. Examination via colonoscopy revealed 2 yellowish submucosal tumors in the lower rectum that were 5mm and 10mm in diameter. A rectal carcinoid tumor was diagnosed based on histopathology. Abdominal computed tomography demonstrated no metastases to the liver or lymph nodes. First, we performed ALTA therapy for the internal hemorrhoids. Two weeks later, we performed laparoscopic-assisted low anterior resection (D2) for the rectal carcinoid. The patient was discharged without complications and has not experienced recurrence during the 2 years of follow-up care.

Circular vs. three-quadrant hemorrhoidectomy for end-stage hemorrhoids: short- and long-term outcomes of a prospective randomized trial.

PubMed

Qarabaki, Maia A; Mukhashavria, Gela A; Mukhashavria, Gia G; Giorgadze, Nodari G

2014-04-01

Circumferential excisional hemorrhoidectomy (CEH) enables the surgeon to remove the encircling hemorrhoids completely. The purpose of this study is to compare the efficacy of CEH with that of Ferguson hemorrhoidectomy (FH) for end-stage hemorrhoids. Between February 1998 and December 2011, a prospective randomized trial was conducted with 688 patients who presented with end-stage hemorrhoids and underwent FH or CEH at our center. The patient demographics, mean operative times, lengths of hospital stay, and cumulative rates of postoperative complications were similar in the study groups. Significant differences were revealed in the incidence of postoperative hemorrhage (9 vs. 0 patients in the FH and CEH groups, respectively; p = 0.002) and in the tendency to form anal stricture (15 vs. 32 patients in the FH and CEH groups, respectively; p = 0.02). However, all cases of anal strictures were easily managed by digital dilatations. At a mean follow-up of 7.4 (range, 1-14) years, accessible patients from the CEH group remained symptom free, whereas 126 of 308 patients in the FH group indicated that they had recurrent hemorrhoidal symptoms. Without increasing postoperative complications, CEH demonstrates an advantage compared with FH, with regard to reducing the rate of recurrence to 0 through complete hemorrhoid removal.

Ligation under vision in the management of symptomatic hemorrhoids: A preliminary experience.

PubMed

Kara, Cemal; Sozutek, Alper; Yaman, Ismail; Yurekli, Semih; Karabuga, Turker

2015-07-01

To evaluate the surgical outcomes of 47 patients who underwent hemorrhoidal arterial ligation under vision (LUV) for symptomatic Grade II and Grade III hemorrhoids. A total of 47 patients who underwent LUV between May 2005 and February 2009 were analyzed retrospectively. The patients were evaluated with regard to demographic data, grade of the disease, symptoms, medical and/or surgical treatment previously received, operation time, pain scores, analgesic requirement, length of hospital stay, and complications related to the procedure. The study population (n = 47) included 31 (65.9%) men and 16 (34.1%) women with a median age of 37.4 ± 11.7 (range, 19-63) years. Of these 47 patients, 18 (38.3%) patients had Grade II hemorrhoidal disease (HD) and 29 (61.7%) patients had Grade III HD. On average, six ligatures (range, 3-8) were used. The mean operation time was 27 ± 4.8 (range, 15-35) minutes. No major complication that required surgical intervention occurred in the early postoperative period for any of the patients except for two patients with rectal submucosal hematoma. The mean hospital stay was 1.2 ± 0.65 (range, 1-4) days. The median follow-up period was 21.5 ± 7.7 (range, 12-44) months. At the last follow-up, 38 (80.8%) patients remained asymptomatic; two (4.2%) patients with Grade II HD and four (8.5%) patients with Grade III HD were still suffering from bleeding but with a reduction in the frequency; prolapsed hemorrhoids were detected only in three (6.3%) patients. LUV is a safe and easily applied alternative technique with low postoperative complications for the surgical treatment of symptomatic Grade II and III HD. Copyright © 2014. Published by Elsevier Taiwan.

A novel technique for the treatment of stages III to IV hemorrhoids

PubMed Central

Lin, Guoqiang; Ge, Qiongxiang; He, Xiaokang; Qi, Haixin; Xu, Li

2017-01-01

Abstract To compare the efficacy of homemade anal cushion suspension clamp combined with harmonic scalpel (ACS) and Milligan–Morgan hemorrhoidectomy combined with electric knife (MMH) in the treatment of stages III to IV hemorrhoids. We conducted a retrospective study of 99 patients with stages III to IV hemorrhoids hospitalized from January to December in 2013. Among them, 51 patients were treated with ACS, while 48 patients received MMH. Data from clinical recording and follow-up included operative time, intraoperative blood loss, hospitalization information, postoperative pain, and postoperative complications. Operative time, intraoperative blood loss and hospitalization time in ACS group were significantly less than those in MMH group (P < .05). Compared with MMH group, ACS group had a lower postoperative static pain score from days 1 to 14 (P < .01). The patients in ACS group exhibited less postoperative defecation pain scores from days 3 to 20 than those of MMH group (P < .05). The incidence of postoperative anal edema and delayed wound healing in ACS group was lower than that in MMH group (P < .05). Compared with MMH, our novel technique ACS was more effective and had fewer postoperative complications in the treatment of stages III to IV hemorrhoids. PMID:28658138

Hemorrhoids screening and treatment prior to LVAD: is it a necessity?

PubMed

Skouri, Hadi; Shurrab, Mohammed; Zahnan, Jad; Deeba, Samer; Sfeir, Pierre; Gharzuddin, Walid; Haj-Yahia, Saleem

2016-04-12

Continuous-flow left ventricle assist devices (CF-LVADs) has become an essential modality in the management of stage D heart failure (HF) with significant improvement in survival and quality of life. Due to the durability of such devices and long term support complications such as bleeding and aortic insufficiency has emerged. Bleeding accounts for more than 20 % with the majority being from the gastrointestinal tract. The increase of bleeding tendency are mainly attributed to the loss of large von Willebrand's Factor (vWF) multimers due to shear stress with the chronic intake of anticoagulants. We are reporting two cases of patients with Stage D HF and history of hemorrhoids presenting for LVAD implantation. Many efforts that decrease bleeding related to CF-LVADs will be discussed with focus on hemorrhoids.

The anal canal as a risk organ in cervical cancer patients with hemorrhoids undergoing whole pelvic radiotherapy.

PubMed

Jang, Hyunsoo; Baek, Jong Geun; Jo, Sunmi

2015-01-01

Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy. The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications. The anal verge was located an average of 1.2 cm (range -0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range -0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07). The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.

Infrared coagulation versus rubber band ligation in early stage hemorrhoids.

PubMed

Gupta, P J

2003-10-01

The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54) or infrared coagulation (N = 46). Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years). The mean duration of disease was 17.5 months (range 12 to 34 months). The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale). Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059). The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03), but also had a higher recurrence or failure rate (P = 0.03). Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

Impact of less invasive treatments including sclerotherapy with a new agent and hemorrhoidopexy for prolapsing internal hemorrhoids.

PubMed

Tokunaga, Yukihiko; Sasaki, Hirokazu

2013-01-01

Conventional hemorrhoidectomy is applied for the treatment of prolapsing internal hemorrhoids. Recently, less-invasive treatments such as sclerotherapy using aluminum potassium sulphate/tannic acid (ALTA) and a procedure for prolapse and hemorrhoids (PPH) have been introduced. We compared the results of sclerotherapy with ALTA and an improved type of PPH03 with those of hemorrhoidectomy. Between January 2006 and March 2009, we performed hemorrhoidectomy in 464 patients, ALTA in 940 patients, and PPH in 148 patients with second- and third-degree internal hemorrhoids according to the Goligher's classification. The volume of ALTA injected into a hemorrhoid was 7.3 ± 2.2 (mean ± SD) mL. The duration of the operation was significantly shorter in ALTA (13 ± 2 minutes) than in hemorrhoidectomy (43 ± 5 minutes) or PPH (32 ± 12 minutes). Postoperative pain, requiring intravenous pain medications, occurred in 65 cases (14%) in hemorrhoidectomy, in 16 cases (1.7%) in ALTA, and in 1 case (0.7%) in PPH. The disappearance rates of prolapse were 100% in hemorrhoidectomy, 96% in ALTA, and 98.6% in PPH. ALTA can be performed on an outpatient basis without any severe pain or complication, and PPH is a useful alternative treatment with less pain. Less-invasive treatments are beneficial when performed with care to avoid complications.

[Clinical study of tissue-selecting therapy in the treatment of mixed hemorrhoids: a single-blind randomized controlled trail].

PubMed

He, Hongyan; He, Ping; Liu, Ning

2014-06-01

To evaluate the clinical efficacy and safety of tissue-selecting therapy (TST) in treatment of mixed hemorrhoids. A single-blind randomized study was carried out. A total of 120 patients with mixed hemorrhoids from January to December 2012 were prospectively enrolled in the study and equally divided into two groups, TST group and procedure for prolapse and hemorrhoids(PPH) group. Surgical data, efficacy and postoperative complications were compared between the two groups. As compared to PPH group, patients in TST group had shorter operation time [(15.9±5.18) min vs. (22.6±7.1) min, P<0.05], lower scores of rectal urgency (0.5±0.2 vs. 1.5±1.4, P<0.05), and shorter hospital stay [(11.2±3.7) d vs. (14.8±3.7) d, P<0.05]. No anastomotic stricture case was found in TST group, while 11 cases(18.3%) developed anastomotic stricture in PPH group. There were no significant differences in effective rate and pain score of first defecation between the two groups. TST is reliable and safe for mixed hemorrhoids with the advantage of simple, rapid recovery and less complications.

A Randomized Multicenter Clinical Trial of RPH With the Simplified Milligan-Morgan Hemorrhoidectomy in the Treatment of Mixed Hemorrhoids.

PubMed

He, Yong-Heng; Tang, Zhi-Jun; Xu, Xiang-Tong; Huang, De-Quan; Zhang, Li-Shun; Tang, Qing-Zhu; Fan, Zhi-Min; Zou, Xian-Jun; Zou, Guo-Jun; Zhang, Chong-Yang; Hu, Fan; Xie, Biao; Li, Yan-Hua; Tong, Yao; Liu, Hong-Chang; Li, Ke; Luo, Yu-Lian; Liu, Fei; Situ, Guang-Wei; Liu, Zuo-Long

2017-12-01

To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < .05). The operation time was the shortest in patients who received RPH alone and increased in the following order: patients who received RPH+sMMH, PPH alone, MMH alone, and PPH+sMMH ( P < .01). The duration of postoperative hospitalization stay was the shortest in patients who received RPH alone and increased in the following order: PPH alone, RPH+sMMH, PPH+sMMH, and MMH alone ( P < .01). The incidence of postoperative hemorrhage, uroschesis, anal fissure, crissum hematoma or thrombosis, and anorectal stenosis was significantly lower in patients who received RPH+sMMH than in patients who received the other 4 types of surgical treatments ( P < .05, P < .01). No significant differences in postoperative rectovaginal fistula and anal incontinence were observed between the 5 groups of patients. RPH with or without simplified MMH can reduce the incidence of postoperative complications and improve the curative efficacy in the treatment of patients with mixed hemorrhoids.

Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation.

PubMed

Lu, Ming; Yang, Bo; Liu, Yang; Liu, Qing; Wen, Hao

2015-07-14

To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation. One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study. The patients with rectal prolapse hemorrhoids with outlet obstruction-induced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids (PPH) (n = 54) or conventional surgery (n = 54; control group). Short-term (operative time, postoperative hospital stay, postoperative urinary retention, postoperative perianal edema, and postoperative pain) and long-term (postoperative anal stenosis, postoperative sensory anal incontinence, postoperative recurrence, and postoperative difficulty in defecation) clinical effects were compared between the two groups. The short- and long-term efficacies of the two procedures were determined. In terms of short-term clinical effects, operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group (24.36 ± 5.16 min vs 44.27 ± 6.57 min, 2.1 ± 1.4 d vs 3.6 ± 2.3 d, both P < 0.01). The incidence of postoperative urinary retention was higher in the PPH group than in the control group, but the difference was not statistically significant (48.15% vs 37.04%). The incidence of perianal edema was significantly lower in the PPH group (11.11% vs 42.60%, P < 0.05). The visual analogue scale scores at 24 h after surgery, first defecation, and one week after surgery were significantly lower in the PPH group (2.9 ± 0.9 vs 8.3 ± 1.1, 2.0 ± 0.5 vs 6.5 ± 0.8, and 1.7 ± 0.5 vs 5.0 ± 0.7, respectively, all P < 0.01). With regard to long-term clinical effects, the incidence of anal stenosis was lower in the PPH group than in

Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation

PubMed Central

Lu, Ming; Yang, Bo; Liu, Yang; Liu, Qing; Wen, Hao

2015-01-01

AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation. METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study. The patients with rectal prolapse hemorrhoids with outlet obstruction-induced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids (PPH) (n = 54) or conventional surgery (n = 54; control group). Short-term (operative time, postoperative hospital stay, postoperative urinary retention, postoperative perianal edema, and postoperative pain) and long-term (postoperative anal stenosis, postoperative sensory anal incontinence, postoperative recurrence, and postoperative difficulty in defecation) clinical effects were compared between the two groups. The short- and long-term efficacies of the two procedures were determined. RESULTS: In terms of short-term clinical effects, operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group (24.36 ± 5.16 min vs 44.27 ± 6.57 min, 2.1 ± 1.4 d vs 3.6 ± 2.3 d, both P < 0.01). The incidence of postoperative urinary retention was higher in the PPH group than in the control group, but the difference was not statistically significant (48.15% vs 37.04%). The incidence of perianal edema was significantly lower in the PPH group (11.11% vs 42.60%, P < 0.05). The visual analogue scale scores at 24 h after surgery, first defecation, and one week after surgery were significantly lower in the PPH group (2.9 ± 0.9 vs 8.3 ± 1.1, 2.0 ± 0.5 vs 6.5 ± 0.8, and 1.7 ± 0.5 vs 5.0 ± 0.7, respectively, all P < 0.01). With regard to long-term clinical effects, the incidence of anal stenosis was lower in

Treatment of hemorrhoids with individualized homeopathy: An open observational pilot study

PubMed Central

Das, Kaushik Deb; Ghosh, Shubhamoy; Das, Asim Kumar; Ghosh, Aloke; Mondal, Ramkumar; Banerjee, Tanapa; Ali, Seikh Sajid; Ali, Seikh Swaif; Koley, Munmun; Saha, Subhranil

2016-01-01

Aim: Controversies and disagreement exist on conventional treatment strategies of hemorrhoids due to relapse, inefficacy, and complications. We intend to evaluate the role of individualized homeopathic treatment in hemorrhoids. Materials and Methods: In this prospective, open, observational trial, hemorrhoids patients were treated using five standardized scales measuring complaints severity and anoscopic score. It was conducted at two homeopathic hospitals in India, during from mid-July 2014 to mid-July 2015. Patients were intervened as per individualized homeopathic principles and followed up every month up to 6 months. Results: Total 73 were screened, 52 enrolled, 38 completed, 14 dropped out. Intention to treat population (n: = 52) was analyzed in the end. Statistically significant reductions of mean bleeding (month 3: −21.8, 95% confidence interval [CI]: −30.3, −13.3, P: < 0.00001, d = 0.787; month 6: −25.5, 95% CI −35.4, −15.6, P: < 0.00001, d = 0.775), pain (month 3: −21.3, 95% CI −28.6, −14.0, P: < 0.00001, d = 0.851; month 6: −27.6, 95% CI −35.6, −19.6, P: < 0.00001, d = 1.003), heaviness visual analog scales (VASs) (month 3: −8.1, 95% CI −13.9, −2.3, P: = 0.008, d = 0.609; month 6: −12.1, 95% CI −19.1, −5.1, P: = 0.001, d = 0.693), and anoscopic score (month 3: −0.4, 95% CI −0.6, −0.2, P: < 0.0001, d = 0.760; month 6: −0.5, 95% CI −0.7, −0.3, P: < 0.0001, d = 0.703) were achieved. Itching VASs reduced significantly only after 6 months (−8.1, 95% CI −14.6, −1.6, P: = 0.017, d = 0.586). No significant lowering of discharge VASs was achieved after 3 and 6 months. Conclusion: Under classical homeopathic treatment, hemorrhoids patients improved considerably in symptoms severity and anoscopic scores. However, being observational trial, our study cannot provide efficacy data. Controlled studies are required. Trial Reg. CTRI/2015/07/005958. PMID:27757262

Randomized controlled trial to assess the role of raised anal pressures in the pathogenesis of symptomatic early hemorrhoids.

PubMed

Chauhan, Ashutosh; Thomas, Shaji; Bishnoi, Prem Kumar; Hadke, Niladhar S

2007-01-01

Increased maximum resting anal pressures (MRAP) have been found in patients with large prolapsed hemorrhoids undergoing hemorrhoidectomy, but their pathogenic role is controversial especially in view of the sphincteric damage that occurs with open and stapled procedures. This prospective randomized clinical trial was conducted to compare anal pressure changes in early symptomatic hemorrhoidal disease before and after successful treatment with band ligation or injection sclerotherapy, and to compare these pressures with those in normal asymptomatic controls. 32 patients with symptomatic grade II hemorrhoids were randomized to treatment with either band ligation or injection sclerotherapy. Anal manometry was done before treatment and 8 weeks after completion of treatment, and compared with 20 normal age-matched controls. The pretreatment values in both study groups were similar to each other (69.38 cm H(2)O, 95% CI 58.67-80.08, vs. 67.75 cm H(2)O, 95% CI 56.86-78.64; p = 0.790), but were significantly higher (p = 0.0001 in both groups) than in the controls (45.25 cm H(2)O, 95% CI 38.36-52.14). After successful completion of treatment, there was a highly significant drop in the MRAP in both study groups (p = 0.0001 in group A, and p = 0.001 in group B) reaching normal values. Our study shows that even in early-stage hemorrhoids, the anal pressures are significantly raised, but after successful treatment with band ligation or injection sclerotherapy, these pressures return to normal, showing that they do not play a pathogenic role but are secondary to the congested hemorrhoidal cushions. Copyright (c) 2007 S. Karger AG, Basel.

Impact of Less Invasive Treatments Including Sclerotherapy With a New Agent and Hemorrhoidopexy for Prolapsing Internal Hemorrhoids

PubMed Central

Tokunaga, Yukihiko; Sasaki, Hirokazu

2013-01-01

Conventional hemorrhoidectomy is applied for the treatment of prolapsing internal hemorrhoids. Recently, less-invasive treatments such as sclerotherapy using aluminum potassium sulphate/tannic acid (ALTA) and a procedure for prolapse and hemorrhoids (PPH) have been introduced. We compared the results of sclerotherapy with ALTA and an improved type of PPH03 with those of hemorrhoidectomy. Between January 2006 and March 2009, we performed hemorrhoidectomy in 464 patients, ALTA in 940 patients, and PPH in 148 patients with second- and third-degree internal hemorrhoids according to the Goligher's classification. The volume of ALTA injected into a hemorrhoid was 7.3 ± 2.2 (mean ± SD) mL. The duration of the operation was significantly shorter in ALTA (13 ± 2 minutes) than in hemorrhoidectomy (43 ± 5 minutes) or PPH (32 ± 12 minutes). Postoperative pain, requiring intravenous pain medications, occurred in 65 cases (14%) in hemorrhoidectomy, in 16 cases (1.7%) in ALTA, and in 1 case (0.7%) in PPH. The disappearance rates of prolapse were 100% in hemorrhoidectomy, 96% in ALTA, and 98.6% in PPH. ALTA can be performed on an outpatient basis without any severe pain or complication, and PPH is a useful alternative treatment with less pain. Less-invasive treatments are beneficial when performed with care to avoid complications. PMID:23971772

Early rectal stenosis following stapled rectal mucosectomy for hemorrhoids

PubMed Central

Petersen, Sven; Hellmich, Gunter; Schumann, Dietrich; Schuster, Anja; Ludwig, Klaus

2004-01-01

Background Within the last years, stapled rectal mucosectomy (SRM) has become a widely accepted procedure for second and third degree hemorrhoids. One of the delayed complications is a stenosis of the lower rectum. In order to evaluate the specific problem of rectal stenosis following SRM we reviewed our data with special respect to potential predictive factors or stenotic events. Methods A retrospective analysis of 419 consecutive patients, which underwent SRM from December 1998 to August 2003 was performed. Only patients with at least one follow-up check were evaluated, thus the analysis includes 289 patients with a mean follow-up of 281 days (±18 days). For statistic analysis the groups with and without stenosis were evaluated using the Chi-Square Test, using the Kaplan-Meier statistic the actuarial incidence for rectal stenosis was plotted. Results Rectal stenosis was observed in 9 patients (3.1%), eight of these stenoses were detected within the first 100 days after surgery; the median time to stenosis was 95 days. Only one patient had a rectal stenosis after more than one year. 8 of the 9 patients had no obstructive symptoms, however the remaining patients complained of obstructive defecation and underwent surgery for transanal strictureplasty with electrocautery. A statistical analysis revealed that patients with stenosis had significantly more often prior treatment for hemorrhoids (p < 0.01). According to the SRM only severe postoperative pain was significantly associated with stenoses (p < 0.01). Other factors, such as gender (p = 0.11), surgical technique (p = 0.25), revision (p = 0.79) or histological evidence of squamous skin (p = 0.69) showed no significance. Conclusion Rectal stenosis is an uncommon event after SRM. Early stenosis will occur within the first three months after surgery. The majority of the stenoses are without clinical relevance. Only one of nine patients had to undergo surgery for a relevant stenosis. The predictive factor for

Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases

PubMed Central

Nakeeb, Ayman M El; Fikry, Amir A; Omar, Waleed H; Fouda, Elyamani M; Metwally, Tito A El; Ghazy, Hosam E; Badr, Sabry A; Elkhar, Mohmed Y Abu; Elawady, Salih M; Elmoniam, Hisham H Abd; Khafagy, Waiel W; Morshed, Mosaad M; Lithy, Ramadan E El; Farid, Mohamed E

2008-01-01

AIM: To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation (RBL) method. METHODS: A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to September, 2006, data was retrieved from archived files. RBL was performed using the Mc Gown applicator on an outpatient basis. The patients were asked to return to out-patient clinic for follow up at 2 wk, 1 mo, 6 mo and through telephone call every 6 mo for 2 years). RESULTS: After RBL, 696 patients (92.8%) were cured with no difference in outcome for second or third degree hemorrhoids (P = 0.31). Symptomatic recurrence was detected in 11.04% after 2 years. A total of 52 patients (6.93%) had 77 complications from RBL which required no hospitalization. Complications were pain, rectal bleeding and vaso-vagal symptoms (4.13%, 4.13% and 1.33% of patients, respectively). At 1 mo there were a significant improvement in mean SF-36 scores over baseline in five items, while after 2 years there were improvement in all items over baseline, but not significant. No significant manometric changes after band ligation. CONCLUSION: RBL is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an out patient procedure with significant improvement in quality of life. RBL doesn’t alter ano-rectal functions. PMID:19030206

Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases.

PubMed

El Nakeeb, Ayman-M; Fikry, Amir-A; Omar, Waleed-H; Fouda, Elyamani-M; El Metwally, Tito-A; Ghazy, Hosam-E; Badr, Sabry-A; Abu Elkhar, Mohmed-Y; Elawady, Salih-M; Abd Elmoniam, Hisham-H; Khafagy, Waiel-W; Morshed, Mosaad-M; El Lithy, Ramadan-E; Farid, Mohamed-E

2008-11-14

To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation (RBL) method. A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to September, 2006, data was retrieved from archived files. RBL was performed using the Mc Gown applicator on an outpatient basis. The patients were asked to return to out-patient clinic for follow up at 2 wk, 1 mo, 6 mo and through telephone call every 6 mo for 2 years). After RBL, 696 patients (92.8%) were cured with no difference in outcome for second or third degree hemorrhoids (P = 0.31). Symptomatic recurrence was detected in 11.04% after 2 years. A total of 52 patients (6.93%) had 77 complications from RBL which required no hospitalization. Complications were pain, rectal bleeding and vaso-vagal symptoms (4.13%, 4.13% and 1.33% of patients, respectively). At 1 mo there were a significant improvement in mean SF-36 scores over baseline in five items, while after 2 years there were improvement in all items over baseline, but not significant. No significant manometeric changes after band ligation. RBL is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an out patient procedure with significant improvement in quality of life. RBL doesn't alter ano-rectal functions.

Effect of intraoperative transesophageal Doppler-guided fluid therapy versus central venous pressure-guided fluid therapy on renal allograft outcome in patients undergoing living donor renal transplant surgery: a comparative study.

PubMed

Srivastava, Divya; Sahu, Sandeep; Chandra, Abhilash; Tiwari, Tanmay; Kumar, Sanjay; Singh, P K

2015-12-01

Transesophageal Doppler (TED)-guided intraoperative fluid therapy has shown to noninvasively optimize intravascular volume and reduce postoperative morbidity. The aim of this study was to compare the effects of Doppler-guided intraoperative fluid administration and central venous pressure (CVP)-guided fluid therapy on renal allograft outcome and postoperative complications. A prospective nonrandomized active controlled study was conducted on end-stage renal disease patients scheduled for living donor renal transplant surgery. 110 patients received intraoperative fluid guided by corrected flow time (FTc) and variation in stroke volume values obtained by continuous TED monitoring. Data of 104 patients in whom intraoperative fluid administration was guided by CVP values were retrospectively obtained for a control. The amount of intraoperative fluid given in the study group (12.20 ± 4.24 ml/kg/h) was significantly lower than in the controls (22.21 ± 4.67 ml/kg/h). The amount of colloid used was also significantly less and fewer recipients were seen to require colloid (69 vs 85%). The mean arterial pressures were comparable throughout. CVP reached was 7.18 ± 3.17 mmHg in the study group. It was significantly higher in the controls (13.42 ± 3.12 mmHg). The postoperative graft function and rate of dysfunction were comparable. Side-effects like postoperative dyspnoea (4.8 vs 0%) and tissue edema (9.6 vs 2.7%) were higher in the controls. FTc-guided intraoperative fluid therapy achieved the same rate of immediate graft function as CVP-guided fluid therapy but used a significantly less amount of fluid. The incidence of postoperative complications related to fluid overload was also reduced. The use of TED may replace invasive central line insertions in the future.

Randomized Prospective Study of Endoscopic Rubber Band Ligation Compared With Bipolar Coagulation for Chronically Bleeding Internal Hemorrhoids

PubMed Central

Jutabha, Rome; Jensen, Dennis M.; Chavalitdhamrong, Disaya

2013-01-01

OBJECTIVES: Our purpose was to compare the efficacy, complications, success rate, recurrence rate at 1 year, and crossovers of rubber band ligation (RBL) with those of bipolar electrocoagulation (BPEC) treatment for chronically bleeding internal hemorrhoids. METHODS: A total of 45 patients of mean age 51.5 years, who had rectal bleeding from grade II or III hemorrhoids and in whom intensive medical therapy failed, were randomized in a prospective study comparing RBL with BPEC. Treatment failure was predefined as continued bleeding, occurrence of a major complication, or failure to reduce the size of all internal hemorrhoidal segments to grade I in ≤ 3 treatments. Patients were followed up for 1 year. RESULTS: With similar patients, rectal bleeding and other symptoms were controlled with significantly fewer treatments of RBL than of BPEC (2.3±0.2 vs. 3.8±0.4, P < 0.05), and RBL had a significantly higher success rate (92% vs. 62%, P< 0.05). RBL had more cases of severe pain during treatment (8% vs. 0%, P> 0.05), but significantly fewer failures and crossovers (8% vs. 38%). Symptomatic recurrence at 1 year was 10% RBL and 15% BPEC. CONCLUSIONS: For patients with chronically bleeding grade II or III internal hemorrhoids that are unresponsive to medical therapy, safety and complication rates of banding and BPEC were similar. The success rate was significantly higher with RBL than with BPEC. Symptom recurrence rates at 1 year were similar. PMID:19513028

Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids.

PubMed

Yoshikawa, Kenichi; Kawashima, Reimi; Hirose, Yuki; Shibata, Keiko; Akasu, Takafumi; Hagiwara, Noriko; Yokota, Takeharu; Imai, Nami; Iwaku, Akira; Kobayashi, Go; Kobayashi, Hirohiko; Kinoshita, Akiyoshi; Fushiya, Nao; Kijima, Hiroyuki; Koike, Kazuhiko; Saruta, Masayuki

2017-07-21

We are reporting a rare case of acute liver injury that developed after an internal hemorrhoid treatment with the aluminum potassium sulfate and tannic acid (ALTA) regimen. A 41-year-old man developed a fever and liver injury after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA with lidocaine. The acute liver injury was classified clinically as hepatocellular and pathologically as cholestastic. We could not classify the mechanism of injury. High eosinophil and immunoglobulin E levels characterized the injury, and a drug lymphocyte stimulation test was negative on postoperative day 25. Fluid replacement for two weeks after hospitalization improved the liver injury. ALTA therapy involves injecting chemicals into the submucosa, from the rectum to the anus, and this is the first description of a case that developed a severe liver disorder after this treatment; hence, an analysis of future cases as they accumulate is desirable.

Standardised imaging technique for guided M-mode and Doppler echocardiography in the horse.

PubMed

Long, K J; Bonagura, J D; Darke, P G

1992-05-01

Eighteen echocardiographic images useful for diagnostic imaging, M-mode echocardiography, and Doppler echocardiography of the equine heart were standardised by relating the position of the axial beam to various intracardiac landmarks. The transducer orientation required for each image was recorded in 14 adult horses by describing the degree of sector rotation and the orientation of the axial beam relative to the thorax. Repeatable images could be obtained within narrow limits of angulation and rotation for 14 of the 18 standardised images evaluated. Twenty-seven National Hunt horses were subsequently examined using this standardised technique. Selected cardiac dimensions were measured from two-dimensional and guided M-mode studies. Satisfactory results were achieved in 26 of the 27 horses. There was no linear correlation between any of the measured cardiac values and bodyweight. There was no significant difference between measurements taken from the left and the right hemithorax. Six horses were imaged on three consecutive days to assess the repeatability of the measurements. No significant difference was found between measurements obtained on different days. This study demonstrates a method for standardised echocardiographic evaluation of the equine heart that is repeatable, valuable for teaching techniques of equine echocardiography, applicable for diagnostic imaging and quantification of cardiac size, and useful for the evaluation of blood-flow patterns by Doppler ultrasound.

Comparison of clinical outcomes of multi-point umbrella suturing and single purse suturing with two-point traction after procedure for prolapse and hemorrhoids (PPH) surgery.

PubMed

Jiang, Huiyong; Hao, Xiuyan; Xin, Ying; Pan, Youzhen

2017-11-01

To compare the clinical outcomes of multipoint umbrella suture and single-purse suture with two-point traction after procedure for prolapse and hemorrhoids surgery (PPH) for the treatment of mixed hemorrhoids. Ninety patients were randomly divided into a PPH plus single-purse suture group (Group A) and a PPH plus multipoint umbrella suture (Group B). All operations were performed by an experienced surgeon. Operation time, width of the specimen, hemorrhoids retraction extent, postoperative pain, postoperative bleeding, and length of hospitalization were recorded and compared. Statistical analysis was conducted by t-test and χ2 test. There were no significant differences in sex, age, course of disease, and degree of prolapse of hemorrhoids between the two groups. The operative time in Group A was significantly shorter than that in Group B (P < 0.05). However, the incidence rates of submucosal hematoma and incomplete hemorrhoid core retraction were significantly lower in Group B (P < 0.05), whereas the width of the specimens in Group B was greater than that in Group A (P < 0.05). There were fewer redundant skin tags in Group B at three months follow-up. No significant difference in postoperative pain, postoperative bleeding, and time of hospital stay (P > 0.05 for all comparisons) was observed. The multipoint umbrella suture showed better clinical outcomes because of its targeted suture according to the extent of hemorrhoid prolapse. Copyright © 2017. Published by Elsevier Ltd.

Use of the Esophageal Doppler Machine to help guide the intraoperative management of two children with pheochromocytoma.

PubMed

Hack, Henrik

2006-08-01

The anesthetic management of pheochromocytoma has been based upon the intraoperative control of blood pressure and fluid balance following adequate preoperative preparation. This can be difficult, especially in the presence of significant comorbidity such as cardiac or renal dysfunction. Two cases of children with pheochromocytoma are reported where the introperative management of fluid balance and blood pressure control were guided by measurement of changes in descending aortic blood flow using an esophageal Doppler probe. The advantages of such a technique compared with more invasive monitors are discussed.

76 FR 21237 - Medical Devices; Obstetrical and Gynecological Devices; Classification of the Hemorrhoid...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... reasonable assurance of safety and effectiveness of the device. A hemorrhoid prevention pressure wedge... provide reasonable assurance of safety and effectiveness, but there is sufficient information to establish special controls to provide reasonable assurance of the safety and effectiveness of the device for its...

Transesophageal color Doppler evaluation of obstructive lesions using the new "Quasar" technology.

PubMed

Fan, P; Nanda, N C; Gatewood, R P; Cape, E G; Yoganathan, A P

1995-01-01

Due to the unavoidable problem of aliasing, color flow signals from high blood flow velocities cannot be measured directly by conventional color Doppler. A new technology termed Quantitative Un-Aliased Speed Algorithm Recognition (Quasar) has been developed to overcome this limitation. Employing this technology, we used transesophageal color Doppler echocardiography to investigate whether the velocities detected by the Quasar would correlate with those obtained by continuous-wave Doppler both in vitro and in vivo. In the in vitro study, a 5.0 MHz transesophageal transducer of a Kontron Sigma 44 color Doppler flow system was used. Fourteen different peak velocities calculated and recorded by color Doppler-guided continuous-wave Doppler were randomly selected. In the clinical study, intraoperative transesophageal echocardiography was performed using the same transducer 18 adults (13 aortic valve stenosis, 2 aortic and 2 mitral stenosis, 2 hypertrophic obstructive cardiomyopathy and 1 mitral valve stenosis). Following each continuous-wave Doppler measurement, the Quasar was activated, and a small Quasar marker was placed in the brightest area of the color flow jet to obtain the maximum mean velocity readout. The maximum mean velocities measured by Quasar closely correlated with maximum peak velocities obtained by color flow guided continuous-wave Doppler in both in vitro (0.53 to 1.65 m/s, r = 0.99) and in vivo studies (1.50 to 6.01 m/s, r = 0.97). We conclude that the new Quasar technology can accurately measure high blood flow velocities during transesophageal color Doppler echocardiography. This technique has the potential of obviating the need for continuous-wave Doppler.

Comparison of esophageal Doppler and plethysmographic variability index to guide intraoperative fluid therapy for low-risk patients undergoing colorectal surgery.

PubMed

Warnakulasuriya, Samantha R; Davies, Simon J; Wilson, R Jonathan T; Yates, David R A

2016-11-01

This study aims to investigate if there is equivalence in volumes of fluid administered when intravenous fluid therapy is guided by Pleth Variability Index (PVI) compared to the established technology of esophageal Doppler in low-risk patients undergoing major colorectal surgery. Randomized controlled trial. Operating room. Forty low-risk patients undergoing elective colorectal surgery. Patients were monitored by esophageal Doppler and PVI probes and were randomized to have fluid therapy directed by using one of these technologies, with 250 mL boluses of colloid to maintain a maximal stroke volume, or a PVI of less than 14%. Absolute volumes of fluid volumes given intraoperatively were measured as were 24 hours fluid volumes. Perioperative measurements of lactate and base excess were recorded as were postoperative complications. There was no significant difference between PVI and esophageal Doppler groups in mean total fluid administered (1286 vs 1520 mL, P=.300) or mean intraoperative fluid balance (+839 v+1145 mL, P=.150). PVI offers an entirely non-invasive alternative for goal-directed fluid therapy in this group of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

[Effects of electroacupuncture preemptive intervention on postoperative pain of mixed hemorrhoids].

PubMed

Wu, Jing; Zhao, Yu; Yang, Chun-Mei; Xue, Qi-Ming; Li, Ning

2014-03-01

To evaluate clinical efficacy of electroacupuncture at Changqiang (GV 1) and Chengshan (BL 57) 30 min before surgery on postoperative pain and discomforts in patients with mixed hemorrhoids. One hundred and twenty cases of mixed hemorrhoids who received Milligan-Morgan operation were randomly divided into an electroacupuncture group, a sham electroacupuncture group and a blank group, 40 cases in each one. At the same time of basic treatment, the electroacupuncture was applied at Changqiang (GV 1) and Chengshan (BL 57) 30 min before surgery in the electroacupuncture group, while shallow needling without electrical stimulation at sham acupoint (1 cm next to acupoint) was applied 30 min before surgery in the sham electroacupuncture group, while no treatment was given before the surgery in the blank group. The total dose of painkillers in the first 24 h after operation, the number of cases who received additional anesthetic in the operation, the self-score of most severity pain in the first 24 h after operation and sleeping time in the night of surgery were observed. The differences of the numbers of cases who received additional anesthetic in the operation had no statistical significance among the three groups (all P > 0.05), but compared with the sham electroacupuncture group and blank group, the total dose of painkillers in the first 24 h after operation was reduced in the electroacupuncture group [(2.43 +/- 1.08) tablets vs (3.23 +/- 1.33) tablets, (3.10 +/- 1.22) tablets], and the score of most severity pain was also decreased (6.65 +/- 1.00 vs 7.48 +/- 0.96, 7.25 +/- 1.19), besides, the sleeping time in the night of surgery was increased [(220.63 +/- 85.50) min vs (162.00 +/- 92.69) min, (151.50 +/- 80.01) min, all P < 0.05]. The electroacupuncture at Changqiang (GV 1) and Chengshan (BL 57) 30 min before surgery has effects of preemptive analgesia on postoperative pain for patients with mixed hemorrhoids.

Recombinant streptokinase vs hydrocortisone suppositories in acute hemorrhoids: A randomized controlled trial.

PubMed

Hernández-Bernal, Francisco; Castellanos-Sierra, Georgina; Valenzuela-Silva, Carmen M; Catasús-Álvarez, Karem M; Martínez-Serrano, Osmany; Lazo-Diago, Odalys C; Bermúdez-Badell, Cimara H; Causa-García, José R; Domínguez-Suárez, Juan E

2015-06-21

To compare the efficacy and safety of recombinant streptokinase (rSK) vs hydrocortisone acetate-based suppositories in acute hemorrhoidal disease. A multicenter (11 sites), randomized (1:1:1), open, controlled trial with parallel groups was performed. All participating patients gave their written, informed consent. After inclusion, patients with acute symptoms of hemorrhoids were centrally randomized to receive, as outpatients, by the rectal route, suppositories of rSK 200000 IU of one unit every 8 h (first 3 units) and afterwards every 12 h until 8 administrations were completed (schedule A), one unit every 8 h until 6 units were completed (schedule B), or 25 mg hydrocortisone acetate once every 8 h up to a maximum of 24 administrations. Evaluations were performed at 3, 5, and 10 d post-inclusion. The main end-point was the 5(th)-day response (disappearance of pain and bleeding, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were also evaluated. Groups were homogeneous with regards to demographic and baseline characteristics. Fifth day complete response rates were 156/170 (91.8%; 95%CI: 87.3-96.2), 155/170 (91.2%; 95%CI: 86.6%-95.7%), and 46/170 (27.1%; 95%CI: 20.1%-34.0%) with rSK (schedule A and B) and hydrocortisone acetate suppositories, respectively. These 64.6% and 63.9% differences (95%CI: 56.7%-72.2% and 55.7%-72.0%) were highly significant (P < 0.001). This advantage was detected since the early 3(rd) day evaluation (68.8% and 64.1% vs 7.1% for the rSK and active control groups, respectively; P < 0.001) and was maintained even at the late 10(th) day assessment (97.1% and 93.5% vs 67.1% for rSK and hydrocortisone acetate, respectively; P < 0.001). Time to response was 3 d (95%CI: 2.9-3.1) for both rSK groups and 10 d (95%CI: 9.3-10.7) in the hydrocortisone acetate group. This difference was highly significant (P < 0.001). All subgroup stratified analyses (with or

Users Guide to the JPL Doppler Gravity Database

NASA Technical Reports Server (NTRS)

Muller, P. M.; Sjogren, W. L.

1986-01-01

Local gravity accelerations and gravimetry have been determined directly from spacecraft Doppler tracking data near the Moon and various planets by the Jet Propulsion Laboratory. Researchers in many fields have an interest in planet-wide global gravimetric mapping and its applications. Many of them use their own computers in support of their studies and would benefit from being able to directly manipulate these gravity data for inclusion in their own modeling computations. Pubication of some 150 Apollo 15 subsatellite low-altitude, high-resolution, single-orbit data sets is covered. The doppler residuals with a determination of the derivative function providing line-of-sight-gravity are both listed and plotted (on microfilm), and can be ordered in computer readable forms (tape and floppy disk). The form and format of this database as well as the methods of data reduction are explained and referenced. A skeleton computer program is provided which can be modified to support re-reductions and re-formatted presentations suitable to a wide variety of research needs undertaken on mainframe or PC class microcomputers.

Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis.

PubMed

Alonso-Coello, Pablo; Mills, Ed; Heels-Ansdell, Diane; López-Yarto, Maite; Zhou, Qi; Johanson, John F; Guyatt, Gordon

2006-01-01

To evaluate the impact of laxatives on a wide range of symptoms in patients with symptomatic hemorrhoids. We searched using the following sources: MEDLINE, EMBASE, CINAHL and CENTRAL, BIOSIS, AMED, Papers First and Proceedings; study authors, industry, and experts in the field. We included all published and unpublished parallel group randomized controlled trials comparing any type of laxative to placebo or no therapy in patients with symptomatic hemorrhoids. Two reviewers independently screened studies for inclusion, retrieved all potentially relevant studies, and extracted data on study population, intervention, prespecified outcomes, and methodology. Seven trials randomized 378 patients to fiber or a nonfiber control. Studies were of moderate quality for most outcomes. Meta-analyses using random effects models suggested that fiber has an apparent beneficial effect. The risk of not improving/persisting symptoms decreased by 47% in the fiber group (RR = 0.53, 95% CI 0.38-0.73) and the risk of bleeding by 50% (RR = 0.50, 95% CI 0.28-0.89). Studies with multiple follow-ups, usually at 6 wk and at 3 months, showed consistent results over time. Results are also compatible with large treatment effects in prolapse, pain, and itching, but even in the pooled analyses confidence intervals were wide and compatible with no effect (RR = 0.79, 95% CI 0.37-1.67; RR = 0.33, 95% CI 0.07-1.65; and RR = 0.71, 95% CI 0.24-2.10, respectively). One study suggested a decrease in recurrence. Results showed a nonsignificant trend toward increases in mild adverse events in the fiber group (RR = 6.0, 95% CI 0.57-64.8). Trials of fiber show a consistent beneficial effect for symptoms and bleeding in the treatment of symptomatic hemorrhoids.

[Results of Longo's stapled hemorrhoidectomy in ambulatory surgery for grade III-IV hemorrhoids].

PubMed

Zaragozá, Cristóbal; García Fadrique, Alfonso; Castaño, Sergio; Villalba, Raúl; Bruna Esteban, Marcos; Redondo Cano, Carlos

2007-03-01

We prospectively evaluated the results of stapled hemorrhoidectomy for grade III-IV hemorrhoids in the ambulatory setting. Eighty-five consecutive patients with grade III-IV hemorrhoids, treated with the stapled technique with PPH01 in the Ambulatory Surgery Service of the General Hospital of Valencia were studied. Symptomatic, ASA I-II patients who agreed to undergo ambulatory surgery (vehicle, an accompanying adult, address with telephone, elevator, and basic hygiene conditions) were included. Thirty-nine percent were women and 61% were men, with a mean age of 47.6 years. A total of 85.9% had grade IV hemorrhoids and 14.1% had grade III. The average surgical time was 29.81+/- 12 minutes with a mean length of hospital stay of 168.88 +/- 88 minutes. Surgical complications consisted of 16 hemorrhages of the staple line (18.8%) and five hemorrhages due to mucous tear (5.9%). During the first 8 days the most frequent complication was pain (45.9%); only 7.1% of the patients required analgesia with opiates, and one patient required admission for 24 hours for analgesic purposes. Bleeding occurred in 10 patients, five of whom reported slight bleeding on defecation that stopped spontaneously; the remaining five required admission for 24 hours after surgical revision. Nine patients (10.6%) were admitted to the hospital for 24 hours, three due to intraoperative hemorrhage, five due to postoperative hemorrhage and one due to pain. A second intervention was required in 8.2%. Stapled hemorrhoidectomy can be applied in an ambulatory regime. Although technically simple with a short learning curve, this technique is not free of complications. Suitable patient selection and adequate perioperative information are indispensable for the ambulatory management of this disorder.

Recombinant streptokinase vs hydrocortisone suppositories in acute hemorrhoids: A randomized controlled trial

PubMed Central

Hernández-Bernal, Francisco; Castellanos-Sierra, Georgina; Valenzuela-Silva, Carmen M; Catasús-Álvarez, Karem M; Martínez-Serrano, Osmany; Lazo-Diago, Odalys C; Bermúdez-Badell, Cimara H; Causa-García, José R; Domínguez-Suárez, Juan E; Investigators, Pedro A López-Saura; THERESA-4 (Treatment of HEmorrhoids with REcombinant Streptokinase Application) Group of

2015-01-01

AIM: To compare the efficacy and safety of recombinant streptokinase (rSK) vs hydrocortisone acetate-based suppositories in acute hemorrhoidal disease. METHODS: A multicenter (11 sites), randomized (1:1:1), open, controlled trial with parallel groups was performed. All participating patients gave their written, informed consent. After inclusion, patients with acute symptoms of hemorrhoids were centrally randomized to receive, as outpatients, by the rectal route, suppositories of rSK 200000 IU of one unit every 8 h (first 3 units) and afterwards every 12 h until 8 administrations were completed (schedule A), one unit every 8 h until 6 units were completed (schedule B), or 25 mg hydrocortisone acetate once every 8 h up to a maximum of 24 administrations. Evaluations were performed at 3, 5, and 10 d post-inclusion. The main end-point was the 5th-day response (disappearance of pain and bleeding, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were also evaluated. RESULTS: Groups were homogeneous with regards to demographic and baseline characteristics. Fifth day complete response rates were 156/170 (91.8%; 95%CI: 87.3-96.2), 155/170 (91.2%; 95%CI: 86.6%-95.7%), and 46/170 (27.1%; 95%CI: 20.1%-34.0%) with rSK (schedule A and B) and hydrocortisone acetate suppositories, respectively. These 64.6% and 63.9% differences (95%CI: 56.7%-72.2% and 55.7%-72.0%) were highly significant (P < 0.001). This advantage was detected since the early 3rd day evaluation (68.8% and 64.1% vs 7.1% for the rSK and active control groups, respectively; P < 0.001) and was maintained even at the late 10th day assessment (97.1% and 93.5% vs 67.1% for rSK and hydrocortisone acetate, respectively; P < 0.001). Time to response was 3 d (95%CI: 2.9-3.1) for both rSK groups and 10 d (95%CI: 9.3-10.7) in the hydrocortisone acetate group. This difference was highly significant (P < 0.001). All subgroup stratified

The role of radiofrequency surgery in the treatment of hemorrhoidal disease.

PubMed

Filingeri, V; Bellini, M I; Gravante, G

2012-04-01

In this article we reported results obtained in our previous studies concerning application of radiofrequency (RF) in proctology and in particular for hemorrhoids treatment. We compared radiofrequency submucosal hemorrhoidectomy (RSH) and conventional Parks' hemorrhoidectomy (CPH) (group 1), radiofrequency open hemorrhoidectomy (ROH) and Milligan-Morgan hemorrhoidectomy (MMH) (group 2), radiofrequency closed hemorrhoidectomy (RCH) and Ferguson hemorrhoidectomy (FH) (group 3), combined hemorrhoidal radiocoagulation (CHR) and rubber band ligation (RBL) (group 4). In this work primary endpoints were determined as evaluation of the grade of pain felt immediately after the procedure and at the first evacuation, bleeding, operation time, readmission to work, incidence of failures and patient's satisfaction. Group 1 - In comparison to Parks' technique, use of radiofrequency scalpel reduced mean operation time (61.2 min, range 50-75, vs. 37.4 min, range 30-51; p < 0.05), first postoperative day pain score (5.9, range 3-10, vs. 4.0, range 1-10; p < 0.05), pain score at first evacuation (5.7, range 2-10, vs 4.2, range 1-8; p < 0.05) and pain score on postoperative days (3.6, range 1-9, vs. 2.8, range 1-8; p < 0.05). Group 2 - Results show a substantial similarity between these techniques, however the procedure lasted 7 minutes less with RF scalpel (18.6 min, range 16-21, vs. 25.55 min, range 20-30; p < 0.05). Group 3 - Patients treated with RF showed significant reduction in surgical time (23 min, range 21-31, vs. 33 min, range 24-35; p < 0.01), in pain at 1st post-operative day (VAS score 3.4 +/- 1.3 vs. 4.8 +/- 1.0; p < 0.05) and at the first evacuation (3.4 +/- 1.0 vs. 5.0 +/- 0.8; p < 0.05). Group 4 - The study confirmed validity of both the used techniques, however CHR seems to allow a reduction in incidence of failures. Results obtained from radiofrequency surgery compared with those achieved with classic surgery for hemorrhoidal disease show in the majority of cases

Development of a sub-cm high resolution ion Doppler tomography diagnostics for fine structure measurement of guide field reconnection in TS-U

NASA Astrophysics Data System (ADS)

Tanabe, Hiroshi; Koike, Hideya; Hatano, Hironori; Hayashi, Takumi; Cao, Qinghong; Himeno, Shunichi; Kaneda, Taishi; Akimitsu, Moe; Sawada, Asuka; Ono, Yasushi

2017-10-01

A new type of high-throughput/high-resolution 96CH ion Doppler tomography diagnostics has been developed using ``multi-slit'' spectroscopy technique for detailed investigation of fine structure formation during high guide field magnetic reconnection. In the last three years, high field merging experiment in MAST pioneered new frontiers of reconnection heating: formation of highly peaked structure around X-point in high guide field condition (Bt > 0.3 T), outflow dissipation under the influence of better plasma confinement to form high temperature ring structure which aligns with closed flux surface of toroidal plasma, and interaction between ion and electron temperature profile during transport/confinement phase to form triple peak structure (τeiE 4 ms). To investigate more detailed mechanism with in-situ magnetic measurement, the university of Tokyo starts the upgrade of plasma parameters and spatial resolution of optical diagnostics as in MAST. Now, a new type of high-throughput/high-resolution 96CH ion Doppler tomography diagnostics system construction has been completed and it successfully resolved fine structure of ion heating downstream, aligned with closed flux surface formed by reconnected field. This work was supported by JSPS KAKENHI Grant Numbers 15H05750, 15K14279 and 17H04863.

Stapled technique for acute thrombosed hemorrhoids: a randomized, controlled trial with long-term results.

PubMed

Wong, J C H; Chung, C C; Yau, K K; Cheung, H Y S; Wong, D C T; Chan, O C Y; Li, M K W

2008-04-01

This study was designed to compare stapled vs. conventional hemorrhoidectomy for patients with acute thrombosed hemorrhoids. Forty-one patients with acute thrombosed hemorrhoids were randomized into: 1) stapled hemorrhoidectomy (PPH group; n = 21), and 2) open hemorrhoidectomy (open group; n = 20). Emergency surgery was performed with perioperative data and complications were recorded. Patients were followed up by independent assessors to evaluate pain, recurrence, continence function, and satisfaction at regular intervals. The median follow-up for the PPH group and open group were 59 and 56 weeks, respectively. There was no significant difference in terms of the hospital stay, complication rate, and continence function; however, the mean pain intensity in the first postoperative week was significantly less in the PPH group (4.1 vs. 5.7, P = 0.02). Patients in the PPH group recovered significantly faster in terms of the time to become analgesic-free (4 vs. 8.5 days, P < 0.01), time to become pain-free (9 vs. 20.5 days, P = 0.01), resumption of work (7 vs. 12.5 days, P = 0.01), and time for complete wound healing (2 vs. 4 weeks, P < 0.01). On long-term follow-up, significantly fewer patients in the PPH group complained of recurrent symptoms (0 vs. 5, P = 0.02). The overall symptom improvement and patients' satisfaction were significantly better in the PPH group (90 vs. 80 percent, P = 0.03 and +3 vs. +2, P < 0.01 respectively). Stapled hemorrhoidectomy is safe and effective for acute thrombosed hemorrhoids. Similar to elective stapled procedure, emergency stapled excision has greater short-term benefits compared with conventional excision: diminished pain, faster recovery, and earlier return to work. Long-term results and satisfaction were excellent.

Comparative clinical evaluation of Kshara Sutra ligation and hemorrhoidectomy in Arsha (hemorrhoids).

PubMed

Gupta, Meva Lal; Gupta, S K; Bhuyan, Chaturbhuja

2011-04-01

Arsha (hemorrhoids) is engorgement of the hemorrhoidal venous plexus, characterized by bleeding per rectum, constipation, pain, prolapse and discharge. It is manifested due to improper diet, prolonged standing and faulty habits of defecation causing derangement of tridosha, mainly vata dosha. Vitiated dosha localizes in guda vali, pradhana dhamani and mansdhara kala and vitiates twak, mansa, meda and rakta, resulting in the annavaha sroto dushti. Modern management of arsha needs, mainly, a surgical approach, i.e. hemorrhoidectomy, wherein the result was found to be less satisfactory. In this regard, to determine a solution for satisfactory cure, the kshara sutra ligation method in arsha was studied in comparison with hemarrhoidectomy. Kshara sutra ligation in arsha was employed in 35 patients, and 26 patients were dealt with hemorrhoidectomy. The study revealed a better result of the kshara sutra ligation-treated group in comparison with hemorrhoidectomy. The observations revealed that maximum advantages like minimum hospital stay, no bleeding during or after operation, no post-operative anal stenosis, a low cost-effective and more acceptable to different categories of people, etc. were recorded in the kshara sutra-treated group. Statistically, kshara sutra ligation for arsha was found to be highly significant and effective management. No adverse effects were noted during the follow-up period.

Comparative clinical evaluation of Kshara Sutra ligation and hemorrhoidectomy in Arsha (hemorrhoids)

PubMed Central

Gupta, Meva Lal; Gupta, S. K.; Bhuyan, Chaturbhuja

2011-01-01

Arsha (hemorrhoids) is engorgement of the hemorrhoidal venous plexus, characterized by bleeding per rectum, constipation, pain, prolapse and discharge. It is manifested due to improper diet, prolonged standing and faulty habits of defecation causing derangement of tridosha, mainly vata dosha. Vitiated dosha localizes in guda vali, pradhana dhamani and mansdhara kala and vitiates twak, mansa, meda and rakta, resulting in the annavaha sroto dushti. Modern management of arsha needs, mainly, a surgical approach, i.e. hemorrhoidectomy, wherein the result was found to be less satisfactory. In this regard, to determine a solution for satisfactory cure, the kshara sutra ligation method in arsha was studied in comparison with hemarrhoidectomy. Kshara sutra ligation in arsha was employed in 35 patients, and 26 patients were dealt with hemorrhoidectomy. The study revealed a better result of the kshara sutra ligation-treated group in comparison with hemorrhoidectomy. The observations revealed that maximum advantages like minimum hospital stay, no bleeding during or after operation, no post-operative anal stenosis, a low cost-effective and more acceptable to different categories of people, etc. were recorded in the kshara sutra-treated group. Statistically, kshara sutra ligation for arsha was found to be highly significant and effective management. No adverse effects were noted during the follow-up period. PMID:22408307

[Efficiency of combined methods of hemorroid treatment using hal-rar and laser destruction].

PubMed

Rodoman, G V; Kornev, L V; Shalaeva, T I; Malushenko, R N

2017-01-01

To develop the combined method of treatment of hemorrhoids with arterial ligation under Doppler control and laser destruction of internal and external hemorrhoids. The study included 100 patients with chronic hemorrhoids stage II and III. Combined method of HAL-laser was used in study group, HAL RAR-technique in control group 1 and closed hemorrhoidectomy with linear stapler in control group 2. Сomparative evaluation of results in both groups was performed. Combined method overcomes the drawbacks of traditional surgical treatment and limitations in external components elimination which are inherent for HAL-RAR. Moreover, it has a higher efficiency in treating of hemorrhoids stage II-III compared with HAL-RAR and is equally safe and well tolerable for patients. This method does not increase the risk of recurrence, reduces incidence of complications and time of disability.

Embolization of a Hemorrhoid Following 18 Hours of Life-Threatening Bleeding

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

Berczi, Viktor, E-mail: berczi@hotmail.com; Gopalan, Deepa; Cleveland, Trevor J

2008-01-15

Hemorrhoids usually do not pose diagnostic difficulties and they rarely cause massive bleeding. We report a case of massive rectal bleeding over 18 h needing 22 U blood transfusion treated by superselective transcatheter coil embolization 12 h following operative treatment performed in a different hospital. Diagnostic angiography with a view to superselective embolization, following failure of sigmoidoscopy to localize and treat the cause of hemorrhage, might act as a life-saving treatment in massive rectal bleeding, obviating the need for repeated endoscopy or emergency surgery.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids.

PubMed

Lu, Ming; Shi, Guang-Ying; Wang, Guo-Qiang; Wu, Yan; Liu, Yang; Wen, Hao

2013-08-14

To identify a more effective treatment protocol for circumferential mixed hemorrhoids. A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored. The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group. Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.

Prospective, randomized trial comparing diathermy excision and diathermy coagulation for symptomatic, prolapsed hemorrhoids.

PubMed

Quah, H M; Seow-Choen, F

2004-03-01

This study was designed to compare diathermy excision and diathermy coagulation in the treatment of symptomatic prolapsed piles. Forty-five consecutive patients were randomly assigned to diathermy excision hemorrhoidectomy (Group A, n = 25) and diathermy coagulation (Group B, n = 20) under general anesthesia. The median duration of surgery was ten minutes for both groups. There was no statistical difference in the severity of postoperative pain at rest between the two groups, but Group A patients felt less pain during defecation on the third postoperative day (median, 5 (interquartile range, 3-7) vs. 8 (4-9); P = 0.04) and on the sixth postoperative day (median, 5 (interquartile range, 2-6) vs. 9 (5-10); P = 0.02). There was, however, no statistical difference in postoperative oral analgesics use and patients' satisfaction scores between the two groups. Complication rates were similar except that diathermy coagulation tended to leave some residual skin components of external hemorrhoid especially in very large prolapsed piles. Group A patients resumed work earlier (mean, 12 (range, 4-20) vs. 17 (11-21) days); however, this was not statistically significant ( P = 0.1). Diathermy coagulation of hemorrhoids is a simple technique and may be considered in suitable cases.

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.

A novel technique for the treatment of stages III to IV hemorrhoids: Homemade anal cushion suspension clamp combined with harmonic scalpel.

PubMed

Lin, Guoqiang; Ge, Qiongxiang; He, Xiaokang; Qi, Haixin; Xu, Li

2017-06-01

To compare the efficacy of homemade anal cushion suspension clamp combined with harmonic scalpel (ACS) and Milligan-Morgan hemorrhoidectomy combined with electric knife (MMH) in the treatment of stages III to IV hemorrhoids. We conducted a retrospective study of 99 patients with stages III to IV hemorrhoids hospitalized from January to December in 2013. Among them, 51 patients were treated with ACS, while 48 patients received MMH. Data from clinical recording and follow-up included operative time, intraoperative blood loss, hospitalization information, postoperative pain, and postoperative complications. Operative time, intraoperative blood loss and hospitalization time in ACS group were significantly less than those in MMH group (P < .05). Compared with MMH group, ACS group had a lower postoperative static pain score from days 1 to 14 (P < .01). The patients in ACS group exhibited less postoperative defecation pain scores from days 3 to 20 than those of MMH group (P < .05). The incidence of postoperative anal edema and delayed wound healing in ACS group was lower than that in MMH group (P < .05). Compared with MMH, our novel technique ACS was more effective and had fewer postoperative complications in the treatment of stages III to IV hemorrhoids.

Tailored prolapse surgery for the treatment of hemorrhoids with a new dedicated device: TST Starr plus.

PubMed

Naldini, G; Fabiani, B; Menconi, C; Giani, I; Toniolo, G; Martellucci, J

2015-12-01

The aim of the study was to assess the results of the stapled transanal procedure in the treatment of hemorrhoidal prolapse in terms of postoperative complications and recurrence rate using a new dedicated device, TST Starr plus. Patients affected by III-IV degree hemorrhoidal prolapsed that underwent stapled transanal resection with the TST Starr plus were included in the present study. Results of the procedure with perioperative complications, postoperative complications, and recurrence rate were reported. From November 2012 to October 2014, 52 patients (19 females) were enrolled in the study. The main symptoms were prolapse (100 %) and bleeding (28.8 %). Transanal rectal resection was performed with parachute technique in 24 patients (46.2 %) and purse string technique in 23 patients (53.8 %). A mild hematoma at the suture line occurred in one patient (1.9 %). Postoperative bleeding was reported in three patients (5.7 %), in one of which, reoperation was necessary (1.9 %). Tenesmus occurred in one patient (1.9 %), and it was resolved with medical therapy. Urgency was reported in nine patients (17.1 %) at 7 days after surgery. Of these, three patients (5.7 %) complained urgency at the median follow-up of 14.5 months. Reoperation was performed in one patient (1.9 %) for chronic anal pain for rigid suture fixed on the deep plans. Occasional bleeding was reported in four patients (7.7 %). No recurrence of prolapse was reported at a median of 14.5 months after surgery, even if one patient (1.9 %) had a partial recurrent prolapse of a downstaged single pile. TST Starr plus seems to be safe and effective for a tailored transanal stapled surgery for the treatment of III-IV degree hemorrhoidal prolapse. The new conformation and innovative technology of the stapler seems to reduce some postoperative complications and recurrence rate.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids

PubMed Central

Lu, Ming; Shi, Guang-Ying; Wang, Guo-Qiang; Wu, Yan; Liu, Yang; Wen, Hao

2013-01-01

AIM: To identify a more effective treatment protocol for circumferential mixed hemorrhoids. METHODS: A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored. RESULTS: The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group. CONCLUSION: Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings. PMID:23946609

[Effect of preconditioning of thermopaste application at Shenque (CV 8) on stretch reflex induced by procedure for prolapse and hemorrhoids in patients with hemorrhoids].

PubMed

Li, Jun; Wen, Yong; Yue, Chao-Chi; Li, Ya-Ling

2013-08-01

To observe clinical effect, feasibility and security of preconditioning of thermopaste application at Shenque (CV 8) for relieving stretch reflex induced by procedure for prolapse and hemorrhoids (PPH). A total of 100 cases of mixed hemorrhoids (stage III and IV) patients were randomized into 1.0 h, 0.5 h, 0 h and control (no application) groups (n = 25 in each group) according to a random number table. Thermopaste was applied to Shenque (CV 8) 1.0 h and 0.5 h before PPH or conducted simultaneously with PPH. The mean arterial pressure, heart rate, blood oxygen saturation of patients before and after anastomose operation, and the incidence of adverse reactions within 24 hours after the procedure were monitored and recorded. The patient's pain degree was assessed by using visual analogue scale. After the preconditioning, of the 25 patients in the 0.5 h group (0.5 h G), 14 experienced marked improvement (in the stretch reflex during PPH), 10 had an improvement, and 1 was invalid, respectively. The markedly effective rate and the total effective rate were 56% and 96%, respectively. The therapeutic effects for inhibiting stretch reflect being from the better to the poorer were 0.5 h G > 1.0 h G > 0 h G >NG. The heart rate and blood pressure from more stable to lesser stable were 0.5 h G> 1.0 h G > 0 h G > NG. The patients' pain reaction during operation and their adverse effects of nausea, vomiting, abdominal distention and abdominal pain, etc. occurred during operation also presented the same tendency in the 4 groups. Thermopaste application to Shenque (CV 8) can effectively prevent and control visceral reflex in patients undergoing PPH, which effect is significantly better when conducted 0.5 hour before the operation.

Long-term outcome of stapled transanal rectal resection (STARR) versus stapled hemorrhoidopexys (STH) for grade III-IV hemorrhoids: preliminary results.

PubMed

Zanella, Simone; Spirch, Saverio; Scarpa, Marco; Ricci, Francesco; Lumachi, Franco

2014-01-01

Circular stapled transanal hemorrhoidopexy (STH) was first introduced by A. Longo for the correction of internal mucosal prolapse and obstructed defecation and in 1998, was proposed as alternative to conventional excisional hemorrhoidectomy. More recently, stapled transanal rectal resection (STARR) has gradually gained popularity, as the Longo procedure, in the treatment of hemorrhoids. The aim of our study was to evaluate the usefulness of STARR as alternative to STH in patients with grade III (n=218, 68.1%) and IV (n=102, 31.9%) hemorrhoids. A group of 320 consecutive patients (median age=51 years; range=16-85) underwent STH (n=281) or STARR (n=39) procedure. The rate of postoperative bleeding (53.8% vs. 74.4%, p<0.01) was significantly reduced in patients who underwent STARR procedure, which required a longer (45 ± 22 vs. 26 ± 11 min, p<0.01) operative time. There were no differences between groups with regard to use of painkillers, postoperative pain intensity, short- (three months) and long-term (one and three years) residual pain, soiling, incontinence and urgency. Patients treated with the STARR procedure had lower recurrence rate of hemorrhoids and a lower incidence of prolapse, both at one year (none vs. 1.4%, p=0.593 and 2.6% vs. 5.3%, p=0.396, respectively) and at two years (none vs. 6.8%, p=0.078 and none vs. 13.2%, p=0.012, respectively). The one-year (9.0 ± 1.8 vs. 9.4 ± 0.7, p=0.171) and two-year (9.6 ± 0.8 vs. 9.1 ± 1.7, p=0.072) general satisfaction was similar but higher in STARR patients than in the STH group. In conclusion, according to our preliminary results, the STARR procedure leads to a lower incidence of complications and recurrences and should be considered for patients with grade III or IV hemorrhoids previously selected for stapled hemorrhoidectomy, as a promising alternative to STH. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Doppler Football

NASA Astrophysics Data System (ADS)

Ruiz, Michael J.; Abee, Jeremy

2006-10-01

In this paper we present a design for a Doppler football. The classic Doppler ball uses a piezo buzzer and 9-V battery inside a foam ball. In our Doppler football, the sound level is enhanced by directing the 2.8-kHz tone of the buzzer through a hollow cylinder to one end of the football, with an on-off switch placed at the other end. We discuss our device within the historical context of Doppler demonstrations that have evolved over the many decades since Doppler's discovery.

Meta-analysis of randomized controlled trials comparing outcomes for stapled hemorrhoidopexy versus LigaSure hemorrhoidectomy for symptomatic hemorrhoids in adults.

PubMed

Lee, Ko-Chao; Chen, Hong-Hwa; Chung, Kuan-Chih; Hu, Wan-Hsiang; Chang, Chia-Lo; Lin, Shung-Eing; Tsai, Kai-Lung; Lu, Chien-Chang

2013-01-01

This purpose of the meta-analysis was to compare treatment outcomes for adult patients with symptomatic hemorrhoids treated by stapled hemorrhoidopexy or LigaSure hemorrhoidectomy. A search of public medical databases was made to identify randomized controlled trials (RCTs) comparing stapled hemorrhoidopexy (SH) with LigaSure hemorrhoidectomy (LH) for the treatment of adult patients with symptomatic grade 3 and grade 4 hemorrhoids. Postoperative pain as measured using a visual analog scale was the primary outcome, and rate of recurrent prolapse and postoperative bleeding were secondary outcome measures. Four RCTs were identified that met the inclusion criteria. Data for the pooled outcomes were analyzed using odds ratio (OR) analysis. None of the studies in the analysis indicated a significant difference between SH and LH for the outcomes VAS pain score, recurrence rate, or postoperative bleeding. Pooled analysis revealed a significant OR in favor of the SH method for recurrent prolapse (OR = 5.529, P = 0.016) for up to 2 years after surgery. No significant differences between the two methods were identified for VAS pain scores (OR = -1.060, P = 0.149) or postoperative bleeding OR = 1.188, P = 0.871). Pooled analysis of RCT results comparing SH to LH for symptomatic hemorrhoids revealed a significantly greater incidence of recurrent prolapse for SH. The two techniques were associated with similar levels of postoperative pain and postoperative bleeding. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial (THERESA-3)

PubMed Central

Hernández-Bernal, Francisco; Castellanos-Sierra, Georgina; Valenzuela-Silva, Carmen M; Catasús-Álvarez, Karem M; Valle-Cabrera, Roselin; Aguilera-Barreto, Ana; López-Saura, Pedro A

2014-01-01

AIM: To compare the efficacy and safety of recombinant streptokinase (rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease. METHODS: A multicenter (14 sites), randomized (1:1), open, parallel groups, active controlled trial was done. After inclusion, subjects with acute symptoms of hemorrhoids, who gave their written, informed consent to participate, were centrally randomized to receive, as outpatients, rSK (200000 IU) or 0.25% phenylephrine suppositories, which had different organoleptic characteristics. Treatment was administered by the rectal route, one unit every 6 h during 48 h for rSK, and up to a maximum of 5 d (20 suppositories) for phenylephrine. Evaluations were performed at 3, 5 and 10 d post-inclusion. The main end-point was the 5th-day complete clinical response (disappearance of pain and edema, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were evaluated too. RESULTS: 5th day complete response rates were 83/110 (75.5%) and 36/110 (32.7%) with rSK and phenylephrine suppositories, respectively. This 42.7% difference (95%CI: 30.5-54.2) was highly significant (P < 0.001). The advantage was detected since the early 3rd day evaluation (37.3% vs 6.4% for the rSK and active control groups, respectively; P < 0.001) and was kept even at the late 10th day assessment (83.6% vs 58.2% for rSK and phenylephrine, respectively; P < 0.001). Time for complete response was significantly shorter (P = 0.031; log-rank test) in the rSK group (median: 4.9 d; 95%CI: 4.8-5.0) with respect to the active control (median: 9.8 d; 95%CI: 9.8-10.0). Thrombectomy was necessary in 1/59 and 8/57 patients with baseline thrombosis in the rSK and phenylephrine groups, respectively (P = 0.016). There were no adverse events attributable to the experimental treatment. CONCLUSION: rSK suppositories showed a significant advantage over a widely used over-the-counter phenylephrine

A Fiber Optic Doppler Sensor and Its Application in Debonding Detection for Composite Structures

PubMed Central

Li, Fucai; Murayama, Hideaki; Kageyama, Kazuro; Meng, Guang; Ohsawa, Isamu; Shirai, Takehiro

2010-01-01

Debonding is one of the most important damage forms in fiber-reinforced composite structures. This work was devoted to the debonding damage detection of lap splice joints in carbon fiber reinforced plastic (CFRP) structures, which is based on guided ultrasonic wave signals captured by using fiber optic Doppler (FOD) sensor with spiral shape. Interferometers based on two types of laser sources, namely the He-Ne laser and the infrared semiconductor laser, are proposed and compared in this study for the purpose of measuring Doppler frequency shift of the FOD sensor. Locations of the FOD sensors are optimized based on mechanical characteristics of lap splice joint. The FOD sensors are subsequently used to detect the guided ultrasonic waves propagating in the CFRP structures. By taking advantage of signal processing approaches, features of the guided wave signals can be revealed. The results demonstrate that debonding in the lap splice joint results in arrival time delay of the first package in the guided wave signals, which can be the characteristic for debonding damage inspection and damage extent estimation. PMID:22219698

A fiber optic Doppler sensor and its application in debonding detection for composite structures.

PubMed

Li, Fucai; Murayama, Hideaki; Kageyama, Kazuro; Meng, Guang; Ohsawa, Isamu; Shirai, Takehiro

2010-01-01

Debonding is one of the most important damage forms in fiber-reinforced composite structures. This work was devoted to the debonding damage detection of lap splice joints in carbon fiber reinforced plastic (CFRP) structures, which is based on guided ultrasonic wave signals captured by using fiber optic Doppler (FOD) sensor with spiral shape. Interferometers based on two types of laser sources, namely the He-Ne laser and the infrared semiconductor laser, are proposed and compared in this study for the purpose of measuring Doppler frequency shift of the FOD sensor. Locations of the FOD sensors are optimized based on mechanical characteristics of lap splice joint. The FOD sensors are subsequently used to detect the guided ultrasonic waves propagating in the CFRP structures. By taking advantage of signal processing approaches, features of the guided wave signals can be revealed. The results demonstrate that debonding in the lap splice joint results in arrival time delay of the first package in the guided wave signals, which can be the characteristic for debonding damage inspection and damage extent estimation.

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement.

PubMed

Trompetto, M; Clerico, G; Cocorullo, G F; Giordano, P; Marino, F; Martellucci, J; Milito, G; Mistrangelo, M; Ratto, C

2015-10-01

Hemorrhoids are one of the most common medical and surgical diseases and the main reason for a visit to a coloproctologist. This consensus statement was drawn up by the Italian society of colorectal surgery in order to provide practice parameters for an accurate assessment of the disease and consequent appropriate treatment. The authors made a careful search in the main databases (MEDLINE, PubMed, Embase and Cochrane), and all results were classified on the basis of the grade of recommendation (A-C) of the American College of Chest Physicians.

Partial stapled hemorrhoidopexy versus circular stapled hemorrhoidopexy for grade III-IV prolapsing hemorrhoids: a two-year prospective controlled study.

PubMed

Lin, H-C; Ren, D-L; He, Q-L; Peng, H; Xie, S-K; Su, D; Wang, X-X

2012-10-01

Circular stapled hemorrhoidopexy (CSH) is an effective technique for treating prolapsing hemorrhoids; but urgency and anal stenosis are common postoperative complications. The aim of this study was to assess the efficacy and postoperative outcomes of partial stapled hemorrhoidopexy (PSH), compared with CSH. Seventy-two consecutive patients with grade III and IV hemorrhoids who met the inclusion/exclusion criteria were divided in a non-randomized manner to undergo either PSH (n = 34) or CSH (n = 38). Intraoperative and postoperative parameters in both groups were collected and compared. The postoperative visual analog score for pain at first defecation was significantly lower in the PSH group than that in the CSH group (P = 0.001). Fewer patients in the PSH group experienced postoperative urgency, compared with those in the CSH group at 12 h, 1 day, and 7 days after surgery (P = 0.025, P = 0.019, and P = 0.043, respectively). Gas incontinence occurred in 3 patients (7.9%) in the CSH group, but in none of patients in the PSH group (P = 0.242). Postoperative anal stenosis developed in one patient (2.6%) in the CSH group, but in none of the patients in the PSH group (P = 1.0). The 2-year recurrence rate was 2.9 and 5.3%, respectively, in the PSH and CSH groups (P = 1.0). The 2-year recurrence rate is similar in patients with grade III-IV hemorrhoids treated with PSH or CSH. However, PSH is associated with less postoperative pain, fewer episodes of urgency, and no anal incontinence or anal stenosis.

Prostate: techniques, results, and potential applications of color Doppler US scanning.

PubMed

Rifkin, M D; Sudakoff, G S; Alexander, A A

1993-02-01

Color Doppler ultrasound (US) scanning and conventional endorectal gray-scale US of the prostate were performed in 619 patients. Pathologic correlation was available in all cases after US-guided transrectal biopsy. There were 132 cancers in 121 men, 13 foci of atypia in 10 men, 33 foci of inflammation in 31 men, and 469 benign lesions in 457 men. Two hundred seventy patients with abnormal areas of flow identified at color Doppler scanning also underwent spectral waveform analysis of the area of potential concern. No statistical difference in the mean resistive indexes was identified in any patient (P = .25; Scheffe F test, analysis of variance). All malignant lesions had abnormalities demonstrated at gray-scale US and/or focal or diffuse abnormal flow demonstrated at color Doppler scanning. Of the 132 cancers, 123 (93%) had corresponding gray-scale abnormalities and 114 (86%) demonstrated abnormal flow at color Doppler imaging. Nine of the 132 cancers (7%) had no obviously identifiable abnormality at gray-scale scanning but had distinctly abnormal flow at color Doppler scanning. Abnormal findings at color scanning without abnormal findings at gray-scale scanning occurred in eight of the 33 cases of inflammatory foci (24%) and in 24 of the 469 (5%) benign lesions.

[The application of Doppler broadening and Doppler shift to spectral analysis].

PubMed

Xu, Wei; Fang, Zi-shen

2002-08-01

The distinction between Doppler broadening and Doppler shift has analyzed, Doppler broadening locally results from the distribution of velocities of the emitting particles, the line width gives the information on temperature of emitting particles. Doppler shift results when the emitting particles have a bulk non random flow velocity in a particular direction, the drift of central wavelength gives the information on flow velocity of emitting particles, and the Doppler shift only drifts the profile of line without changing the width. The difference between Gaussian fitting and the distribution of chord-integral line shape have also been discussed. The distribution of H alpha spectral line shape has been derived from the surface of limiter in HT-6M Tokamak with optical spectroscope multichannel analysis (OSMA), the result by double Gaussian fitting shows that the line shape make up of two port, the emitting of reflect particles with higher energy and the release particle from the limiter surface. Ion temperature and recycling particle flow velocity have been obtained from Doppler broadening and Doppler shift.

Developments in laser Doppler blood perfusion monitoring

NASA Astrophysics Data System (ADS)

Leahy, Martin J.; de Mul, Frits F. M.; Nilsson, Gert E.; Maniewski, Roman; Liebert, Adam

2003-03-01

This paper reviews the development and use of laser Doppler perfusion monitors and imagers. Despite their great success and almost universal applicability in microcirculation research, they have had great difficulty in converting to widespread clinical application. The enormous interest in microvascular blood perfusion coupled with the 'ease of use' of the technique has led to 2000+ publications citing its use. However, useful results can only be achieved with an understanding of the basic principles of the instrumentation and its application in the various clinical disciplines. The basic technical background is explored and definitions of blood perfusion and laser Doppler perfusion are established. The calibration method is then described together with potential routes to standardisation. A guide to the limitations in application of the technique gives the user a clear indication of what can be achieved in new studies as well as possible inadequacy in some published investigations. Finally some clinical applications have found acceptability and these will be explored.

Hemostatic action of OC-108, a novel agent for hemorrhoids, is associated with regional blood flow arrest induced by acute inflammation.

PubMed

Ono, Takashi; Nakagawa, Haruto; Fukunari, Atsushi; Hashimoto, Toshio; Komatsu, Hirotsugu

2006-11-01

Clinically, hemorrhoidal bleeding and prolapse disappeared immediately after injection of the sclerosing agent OC-108 into submucosa of hemorrhoids. The aim of this study was to elucidate the mechanism of action responsible for the immediate hemostatic effect of OC-108 using anesthetized rats. Subcutaneous injection of OC-108 in rats decreased blood flow at the injection site within 5 min. Aluminum potassium sulfate, one of the main ingredients of OC-108, reduced the skin blood flow. However, tannic acid, another main ingredient, did not. By perfusion of OC-108 on the mesenteric surface, microcirculatory blood flow was arrested without remarkable change in blood vessel diameter, accompanied by increased vascular permeability and venous hematocrit. These results indicate that OC-108 induces regional blood flow arrest with rapid onset, this effect being attributed to the action of aluminum potassium sulfate, and that hemoconcentration due to increased vascular permeability (plasma extravasation), an acute inflammatory reaction, is involved in the mechanisms of the immediate hemostatic action of OC-108.

Colour Doppler and microbubble contrast agent ultrasonography do not improve cancer detection rate in transrectal systematic prostate biopsy sampling.

PubMed

Taverna, Gianluigi; Morandi, Giovanni; Seveso, Mauro; Giusti, Guido; Benetti, Alessio; Colombo, Piergiuseppe; Minuti, Francesco; Grizzi, Fabio; Graziotti, Pierpaolo

2011-12-01

What's known on the subject? and What does the study add? Transrectal gray-scale ultrasonography guided prostate biopsy sampling is the method for diagnosing prostate cancer (PC) in patients with an increased prostate specific antigen level and/or abnormal digital rectal examination. Several imaging strategies have been proposed to optimize the diagnostic value of biopsy sampling, although at the first biopsy nearly 10-30% of PC still remains undiagnosed. This study compares the PC detection rate when employing Colour Doppler ultransongraphy with or without the injection of SonoVue™ microbubble contrast agent, versus the transrectal ultrasongraphy-guided systematic biopsy sampling. The limited accuracy, sensitivity, specificity and the additional cost of using the contrast agent do not justify its routine application in PC detection. • To compare prostate cancer (PC) detection rate employing colour Doppler ultrasonography with or without SonoVue™ contrast agent with transrectal ultrasonography-guided systematic biopsy sampling. • A total of 300 patients with negative digital rectal examination and transrectal grey-scale ultrasonography, with PSA values ranging between 2.5 and 9.9 ng/mL, were randomized into three groups: 100 patients (group A) underwent transrectal ultrasonography-guided systematic bioptic sampling; 100 patients (group B) underwent colour Doppler ultrasonography, and 100 patients (group C) underwent colour Doppler ultrasonography before and during the injection of SonoVue™. • Contrast-enhanced targeted biopsies were sampled into hypervascularized areas of peripheral, transitional, apical or anterior prostate zones. • All the patients included in Groups B and C underwent a further 13 systematic prostate biopsies. The cancer detection rate was calculated for each group. • In 88 (29.3%) patients a histological diagnosis of PC was made, whereas 22 (7.4%) patients were diagnosed with high-grade prostatic intraepithelial

Endoscopic submucosal dissection for anorectal tumor with hemorrhoids close to the dentate line: a multicenter study of Hiroshima GI Endoscopy Study Group.

PubMed

Tamaru, Yuzuru; Oka, Shiro; Tanaka, Shinji; Hiraga, Yuko; Kunihiro, Masaki; Nagata, Shinji; Furudoi, Akira; Ninomiya, Yuki; Asayama, Naoki; Shigita, Kenjiro; Nishiyama, Soki; Hayashi, Nana; Chayama, Kazuaki

2016-10-01

The lower rectum close to the dentate line has distinct characteristics, making endoscopic submucosal dissection (ESD) of tumors challenging. We assessed clinical outcomes of ESD for such patients with hemorrhoids. Sixty-four patients (mean age, 68 years) underwent ESD for anorectal tumors close to the dentate line. We divided patients into those with (Group A, 45 patients) and without hemorrhoids (Group B, 19 patients). We examined en bloc and histological en bloc resection rates, procedure time, complication rates, and postoperative prognosis after ESD. The mean tumor size was 43 mm. Histologic diagnoses were adenoma (42 %, 27/64), carcinoma in situ (44 %, 28/64), and T1 carcinoma (14 %, 9/64). There was no significant difference in en bloc resection (93 %, 42/45 vs. 95 %, 18/19) or postoperative bleeding rates (16 %, 7/45 vs. 11 %, 2/19) between Groups A and B, respectively. The mean procedural durations were 120 and 124 min, respectively, in Groups A and B. No perforations occurred. There was no significant difference in postoperative anal pain rate between Groups A (18 %, 8/45) and B (16 %, 3/19), and it resolved within a few days in all cases. There was one case of stricture in Group B. Two patients with T1 carcinoma underwent additional surgery, one underwent chemotherapy, and five had no additional treatment. No recurrence occurred during the follow-up period of 38 months. ESD is safe and effective for anorectal tumors close to the dentate line in patients with hemorrhoids.

Biological findings from the PheWAS catalog: focus on connective tissue-related disorders (pelvic floor dysfunction, abdominal hernia, varicose veins and hemorrhoids).

PubMed

Salnikova, Lyubov E; Khadzhieva, Maryam B; Kolobkov, Dmitry S

2016-07-01

Pelvic floor dysfunction, specifically genital prolapse (GP) and stress urinary inconsistency (SUI) presumably co-occur with other connective tissue disorders such as hernia, hemorrhoids, and varicose veins. Observations on non-random coexistence of these disorders have never been summarized in a meta-analysis. The performed meta-analysis demonstrated that varicose veins and hernia are associated with GP. Disease connections on the molecular level may be partially based on shared genetic susceptibility. A unique opportunity to estimate shared genetic susceptibility to disorders is provided by a PheWAS (phenome-wide association study) designed to utilize GWAS data concurrently to many phenotypes. We searched the PheWAS Catalog, which includes the results of the PheWAS study with P value < 0.05, for genes associated with GP, SUI, abdominal hernia, varicose veins and hemorrhoids. We found pronounced signals for the associations of the SLC2A9 gene with SUI (P = 6.0e-05) and the MYH9 gene with varicose veins of lower extremity (P = 0.0001) and hemorrhoids (P = 0.0007). The comparison of the PheWAS Catalog and the NHGRI Catalog data revealed enrichment of genes associated with bone mineral density in GP and with activated partial thromboplastin time in varicose veins of lower extremity. In cross-phenotype associations, genes responsible for peripheral nerve functions seem to predominate. This study not only established novel biologically plausible associations that may warrant further studies but also exemplified an effective use of the PheWAS Catalog data.

Doppler Endoscopic Probe Monitoring of Blood Flow Improves Risk Stratification and Outcomes of Patients With Severe Nonvariceal Upper Gastrointestinal Hemorrhage.

PubMed

Jensen, Dennis M; Kovacs, Thomas O G; Ohning, Gordon V; Ghassemi, Kevin; Machicado, Gustavo A; Dulai, Gareth S; Sedarat, Alireza; Jutabha, Rome; Gornbein, Jeffrey

2017-05-01

For 4 decades, stigmata of recent hemorrhage in patients with nonvariceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata rarely is monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe nonvariceal upper gastrointestinal hemorrhage. In a single-blind study performed at 2 referral centers we assigned 148 patients with severe nonvariceal upper gastrointestinal bleeding (125 with ulcers, 19 with Dieulafoy's lesions, and 4 with Mallory Weiss tears) to groups that underwent standard, visually guided endoscopic hemostasis (control, n = 76), or endoscopic hemostasis assisted by Doppler monitoring of blood flow under the stigmata (n = 72). The primary outcome was the rate of rebleeding after 30 days; secondary outcomes were complications, death, and need for transfusions, surgery, or angiography. There was a significant difference in the rates of lesion rebleeding within 30 days of endoscopic hemostasis in the control group (26.3%) vs the Doppler group (11.1%) (P = .0214). The odds ratio for rebleeding with Doppler monitoring was 0.35 (95% confidence interval, 0.143-0.8565) and the number needed to treat was 7. In a randomized controlled trial of patients with severe upper gastrointestinal hemorrhage from ulcers or other lesions, Doppler probe guided endoscopic hemostasis significantly reduced 30-day rates of rebleeding compared with standard, visually guided hemostasis. Guidelines for nonvariceal gastrointestinal bleeding should incorporate these results. ClinicalTrials.gov no: NCT00732212 (CLIN-013-07F). Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Application of scanning laser Doppler vibrometry for delamination detection in composite structures

NASA Astrophysics Data System (ADS)

Kudela, Pawel; Wandowski, Tomasz; Malinowski, Pawel; Ostachowicz, Wieslaw

2017-12-01

In this paper application of scanning laser Doppler vibrometry for delamination detection in composite structures was presented. Delamination detection was based on a guided wave propagation method. In this papers results from numerical and experimental research were presented. In the case of numerical research, the Spectral Element Method (SEM) was utilized, in which a mesh was composed of 3D spectral elements. SEM model included also a piezoelectric transducer. In the experimental research guided waves were excited using the piezoelectric transducer whereas the sensing process was conducted using scanning laser Doppler vibrometer (SLDV). Analysis of guided wave propagation and its interaction with delamination was based on a full wavefield approach. Attention was focused on interactions of guided waves with delamination manifested by A0 mode reflection, A0 mode entrapment, and S0/A0 mode conversion. Delamination was simulated by a teflon insert located between plies of composite material. Results of interaction with symmetrically and nonsymmetrical placed delamination (in respect to the composite sample thickness) were presented. Moreover, the authors investigated different size of delaminations. Damage detection was based on a new signal processing algorithm proposed by the authors. In this approach the weighted RMS was utilized selectively. It means that the summation in RMS formula was performed only for a specially selected time instances. Results for simple composite panels, panel with honeycomb core, and real stiffened composite panel from the aircraft were presented.

High-intensity focused ultrasound ablation assisted using color Doppler imaging for the treatment of hepatocellular carcinomas.

PubMed

Fukuda, Hiroyuki; Numata, Kazushi; Nozaki, Akito; Kondo, Masaaki; Morimoto, Manabu; Maeda, Shin; Tanaka, Katsuaki; Ohto, Masao; Ito, Ryu; Ishibashi, Yoshiharu; Oshima, Noriyoshi; Ito, Ayao; Zhu, Hui; Wang, Zhi-Biao

2013-12-01

We evaluated the usefulness of color Doppler flow imaging to compensate for the inadequate resolution of the ultrasound (US) monitoring during high-intensity focused ultrasound (HIFU) for the treatment of hepatocellular carcinoma (HCC). US-guided HIFU ablation assisted using color Doppler flow imaging was performed in 11 patients with small HCC (<3 lesions, <3 cm in diameter). The HIFU system (Chongqing Haifu Tech) was used under US guidance. Color Doppler sonographic studies were performed using an HIFU 6150S US imaging unit system and a 2.7-MHz electronic convex probe. The color Doppler images were used because of the influence of multi-reflections and the emergence of hyperecho. In 1 of the 11 patients, multi-reflections were responsible for the poor visualization of the tumor. In 10 cases, the tumor was poorly visualized because of the emergence of a hyperecho. In these cases, the ability to identify the original tumor location on the monitor by referencing the color Doppler images of the portal vein and the hepatic vein was very useful. HIFU treatments were successfully performed in all 11 patients with the assistance of color Doppler imaging. Color Doppler imaging is useful for the treatment of HCC using HIFU, compensating for the occasionally poor visualization provided by B-mode conventional US imaging.

Psychodynamic and biodynamic analysis of treatment of outlet obstructive constipation (OOC) using Procedure for Prolapse and Hemorrhoids (PPH).

PubMed

Qin, Zhensheng; Pang, Liqun; Dai, Weijie; Yan, Wei; Zhang, Jian; Zhao, Yao; Li, Qianjun; Wu, Kun; Zhou, Baoxiang

2015-07-01

To discuss the possible pathogenesis of outlet obstructive constipation (OOC) and identify the theoretical basis of the Procedure for Prolapse and Hemorrhoids (PPH) used to treat outlet obstructive constipation (OOC). 19 patients diagnosed with outlet obstructive constipation (OOC) form the case group, and 9 healthy volunteers form the control group. Patients, before and after operation, and the control group, were equally given such tests as Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA) and anorectal dynamics. No significant difference in the functional lengths of anal canals was found between all groups (F = 0.98, p = 0.41). The minimum perception threshold, maximum tolerance threshold, and rectal defecation threshold of Group A, of 15 days after operation, were equally lower than those before operation, and than the control group (P < 0.05). These thresholds rebounded significantly in Group B 90 days after operation. Mentally, HAMA (F = 23.75, p = 0.00) and HAMD (F = 20.99, p = 0.00) total scores, after operation, were equally decreased first and then rebounded. Patients with outlet obstructive constipation (OOC) are subject to anorectal dynamic disorders as well as mental and psychological disorders, which can be remarkably improved using the Procedure for Prolapse and Hemorrhoids (PPH). Copyright © 2015 Elsevier Ltd. All rights reserved.

Serum aluminum levels in dialysis patients after sclerotherapy of internal hemorrhoids with aluminum potassium sulfate and tannic acid.

PubMed

Tsunoda, Akira; Nakagi, Masafumi; Kano, Nobuyasu; Mizutani, Masahiko; Yamaguchi, Kenji

2014-12-01

Aluminum potassium sulfate and tannic acid (ALTA) is an effective sclerosing agent for internal hemorrhoids. However, it is contraindicated for patients with chronic renal failure on dialysis, because the aluminum in ALTA can cause aluminum encephalopathy when it is not excreted effectively. We conducted this study to measure the serum aluminum concentrations and observe for symptoms relating to aluminum encephalopathy in dialysis patients after ALTA therapy. Ten dialysis patients underwent ALTA therapy for hemorrhoids. We measured their serum aluminum concentrations and observed them for possible symptoms of aluminum encephalopathy. The total injection volume of ALTA solution was 31 mL (24-37). The median serum aluminum concentration before ALTA therapy was 9 μg/L, which increased to 741, 377, and 103 μg/L, respectively, 1 h, 1 day, and 1 week after ALTA therapy. These levels decreased rapidly, to 33 μg/L by 1 month and 11 μg/L by 3 months after ALTA therapy. No patient suffered symptoms related to aluminum encephalopathy. Although the aluminum concentrations increased temporarily after ALTA therapy, dialysis patients with levels below 150 μg/L by 1 week and thereafter are considered to be at low risk of the development of aluminum encephalopathy.

Rubber band ligation and infrared photocoagulation for the outpatient treatment of hemorrhoidal disease.

PubMed

Ricci, Maurício Pichler; Matos, Délcio; Saad, Sarhan Sydney

2008-01-01

To compare the results of rubber band ligation and infrared photocoagulation for the treatment of hemorrhoidal disease through the analysis of the incidence of complications after each treatment and respective success rate. Forty-eight patients with first, second or third degree hemorrhoidal disease were randomized to receive treatment with either rubber band ligation (n=23) or infrared photocoagulation (n=25). Each patient was assessed at 1 week and 4 week intervals after treatment. We compared the incidence of complications and efficiency of each treatment modality and Qui-square, Fisher's Exact Test and Student's t Test were used to statistical analysis. Bleeding occured in eight (34,7%) patients treated with rubber band ligation and in four (16,0%) after infrared photocoagulation (p=0,243). Thirteen (52,0%) patients felt pain during infrared photocoagulation and 9 (39,1%) after rubber band ligation (p=0,546). After rubber band ligation, 14 (60,8%) required medication for pain relief. One patient (4,0%) required medication after infrared photocoagulation (p<0,001). Three (13,0%) patients treated with rubber band ligator and 1 (4,0%) treated with infrared photocoagulation had symptomatic mucosal ulcers. Perianal dermatitis occured in two (8,0%) patients treated with infrared photocoagulation and one patient (4,3%) was observed to have prolapsed thrombosed piles after rubber band ligation. One month after treatment, 17 of 23 patients treated with rubber band ligation (73,9%) and 18 of 25 patients treated with infrared photocoagulation were asymptomatic. Rubber band ligation treated bleeding and prolapse in 90,0% and 82,4% respectively. Infrared photocoagulation treats bleeding and prolapse in 93,7% and 87,5% respectively. Those differences are not significant. Rubber band ligation causes significantly more pain than infrared photocoagulation during the first week after the procedures and their success rate are not different after four weeks of treatment.

Doppler endoscopic probe as a guide to risk stratification and definitive hemostasis of peptic ulcer bleeding.

PubMed

Jensen, Dennis M; Ohning, Gordon V; Kovacs, Thomas O G; Ghassemi, Kevin A; Jutabha, Rome; Dulai, Gareth S; Machicado, Gustavo A

2016-01-01

For more than 4 decades endoscopists have relied on ulcer stigmata for risk stratification and as a guide to hemostasis. None used arterial blood flow underneath stigmata to predict outcomes. For patients with severe peptic ulcer bleeding (PUB), we used a Doppler endoscopic probe (DEP) for (1) detection of blood flow underlying stigmata of recent hemorrhage (SRH), (2) quantitating rates of residual arterial blood flow under SRH after visually directed standard endoscopic treatment, and (3) comparing risks of rebleeding and actual 30-day rebleed rates for spurting arterial bleeding (Forrest [F] IA) and oozing bleeding (F IB). Prospective cohort study of 163 consecutive patients with severe PUB and different SRH. All blood flow detected by the DEP was arterial. Detection rates were 87.4% in major SRH-spurting arterial bleeding (F IA), non-bleeding visible vessel (F IIA), clot (F IIB)-and were significantly lower at 42.3% (P < .0001) for an intermediate group of oozing bleeding (F IB) or flat spot (F IIC). For spurting bleeding (F IA) versus oozing (F IB), baseline DEP arterial flow was 100% versus 46.7%, residual blood flow detected after endoscopic hemostasis was 35.7% versus 0%, and 30-day rebleed rates were 28.6% versus 0% (all P < .05). (1) For major SRH versus oozing or spot, the arterial blood flow detection rate by the DEP was significantly higher, indicating a higher rebleed risk. (2) Before and after endoscopic treatment, spurting (F IA) PUB had significantly higher rates of blood flow detection than oozing (F IB) PUB and a significantly higher 30-day rebleed rate. (3) The DEP is recommended as a new endoscopic guide with SRH to improve risk stratification and potentially definitive hemostasis for PUB. Published by Elsevier Inc.

Doppler Endoscopic Probe as a Guide to Risk Stratification and Definitive Hemostasis of Peptic Ulcer Bleeding

PubMed Central

Jensen, Dennis M.; Ohning, Gordon V.; Kovacs, Thomas OG; Ghassemi, Kevin A.; Jutabha, Rome; Dulai, Gareth S.; Machicado, Gustavo A.

2015-01-01

Background and Aims For more than 4 decades endoscopists have relied on ulcer stigmata for risk stratification and as a guide to hemostasis. None used arterial blood flow underneath stigmata to predict outcomes. For patients with severe peptic ulcer bleeding (PUBs), we used Doppler endoscopic probe (DEP) for: 1. detection of blood flow underlying stigmata of recent hemorrhage (SRH), 2. quantitating rates of residual arterial blood flow under SRH after visually directed standard endoscopic treatment, and 3. comparing risks of rebleeding and actual 30 day rebleed rates for spurting arterial bleeding (Forrest – FIA) and oozing bleeding (FIB). Methods Prospective cohort study of 163 consecutive patients with severe PUBs and different SRH. Results All blood flow detected by DEP was arterial. Detection rates were 87.4% in major SRH - spurting arterial bleeding (FIA), non bleeding visible vessel (FIIA), clot (FIIB) - and significantly lower at 42.3% (p<0.0001) for intermediate group of oozing bleeding (FIB) or flat spot (FIIC). For spurting bleeding (FIA) vs. oozing (FIB), baseline DEP arterial flow was 100% vs. 46.7%; residual blood flow detected after endoscopic hemostasis was 35.7% vs. 0%; and 30 day rebleed rates were 28.6% vs. 0% (all p<0.05). Conclusions 1. For major SRH vs. oozing or spot, the arterial blood flow detection rates by DEP was significantly higher, indicating a higher rebleed risk. 2. Before and after endoscopic treatment, spurting FIA PUB’s had significantly higher rates of blood flow detection than oozing FIB PUB’s and a significantly higher 30 rebleed rate. 3. DEP is recommended as a new endoscopic guide with SRH to improve risk stratification and potentially definitive hemostasis for PUBs. PMID:26318834

A new fringeline-tracking approach for color Doppler ultrasound imaging phase unwrapping

NASA Astrophysics Data System (ADS)

Saad, Ashraf A.; Shapiro, Linda G.

2008-03-01

Color Doppler ultrasound imaging is a powerful non-invasive diagnostic tool for many clinical applications that involve examining the anatomy and hemodynamics of human blood vessels. These clinical applications include cardio-vascular diseases, obstetrics, and abdominal diseases. Since its commercial introduction in the early eighties, color Doppler ultrasound imaging has been used mainly as a qualitative tool with very little attempts to quantify its images. Many imaging artifacts hinder the quantification of the color Doppler images, the most important of which is the aliasing artifact that distorts the blood flow velocities measured by the color Doppler technique. In this work we will address the color Doppler aliasing problem and present a recovery methodology for the true flow velocities from the aliased ones. The problem is formulated as a 2D phase-unwrapping problem, which is a well-defined problem with solid theoretical foundations for other imaging domains, including synthetic aperture radar and magnetic resonance imaging. This paper documents the need for a phase unwrapping algorithm for use in color Doppler ultrasound image analysis. It describes a new phase-unwrapping algorithm that relies on the recently developed cutline detection approaches. The algorithm is novel in its use of heuristic information provided by the ultrasound imaging modality to guide the phase unwrapping process. Experiments have been performed on both in-vitro flow-phantom data and in-vivo human blood flow data. Both data types were acquired under a controlled acquisition protocol developed to minimize the distortion of the color Doppler data and hence to simplify the phase-unwrapping task. In addition to the qualitative assessment of the results, a quantitative assessment approach was developed to measure the success of the results. The results of our new algorithm have been compared on ultrasound data to those from other well-known algorithms, and it outperforms all of them.

Dual-Doppler Feasibility Study

NASA Technical Reports Server (NTRS)

Huddleston, Lisa L.

2012-01-01

When two or more Doppler weather radar systems are monitoring the same region, the Doppler velocities can be combined to form a three-dimensional (3-D) wind vector field thus providing for a more intuitive analysis of the wind field. A real-time display of the 3-D winds can assist forecasters in predicting the onset of convection and severe weather. The data can also be used to initialize local numerical weather prediction models. Two operational Doppler Radar systems are in the vicinity of Kennedy Space Center (KSC) and Cape Canaveral Air Force Station (CCAFS); these systems are operated by the 45th Space Wing (45 SW) and the National Weather Service Melbourne, Fla. (NWS MLB). Dual-Doppler applications were considered by the 45 SW in choosing the site for the new radar. Accordingly, the 45th Weather Squadron (45 WS), NWS MLB and the National Aeronautics and Space Administration tasked the Applied Meteorology Unit (AMU) to investigate the feasibility of establishing dual-Doppler capability using the two existing systems. This study investigated technical, hardware, and software requirements necessary to enable the establishment of a dual-Doppler capability. Review of the available literature pertaining to the dual-Doppler technique and consultation with experts revealed that the physical locations and resulting beam crossing angles of the 45 SW and NWS MLB radars make them ideally suited for a dual-Doppler capability. The dual-Doppler equations were derived to facilitate complete understanding of dual-Doppler synthesis; to determine the technical information requirements; and to determine the components of wind velocity from the equation of continuity and radial velocity data collected by the two Doppler radars. Analysis confirmed the suitability of the existing systems to provide the desired capability. In addition, it is possible that both 45 SW radar data and Terminal Doppler Weather Radar data from Orlando International Airport could be used to alleviate any

Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions

PubMed Central

Goel, Sumit; Nagendrareddy, Suma Gundareddy; Raju, Manthena Srinivasa; Krishnojirao, Dayashankara Rao Jingade; Rastogi, Rajul; Mohan, Ravi Prakash Sasankoti; Gupta, Swati

2011-01-01

Aim: To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions. Materials and Methods: Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed. Results: USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case. Conclusions: USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions. PMID:22223940

Implementation of a New High-Volume Circular Stapler in Stapled Anopexy for Hemorrhoidal Disease: Is Patient's Short-Term Outcome Affected by a Higher Volume of Resected Tissue?

PubMed

Grotenhuis, Brechtje A; Nonner, Joost; de Graaf, Eelco J R; Doornebosch, Pascal G

2017-11-02

Stapled anopexy is a safe technique for the treatment of hemorrhoids but carries a higher risk of recurrence, which might be caused due to the limited volume of resected tissue. In this study, we investigated the introduction of a high-volume circular stapling device; in particular whether an increased amount of resected tissue could affect patients' short-term postoperative outcome. Between 2011 and 2015, stapled anopexy was performed for hemorrhoids and/or anal prolapse in 141 patients (n = 25 conventional PPH-3©-stapler versus n = 116 high-volume CHEX©-stapler). In this prospectively collected dataset, operation details and short-term postoperative outcome were compared. With the high-volume stapler, a significantly higher amount of tissue was resected: 9.8 g (range 6.2-11.4) vs. 6.4 g (range 4.9-8.8) with the conventional stapler, p < 0.01. Postoperative short-term outcome did not differ in terms of readmission and complication rates. In all 5 patients who underwent a redo operation for residual hemorrhoids or prolapse, the high-volume stapler was used in the primary operation. A high-volume stapling device for stapled anopexy was introduced safely with a significantly higher amount of resected tissue without a worse short-term outcome. However, it remains unclear whether higher stapling volumes may lead to improved long-term outcome with less reinterventions. © 2017 S. Karger AG, Basel.

Six-beam homodyne laser Doppler vibrometry based on silicon photonics technology.

PubMed

Li, Yanlu; Zhu, Jinghao; Duperron, Matthieu; O'Brien, Peter; Schüler, Ralf; Aasmul, Soren; de Melis, Mirko; Kersemans, Mathias; Baets, Roel

2018-02-05

This paper describes an integrated six-beam homodyne laser Doppler vibrometry (LDV) system based on a silicon-on-insulator (SOI) full platform technology, with on-chip photo-diodes and phase modulators. Electronics and optics are also implemented around the integrated photonic circuit (PIC) to enable a simultaneous six-beam measurement. Measurement of a propagating guided elastic wave in an aluminum plate (speed ≈ 909 m/s @ 61.5 kHz) is demonstrated.

Comparison of Doppler-guided haemorrhoidal artery ligation without mucopexy and rubber band ligation for haemorrhoids.

PubMed

Pol, Robert A; van der Zwet, Wil C; Kaijser, Mirjam; Schattenkerk, Marinus Eeftinck; Eddes, Eric-Hans

2011-12-01

Recurrences after Doppler-guided haemorrhoidal artery ligation (DG-HAL) tend to occur in patients with concurrent mucosal prolapse. We retrospectively compared the results of DG-HAL and rubber band ligation (RBL) for the treatment of haemorrhoidal disease. From 2005 to 2009, all patients who underwent either a DG-HAL procedure or RBL were selected. Follow-up was done by telephone using a standardised questionnaire survey to assess patient satisfaction and complaints. When recurrent disease was suspected, patients revisited the clinic for further examination and treatment. A total of 239 DG-HAL patients and 47 RBL patients were analysed. Sixty-seven percent in the DG-HAL group and 79% in the RBL group had an improvement in symptoms after one treatment (p=0.22). Forty-six DG-HAL patients (19%) needed a second procedure versus three patients (6%) in the RBL group (p<0.05). Cox regression analysis showed a significant difference in disease recurrence in favour of RBL (hazard ratio (HR) 3.71, 95% confidence interval (CI) 1.13-12.2). Patients in the DG-HAL group with recurrent haemorrhoids had a higher incidence of mucosal prolapse. DG-HAL seems very effective in treating lower-grade haemorrhoids. In more advanced disease, recurrence occurs due to persisting mucosal prolapse. RBL seems much more effective in reducing the prolapse and the chance of recurrence. Copyright © 2011 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

The Cognitive Doppler.

ERIC Educational Resources Information Center

Kozoil, Micah E.

1989-01-01

Discusses the learning needs of students in the concrete operational stage in mathematics. Identifies the phenomenon of reduced cognitive performance in an out-of-class environment as the "Cognitive Doppler." Suggests methods of reducing the pronounced effects of the Cognitive Doppler by capitalizing on the students' ability to memorize…

Doppler flowmetry in preeclampsia.

PubMed

Zahumensky, J

2009-01-01

The purpose of this study was to summarize the new published data on the Doppler flowmetry in preeclampsia. We summarize the new published data on the Doppler flowmetry in uteroplacental, fetoplacental and fetal circulation in preeclampsia. The present review summarized the results of clinical research on the Doppler flowmetry in the screening of risk of preclampsia, in the diagnosis of preclampsia and in the fetal risk in preclampsia (Ref. 19). Full Text (Free, PDF) www.bmj.sk.

Multiple clinical presentations of anal ultra slow waves and high anal pressure: megacolon, hemorrhoids and constipation.

PubMed

Yoshino, Hiroaki; Kayaba, Hiroyuki; Hebiguchi, Tatsuzo; Morii, Mayako; Hebiguchi, Taku; Ito, Wataru; Chihara, Junichi; Kato, Tetsuo

2007-02-01

The physiopathology of idiopathic chronic constipation is complex and yet to be investigated. In the manometric studies of the patients with severe chronic constipation, we noticed that some patients with megacolon show very slow periodical (< 2/min) pressure change in the anal canal, namely ultra slow waves (USWs). USWs are considered to represent the hyperactivity of the internal anal sphincter; however, USW-related clinical presentations have yet to be investigated. We retrospectively re-evaluated the patient records and manometric studies of 85 cases, 51 subjects without defecatory problems and 34 patients with constipation, to elucidate USW-related clinical presentations. USWs were seen in 10 patients, including eight patients with chronic constipation and two subjects without defecatory problems. Out of the eight patients with constipation, one had no organic change in the anorectum, three had hemorrhoids and four exhibited megacolon. Manometric and pathological studies proved that none of the four patients with megacolon was suffering from Hirschsprung's disease. Among the 51 subjects without defecatory problems, only two had USWs. Anal pressure in the USW-positive group (106.0 +/- 37.0 cmH2O) was significantly higher than that in the group without defecatory problems (56.0 +/- 27.0 cmH2O) or constipated patients without USWs (55.0 +/- 26.0 cmH2O). Megacolon and high anal pressure, as well as chronic constipation and hemorrhoids, were the clinical presentations related to USWs. This is the first report to show the clinical relevance of USWs to megacolon. USWs should be recognized as an important manometric finding indicating a possible new clinical entity in chronic constipation.

Evaluation of meteorological airborne Doppler radar

NASA Technical Reports Server (NTRS)

Hildebrand, P. H.; Mueller, C. K.

1984-01-01

This paper will discuss the capabilities of airborne Doppler radar for atmospheric sciences research. The evaluation is based on airborne and ground based Doppler radar observations of convective storms. The capability of airborne Doppler radar to measure horizontal and vertical air motions is evaluated. Airborne Doppler radar is shown to be a viable tool for atmospheric sciences research.

Doppler radar flowmeter

DOEpatents

Petlevich, Walter J.; Sverdrup, Edward F.

1978-01-01

A Doppler radar flowmeter comprises a transceiver which produces an audio frequency output related to the Doppler shift in frequency between radio waves backscattered from particulate matter carried in a fluid and the radiated radio waves. A variable gain amplifier and low pass filter are provided for amplifying and filtering the transceiver output. A frequency counter having a variable triggering level is also provided to determine the magnitude of the Doppler shift. A calibration method is disclosed wherein the amplifier gain and frequency counter trigger level are adjusted to achieve plateaus in the output of the frequency counter and thereby allow calibration without the necessity of being able to visually observe the flow.

Finnish Meteorological Institute Doppler Lidar

DOE Data Explorer

Ewan OConnor

2015-03-27

This doppler lidar system provides co-polar and cross polar attenuated backscatter coefficients,signal strength, and doppler velocities in the cloud and in the boundary level, including uncertainties for all parameters. Using the doppler beam swinging DBS technique, and Vertical Azimuthal Display (VAD) this system also provides vertical profiles of horizontal winds.

Doppler-corrected differential detection system

NASA Technical Reports Server (NTRS)

Simon, Marvin K. (Inventor); Divsalar, Dariush (Inventor)

1991-01-01

Doppler in a communication system operating with a multiple differential phase-shift-keyed format (MDPSK) creates an adverse phase shift in an incoming signal. An open loop frequency estimation is derived from a Doppler-contaminated incoming signal. Based upon the recognition that, whereas the change in phase of the received signal over a full symbol contains both the differentially encoded data and the Doppler induced phase shift, the same change in phase over half a symbol (within a given symbol interval) contains only the Doppler induced phase shift, and the Doppler effect can be estimated and removed from the incoming signal. Doppler correction occurs prior to the receiver's final output of decoded data. A multiphase system can operate with two samplings per symbol interval at no penalty in signal-to-noise ratio provided that an ideal low pass pre-detection filter is employed, and two samples, at 1/4 and 3/4 of the symbol interval T sub s, are taken and summed together prior to incoming signal data detection.

Results of vardenafil mediated power Doppler ultrasound, contrast enhanced ultrasound and systematic random biopsies to detect prostate cancer.

PubMed

Morelli, Girolamo; Pagni, Riccardo; Mariani, Chiara; Minervini, Riccardo; Morelli, Andrea; Gori, Francesco; Ferdeghini, Ezio Maria; Paterni, Marco; Mauro, Eva; Guidi, Elisa; Armillotta, Nicola; Canale, Domenico; Vitti, Paolo; Caramella, Davide; Minervini, Andrea

2011-06-01

We evaluated the ability of the phosphodiesterase-5 inhibitor vardenafil to increase prostate microcirculation during power Doppler ultrasound. We also evaluated the results of contrast and vardenafil enhanced targeted biopsies compared to those of standard 12-core random biopsies to detect cancer. Between May 2008 and January 2010, 150 consecutive patients with prostate specific antigen more than 4 ng/ml at first diagnosis with negative digital rectal examination and transrectal ultrasound, and no clinical history of prostatitis underwent contrast enhanced power Doppler ultrasound (bolus injection of 2.4 ml SonoVue® contrast agent), followed by vardenafil enhanced power Doppler ultrasound (1 hour after oral administration of vardenafil 20 mg). All patients underwent standard 12-core transrectal ultrasound guided random prostate biopsy plus 1 further sampling from each suspected hypervascular lesion detected by contrast and vardenafil enhanced power Doppler ultrasound. Prostate cancer was detected in 44 patients (29.3%). Contrast and vardenafil enhanced power Doppler ultrasound detected suspicious, contrast enhanced and vardenafil enhanced areas in 112 (74.6%) and 110 patients (73.3%), and was diagnostic for cancer in 32 (28.5%) and 42 (38%), respectively. Analysis of standard technique, and contrast and vardenafil enhanced power Doppler ultrasound findings by biopsy core showed significantly higher detection using vardenafil vs contrast enhanced power Doppler ultrasound and standard technique (41.2% vs 22.7% and 8.1%, p <0.005 and <0.001, respectively). The detection rate of standard plus contrast or vardenafil enhanced power Doppler ultrasound was 10% and 11.7% (p not significant). Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique. Copyright © 2011 American Urological

Laser Doppler Velocimetry Workshop

NASA Technical Reports Server (NTRS)

Owen, R. B.

1979-01-01

The potential of laser Doppler velocimetry as a technique for use in mapping flows in the several fluid systems under development for doing research on low-gravity processes, is investigated. Laser Doppler velocimetry techniques, equipment, and applications are summarized.

Doppler color imaging. Principles and instrumentation.

PubMed

Kremkau, F W

1992-01-01

DCI acquires Doppler-shifted echoes from a cross-section of tissue scanned by an ultrasound beam. These echoes are then presented in color and superimposed on the gray-scale anatomic image of non-Doppler-shifted echoes received during the scan. The flow echoes are assigned colors according to the color map chosen. Usually red, yellow, or white indicates positive Doppler shifts (approaching flow) and blue, cyan, or white indicates negative shifts (receding flow). Green is added to indicate variance (disturbed or turbulent flow). Several pulses (the number is called the ensemble length) are needed to generate a color scan line. Linear, convex, phased, and annular arrays are used to acquire the gray-scale and color-flow information. Doppler color-flow instruments are pulsed-Doppler instruments and are subject to the same limitations, such as Doppler angle dependence and aliasing, as other Doppler instruments. Color controls include gain, TGC, map selection, variance on/off, persistence, ensemble length, color/gray priority. Nyquist limit (PRF), baseline shift, wall filter, and color window angle, location, and size. Doppler color-flow instruments generally have output intensities intermediate between those of gray-scale imaging and pulsed-Doppler duplex instruments. Although there is no known risk with the use of color-flow instruments, prudent practice dictates that they be used for medical indications and with the minimum exposure time and instrument output required to obtain the needed diagnostic information.

Doppler ultrasound monitoring technology.

PubMed

Docker, M F

1993-03-01

Developments in the signal processing of Doppler ultrasound used for the detection of fetal heart rate (FHR) have improved the operation of cardiotocographs. These developments are reviewed and the advantages and disadvantages of the various Doppler and signal processing methods are compared.

Expression pattern, ethanol-metabolizing activities, and cellular localization of alcohol and aldehyde dehydrogenases in human large bowel: association of the functional polymorphisms of ADH and ALDH genes with hemorrhoids and colorectal cancer.

PubMed

Chiang, Chien-Ping; Jao, Shu-Wen; Lee, Shiao-Pieng; Chen, Pei-Chi; Chung, Chia-Chi; Lee, Shou-Lun; Nieh, Shin; Yin, Shih-Jiun

2012-02-01

Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are principal enzymes responsible for metabolism of ethanol. Functional polymorphisms of ADH1B, ADH1C, and ALDH2 genes occur among racial populations. The goal of this study was to systematically determine the functional expressions and cellular localization of ADHs and ALDHs in human rectal mucosa, the lesions of adenocarcinoma and hemorrhoid, and the genetic association of allelic variations of ADH and ALDH with large bowel disorders. Twenty-one surgical specimens of rectal adenocarcinoma and the adjacent normal mucosa, including 16 paired tissues of rectal tumor, normal mucosae of rectum and sigmoid colon from the same individuals, and 18 surgical mixed hemorrhoid specimens and leukocyte DNA samples from 103 colorectal cancer patients, 67 hemorrhoid patients, and 545 control subjects recruited in previous study, were investigated. The isozyme/allozyme expression patterns of ADH and ALDH were identified by isoelectric focusing and the activities were assayed spectrophotometrically. The protein contents of ADH/ALDH isozymes were determined by immunoblotting using the corresponding purified class-specific antibodies; the cellular activity and protein localizations were detected by immunohistochemistry and histochemistry, respectively. Genotypes of ADH1B, ADH1C, and ALDH2 were determined by polymerase chain reaction-restriction fragment length polymorphisms. At 33mM ethanol, pH 7.5, the activity of ADH1C*1/1 phenotypes exhibited 87% higher than that of the ADH1C*1/*2 phenotypes in normal rectal mucosa. The activity of ALDH2-active phenotypes of rectal mucosa was 33% greater than ALDH2-inactive phenotypes at 200μM acetaldehyde. The protein contents in normal rectal mucosa were in the following order: ADH1>ALDH2>ADH3≈ALDH1A1, whereas those of ADH2, ADH4, and ALDH3A1 were fairly low. Both activity and content of ADH1 were significantly decreased in rectal tumors, whereas the ALDH activity remained

Laser Doppler diagnostics for orthodontia

NASA Astrophysics Data System (ADS)

Ryzhkova, Anastasia V.; Lebedeva, Nina G.; Sedykh, Alexey V.; Ulyanov, Sergey S.; Lepilin, Alexander V.; Kharish, Natalia A.

2004-06-01

The results of statistical analysis of Doppler spectra of intensity fluctuations of light, scattered from mucous membrane of oral cavity of healthy volunteers and patients, abused by the orthodontic diseases, are presented. Analysis of Doppler spectra, obtained from tooth pulp of patients, is carried out. New approach to monitoring of blood microcirculation in orthodontics is suggested. Influence of own noise of Doppler measuring system on formation of the output signal is studied.

Clinical observations on the treatment of prolapsing hemorrhoids with tissue selecting therapy

PubMed Central

Wang, Zhi-Gang; Zhang, Yong; Zeng, Xian-Dong; Zhang, Tie-Hui; Zhu, Qi-Dong; Liu, De-Long; Qiao, Yun-Yu; Mu, Nan; Yin, Zhi-Tao

2015-01-01

AIM: To compare the effects and postoperative complications between tissue selecting therapy stapler (TST) and Milligan-Morgan hemorrhoidectomy (M-M). METHODS: Four hundred and eighty patients with severe prolapsing hemorrhoids, who were admitted to the Shenyang Coloproctology Hospital between 2009 and 2012, were randomly divided into observation (n = 240) and control (n = 240) groups. Hemorrhoidectomies were performed with TST in the observation group and with the M-M technique in the control group. The therapeutic effects, operation security, and postoperative complications in the two groups were compared. The immediate and long-term complications were assessed according to corresponding criteria. Pain was assessed on a visual analogue scale. The efficacy was assessed by specialized criteria. The follow-up was conducted one year after the operation. RESULTS: The total effective rates of the observation and control groups were 99.5% (217/218) and 98.6% (218/221) respectively; the difference was not statistically significant (P = 0.322). Their were significant differences between observation and control groups in intraoperative blood loss (5.07 ± 1.14 vs 2.45 ± 0.57, P = 0.000), pain (12 h after the surgery: 5.08 ± 1.62 vs 7.19 ± 2.01, P = 0.000; at first dressing change: 2.64 ± 0.87 vs 4.34 ± 1.15, P = 0.000; first defecation: 3.91 ± 1.47 vs 5.63 ± 1.98, P = 0.001), urine retention (n = 22 vs n = 47, P = 0.001), anal pendant expansion after the surgery (2.35 ± 0.56 vs 5.16 ± 1.42, P = 0.000), operation time (18.3 ± 5.6 min vs 29.5 ± 8.2 min, P = 0.000), and the length of hospital stay (5.3 ± 0.6 d vs 11.4 ± 1.8 d, P = 0.000). Moreover TST showed significant reductions compared to M-M in the rates of long-term complications such as fecal incontinence (n = 3 vs n = 16, P = 0.003), difficult bowel movement (n = 1 vs n = 9, P = 0.011), intractable pain (n = 2 vs n = 12, P = 0.007), and anal discharge (n = 3 vs n = 23, P = 0.000). CONCLUSION: TST for

Clinical observations on the treatment of prolapsing hemorrhoids with tissue selecting therapy.

PubMed

Wang, Zhi-Gang; Zhang, Yong; Zeng, Xian-Dong; Zhang, Tie-Hui; Zhu, Qi-Dong; Liu, De-Long; Qiao, Yun-Yu; Mu, Nan; Yin, Zhi-Tao

2015-02-28

To compare the effects and postoperative complications between tissue selecting therapy stapler (TST) and Milligan-Morgan hemorrhoidectomy (M-M). Four hundred and eighty patients with severe prolapsing hemorrhoids, who were admitted to the Shenyang Coloproctology Hospital between 2009 and 2012, were randomly divided into observation (n=240) and control (n=240) groups. Hemorrhoidectomies were performed with TST in the observation group and with the M-M technique in the control group. The therapeutic effects, operation security, and postoperative complications in the two groups were compared. The immediate and long-term complications were assessed according to corresponding criteria. Pain was assessed on a visual analogue scale. The efficacy was assessed by specialized criteria. The follow-up was conducted one year after the operation. The total effective rates of the observation and control groups were 99.5% (217/218) and 98.6% (218/221) respectively; the difference was not statistically significant (P=0.322). Their were significant differences between observation and control groups in intraoperative blood loss (5.07±1.14 vs 2.45±0.57, P=0.000), pain (12 h after the surgery: 5.08±1.62 vs 7.19±2.01, P=0.000; at first dressing change: 2.64±0.87 vs 4.34±1.15, P=0.000; first defecation: 3.91±1.47 vs 5.63±1.98, P=0.001), urine retention (n=22 vs n=47, P=0.001), anal pendant expansion after the surgery (2.35±0.56 vs 5.16±1.42, P=0.000), operation time (18.3±5.6 min vs 29.5±8.2 min, P=0.000), and the length of hospital stay (5.3±0.6 d vs 11.4±1.8 d, P=0.000). Moreover TST showed significant reductions compared to M-M in the rates of long-term complications such as fecal incontinence (n=3 vs n=16, P=0.003), difficult bowel movement (n=1 vs n=9, P=0.011), intractable pain (n=2 vs n=12, P=0.007), and anal discharge (n=3 vs n=23, P=0.000). TST for severe prolapsing hemorrhoids is a satisfactory technique for more rapid recovery, lower complication rates, and

Distal left circumflex coronary artery flow reserve recorded by transthoracic Doppler echocardiography: a comparison with Doppler-wire

PubMed Central

Auriti, Antonio; Pristipino, Christian; Cianfrocca, Cinzia; Granatelli, Antonino; Guido, Vincenzo; Pelliccia, Francesco; Greco, Salvatore; Richichi, Giuseppe; Santini, Massimo

2007-01-01

Background Coronary flow reserve (CFR) recording by means of transthoracic echocardiography (TTDE) in all the main distal coronary arteries is a challenge for advanced echocardiography. Validation studies of TTDE versus Doppler-wire (DW) recordings are available for Left Anterior Descending artery (LAD) and the Posterior Descending coronary artery (PD), but lacking for the more technically challenging Left Circumflex coronary artery (LCx). Aim To evaluate the reliability of TTDE in assessing CFR in LCx when compared to the intracoronary Doppler flow-wire gold standard. Methods we evaluated 5 patients (age = 60 ± 9 years, 5 males) on LCx by TTDE and invasive CFR assessment. TTDE recording was performed using a low-frequency probe, with a four-chamber as a guiding 2D view. The 2 tests were performed on different days and in random order within 48 hours in a blind fashion. Vasodilator stimulus was adenosine, intravenously (140 γ/kg/min × 3–6 min) for TTDE and intracoronary (40 γ bolus) for DW recordings. Results CFR values on LCx ranged from 1.9 to 2.8 for DW, and from 2.0 to 3.0 for TTDE, with an overall correlation of R = 0,85 (p = 0,06); normal (CFR > 2.5) or abnormal (CFR < 2.5) value was concordantly identified by the 2 techniques in 4 out 5 cases (80%). Conclusion CFR of LCx artery can be obtained noninvasively with TTDE. PMID:17572907

Hands-Free Transcranial Color Doppler Probe

NASA Technical Reports Server (NTRS)

Chin, Robert; Madala, Srihdar; Sattler, Graham

2012-01-01

Current transcranial color Doppler (TCD) transducer probes are bulky and difficult to move in tiny increments to search and optimize TCD signals. This invention provides miniature motions of a TCD transducer probe to optimize TCD signals. The mechanical probe uses spherical bearing in guiding and locating the tilting crystal face. The lateral motion of the crystal face as it tilts across the full range of motion was achieved by minimizing the distance between the pivot location and the crystal face. The smallest commonly available metal spherical bearing was used with an outer diameter of 12 mm, a 3-mm tall retaining ring, and 5-mm overall height. Small geared motors were used that would provide sufficient power in a very compact package. After confirming the validity of the basic positioning concept, optimization design loops were completed to yield the final design.

The Novel Nonlinear Adaptive Doppler Shift Estimation Technique and the Coherent Doppler Lidar System Validation Lidar

NASA Technical Reports Server (NTRS)

Beyon, Jeffrey Y.; Koch, Grady J.

2006-01-01

The signal processing aspect of a 2-m wavelength coherent Doppler lidar system under development at NASA Langley Research Center in Virginia is investigated in this paper. The lidar system is named VALIDAR (validation lidar) and its signal processing program estimates and displays various wind parameters in real-time as data acquisition occurs. The goal is to improve the quality of the current estimates such as power, Doppler shift, wind speed, and wind direction, especially in low signal-to-noise-ratio (SNR) regime. A novel Nonlinear Adaptive Doppler Shift Estimation Technique (NADSET) is developed on such behalf and its performance is analyzed using the wind data acquired over a long period of time by VALIDAR. The quality of Doppler shift and power estimations by conventional Fourier-transform-based spectrum estimation methods deteriorates rapidly as SNR decreases. NADSET compensates such deterioration in the quality of wind parameter estimates by adaptively utilizing the statistics of Doppler shift estimate in a strong SNR range and identifying sporadic range bins where good Doppler shift estimates are found. The authenticity of NADSET is established by comparing the trend of wind parameters with and without NADSET applied to the long-period lidar return data.

IIP Update: A Packaged Coherent Doppler Wind Lidar Transceiver. Doppler Aerosol WiNd Lidar (DAWN)

NASA Technical Reports Server (NTRS)

Kavaya, Michael J.; Koch, Grady J.; Yu, Jirong; Trieu, Bo C.; Amzajerdian, Farzin; Singh, Upendra N.; Petros, Mulugeta

2006-01-01

The state-of-the-art 2-micron coherent Doppler wind lidar breadboard at NASA/LaRC will be engineered and compactly packaged consistent with future aircraft flights. The packaged transceiver will be integrated into a coherent Doppler wind lidar system test bed at LaRC. Atmospheric wind measurements will be made to validate the packaged technology. This will greatly advance the coherent part of the hybrid Doppler wind lidar solution to the need for global tropospheric wind measurements.

Calculation of Left Ventricular Diastolic Time Constant (TAU) in Dogs with Mitral Regurgitation Using Continuous-Wave Doppler.

PubMed

Wen, Chaoyang; Sun, Jing; Fan, Chunzhi; Dou, Jianping

2018-05-04

The left ventricular diastolic time constant (Tau) cannot be practically measured non-invasively. Thus, the aim of this study was to investigate a new method for the evaluation of Tau using continuous-wave (CW) Doppler in dogs with mitral regurgitation. Guided by ultrasound, we created 12 beagle models of mitral regurgitation and acute ischemic left ventricular diastolic dysfunction. Raw audio signals of the CW Doppler spectra were collected, and new mitral regurgitation Doppler spectra were observed after computer re-processing. The new Doppler spectra contour line was constructed using MATLAB (Version R2009), and two time intervals, t1-t2 and t1-t3, were measured on the descending branch of the mitral regurgitation Doppler spectrum and were substituted into Bai's equation group. The Doppler-derived Tau (Tau-d) was resolved and compared with the simultaneous catheter-derived Tau (Tau-c). No significant difference (p > 0.05) between Tau-d (49.33 ± 18.79 ms) and Tau-c (48.76 ± 17.60 ms) was found. A correlation analysis between Tau-d and Tau-c suggested a strong positive relationship (r = 0.85, p = 0.000). Bland-Altman plots of Tau-d and Tau-c revealed fair agreement. Compared with previous non-invasive approaches, this method is simpler and more accurate. There is a strong positive relationship and fair agreement between Tau-d and Tau-c. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Clopidogrel bisulfate (Plavix) does not increase bleeding complications in patients undergoing rubber band ligation for symptomatic hemorrhoids.

PubMed

Hite, Nathan; Klinger, Aaron L; Miller, Peter; Beck, David E; Whitlow, Charles B; Hicks, Terry C; Green, Heather M; Margolin, David A

2018-09-01

The incidence of postprocedural bleeding in patients undergoing rubber band ligation (RBL) for symptomatic internal hemorrhoids while taking clopidogrel bisulfate is unknown. To determine the postprocedural bleeding risk of RBL for patients taking clopidogrel compared with age- and sex-matched controls. This is a retrospective case-controlled cohort study analyzing data from 2005 to 2013 conducted at a single tertiary care academic center. The study included a total of 80 rubber bands placed on 41 patients taking clopidogrel bisulfate and 72 bands placed on 41 control patients not taking clopidogrel matched for age and sex. The 30-d rates of significant and insignificant bleeding events after RBL were recorded. A bleeding event was considered significant if the patient required admission to the hospital, transfusion of blood products, or additional procedures to stop the bleeding. Insignificant bleeding was defined as passage of blood or clots per rectum with spontaneous cessation and no need for additional intervention. There was no significant difference in the number of bleeding events per band placed in the clopidogrel group when compared with the control group (3.75% versus 2.78%, P = 0.7387). The rate of significant (2.5% versus 1.39%, P = 0.6244) and insignificant bleeding events (1.25% versus 1.39%, P = 0.9399) was also similar between the two groups. Two significant bleeding events occurred in the clopidogrel group requiring intervention: cauterization in one patient and colonoscopy and transfusion in the other. The risk of a bleeding complication after RBL for hemorrhoids does not appear to be increased in patients taking clopidogrel. Our results support the practice of continuing clopidogrel bisulfate in the periprocedural period as the associated risk of thrombosis is greater than the risk of bleeding. Copyright © 2018 Elsevier Inc. All rights reserved.

Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta‐analysis

PubMed Central

De Boer, M. A.; Heymans, M. W.; Schoonmade, L. J.; Bossuyt, P. M. M.; Mol, B. W. J.; De Groot, C. J. M.; Bax, C. J.

2018-01-01

than did UA Doppler in the prediction of low Apgar score (P = 0.017) and emergency delivery for fetal distress (P = 0.034). CPR outperformed MCA Doppler in the prediction of composite adverse outcome (P < 0.001) and emergency delivery for fetal distress (P = 0.013). Conclusion Calculating the CPR with MCA Doppler can add value to UA Doppler assessment in the prediction of adverse perinatal outcome in women with a singleton pregnancy. However, it is unclear to which subgroup of pregnant women this applies. The effectiveness of the CPR in guiding clinical management needs to be evaluated in clinical trials. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. PMID:28708272

[A severe epicutaneous test reaction to the bufexamac in a hemorrhoidal therapeutic preparation].

PubMed

Bauer, A; Greif, C; Gebhardt, M; Elsner, P

1999-10-08

A 49-year-old woman presented with acute perianal vesicular/bullous contact dermatitis. Other areas were over the trunk, face, neck and wrists. She reported occasional application of an ointment (Mastu S) to treat her hemorrhoids. Patch tests (basic series, anal block, own ointment, local anesthetic, cosmetics) provoked strong vesicular and bullous reactions of persisting crescendo type, spreading far beyond the site of application, to Bufexamac, to a derivative of hydroxxamine acid, and to local applied ointment with mild or moderate antiinflammatory action. A week after the patch tests there was a flare-up of the previous foci of dermatitis. These reactions subsided two days later after intravenous injection of prednisolone. The skin lesions healed after rapid reduction of the systemic treatment and local application of corticosteroids, bathing with tanning substances and basic preparations. While Bufexamac is not absorbed when applied rectally, perianal contamination may not be avoidable on intra-anal application and can produce sensitization.

Staggered Multiple-PRF Ultrafast Color Doppler.

PubMed

Posada, Daniel; Poree, Jonathan; Pellissier, Arnaud; Chayer, Boris; Tournoux, Francois; Cloutier, Guy; Garcia, Damien

2016-06-01

Color Doppler imaging is an established pulsed ultrasound technique to visualize blood flow non-invasively. High-frame-rate (ultrafast) color Doppler, by emissions of plane or circular wavefronts, allows severalfold increase in frame rates. Conventional and ultrafast color Doppler are both limited by the range-velocity dilemma, which may result in velocity folding (aliasing) for large depths and/or large velocities. We investigated multiple pulse-repetition-frequency (PRF) emissions arranged in a series of staggered intervals to remove aliasing in ultrafast color Doppler. Staggered PRF is an emission process where time delays between successive pulse transmissions change in an alternating way. We tested staggered dual- and triple-PRF ultrafast color Doppler, 1) in vitro in a spinning disc and a free jet flow, and 2) in vivo in a human left ventricle. The in vitro results showed that the Nyquist velocity could be extended to up to 6 times the conventional limit. We found coefficients of determination r(2) ≥ 0.98 between the de-aliased and ground-truth velocities. Consistent de-aliased Doppler images were also obtained in the human left heart. Our results demonstrate that staggered multiple-PRF ultrafast color Doppler is efficient for high-velocity high-frame-rate blood flow imaging. This is particularly relevant for new developments in ultrasound imaging relying on accurate velocity measurements.

Doppler characteristics of sea clutter.

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

Raynal, Ann Marie; Doerry, Armin Walter

2010-06-01

Doppler radars can distinguish targets from clutter if the target's velocity along the radar line of sight is beyond that of the clutter. Some targets of interest may have a Doppler shift similar to that of clutter. The nature of sea clutter is different in the clutter and exo-clutter regions. This behavior requires special consideration regarding where a radar can expect to find sea-clutter returns in Doppler space and what detection algorithms are most appropriate to help mitigate false alarms and increase probability of detection of a target. This paper studies the existing state-of-the-art in the understanding of Doppler characteristicsmore » of sea clutter and scattering from the ocean to better understand the design and performance choices of a radar in differentiating targets from clutter under prevailing sea conditions.« less

Linking Brain Arteriovenous Malformations With Anorectal Hemorrhoids: A Clinical and Anatomical Review

PubMed Central

Cuoco, Joshua A.; Hoehmann, Christopher L.; Hitscherich, Kyle; Zakhary, Sherry M.; Leheste, Joerg R.

2017-01-01

ABSTRACT Patients who harbor brain arteriovenous malformations are at risk for intracranial hemorrhage. These malformations are often seen in inherited vascular diseases such as hereditary hemorrhagic telangiectasia. However, malformations within the brain also sporadically occur without a hereditary‐coding component. Here, we review recent insights into the pathophysiology of arteriovenous malformations, in particular, certain signaling pathways that might underlie endothelial cell pathology. To better interpret the origins, determinants and consequences of brain arteriovenous malformations, we present a clinical case to illustrate the phenotypic landscape of the disease. We also propose that brain arteriovenous malformations might share certain signaling dimensions with those of anorectal hemorrhoids. This working hypothesis provides casual anchors from which to understand vascular diseases characterized by arteriovenous lesions with a hemorrhagic‐ or bleeding‐risk component. Anat Rec, 2017. © The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists. Anat Rec, 300:1973–1980, 2017. © 2017 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists. PMID:28696502

May radiofrequency be the best choice for III-IV degree hemorrhoids?

PubMed

Milito, Giovanni; Lisi, Giorgio; Aronadio, Elena; Campanelli, Michela; Venditti, Dario; Grande, Simona; Grande, Michele

2017-03-01

Hemorrhoidectomy is considered the most efficient method to treat hemorrhoids of III and IV grades. The aim of this study was to compare conventional diathermy hemorrhoidectomy and radiofrequency hemorrhoidectomy based on a large series of patients. Between June 2001 and June 2014, 1000 patients have been treated with radiofrequency hemorrhoidectomy (group A) and 500 patients have been treated with diathermy (group B) as a day-case procedure. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. The mean follow-up was seven years. The mean operating time for radiofrequency hemorrhoidectomy was shorter than diathermy but not significantly. Patients treated with radiofrequency had significantly less postoperative pain (measured on a Visual Analogue Scale; P=0.001), a shorter wound healing time, less time off work and postoperative complications (P=0.001) than patients who had diathermy. Neither wound healing nor mean hospital stay (day-case surgery) was significantly different. Radiofrequency hemorrhoidectomyis a valid alternative to the conventional diathermy technique, due to the reduction of operative time, postoperative pain, early and late complication rate.

Eyeballing oscillators for pulsed Doppler radar

NASA Astrophysics Data System (ADS)

Goldman, S.

1985-03-01

The visibility of small targets to a Doppler radar system in the presence of large targets is limited by phase noise. Such limitations occur when an airborne radar searches the ground for a mobile vehicle. Under these conditions, the performance of the Doppler radar depends greatly on the specifications of its phased-locked oscillator. Goldman (1984) has discussed the steps required to evaluate the noise resulting from a pulsed Doppler radar system. In the present investigation, these techniques are applied in reverse to determine system specifications for oscillator noise. A 95-GHz pulsed Doppler radar system is used as an example of specifying system phase noise.

An audit of a hospital-based Doppler ultrasound quality control protocol using a commercial string Doppler phantom.

PubMed

Cournane, S; Fagan, A J; Browne, J E

2014-05-01

Results from a four-year audit of a Doppler quality assurance (QA) program using a commercially available Doppler string phantom are presented. The suitability of the phantom was firstly determined and modifications were made to improve the reliability and quality of the measurements. QA of Doppler ultrasound equipment is very important as data obtained from these systems is used in patient management. It was found that if the braided-silk filament of the Doppler phantom was exchanged with an O-ring rubber filament and the velocity range below 50 cm/s was avoided for Doppler quality control (QC) measurements, then the maximum velocity accuracy (MVA) error and intrinsic spectral broadening (ISB) results obtained using this device had a repeatability of 18 ± 3.3% and 19 ± 3.5%, respectively. A consistent overestimation of the MVA of between 12% and 56% was found for each of the tested ultrasound systems. Of more concern was the variation of the overestimation within each respective transducer category: MVA errors of the linear, curvilinear and phased array probes were in the range 12.3-20.8%, 32.3-53.8% and 27-40.7%, respectively. There is a dearth of QA data for Doppler ultrasound; it would be beneficial if a multicentre longitudinal study was carried out using the same Doppler ultrasound test object to evaluate sensitivity to deterioration in performance measurements. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

New Approaches For Asteroid Spin State and Shape Modeling From Delay-Doppler Radar Images

NASA Astrophysics Data System (ADS)

Raissi, Chedy; Lamee, Mehdi; Mosiane, Olorato; Vassallo, Corinne; Busch, Michael W.; Greenberg, Adam; Benner, Lance A. M.; Naidu, Shantanu P.; Duong, Nicholas

2016-10-01

Delay-Doppler radar imaging is a powerful technique to characterize the trajectories, shapes, and spin states of near-Earth asteroids; and has yielded detailed models of dozens of objects. Reconstructing objects' shapes and spins from delay-Doppler data is a computationally intensive inversion problem. Since the 1990s, delay-Doppler data has been analyzed using the SHAPE software. SHAPE performs sequential single-parameter fitting, and requires considerable computer runtime and human intervention (Hudson 1993, Magri et al. 2007). Recently, multiple-parameter fitting algorithms have been shown to more efficiently invert delay-Doppler datasets (Greenberg & Margot 2015) - decreasing runtime while improving accuracy. However, extensive human oversight of the shape modeling process is still required. We have explored two new techniques to better automate delay-Doppler shape modeling: Bayesian optimization and a machine-learning neural network.One of the most time-intensive steps of the shape modeling process is to perform a grid search to constrain the target's spin state. We have implemented a Bayesian optimization routine that uses SHAPE to autonomously search the space of spin-state parameters. To test the efficacy of this technique, we compared it to results with human-guided SHAPE for asteroids 1992 UY4, 2000 RS11, and 2008 EV5. Bayesian optimization yielded similar spin state constraints within a factor of 3 less computer runtime.The shape modeling process could be further accelerated using a deep neural network to replace iterative fitting. We have implemented a neural network with a variational autoencoder (VAE), using a subset of known asteroid shapes and a large set of synthetic radar images as inputs to train the network. Conditioning the VAE in this manner allows the user to give the network a set of radar images and get a 3D shape model as an output. Additional development will be required to train a network to reliably render shapes from delay-Doppler

The tissue selecting technique (TST) versus the Milligan-Morgan hemorrhoidectomy for prolapsing hemorrhoids: a retrospective case-control study.

PubMed

Lin, H-C; Luo, H-X; Zbar, A P; Xie, S-K; Lian, L; Ren, D-L; Wang, J-P

2014-08-01

Milligan-Morgan hemorrhoidectomy (MMH) is the procedure of choice in the management of hemorrhoidal disease. However, this procedure is associated with significant postoperative pain. Tissue selecting technique (TST) is a segmental stapled hemorrhoidopexy, which aims to reduce the postoperative pain, rectovaginal fistula (RVF) and rectal stenosis. The aim of the present study was to compare the clinical outcomes between TST and MMH. A case-control study was undertaken to investigate the difference in clinical characteristics between the patients treated with TST and those treated with MMH. Intraoperative and postoperative parameters in both groups were collected and compared. One hundred and ninety-five eligible patients underwent either TST (n = 121) or MMH (n = 74). The pain score was significantly less in the TST group than that in the MMH group at the first defecation and at 12 h, day 3 and day 7 postoperatively (P = 0.001). Further analysis revealed that, at the time point of 12 h, day 3, day 7 and during first defecation, the pain score in the TST group and TST + STE group was less than that in the MMH group (P = 0.001). No patient in either group developed postoperative rectal stenosis. Furthermore, no case of RVF was identified in the TST group. The 1-year recurrence rate was 3.3 % (4/121) and 2.7 % (2/74), respectively, in TST and MMH groups (P = 1.0). The 1-year recurrence rate after TST and MMH for the treatment of patients with grade III-IV hemorrhoids is similar. It is encouraging that TST is associated with less postoperative pain and no RVF or rectal stenosis.

Noncoherent Doppler tracking: first flight results

NASA Astrophysics Data System (ADS)

DeBoy, Christopher C.; Robert Jensen, J.; Asher, Mark S.

2005-01-01

Noncoherent Doppler tracking has been devised as a means to achieve highly accurate, two-way Doppler measurements with a simple, transceiver-based communications system. This technique has been flown as an experiment on the Thermosphere, Ionosphere, Mesosphere, Energetics and Dynamics (TIMED) spacecraft, (launched 7 December 2001), as the operational technique for Doppler tracking on CONTOUR, and is baselined on several future deep space missions at JHU/APL. This paper reports on initial results from a series of successful tests of this technique between the TIMED spacecraft and NASA ground stations in the Deep Space Network. It also examines the advantages that noncoherent Doppler tracking and a transceiver-based system may offer to small satellite systems, including reduced cost, mass, and power.

The medical Doppler in hand surgery: its scientific basis, applications, and the history of its namesake, Christian Johann Doppler.

PubMed

Ghori, Ahmer K; Chung, Kevin C

2007-12-01

The word Doppler is used synonymously in hand surgery for evaluating patency of vascular structures; however, the science and history behind the Doppler effect are not as well-known. We will present the theories behind the Doppler effect and the history of the person who made this discovery.

Digital Doppler measurement with spacecraft

NASA Technical Reports Server (NTRS)

Kinman, Peter W.; Hinedi, Sami M.; Labelle, Remi C.; Bevan, Roland P.; Del Castillo, Hector M.; Chong, Dwayne C.

1991-01-01

Digital and analog phase-locked loop (PLL) receivers were operated in parallel, each tracking the residual carrier from a spacecraft. The PLL tracked the downlink carrier and measured its instantaneous phase. This information, combined with a knowledge of the uplink carrier and the transponder ratio, permitted the computation of a Doppler observable. In this way, two separate Doppler measurements were obtained for one observation window. The two receivers agreed on the magnitude of the Doppler effect to within 1 mHz. There was less jitter on the data from the digital receiver. This was due to its smaller noise bandwidth. The demonstration and its results are described.

Laser Doppler flowmetry, transcutaneous oxygen tension measurements and Doppler pressure compared in patients undergoing amputation.

PubMed

Lantsberg, L; Goldman, M

1991-04-01

The level of amputation continues to present a challenge for surgeons. In view of this, 24 patients who required an amputation of their ischaemic leg were studied prospectively using Laser Doppler flowmetry (LDF), TcpO2 measurements and Doppler ultrasound to assess the best level for amputation. In all patients gangrene of the leg and rest pain were the indication for an amputation. Skin oxygen tension (TcpO2) and skin blood flow (LDF) measurements were obtained the day before surgery on the proposed anterior and posterior skin flaps for below knee amputation and the maximum Doppler systolic pressure was measured. The level of amputation was chosen at surgery by clinical judgement without reference to the measurements mentioned above. A below knee amputation was performed in 17 patients and an above knee in seven. All amputations healed by primary intention. Doppler pressures showed poor discrimination with a median value of 10 mmHg (0-25) in AK patients and 35 mmHg (0-85) in the BK group (p greater than 0.05). In contrast TcpO2 showed a trend. In the BK group the median value was 20 mmHg (4-50) on the anterior and 22 mmHg (2-60) on the posterior flap compared to above knee amputees with median values of 6 mmHg (2-11) and 8 mmHg (3-38), respectively (p greater than 0.05). Laser Doppler seemed more useful. In BK patients the median LDF values were 36 mV (20-85) on the anterior and 34 mV (20-80) on the posterior flap with median LDF values of 10 mV (10-18) on the anterior and 11 mV (8-38) on the posterior flap in the above knee group (p less than 0.01). Laser Doppler flowmetry is a simple objective test, which is a better discriminator of skin flap perfusion than either TcpO2 or Doppler ankle pressures.

Transoesophageal Doppler compared to central venous pressure for perioperative hemodynamic monitoring and fluid guidance in liver resection.

PubMed

El Sharkawy, Osama A; Refaat, Emad K; Ibraheem, Abdel Elmoniem M; Mahdy, Wafiya R; Fayed, Nirmeen A; Mourad, Wesam S; Abd Elhafez, Hanaa S; Yassen, Khaled A

2013-10-01

Major hepatic resections may result in hemodynamic changes. Aim is to study transesophageal Doppler (TED) monitoring and fluid management in comparison to central venous pressure (CVP) monitoring. A follow-up comparative hospital based study. 59 consecutive cirrhotic patients (CHILD A) undergoing major hepatotomy. CVP monitoring only (CVP group), (n=30) and TED (Doppler group), (n=29) with CVP transduced but not available on the monitor. Exclusion criteria include contra-indication for Doppler probe insertion or bleeding tendency. An attempt to reduce CVP during the resection in both groups with colloid restriction, but crystalloids infusion of 6 ml/kg/h was allowed to replace insensible loss. Post-resection colloids infusion were CVP guided in CVP group (5-10 mmHg) and corrected flow time (FTc) aortic guided in Doppler group (>0.4 s) blood products given according to the laboratory data. Using the FTc to guide Hydroxyethyl starch 130/0.4 significantly decreased intake in TED versus CVP (1.03 [0.49] versus 1.74 [0.41] Liter; P<0.05). Nausea, vomiting, and chest infection were less in TED with a shorter hospital stay (P<0.05). No correlation between FTc and CVP (r=0.24, P > 0.05). Cardiac index and stroke volume of TED increased post-resection compared to baseline, 3.0 (0.9) versus 3.6 (0.9) L/min/m(2), P<0.05; 67.1 (14.5) versus 76 (13.2) ml, P<0.05, respectively, associated with a decrease in systemic vascular resistance (SVR) 1142.7 (511) versus 835.4 (190.9) dynes.s/cm(5), P<0.05. No significant difference in arterial pressure and CVP between groups at any stage. CVP during resection in TED 6.4 (3.06) mmHg versus 6.1 (1.4) in CVP group, P=0.6. TED placement consumed less time than CVP (7.3 [1.5] min versus 13.2 [2.9], P<0.05). TED in comparison to the CVP monitoring was able to reduced colloids administration post-resection, lower morbidity and shorten hospital stay. TED consumed less time to insert and was also able to present significant hemodynamic changes

De-Dopplerization of Acoustic Measurements

DTIC Science & Technology

2017-08-10

band energy obtained from fractional octave band digital filters generates a de-Dopplerized spectrum without complex resampling algorithms. An...energy obtained from fractional octave band digital filters generates a de-Dopplerized spectrum without complex resampling algorithms. An equation...fractional octave representation and smearing that occurs within the spectrum11, digital filtering techniques were not considered by these earlier

Analysis and prediction of Doppler noise during solar conjunctions

NASA Technical Reports Server (NTRS)

Berman, A. L.; Rockwell, S. T.

1975-01-01

The results of a study of Doppler data noise during solar conjunctions were presented. During the first half of 1975, a sizeable data base of Doppler data noise (estimates) for the Pioneer 10, Pioneer 11, and Helios 1 solar conjunctions was accumulated. To analyze this data, certain physical assumptions are made, leading to the development of a geometric parameter ("ISI") which correlates strongly with Doppler data noise under varying sun-earth-spacecraft geometries. Doppler noise models are then constructed from this parameter, resulting in the newfound ability to predict Doppler data noise during solar conjunctions, and hence to additionally be in a position to validate Doppler data acquired during solar conjunctions.

Inverse Doppler Effects in Broadband Acoustic Metamaterials

PubMed Central

Zhai, S. L.; Zhao, X. P.; Liu, S.; Shen, F. L.; Li, L. L.; Luo, C. R.

2016-01-01

The Doppler effect refers to the change in frequency of a wave source as a consequence of the relative motion between the source and an observer. Veselago theoretically predicted that materials with negative refractions can induce inverse Doppler effects. With the development of metamaterials, inverse Doppler effects have been extensively investigated. However, the ideal material parameters prescribed by these metamaterial design approaches are complex and also challenging to obtain experimentally. Here, we demonstrated a method of designing and experimentally characterising arbitrary broadband acoustic metamaterials. These omni-directional, double-negative, acoustic metamaterials are constructed with ‘flute-like’ acoustic meta-cluster sets with seven double meta-molecules; these metamaterials also overcome the limitations of broadband negative bulk modulus and mass density to provide a region of negative refraction and inverse Doppler effects. It was also shown that inverse Doppler effects can be detected in a flute, which has been popular for thousands of years in Asia and Europe. PMID:27578317

Inverse Doppler Effects in Broadband Acoustic Metamaterials

NASA Astrophysics Data System (ADS)

Zhai, S. L.; Zhao, X. P.; Liu, S.; Shen, F. L.; Li, L. L.; Luo, C. R.

2016-08-01

The Doppler effect refers to the change in frequency of a wave source as a consequence of the relative motion between the source and an observer. Veselago theoretically predicted that materials with negative refractions can induce inverse Doppler effects. With the development of metamaterials, inverse Doppler effects have been extensively investigated. However, the ideal material parameters prescribed by these metamaterial design approaches are complex and also challenging to obtain experimentally. Here, we demonstrated a method of designing and experimentally characterising arbitrary broadband acoustic metamaterials. These omni-directional, double-negative, acoustic metamaterials are constructed with ‘flute-like’ acoustic meta-cluster sets with seven double meta-molecules; these metamaterials also overcome the limitations of broadband negative bulk modulus and mass density to provide a region of negative refraction and inverse Doppler effects. It was also shown that inverse Doppler effects can be detected in a flute, which has been popular for thousands of years in Asia and Europe.

Evaluation of joint effusion in rabbits by color Doppler, power Doppler, and contrast-enhanced power Doppler ultrasonography.

PubMed

Lim, Gye-Yeon; Im, Soo Ah; Jung, Won Sang; Lee, Jae Mun; Lee, Ah Won

2005-09-01

The aim of this prospective study was to evaluate the diagnostic value of power Doppler ultrasonography (PDUS) and contrast-enhanced PDUS (CEPDUS) in the depiction and characterization of experimentally induced arthritis in the rabbit. Thirty rabbits were divided into three groups consisting of one control group (saline injection group) and two experimental groups: a suppurative arthritis group and a chemically induced synovitis group. The same amount (1 ml) of each agent was directly injected into the right hip joint. Serial color Doppler ultrasound (CDUS), PDUS, and CEPDUS images were obtained before and after injection. We observed that all of the infected knees in the suppurative arthritis group with Staphylococcus aureus demonstrated an increased signal on PDUS after inoculation. A minimal power Doppler signal was presented in the chemically induced synovitis group with talc injection, but none of the control knees demonstrated any increased signals. CEPDUS was the most sensitive imaging modality for evaluating the increase of blood flows in suppurative arthritis and was subsequently followed by PDUS and CDUS. The increased signals obtained with PDUS represent increased local blood flows; therefore, this technique can be used for evaluating the degree of inflammation. Furthermore, using the contrast agent enhances the sensitivity of PDUS, and it can even be useful for differentiating borderline cases. Copyright 2005 Wiley Periodicals, Inc

Validation of continuous-wave Doppler echocardiographic measurements of mitral and tricuspid prosthetic valve gradients: a simultaneous Doppler-catheter study.

PubMed

Wilkins, G T; Gillam, L D; Kritzer, G L; Levine, R A; Palacios, I F; Weyman, A E

1986-10-01

For patients with stenotic native valves, the modified Bernoulli equation (delta P = 4V2) may be applied to Doppler-measured transvalvular velocities to yield an accurate estimate of transvalvular gradients. Although it would be useful if the same approach could be used for those with stenotic prosthetic valves, no previous study has validated the Doppler technique in this setting. We therefore recorded simultaneous continuous-wave Doppler flow profiles and transvalvular manometric gradients in 12 catheterized patients in whom all atrial and ventricular pressures were directly measured (transseptal left atrial catheterization and transthoracic ventricular puncture were performed where necessary). A total of 13 prostheses were studied: 11 mitral (seven porcine, three Starr-Edwards, and one Björk-Shiley) and two tricuspid (one porcine and one Björk-Shiley). The Doppler-determined mean gradient was calculated as the mean of the instantaneous gradients (delta P = 4V2) at 10 msec intervals throughout diastole. The correlation of simultaneous Doppler (DMG) and manometric mean gradients (MG) for the whole group (n = 13) demonstrated a highly significant relationship (MG = 1.07 DMG + 0.28; r = .96, p = .0001). The correlation was equally good for porcine valves alone (n = 8) (MG = 1.06 DMG + 0.55; r = .96, p = .001) and for mechanical valves alone (n = 5) (MG = 1.06 DMG - 0.04; r = .93, p = .02). In a subset of patients without regurgitation (n = 8), prosthetic valve areas were estimated by two Doppler methods originally described by Holen and Hatle, as well as by the invasive Gorlin method. As expected from theoretical considerations, a close correlation was not demonstrated between results of the Gorlin method and those of either Hatle's Doppler method (r = .65, fp = NS) or Holen's method (r = .14, p = NS). Comparison of the results of the two Doppler methods yielded a somewhat closer correlation (r = .73, p less than or equal to .05). These results suggest that in

Doppler term in the galaxy two-point correlation function: Wide-angle, velocity, Doppler lensing and cosmic acceleration effects

NASA Astrophysics Data System (ADS)

Raccanelli, Alvise; Bertacca, Daniele; Jeong, Donghui; Neyrinck, Mark C.; Szalay, Alexander S.

2018-03-01

We study the parity-odd part (that we shall call Doppler term) of the linear galaxy two-point correlation function that arises from wide-angle, velocity, Doppler lensing and cosmic acceleration effects. As it is important at low redshift and at large angular separations, the Doppler term is usually neglected in the current generation of galaxy surveys. For future wide-angle galaxy surveys, however, we show that the Doppler term must be included. The effect of these terms is dominated by the magnification due to relativistic aberration effects and the slope of the galaxy redshift distribution and it generally mimics the effect of the local type primordial non-Gaussianity with the effective nonlinearity parameter fNLeff of a few; we show that this would affect forecasts on measurements of fNL at low-redshift. Our results show that a survey at low redshift with large number density over a wide area of the sky could detect the Doppler term with a signal-to-noise ratio of ∼ 1 - 20, depending on survey specifications.

[Venous Doppler color echography: importance and inconveniences].

PubMed

Laroche, J P; Dauzat, M; Muller, G; Janbon, C

1993-01-01

Color Doppler is a technique which performs a real-time opacification of the vascular system with blue indicating reverse flow and red indicating forward flow (directional color coding). In venous pathology, the use of color Doppler improves significantly the anatomical evaluation of the inferior vena cava, the iliac vein, the deep femoral vein, and the sural system. Color Doppler facilitates the study of deep venous thrombosis (providing useful information to differentiate ancient from most recent thrombus) and also the study of post-thrombotic conditions (assessment of reverse flow, repermeation phenomena). Finally, color Doppler produces a better insight for the study of varicose veins, especially with regard to mapping, identification of communicante veins, and study of the external saphenous vein.

Micro-Doppler analysis of multiple frequency continuous wave radar signatures

NASA Astrophysics Data System (ADS)

Anderson, Michael G.; Rogers, Robert L.

2007-04-01

Micro-Doppler refers to Doppler scattering returns produced by non rigid-body motion. Micro-Doppler gives rise to many detailed radar image features in addition to those associated with bulk target motion. Targets of different classes (for example, humans, animals, and vehicles) produce micro-Doppler images that are often distinguishable even by nonexpert observers. Micro-Doppler features have great potential for use in automatic target classification algorithms. Although the potential benefit of using micro-Doppler in classification algorithms is high, relatively little experimental (non-synthetic) micro-Doppler data exists. Much of the existing experimental data comes from highly cooperative targets (human or vehicle targets directly approaching the radar). This research involved field data collection and analysis of micro-Doppler radar signatures from non-cooperative targets. The data was collected using a low cost Xband multiple frequency continuous wave (MFCW) radar with three transmit frequencies. The collected MFCW radar signatures contain data from humans, vehicles, and animals. The presented data includes micro-Doppler signatures previously unavailable in the literature such as crawling humans and various animal species. The animal micro-Doppler signatures include deer, dog, and goat datasets. This research focuses on the analysis of micro-Doppler from noncooperative targets approaching the radar at various angles, maneuvers, and postures.

Natural history of definitive diverticular hemorrhage based upon stigmata of recent hemorrhage and colonoscopic Doppler blood flow monitoring for risk stratification and definitive hemostasis

PubMed Central

Jensen, Dennis M.; Ohning, Gordon V.; Kovacs, Thomas O.G.; Jutabha, Rome; Ghassemi, Kevin; Dulai, Gareth S.; Machicado, Gustavo A.

2015-01-01

BACKGROUND AND AIMS Few prospective reports describe the short term natural history of colon diverticular hemorrhage based upon stigmata of recent hemorrhage and none include blood flow detection for risk stratification or as a guide to definitive hemostasis. Our purposes are to report the 30 day natural history of definitive diverticular hemorrhage based upon stigmata and to describe Doppler probe blood flow detection and as a guide to definitive hemostasis. METHODS Different cohorts of patients with severe diverticular bleeding and stigmata on urgent colonoscopy are reported. For 30 day natural history, patients were treated medically. If severe rebleeding occurred, they had surgical or angiographic treatment. Natural history with major stigmata (active bleeding, visible vessel, or adherent clot) and no stigmata or flat spots after washing away clots are reported. Doppler probe detection of arterial blood flow underneath stigmata before and after hemostasis is also reported in a recent cohort. RESULTS For natural history patients with major stigmata treated medically had 65.8% (25/38) rebleeding rates and 44.7% (17/38) had intervention for hemostasis. Patients with spots or clean bases had no rebleeding. Doppler probe detected arterial blood flow in 92% of major stigmata, none after hemostasis and no one rebled. CONCLUSIONS 1. Patients with major stigmata treated medically had high rates of rebleeding and intervention for hemostasis. 2. Patients with clean diverticula or only flat spots had no rebleeding. 3. High rates of arterial blood flow were detected under major stigmata with Doppler probe but with obliteration by hemostasis no rebleeding occurred. PMID:26227931

Velocity measurement by vibro-acoustic Doppler.

PubMed

Nabavizadeh, Alireza; Urban, Matthew W; Kinnick, Randall R; Fatemi, Mostafa

2012-04-01

We describe the theoretical principles of a new Doppler method, which uses the acoustic response of a moving object to a highly localized dynamic radiation force of the ultrasound field to calculate the velocity of the moving object according to Doppler frequency shift. This method, named vibro-acoustic Doppler (VAD), employs two ultrasound beams separated by a slight frequency difference, Δf, transmitting in an X-focal configuration. Both ultrasound beams experience a frequency shift because of the moving objects and their interaction at the joint focal zone produces an acoustic frequency shift occurring around the low-frequency (Δf) acoustic emission signal. The acoustic emission field resulting from the vibration of the moving object is detected and used to calculate its velocity. We report the formula that describes the relation between Doppler frequency shift of the emitted acoustic field and the velocity of the moving object. To verify the theory, we used a string phantom. We also tested our method by measuring fluid velocity in a tube. The results show that the error calculated for both string and fluid velocities is less than 9.1%. Our theory shows that in the worst case, the error is 0.54% for a 25° angle variation for the VAD method compared with an error of -82.6% for a 25° angle variation for a conventional continuous wave Doppler method. An advantage of this method is that, unlike conventional Doppler, it is not sensitive to angles between the ultrasound beams and direction of motion.

Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

PubMed

Lin, Lawrence H; Bernardes, Lisandra S; Hase, Eliane A; Fushida, Koji; Francisco, Rossana P V

2015-12-01

Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: "Gestational trophoblastic disease AND Ultrasonography, Doppler." Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. (1) Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. (2) There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. (3) Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. (4) Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia.

Mathematical Models for Doppler Measurements

NASA Technical Reports Server (NTRS)

Lear, William M.

1987-01-01

Error analysis increases precision of navigation. Report presents improved mathematical models of analysis of Doppler measurements and measurement errors of spacecraft navigation. To take advantage of potential navigational accuracy of Doppler measurements, precise equations relate measured cycle count to position and velocity. Drifts and random variations in transmitter and receiver oscillator frequencies taken into account. Mathematical models also adapted to aircraft navigation, radar, sonar, lidar, and interferometry.

Coherent Doppler lidar for measurements of wind fields

NASA Technical Reports Server (NTRS)

Menzies, Robert T.; Hardesty, R. Michael

1989-01-01

The signal-processing techniques for obtaining the velocity estimates and the fundamental factors that influence coherent lidar performance are considered. The similarities and distinctions between Doppler lidar and Doppler radars are discussed. The capability of coherent Doppler lidars for mapping wind fields over selected regions in the lower atmosphere and greatly enhancing the capability to visualize flow patterns in real time is discussed, and examples are given. Salient features of a concept for an earth-orbiting Doppler lidar to be launched in the late 1990s are examined.

The "Swiss-cheese Doppler-guided laser tonsillectomy": a new safe cribriform approach to intracapsular tonsillectomy.

PubMed

Palmieri, B; Iannitti, T; Fistetto, G; Rottigni, V

2013-05-01

Outpatient laser ablation of palatine tonsils is a very interesting procedure that has been recently introduced as a routine in head and neck surgery departments. The aim of this study was to describe a new strategy using a Doppler-guided fibre optic neodymium-yttrium-aluminium-garnet (YAG) laser to remove up to 80 % of tonsillar tissue, as assessed in the long-term postoperative clinical evaluation of the volume of the tonsils at the follow-up, and leaving the capsule in place, thus avoiding any haemorrhagic complication and minimize pain. A total of 20 patients (men, n=13; women, n=7), aged between 6 and 63, were recruited for the procedure. They were affected by chronic hypertrophic tonsillitis with a recurrent fever and other symptoms that were related to oral inflammation. Among the 20 patients, no serious adverse events, including haemorrhage-related complications, were observed. Treatment was well tolerated, even in patients displaying an overall low pain threshold. No dropout or uncompleted procedure occurred in the present study. Minor complications included sore throat, moderate oedema, mild acute pharynx inflammation, slight peritonsillar exudate and local burning. The postoperative pain, measured by Scott-Huskisson visual analogue scale, was between 5 and 40 mm and was easily counteracted by means of external ice packages and nonsteroidal anti-inflammatory drugs, according to the individual patient's need. During the 12-36-month follow-up patients showed improved symptoms (n=7) and complete recovery (n=13). A relapse episode was observed in two patients. This study supports fibre optic laser neodymium-YAG tonsil surgery, named "cribriform intracapsular tonsillectomy" or "Swiss-cheese laser tonsillectomy", as an effective alternative to the traditional cold knife approach or electrosurgery. This approach could become the gold standard for tonsil surgery in the third millennium for safety reasons, acceptable cost-benefit ratio, the precise targeting of

L wave in echo Doppler.

PubMed

Kumar, Vipin; Jose, John; Jose, V Jacob

2014-01-01

62-year-old female presented with progressive dyspnea NYHA class III for six months. Echocardiography showed normal left ventricular (LV) systolic function, mild biatrial enlargement, an L wave in pulse wave Doppler at mitral inflow and in M mode echocardiography across mitral valve. Tissue Doppler imaging at medial mitral annulus showed an L' wave in mid diastole in addition to E' and A' wave. An L wave in pulse wave Doppler and M mode echocardiography represents continued pulmonary vein mid diastolic flow through the left atrium in to LV across mitral valve after early rapid filling. Presence of an L' wave in these patients associated with higher E/E' is indicative of advance diastolic dysfunction with elevated filling pressures. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Molecular filter based planar Doppler velocimetry

NASA Astrophysics Data System (ADS)

Elliott, Gregory S.; Beutner, Thomas J.

1999-11-01

Molecular filter based diagnostics are continuing to gain popularity as a research tool for investigations in areas of aerodynamics, fluid mechanics, and combustion. This class of diagnostics has gone by many terms including Filtered Rayleigh Scattering, Doppler Global Velocimetry, and Planar Doppler Velocimetry. The majority of this article reviews recent advances in Planar Doppler Velocimetry in measuring up to three velocity components over a planar region in a flowfield. The history of the development of these techniques is given with a description of typical systems, components, and levels of uncertainty in the measurement. Current trends indicate that uncertainties on the order of 1 m/s are possible with these techniques. A comprehensive review is also given on the application of Planar Doppler Velocimetry to laboratory flows, supersonic flows, and large scale subsonic wind tunnels. The article concludes with a description of future trends, which may simplify the technique, followed by a description of techniques which allow multi-property measurements (i.e. velocity, density, temperature, and pressure) simultaneously.

Analysis of airborne Doppler lidar, Doppler radar and tall tower measurements of atmospheric flows in quiescent and stormy weather

NASA Technical Reports Server (NTRS)

Bluestein, H. B.; Doviak, R. J.; Eilts, M. D.; Mccaul, E. W.; Rabin, R.; Sundara-Rajan, A.; Zrnic, D. S.

1986-01-01

The first experiment to combine airborne Doppler Lidar and ground-based dual Doppler Radar measurements of wind to detail the lower tropospheric flows in quiescent and stormy weather was conducted in central Oklahoma during four days in June-July 1981. Data from these unique remote sensing instruments, coupled with data from conventional in-situ facilities, i.e., 500-m meteorological tower, rawinsonde, and surface based sensors, were analyzed to enhance understanding of wind, waves and turbulence. The purposes of the study were to: (1) compare winds mapped by ground-based dual Doppler radars, airborne Doppler lidar, and anemometers on a tower; (2) compare measured atmospheric boundary layer flow with flows predicted by theoretical models; (3) investigate the kinematic structure of air mass boundaries that precede the development of severe storms; and (4) study the kinematic structure of thunderstorm phenomena (downdrafts, gust fronts, etc.) that produce wind shear and turbulence hazardous to aircraft operations. The report consists of three parts: Part 1, Intercomparison of Wind Data from Airborne Lidar, Ground-Based Radars and Instrumented 444 m Tower; Part 2, The Structure of the Convective Atmospheric Boundary Layer as Revealed by Lidar and Doppler Radars; and Part 3, Doppler Lidar Observations in Thunderstorm Environments.

A low cost Doppler system for vascular dialysis access surveillance.

PubMed

Molina, P S C; Moraes, R; Baggio, J F R; Tognon, E A

2004-01-01

The National Kidney Foundation guidelines for vascular access recommend access surveillance to avoid morbidity among patients undergoing hemodialysis. Methods to detect access failure based on CW Doppler system are being proposed to implement surveillance programs at lower cost. This work describes a low cost Doppler system implemented in a PC notebook designed to carry out this task. A Doppler board samples the blood flow velocity and delivers demodulated quadrature Doppler signals. These signals are sampled by a notebook sound card. Software for Windows OS (running at the notebook) applies CFFT to consecutive 11.6 ms intervals of Doppler signals. The sonogram is presented on the screen in real time. The software also calculates the maximum and the intensity weighted mean frequency envelopes. Since similar systems employ DSP boards to process the Doppler signals, cost reduction was achieved. The Doppler board electronic circuits and routines to process the Doppler signals are presented.

Spacecraft Doppler Tracking as a Xylophone Detector

NASA Technical Reports Server (NTRS)

Tinto, Massimo

1996-01-01

We discuss spacecraft Doppler tracking in which Doppler data recorded on the ground are linearly combined with Doppler measurements made on board a spacecraft. By using the four-link radio system first proposed by Vessot and Levine, we derive a new method for removing from the combined data the frequency fluctuations due to the Earth troposphere, ionosphere, and mechanical vibrations of the antenna on the ground. Our method provides also for reducing by several orders of magnitude, at selected Fourier components, the frequency fluctuations due to other noise sources, such as the clock on board the spacecraft or the antenna and buffeting of the probe by non-gravitational forces. In this respect spacecraft Doppler tracking can be regarded as a xylophone detector. Estimates of the sensitivities achievable by this xylophone are presented for two tests of Einstein's theory of relativity: searches for gravitational waves and measurements of the gravitational red shift. This experimental technique could be extended to other tests of the theory of relativity, and to radio science experiments that rely on high-precision Doppler measurements.

MP3 compression of Doppler ultrasound signals.

PubMed

Poepping, Tamie L; Gill, Jeremy; Fenster, Aaron; Holdsworth, David W

2003-01-01

The effect of lossy, MP3 compression on spectral parameters derived from Doppler ultrasound (US) signals was investigated. Compression was tested on signals acquired from two sources: 1. phase quadrature and 2. stereo audio directional output. A total of 11, 10-s acquisitions of Doppler US signal were collected from each source at three sites in a flow phantom. Doppler signals were digitized at 44.1 kHz and compressed using four grades of MP3 compression (in kilobits per second, kbps; compression ratios in brackets): 1400 kbps (uncompressed), 128 kbps (11:1), 64 kbps (22:1) and 32 kbps (44:1). Doppler spectra were characterized by peak velocity, mean velocity, spectral width, integrated power and ratio of spectral power between negative and positive velocities. The results suggest that MP3 compression on digital Doppler US signals is feasible at 128 kbps, with a resulting 11:1 compression ratio, without compromising clinically relevant information. Higher compression ratios led to significant differences for both signal sources when compared with the uncompressed signals. Copyright 2003 World Federation for Ultrasound in Medicine & Biology

One way Doppler extractor. Volume 1: Vernier technique

NASA Technical Reports Server (NTRS)

Blasco, R. W.; Klein, S.; Nossen, E. J.; Starner, E. R.; Yanosov, J. A.

1974-01-01

A feasibility analysis, trade-offs, and implementation for a One Way Doppler Extraction system are discussed. A Doppler error analysis shows that quantization error is a primary source of Doppler measurement error. Several competing extraction techniques are compared and a Vernier technique is developed which obtains high Doppler resolution with low speed logic. Parameter trade-offs and sensitivities for the Vernier technique are analyzed, leading to a hardware design configuration. A detailed design, operation, and performance evaluation of the resulting breadboard model is presented which verifies the theoretical performance predictions. Performance tests have verified that the breadboard is capable of extracting Doppler, on an S-band signal, to an accuracy of less than 0.02 Hertz for a one second averaging period. This corresponds to a range rate error of no more than 3 millimeters per second.

Rectal distensibility and symptoms after stapled and Milligan-Morgan operation for hemorrhoids.

PubMed

Corsetti, Maura; De Nardi, Paola; Di Pietro, Salvatore; Passaretti, Sandro; Testoni, Pier Alberto; Staudacher, Carlo

2009-12-01

In a previous uncontrolled study, a reduction of rectal distensibility and volume thresholds for sensations have been related to the occurrence of fecal urgency and/or increased stool frequency after stapled hemorrhoidopexy. The aim of this study was to compare rectal symptoms and sensory-motor function after stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy. The clinical records of 12 (four women) and ten patients (four women) with third- and fourth-degree hemorrhoids, respectively, who underwent stapled hemorrhoidopexy or Milligan-Morgan's hemorrhoidectomy, were evaluated. One week before and 6 months after surgery, rectal motor and sensory response to distension was assessed by an electronic barostat, and bowel and rectal symptoms were recorded by means of a 7-day diary and Bristol Index scale and psychological symptoms with SCL-90 questionnaire. Rectal distensibility and volume thresholds for sensations were significantly lower after surgery (P < 0.02) in the stapled group. Increased stool frequency and/or fecal urgency arose in 41% of patients in the stapled group and associated with altered rectal distensibility. No difference within and between groups could be demonstrated in SCL-90 score. Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. Altered rectal distensibility was associated with rectal urgency and/or increased stool frequency.

Photoacoustic Doppler effect from flowing small light-absorbing particles.

PubMed

Fang, Hui; Maslov, Konstantin; Wang, Lihong V

2007-11-02

From the flow of a suspension of micrometer-scale carbon particles, the photoacoustic Doppler shift is observed. As predicted theoretically, the observed Doppler shift equals half of that in Doppler ultrasound and does not depend on the direction of laser illumination. This new physical phenomenon provides a basis for developing photoacoustic Doppler flowmetry, which can potentially be used for detecting fluid flow in optically scattering media and especially low-speed blood flow of relatively deep microcirculation in biological tissue.

Complex regression Doppler optical coherence tomography

NASA Astrophysics Data System (ADS)

Elahi, Sahar; Gu, Shi; Thrane, Lars; Rollins, Andrew M.; Jenkins, Michael W.

2018-04-01

We introduce a new method to measure Doppler shifts more accurately and extend the dynamic range of Doppler optical coherence tomography (OCT). The two-point estimate of the conventional Doppler method is replaced with a regression that is applied to high-density B-scans in polar coordinates. We built a high-speed OCT system using a 1.68-MHz Fourier domain mode locked laser to acquire high-density B-scans (16,000 A-lines) at high enough frame rates (˜100 fps) to accurately capture the dynamics of the beating embryonic heart. Flow phantom experiments confirm that the complex regression lowers the minimum detectable velocity from 12.25 mm / s to 374 μm / s, whereas the maximum velocity of 400 mm / s is measured without phase wrapping. Complex regression Doppler OCT also demonstrates higher accuracy and precision compared with the conventional method, particularly when signal-to-noise ratio is low. The extended dynamic range allows monitoring of blood flow over several stages of development in embryos without adjusting the imaging parameters. In addition, applying complex averaging recovers hidden features in structural images.

Defect induced guided waves mode conversion

NASA Astrophysics Data System (ADS)

Wandowski, Tomasz; Kudela, Pawel; Malinowski, Pawel; Ostachowicz, Wieslaw

2016-04-01

This paper deals with analysis of guided waves mode conversion phenomenon in fiber reinforced composite materials. Mode conversion phenomenon may take place when propagating elastic guided waves interact with discontinuities in the composite waveguide. The examples of such discontinuities are sudden thickness change or delamination between layers in composite material. In this paper, analysis of mode conversion phenomenon is based on full wave-field signals. In the full wave-field approach signals representing propagation of elastic waves are gathered from dense mesh of points that span over investigated area of composite part. This allow to animate the guided wave propagation. The reported analysis is based on signals resulting from numerical calculations and experimental measurements. In both cases defect in the form of delamination is considered. In the case of numerical research, Spectral Element Method (SEM) is utilized, in which a mesh is composed of 3D elements. Numerical model includes also piezoelectric transducer. Full wave-field experimental measurements are conducted by using piezoelectric transducer for guided wave excitation and Scanning Laser Doppler Vibrometer (SLDV) for sensing.

Cross-correlation Doppler global velocimetry (CC-DGV)

NASA Astrophysics Data System (ADS)

Cadel, Daniel R.; Lowe, K. Todd

2015-08-01

A flow velocimetry method, cross-correlation Doppler global velocimetry (CC-DGV), is presented as a robust, simplified, and high dynamic range implementation of the Doppler global/planar Doppler velocimetry technique. A sweep of several gigahertz of the vapor absorption spectrum is used for each velocity sample, with signals acquired from both Doppler-shifted scattered light within the flow and a non-Doppler shifted reference beam. Cross-correlation of these signals yields the Doppler shift between them, averaged over the duration of the scan. With presently available equipment, velocities from 0 ms-1 to over 3000 ms-1 can notionally be measured simultaneously, making the technique ideal for high speed flows. The processing routine is shown to be robust against large changes in the vapor pressure of the iodine cell, benefiting performance of the system in facilities where ambient conditions cannot be easily regulated. Validation of the system was performed with measurements of a model wind turbine blade boundary layer made in a 1.83 m by 1.83 m subsonic wind tunnel for which laser Doppler velocimetry (LDV) measurements were acquired alongside the CC-DGV results. CC-DGV uncertainties of ±1.30 ms-1, ±0.64 ms-1, and ±1.11 ms-1 were determined for the orthogonal stream-wise, transverse-horizontal, and transverse-vertical velocity components, and root-mean-square deviations of 2.77 ms-1 and 1.34 ms-1 from the LDV validation results were observed for Reynolds numbers of 1.5 million and 2 million, respectively. Volumetric mean velocity measurements are also presented for a supersonic jet, with velocity uncertainties of ±4.48 ms-1, ±16.93 ms-1, and ±0.50 ms-1 for the orthogonal components, and self-validation done by collapsing the data with a physical scaling.

New Doppler echocardiographic applications for the study of diastolic function

NASA Technical Reports Server (NTRS)

Garcia, M. J.; Thomas, J. D.; Klein, A. L.

1998-01-01

Doppler echocardiography is one of the most useful clinical tools for the assessment of left ventricular (LV) diastolic function. Doppler indices of LV filling and pulmonary venous (PV) flow are used not only for diagnostic purposes but also for establishing prognosis and evaluating the effect of therapeutic interventions. The utility of these indices is limited, however, by the confounding effects of different physiologic variables such as LV relaxation, compliance and filling pressure. Since alterations in these variables result in changes in Doppler indices of opposite direction, it is often difficult to determine the status of a given variable when a specific Doppler filling pattern is observed. Recently, color M-mode and tissue Doppler have provided useful insights in the study of diastolic function. These new Doppler applications have been shown to provide an accurate estimate of LV relaxation and appear to be relatively insensitive to the effects of preload compensation. This review will focus on the complementary role of color M-mode and tissue Doppler echocardiography and traditional Doppler indices of LV filling and PV flow in the assessment of diastolic function.

Right Ventricular Tissue Doppler in Space Flight

NASA Technical Reports Server (NTRS)

Garcia, Kathleen M.; Hamilton, Douglas R.; Sargsyan, Ashot E.; Ebert, Douglas; Martin, David S.; Barratt, Michael R.; Martin, David S.; Bogomolov, Valery V.; Dulchavsky, Scott A.; Duncan, J. Michael

2010-01-01

The presentation slides review normal physiology of the right ventricle in space, general physiology of the right ventricle; difficulties in imaging the heart in space, imaging methods, tissue Doppler spectrum, right ventricle tissue Doppler, and Rt Tei Index.

Doppler Imaging of Exoplanets and Brown Dwarfs

NASA Astrophysics Data System (ADS)

Crossfield, I.; Biller, B.; Schlieder, J.; Deacon, N.; Bonnefoy, M.; Homeier, D.; Allard, F.; Buenzli, E.; Henning, T.; Brandner, W.; Goldman, Bertr; Kopytova, T.

2014-03-01

Doppler Imaging produces 2D global maps. When applied to cool planets or more massive brown dwarfs, it can map atmospheric features and track global weather patterns. The first substellar map, of the 2pc-distant brown dwarf Luhman 16B (Crossfeld et al. 2014), revealed patchy regions of thin & thick clouds. Here, I investigate the feasibility of future Doppler Imaging of additional objects. Searching the literature, I find that all 3 of P, v sin i, and variability are published for 22 brown dwarfs. At least one datum exists for 333 targets. The sample is very incomplete below ~L5; we need more surveys to find the best targets for Doppler Imaging! I estimate limiting magnitudes for Doppler Imaging with various hi-resolution near-infrared spectrographs. Only a handful of objects - at the M/L and L/T transitions - can be mapped with current tools. Large telescopes such as TMT and GMT will allow Doppler Imaging of many dozens of brown dwarfs and the brightest exoplanets. More targets beyond type L5 likely remain to be found. Future observations will let us probe the global atmospheric dynamics of many diverse objects.

Editorial special issue on "Laser Doppler vibrometry"

NASA Astrophysics Data System (ADS)

Vanlanduit, Steve; Dirckx, Joris

2017-12-01

The invention of the laser in 1960 has opened up many opportunities in the field of measurement science and technology. Just a few years after the invention of the laser, a novel fluid flow measurement technique based on the Doppler effect was introduced: at that moment the laser Doppler anemometer or shortly LDA [1] was born. The technique enabled fluid velocity measurement by using the light of a He-Ne beam which was scattered by very small polystyrene spheres entrained in the fluid. Later on, in the late nineteen seventees it was recognized that the detection of the Doppler frequency shift that occurs when light is scattered by a moving surface can also be used to measure the vibration velocity of an object. The instrument to perform these vibration measurements was called the laser Doppler vibrometer or LDV [2]. In the last decades several technological advances were made in the field of laser Doppler vibrometry. The result is that nowadays, velocity measurements of fluids (using LDA) and vibrating objects (using LDV) are performed in many challenging applications in different fields (microelectronics, civil structures, biomedical engineering, material science, etc.).

Radar Doppler Processing with Nonuniform Sampling.

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

Doerry, Armin W.

2017-07-01

Conventional signal processing to estimate radar Doppler frequency often assumes uniform pulse/sample spacing. This is for the convenience of t he processing. More recent performance enhancements in processor capability allow optimally processing nonuniform pulse/sample spacing, thereby overcoming some of the baggage that attends uniform sampling, such as Doppler ambiguity and SNR losses due to sidelobe control measures.

Temporal enhancement of two-dimensional color doppler echocardiography

NASA Astrophysics Data System (ADS)

Terentjev, Alexey B.; Settlemier, Scott H.; Perrin, Douglas P.; del Nido, Pedro J.; Shturts, Igor V.; Vasilyev, Nikolay V.

2016-03-01

Two-dimensional color Doppler echocardiography is widely used for assessing blood flow inside the heart and blood vessels. Currently, frame acquisition time for this method varies from tens to hundreds of milliseconds, depending on Doppler sector parameters. This leads to low frame rates of resulting video sequences equal to tens of Hz, which is insufficient for some diagnostic purposes, especially in pediatrics. In this paper, we present a new approach for reconstruction of 2D color Doppler cardiac images, which results in the frame rate being increased to hundreds of Hz. This approach relies on a modified method of frame reordering originally applied to real-time 3D echocardiography. There are no previous publications describing application of this method to 2D Color Doppler data. The approach has been tested on several in-vivo cardiac 2D color Doppler datasets with approximate duration of 30 sec and native frame rate of 15 Hz. The resulting image sequences had equivalent frame rates to 500Hz.

Doppler flowmeter

DOEpatents

Karplus, H.H.B.; Raptis, A.C.

1981-11-13

A Doppler flowmeter impulses an ultrasonic fixed-frequency signal obliquely into a slurry flowing in a pipe and a reflected signal is detected after having been scattered off of the slurry particles, whereby the shift in frequencies between the signals is proportional to the slurry velocity and hence slurry flow rate. This flowmeter filters the Doppler frequency-shift signal, compares the filtered and unfiltered shift signals in a divider to obtain a ratio, and then further compares this ratio against a preset fractional ratio. The flowmeter utilizes a voltage-to-frequency convertor to generate a pulsed signal having a determinable rate of repetition precisely proportional to the divergence of the ratios. The pulsed signal serves as the input control for a frequency-controlled low-pass filter, which provides thereby that the cutoff frequency of the filtered signal is known. The flowmeter provides a feedback control by minimizing the divergence. With the cutoff frequency and preset fractional ratio known, the slurry velocity and hence flow will also be determinable.

Doppler flowmeter

DOEpatents

Karplus, Henry H. B.; Raptis, Apostolos C.

1983-01-01

A Doppler flowmeter impulses an ultrasonic fixed-frequency signal obliquely into a slurry flowing in a pipe and a reflected signal is detected after having been scattered off of the slurry particles, whereby the shift in frequencies between the signals is proportional to the slurry velocity and hence slurry flow rate. This flowmeter filters the Doppler frequency-shift signal, compares the filtered and unfiltered shift signals in a divider to obtain a ratio, and then further compares this ratio against a preset fractional ratio. The flowmeter utilizes a voltage-to-frequency convertor to generate a pulsed signal having a determinable rate of repetition precisely proportional to the divergence of the ratios. The pulsed signal serves as the input control for a frequency-controlled low-pass filter, which provides thereby that the cutoff frequency of the filtered signal is known. The flowmeter provides a feedback control by minimizing the divergence. With the cutoff frequency and preset fractional ratio known, the slurry velocity and hence flow will also be determinable.

Causes of Ultrasound Doppler Twinkling Artifact

NASA Astrophysics Data System (ADS)

Leonov, D. V.; Kulberg, N. S.; Gromov, A. I.; Morozov, S. P.; Kim, S. Yu.

2018-01-01

Ultrasound Doppler twinkling artifact is analyzed. It usually appears as a frequent color alteration in the region of hyperechoic objects. Its noiselike spectrum can also be seen in spectral Doppler mode. Physicians use twinkling artifact as a clinical sign for kidney-stone and soft-tissue calculi detection. The advantageous peculiarity of this study is that the experiments were conducted utilizing raw signals obtained from a custom ultrasonic machine and a specially developed phantom. The phantom contained specimens with known qualities, allowing for reproducible and predictable results. The experiments revealed evidence for two physical causes of twinkling artifact, which were associated with two unique Doppler signals. The research laid the foundation for the new reflected-signal model introduced and used throughout this paper.

Comparing the effect of An's Shaobei Injection ([symbols; see text]) with Xiaozhiling Injection ([symbols; see text]) in patients with internal hemorrhoids of grade I-III: a prospective cohort study.

PubMed

An, A-yue; Feng, Da-yong; Wang, Chun-hui; Shi, Yu-ying; Xiang, Jing-jing; Bai, Zhi-yong; Li, Kun-cheng; Liu, Jin-yang

2014-07-01

To compare the effect of An's Shaobei Injection ([symbols; see text]) with Xiaozhiling Injection ([symbols; see text]) in patients with internal hemorrhoids of grade I-III. This cohort study included 1,520 internal hemorrhoids patients with grade I-III who were scheduled for liquid injection treatment from July 2003 to July 2009. The cohort included patients who underwent either An's Shaobei Injection treatment (the treatment group, 760 cases) or Xiaozhiling Injection treatment (the control group, 760 cases). All patients were followed up regularly for 3 years; the observing indices included anal function recovery and clinical response after operation. Among the 1,520 patients, 1,508 (99.2%) completed the 3-year follow-up. The efficacy rate was 97.5% in the treatment group, significantly higher than the control group (91.8%, P<0.01). The recurrence rate in the treatment group was 0.5%, significantly lower than that of the control group (1.3%, P<0.01). In addition, perianal callosity occurred in 8 cases (1.1%) and anorectal stricture in 26 cases (3.5%) after operation in the control group. There was no perianal callosity and anorectal stricture in the treatment group. The treatment with An's Shaobei Injection demonstrated superior clinical effect to Xiaozhiling Injection with fewer adverse effects.

Applications of Doppler ultrasound in clinical vascular disease

NASA Technical Reports Server (NTRS)

Barnes, R. W.; Hokanson, D. E.; Sumner, D. S.; Strandness, D. E., Jr.

1975-01-01

Doppler ultrasound has become the most useful and versatile noninvasive technique for objective evaluation of clinical vascular disease. Commercially available continuous-wave instruments provide qualitative and quantitative assessment of venous and arterial disease. Pulsed Doppler ultrasound was developed to provide longitudinal and transverse cross-sectional images of the arterial lumen with a resolution approaching that of conventional X-ray techniques. Application of Doppler ultrasound in venous, peripheral arterial, and cerebrovascular diseases is reviewed.

Use of global ionospheric maps for HF Doppler measurements interpretation

NASA Astrophysics Data System (ADS)

Petrova, I. R.; Bochkarev, V. V.; Latypov, R. R.

2018-04-01

The HF Doppler technique, a method of measurement of Doppler frequency shift of ionospheric signal, is one of the well-known and widely used techniques of ionosphere research. It allows investigation of various disturbances in the ionosphere. There are different sources of disturbances in the ionosphere such as geomagnetic storms, solar flashes, meteorological effects and atmospheric waves. The HF Doppler technique allows us to find out the influence of earthquakes, explosions and other processes on the ionosphere, which occurs near the Earth. HF Doppler technique has high sensitivity to small frequency variations and high time resolution but interpretation of results is difficult. In this paper, we attempt to use GPS data for Doppler measurements interpretation. Modeling of Doppler frequency shift variations with use of TEC allows separation of ionosphere disturbances of medium scale.

Randomized comparison of power Doppler ultrasonography-guided core-needle biopsy with open surgical biopsy for the characterization of lymphadenopathies in patients with suspected lymphoma.

PubMed

Pugliese, Novella; Di Perna, M; Cozzolino, I; Ciancia, G; Pettinato, G; Zeppa, P; Varone, V; Masone, S; Cerchione, C; Della Pepa, R; Simeone, L; Giordano, C; Martinelli, V; Salvatore, C; Pane, F; Picardi, M

2017-04-01

The sensitivity of lymph node core-needle biopsy under imaging guidance requires validation. We employed power Doppler ultrasonography (PDUS) to select the lymph node most suspected of malignancy and to histologically characterize it through the use of large cutting needle. Institutional review board approval and informed consent were obtained for this randomized clinical trial. In a single center between 1 January 2009 and 31 December 2015, patients with lymph node enlargement suspected for lymphoma were randomly assigned (1:1) to biopsy with either standard surgery or PDUS-guided 16-gauge modified Menghini needle. The primary endpoint was the superiority of sensitivity for the diagnosis of malignancy for core-needle cutting biopsy (CNCB). Secondary endpoints were times to biopsy, complications, and costs. A total of 376 patients were randomized into the two arms and received allocated biopsy. However, four patients undergoing CNCB were excluded for inadequate samples; thus, 372 patients were analyzed. Sensitivity for the detection of malignancy was significantly better for PDUS-guided CNCB [98.8%; 95% confidence interval (CI), 95.9-99.9] than standard biopsy (88.7%; 95% CI, 82.9-93; P < 0.001). For all secondary endpoints, the comparison was significantly disadvantageous for conventional approach. In particular, estimated cost per biopsy performed with standard surgery was 24-fold higher compared with that performed with CNCB. The presence of satellite enlarged reactive and/or necrotic lymph nodes may impair the success of an open surgical biopsy (OSB). PDUS and CNCB with adequate gauge are diagnostic tools that enable effective, safe, fast, and low-cost routine biopsy for patients with suspected lymphoma, avoiding psychological and physical pain of an unnecessary surgical intervention.

Doppler and speckle methods for diagnostics in dentistry

NASA Astrophysics Data System (ADS)

Ulyanov, Sergey S.; Lepilin, Alexander V.; Lebedeva, Nina G.; Sedykh, Alexey V.; Kharish, Natalia A.; Osipova, Yulia; Karpovich, Alexander

2002-02-01

The results of statistical analysis of Doppler spectra of scattered intensity, obtained from tissues of oral cavity membrane of healthy volunteers, are presented. The dependence of the spectral moments of Doppler signal on cutoff frequency is investigated. Some results of statistical analysis of Doppler spectra, obtained from tooth pulp of patients, are presented. New approach for monitoring of blood microcirculation in orthodontics is suggested. Influence of own noise of measuring system on formation of speckle-interferometric signal is studied.

Doppler optical coherence tomography of retinal circulation.

PubMed

Tan, Ou; Wang, Yimin; Konduru, Ranjith K; Zhang, Xinbo; Sadda, SriniVas R; Huang, David

2012-09-18

Noncontact retinal blood flow measurements are performed with a Fourier domain optical coherence tomography (OCT) system using a circumpapillary double circular scan (CDCS) that scans around the optic nerve head at 3.40 mm and 3.75 mm diameters. The double concentric circles are performed 6 times consecutively over 2 sec. The CDCS scan is saved with Doppler shift information from which flow can be calculated. The standard clinical protocol calls for 3 CDCS scans made with the OCT beam passing through the superonasal edge of the pupil and 3 CDCS scan through the inferonal pupil. This double-angle protocol ensures that acceptable Doppler angle is obtained on each retinal branch vessel in at least 1 scan. The CDCS scan data, a 3-dimensional volumetric OCT scan of the optic disc scan, and a color photograph of the optic disc are used together to obtain retinal blood flow measurement on an eye. We have developed a blood flow measurement software called "Doppler optical coherence tomography of retinal circulation" (DOCTORC). This semi-automated software is used to measure total retinal blood flow, vessel cross section area, and average blood velocity. The flow of each vessel is calculated from the Doppler shift in the vessel cross-sectional area and the Doppler angle between the vessel and the OCT beam. Total retinal blood flow measurement is summed from the veins around the optic disc. The results obtained at our Doppler OCT reading center showed good reproducibility between graders and methods (<10%). Total retinal blood flow could be useful in the management of glaucoma, other retinal diseases, and retinal diseases. In glaucoma patients, OCT retinal blood flow measurement was highly correlated with visual field loss (R(2)>0.57 with visual field pattern deviation). Doppler OCT is a new method to perform rapid, noncontact, and repeatable measurement of total retinal blood flow using widely available Fourier-domain OCT instrumentation. This new technology may improve the

Corruption of radio metric Doppler due to solar plasma dynamics: S/X dual-frequency Doppler calibration for these effects

NASA Technical Reports Server (NTRS)

Winn, F. B.; Reinbold, S. R.; Yip, K. W.; Koch, R. E.; Lubeley, A.

1975-01-01

Doppler data from Mariner 6, 7, 9, and 10 and Pioneer 10 and 11 were discussed and the rms noise level for various sun-earth-probe angles were shown. The noise levels of both S- and X-band Doppler data for sun-earth-probe angles smaller than 20 deg were observed to be orders of magnitude greater than nominal. Such solar plasma-related Doppler degradation reduced the Mariner 10-Mercury 11 encounter navigation accuracy by nearly a factor of 10. Furthermore, this degradation was shown to be indirectly related to plasma dynamics and not a direct measure of the dynamics.

Optimized doppler optical coherence tomography for choroidal capillary vasculature imaging

NASA Astrophysics Data System (ADS)

Liu, Gangjun; Qi, Wenjuan; Yu, Lingfeng; Chen, Zhongping

2011-03-01

In this paper, we analyzed the retinal and choroidal blood vasculature in the posterior segment of the human eye with optimized color Doppler and Doppler variance optical coherence tomography. Depth-resolved structure, color Doppler and Doppler variance images were compared. Blood vessels down to capillary level were able to be obtained with the optimized optical coherence color Doppler and Doppler variance method. For in-vivo imaging of human eyes, bulkmotion induced bulk phase must be identified and removed before using color Doppler method. It was found that the Doppler variance method is not sensitive to bulk motion and the method can be used without removing the bulk phase. A novel, simple and fast segmentation algorithm to indentify retinal pigment epithelium (RPE) was proposed and used to segment the retinal and choroidal layer. The algorithm was based on the detected OCT signal intensity difference between different layers. A spectrometer-based Fourier domain OCT system with a central wavelength of 890 nm and bandwidth of 150nm was used in this study. The 3-dimensional imaging volume contained 120 sequential two dimensional images with 2048 A-lines per image. The total imaging time was 12 seconds and the imaging area was 5x5 mm2.

Power Doppler evaluation of joint effusions: investigation in a rabbit model.

PubMed

Strouse, P J; DiPietro, M A; Teo, E L; Doi, K; Chrisp, C E

1999-08-01

To study the power Doppler findings of septic arthritis and noninfectious synovitis in an animal model. The right knees of 10 rabbits were inoculated with an aqueous suspension of Staphylococcus aureus. The right knees of 5 rabbits were injected with talc suspension. The right knees of 5 rabbits were injected with saline. All 20 left knees were injected with saline. Serial power Doppler images were obtained using constant-imaging parameters. Images were reviewed by blinded observers who assessed for increased power Doppler signal. All 10 knees inoculated with S. aureus developed septic arthritis. Each infected rabbit knee demonstrated increased signal on power Doppler on at least one examination, ranging from 1-6 days after inoculation. Only 23 of 45 examinations of infected knees were unequivocally positive by power Doppler on examinations performed 1 to 6 days after inoculation. No knee with talc synovitis demonstrated increased power Doppler signal. No control knee demonstrated increased power Doppler signal. Increased power Doppler signal may be seen with septic arthritis; however, its intensity and timing may vary from subject to subject. A normal power Doppler examination does not exclude septic arthritis.

Coherent Doppler Lidar for Precision Navigation of Spacecrafts

NASA Technical Reports Server (NTRS)

Amzajerdian, Farzin; Pierrottet, Diego; Petway, Larry; Hines, Glenn; Lockhard, George; Barnes, Bruce

2011-01-01

A fiber-based coherent Doppler lidar, utilizing an FMCW technique, has been developed and its capabilities demonstrated through two successful helicopter flight test campaigns. This Doppler lidar is expected to play a critical role in future planetary exploration missions because of its ability in providing the necessary data for soft landing on the planetary bodies and for landing missions requiring precision navigation to the designated location on the ground. Compared with radars, the Doppler lidar can provide significantly higher precision velocity and altitude data at a much higher rate without concerns for measurement ambiguity or target clutter. Future work calls for testing the Doppler lidar onboard a rocket-powered free-flyer platform operating in a closed-loop with the vehicle s guidance, navigation, and control (GN&C) unit.

[Urodynamics foundations: contractile potency and urethral doppler].

PubMed

Benítez Navío, Julio; Caballero Gómez, Pilar; Delgado Elipe, Ildefonso

2002-12-01

To calculate the bladder softening factor, elastic constant and contractile potency. For the analysis we considered bladder behavior like that of a spring. See articles 1 and 2 published in this issue. Using flowmetry, Doppler ultrasound and abdominal pressure (Transrectal pressure register catheter) an analytical solution that permits calculation of factors defining bladder behavior was looked for. Doppler ultrasound allows us to know urine velocity through the prostatic urethra and, therefore, to calculate bladder contractile potency. Equations are solved reaching an analytical solution that allows calculating those factors that define bladder behavior: Bladder contractile potency, detrusor elastic constant, considering it behaves like a spring, and calculation of muscle resistance to movement. All thanks to Doppler ultrasound that allows to know urine speed. The bladder voiding phase is defined with the aforementioned factors; storage phase behavior can be indirectly inferred. Only uroflowmetry curves, Doppler ultrasound and abdominal pressure value are used. We comply with the so called non invasive urodynamics although for us it is just another phase in the biomechanical study of the detrusor muscle. Main conclusion is the addition of Doppler ultrasound to the urodynamist armamentarium as an essential instrument for the comprehension of bladder dynamics and calculation of bladder behavior defining factors. It is not a change in the focus but in the methods, gaining knowledge and diminishing invasion.

The EVE Doppler Sensitivity and Flare Observations

NASA Technical Reports Server (NTRS)

Hudson, H. S.; Woods, T. N.; Chamberlin, P. C.; Didkovsky, L.; Del Zanna, G.

2011-01-01

The Extreme-ultraviolet Variability Experiment (EVE) obtains continuous EUV spectra of the Sun viewed as a star. Its primary objective is the characterization of solar spectral irradiance, but its sensitivity and stability make it extremely interesting for observations of variability on time scales down to the limit imposed by its basic 10 s sample interval. In this paper we characterize the Doppler sensitivity of the EVE data. We find that the 30.4 nm line of He II has a random Doppler error below 0.001 nm (1 pm, better than 10 km/s as a redshift), with ample stability to detect the orbital motion of its satellite, the Solar Dynamics Observatory (SDO). Solar flares also displace the spectrum, both because of Doppler shifts and because of EVE's optical layout, which (as with a slitless spectrograph) confuses position and wavelength. As a flare develops, the centroid of the line displays variations that reflect Doppler shifts and therefore flare dynamics. For the impulsive phase of the flare SOL2010-06-12, we find the line centroid to have a redshift of 16.8 +/- 5.9 km/s relative to that of the flare gradual phase (statistical errors only). We find also that high-temperature lines, such as Fe XXIV 19.2 nm, have well-determined Doppler components for major flares, with decreasing apparent blueshifts as expected from chromospheric evaporation flows.

Optimization of cw-QC lasers for Doppler and sub-Doppler molecular spectroscopy

NASA Astrophysics Data System (ADS)

Kelly, James F.; Disselkamp, Robert S.; Sams, Robert L.; Blake, Thomas A.; Sharpe, Steven W.; Richter, Dirk A.; Fried, Alan

2002-09-01

Inter-subband (Type I) quantum-cascade (QC) lasers have shown the potential to generate tunable mid-IR radiation with narrow intrinsic linewidths (< 160 KHz in 15 mSec sweeps) and excellent amplitude stability (< 3 ppm averaged over minutes). Our bench-scale efforts to develop the Type I distributed feedback (DFB)-QC lasers for fieldable atmospheric chemistry campaigns, where multipass (Herriot or White) cells are used to enhance path-length, have not yet realized performance to the low intrinsic noise levels seen in these devices. By comparison, many operational systems' levels of noise-equivalent-absorbance (NEA) using Pb-salt lasers can routinely achieve at least one-order of magnitude better cw-performance, and with much lower powers. We have found that instability effets from weak back-scattered laser light -primarily from the Herriot cell- results in feedback-implicated technical noise well above the thermal and shot-noise of standard IR detectors. Of more fundamental concern is the fact that planar-stripe DFB-QC lasers undergo beam steering and transverse spatial-mode competitions during current tuning. It is the development of fully automated sub-ppbV sensitive IR chem-sensors. It is possible to reach low-ppm levels of absorptance change-detection (ΔI/I0) over small wavelength regions with careful alignment to 100 M Herriott cells, but extreme care in spatial filtering is critical. However in the case of optical configurations which preclude significant optical feedback and need for stringent mode coupling alignments, the cw-DFB-QC lasers show great promise to do high resolution sub-Doppler spectroscopy. By serendipitous events, a varient of 'mode- or level-crossing' spectroscopy was probably rediscovered, which may allow very high resolution, sub-Doppler features and/or hyperfine alignments to be probed with 'uni-directional' topologies. We will primarily discuss the basic features of the 'uni-directional' sub-Doppler spectroscopy concept in this report

High-resolution Doppler model of the human gait

NASA Astrophysics Data System (ADS)

Geisheimer, Jonathan L.; Greneker, Eugene F., III; Marshall, William S.

2002-07-01

A high resolution Doppler model of the walking human was developed for analyzing the continuous wave (CW) radar gait signature. Data for twenty subjects were collected simultaneously using an infrared motion capture system along with a two channel 10.525 GHz CW radar. The motion capture system recorded three-dimensional coordinates of infrared markers placed on the body. These body marker coordinates were used as inputs to create the theoretical Doppler output using a model constructed in MATLAB. The outputs of the model are the simulated Doppler signals due to each of the major limbs and the thorax. An estimated radar cross section for each part of the body was assigned using the Lund & Browder chart of estimated body surface area. The resultant Doppler model was then compared with the actual recorded Doppler gait signature in the frequency domain using the spectrogram. Comparison of the two sets of data has revealed several identifiable biomechanical features in the radar gait signature due to leg and body motion. The result of the research shows that a wealth of information can be unlocked from the radar gait signature, which may be useful in security and biometric applications.

Temporal Doppler Effect and Future Orientation: Adaptive Function and Moderating Conditions.

PubMed

Gan, Yiqun; Miao, Miao; Zheng, Lei; Liu, Haihua

2017-06-01

The objectives of this study were to examine whether the temporal Doppler effect exists in different time intervals and whether certain individual and environmental factors act as moderators of the effect. Using hierarchical linear modeling, we examined the existence of the temporal Doppler effect and the moderating effect of future orientation among 139 university students (Study 1), and then the moderating conditions of the temporal Doppler effect using two independent samples of 143 and 147 university students (Studies 2 and 3). Results indicated that the temporal Doppler effect existed in all of our studies, and that future orientation moderated the temporal Doppler effect. Further, time interval perception mediated the relationship between future orientation and the motivation to cope at long time intervals. Finally, positive affect was found to enhance the temporal Doppler effect, whereas control deprivation did not influence the effect. The temporal Doppler effect is moderated by the personality trait of future orientation and by the situational variable of experimentally manipulated positive affect. We have identified personality and environmental processes that could enhance the temporal Doppler effect, which could be valuable in cases where attention to a future task is necessary. © 2016 Wiley Periodicals, Inc.

Coherent Doppler lidar signal covariance including wind shear and wind turbulence

NASA Technical Reports Server (NTRS)

Frehlich, R. G.

1993-01-01

The performance of coherent Doppler lidar is determined by the statistics of the coherent Doppler signal. The derivation and calculation of the covariance of the Doppler lidar signal is presented for random atmospheric wind fields with wind shear. The random component is described by a Kolmogorov turbulence spectrum. The signal parameters are clarified for a general coherent Doppler lidar system. There are two distinct physical regimes: one where the transmitted pulse determines the signal statistics and the other where the wind field dominates the signal statistics. The Doppler shift of the signal is identified in terms of the wind field and system parameters.

Doppler Feature Based Classification of Wind Profiler Data

NASA Astrophysics Data System (ADS)

Sinha, Swati; Chandrasekhar Sarma, T. V.; Lourde. R, Mary

2017-01-01

Wind Profilers (WP) are coherent pulsed Doppler radars in UHF and VHF bands. They are used for vertical profiling of wind velocity and direction. This information is very useful for weather modeling, study of climatic patterns and weather prediction. Observations at different height and different wind velocities are possible by changing the operating parameters of WP. A set of Doppler power spectra is the standard form of WP data. Wind velocity, direction and wind velocity turbulence at different heights can be derived from it. Modern wind profilers operate for long duration and generate approximately 4 megabytes of data per hour. The radar data stream contains Doppler power spectra from different radar configurations with echoes from different atmospheric targets. In order to facilitate systematic study, this data needs to be segregated according the type of target. A reliable automated target classification technique is required to do this job. Classical techniques of radar target identification use pattern matching and minimization of mean squared error, Euclidean distance etc. These techniques are not effective for the classification of WP echoes, as these targets do not have well-defined signature in Doppler power spectra. This paper presents an effective target classification technique based on range-Doppler features.

Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids.

PubMed

Infantino, A; Altomare, D F; Bottini, C; Bonanno, M; Mancini, S; Yalti, T; Giamundo, P; Hoch, J; El Gaddal, A; Pagano, C

2012-02-01

Doppler-guided transanal haemorrhoid dearterialization (THD) and stapler haemorrhoidopexy (SH) have been demonstrated to be less painful than the Milligan-Morgan procedure. The aim of this study was to compare the effectiveness of THD vs SH in the treatment of third-degree haemorrhoids in an equivalent trial. One hundred and sixty-nine patients with third-degree haemorrhoids were randomized online to receive THD (n = 85) or SH (n = 84) in 10 Colorectal Units in which the staff were well trained in both techniques. The mean follow-up period was 17 (range 15-20) months. Early minor postoperative complications occurred in 30.6% of patients in the THD group and in 32.1% of patients in the SH group. Milder spontaneous pain and pain on defecation were reported in the THD group in the first postoperative week, but this was not statistically significant. Late complications were significantly higher (P = 0.028) in the SH group. Residual haemorrhoids persisted in 12 patients in the THD group and in six patients in the SH group (P = 0.14). Six patients in the SH group and 10 in the THD group underwent further treatment of haemorrhoids (P = 0.34). No differences were found in postoperative incontinence. The obstructed defecation score (ODS) was significantly higher in the SH group (P < 0.02). Improvement in quality of life was similar in both groups. Postoperative in-hospital stay was 1.14 days in the THD group and 1.31 days in the SH group (P = 0.03). Both THD and SH techniques are effective for the treatment of third-degree haemorrhoids in the medium term. THD has a better cost-effective ratio and lower (not significant) pain compared with SH. Postoperative pain and recurrence did not differ significantly between the two groups. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

MicroV Technology to Improve Transcranial Color Coded Doppler Examinations.

PubMed

Malferrari, Giovanni; Pulito, Giuseppe; Pizzini, Attilia Maria; Carraro, Nicola; Meneghetti, Giorgio; Sanzaro, Enzo; Prati, Patrizio; Siniscalchi, Antonio; Monaco, Daniela

2018-05-04

The purpose of this review is to provide an update on technology related to Transcranial Color Coded Doppler Examinations. Microvascularization (MicroV) is an emerging Power Doppler technology which can allow visualization of low and weak blood flows even at high depths, thus providing a suitable technique for transcranial ultrasound analysis. With MicroV, reconstruction of the vessel shape can be improved, without any overestimation. Furthermore, by analyzing the Doppler signal, MicroV allows a global image of the Circle of Willis. Transcranial Doppler was originally developed for the velocimetric analysis of intracranial vessels, in particular to detect stenoses and the assessment of collateral circulation. Doppler velocimetric analysis was then compared to other neuroimaging techniques, thus providing a cut-off threshold. Transcranial Color Coded Doppler sonography allowed the characterization of vessel morphology. In both Color Doppler and Power Doppler, the signal overestimated the shape of the intracranial vessels, mostly in the presence of thin vessels and high depths of study. In further neurosonology technology development efforts, attempts have been made to address morphology issues and overcome technical limitations. The use of contrast agents has helped in this regard by introducing harmonics and subtraction software, which allowed better morphological studies of vessels, due to their increased signal-to-noise ratio. Having no limitations in the learning curve, in time and contrast agent techniques, and due to its high signal-to-noise ratio, MicroV has shown great potential to obtain the best morphological definition. Copyright © 2018 by the American Society of Neuroimaging.

Doppler effect of subluminal and superluminal sources in eight dimensions

NASA Astrophysics Data System (ADS)

Chandola, H. C.; Rajput, B. S.

1984-06-01

The study of the relativistic Doppler effect of subliminal and superluminal sources has been undertaken in the eight-dimensional space. It has been shown that correct Doppler shifts are obtained in the external spaces of these sources and the conformal correspondence between Doppler effect curves holds in case of approaching and receeding sources but not in the transverse case.

Laser Doppler measurement techniques for spacecraft

NASA Technical Reports Server (NTRS)

Kinman, Peter W.; Gagliardi, Robert M.

1986-01-01

Two techniques are proposed for using laser links to measure the relative radial velocity of two spacecraft. The first technique determines the relative radial velocity from a measurement of the two-way Doppler shift on a transponded radio-frequency subcarrier. The subcarrier intensity-modulates reciprocating laser beams. The second technique determines the relative radial velocity from a measurement of the two-way Doppler shift on an optical frequency carrier which is transponded between spacecraft using optical Costas loops. The first technique might be used in conjunction with noncoherent optical communications, while the second technique is compatible with coherent optical communications. The first technique simultaneously exploits the diffraction advantage of laser beams and the maturity of radio-frequency phase-locked loop technology. The second technique exploits both the diffraction advantage of laser beams and the large Doppler effect at optical frequencies. The second technique has the potential for greater accuracy; unfortunately, it is more difficult to implement since it involves optical Costas loops.

A randomised controlled trial of fluid restriction compared to oesophageal Doppler-guided goal-directed fluid therapy in elective major colorectal surgery within an Enhanced Recovery After Surgery program.

PubMed

Phan, T D; D'Souza, B; Rattray, M J; Johnston, M J; Cowie, B S

2014-11-01

There is continued controversy regarding the benefits of goal-directed fluid therapy, with earlier studies showing marked improvement in morbidity and length-of-stay that have not been replicated more recently. The aim of this study was to compare patient outcomes in elective colorectal surgery patients having goal-directed versus restrictive fluid therapy. Inclusion criteria included suitability for an Enhanced Recovery After Surgery care pathway and patients with an American Society of Anesthesiologists Physical Status score of 1 to 3. Patients were intraoperatively randomised to either restrictive or Doppler-guided goal-directed fluid therapy. The primary outcome was length-of-stay; secondary outcomes included complication rate, change in haemodynamic variables and fluid volumes. Compared to restrictive therapy, goal-directed therapy resulted in a greater volume of intraoperative fluid, 2115 (interquartile range 1350 to 2560) ml versus 1500 (1200 to 2000) ml, P=0.008, and was associated with an increase in Doppler-derived stroke volume index from beginning to end of surgery, 43.7 (16.3) to 54.2 (21.1) ml/m(2), P <0.001, in the latter group. Length-of-stay was similar, 6.5 (5 to 9) versus 6 (4 to 9) days, P=0.421. The number of patients with any complication (minor or major) was similar; 0% (30) versus 52% (26), P=0.42, or major complications, 1 (2%) versus 4 (8%), P=0.36, respectively. The increased perioperative fluid volumes and increased stroke volumes at the end of surgery in patients receiving goal-directed therapy did not translate to a significant difference in length-of-stay and we did not observe a difference in the number of patients experiencing minor or major complications.

Clinical acceptability study of micronized purified flavonoid fraction 1000 mg tablets versus 500 mg tablets in patients suffering acute hemorrhoidal disease.

PubMed

Shelygin, Yuri; Krivokapic, Zoran; Frolov, S A; Kostarev, I V; Astashov, V L; Vasiliev, S V; Lakhin, A V; Rodoman, G V; Soloviev, A O; Stoyko, Y M; Khitaryan, A G; Nechay, I A

2016-11-01

To compare the clinical acceptability of micronized purified flavonoid fraction (MPFF) 1000 mg with MPFF 500 mg tablets, administered at the same daily dose in patients suffering non-complicated acute hemorrhoids. MPFF is an established treatment for hemorrhoidal disease. This was a double-blind, multi-center, randomized study. Patients took either MPFF 1000 mg or 500 mg tablets for 7 days (daily dose; 3 g over 4 days followed by 2 g over 3 days). Adverse events were recorded in a patient diary. On day 7, anal pain and bleeding were assessed (visual analog scale [VAS] and Dimitroulopoulos scale, respectively). Patients (162) were randomized to MPFF 1000 mg (79) and MPFF 500 mg (83). No serious adverse events (AEs) occurred; 10 emergent AEs were considered treatment-related (6 for MPFF 1000 mg and 4 for 500 mg). Both regimens were associated with significant reduction in anal pain (VAS); -2.37 cm MPFF 1000 mg (P < 0.001) and -2.17 cm 500 mg (P < 0.001), with a slight trend in favor of MPFF 1000 mg (mean global reduction -2.27 cm, P < 0.001). Bleeding improved significantly in both groups of patients, 56% of patients on MPFF 1000 mg versus 61% on MPFF 500 mg. Bleeding ceased after treatment in 47% patients on MPFF 1000 mg versus 54% on 500 mg. After 7 days of treatment with MPFF at the same daily dose, both regimens reduced anal pain and bleeding. MPFF 1000 mg had a comparable safety profile to MPFF 500 mg, with the advantage of fewer tablets. Key limitations: Safety study.

Millimeter-wave micro-Doppler measurements of small UAVs

NASA Astrophysics Data System (ADS)

Rahman, Samiur; Robertson, Duncan A.

2017-05-01

This paper discusses the micro-Doppler signatures of small UAVs obtained from a millimeter-wave radar system. At first, simulation results are shown to demonstrate the theoretical concept. It is illustrated that whilst the propeller rotation rate of the small UAVs is quite high, millimeter-wave radar systems are capable of capturing the full micro-Doppler spread. Measurements of small UAVs have been performed with both CW and FMCW radars operating at 94 GHz. The CW radar was used for obtaining micro-Doppler signatures of individual propellers. The field test data of a flying small UAV was collected with the FMCW radar and was processed to extract micro-Doppler signatures. The high fidelity results clearly reveal features such as blade flashes and propeller rotation modulation lines which can be used to classify targets. This work confirms that millimeter-wave radar is suitable for the detection and classification of small UAVs at usefully long ranges.

Hyperemia in plantar fasciitis determined by power Doppler ultrasound.

PubMed

McMillan, Andrew M; Landorf, Karl B; Gregg, Julie M; De Luca, Jason; Cotchett, Matthew P; Menz, Hylton B

2013-12-01

Cross-sectional observational study. To investigate the presence of soft tissue hyperemia in plantar fasciitis with power Doppler ultrasound. Localized hyperemia is an established feature of tendinopathy, suggesting that neurovascular in-growth may contribute to tendon-associated pain in some patients. The presence of abnormal soft tissue vascularity can be assessed with Doppler ultrasound, and a positive finding can assist with targeted treatment plans. However, very little is known regarding the presence of hyperemia in plantar fasciitis and the ability of routine Doppler ultrasound to identify vascular in-growth in the plantar fascia near its proximal insertion. This observational study included 30 participants with plantar fasciitis unrelated to systemic disease and 30 age- and sex-matched controls. Ultrasound examination was performed with a 13- to 5-MHz linear transducer, and power Doppler images were assessed by 2 blinded investigators. Hyperemia of the plantar fascia was present in 8 of 30 participants with plantar fasciitis and in 2 of 30 controls. The between-group difference for hyperemia, using a 4-point scale, was statistically significant, with participants with plantar fasciitis showing increased Doppler ultrasound signal compared to controls (Mann-Whitney U, P = .03). However, the majority of participants with plantar fasciitis with evidence of hyperemia demonstrated very mild color changes, and only 3 were found to have moderate or marked hyperemia. Mild hyperemia can occur with plantar fasciitis, but most individuals will not exhibit greater soft tissue vascularity when assessed with routine Doppler ultrasound. Clinicians treating plantar fasciitis should not consider a positive Doppler signal as essential for diagnosis of the condition but, rather, as a feature that may help to refine the treatment plan for an individual patient.

Orbit determination singularities in the Doppler tracking of a planetary orbiter

NASA Technical Reports Server (NTRS)

Wood, L. J.

1985-01-01

On a number of occasions, spacecraft launched by the U.S. have been placed into orbit about the moon, Venus, or Mars. It is pointed out that, in particular, in planetary orbiter missions two-way coherent Doppler data have provided the principal data type for orbit determination applications. The present investigation is concerned with the problem of orbit determination on the basis of Doppler tracking data in the case of a spacecraft in orbit about a natural body other than the earth or the sun. Attention is given to Doppler shift associated with a planetary orbiter, orbit determination using a zeroth-order model for the Doppler shift, and orbit determination using a first-order model for the Doppler shift.

Is Doppler tissue velocity during early left ventricular filling preload independent?

NASA Technical Reports Server (NTRS)

Yalcin, F.; Kaftan, A.; Muderrisoglu, H.; Korkmaz, M. E.; Flachskampf, F.; Garcia, M.; Thomas, J. D.

2002-01-01

BACKGROUND: Transmitral Doppler flow indices are used to evaluate diastolic function. Recently, velocities measured by Doppler tissue imaging have been used as an index of left ventricular relaxation. OBJECTIVE: To determine whether Doppler tissue velocities are influenced by alterations in preload. METHODS: Left ventricular preload was altered in 17 patients (all men, mean (SD) age, 49 (8) years) during echocardiographic measurements of left ventricular end diastolic volume, maximum left atrial area, peak early Doppler filling velocity, and left ventricular myocardial velocities during early filling. Preload altering manoeuvres included Trendelenberg (stage 1), reverse Trendelenberg (stage 2), and amyl nitrate (stage 3). Systolic blood pressure was measured at each stage. RESULTS: In comparison with baseline, left ventricular end diastolic volume (p = 0.001), left atrial area (p = 0.003), peak early mitral Doppler filling velocity (p = 0.01), and systolic blood pressures (p = 0.001) were all changed by preload altering manoeuvres. Only left ventricular myocardial velocity during early filling remained unchanged by these manoeuvres. CONCLUSIONS: In contrast to standard transmitral Doppler filling indices, Doppler tissue early diastolic velocities are not significantly affected by physiological manoeuvres that alter preload. Thus Doppler tissue velocities during early left ventricular diastole may provide a better index of diastolic function in cardiac patients by providing a preload independent assessment of left ventricular filling.

Laser Doppler technology applied to atmospheric environmental operating problems

NASA Technical Reports Server (NTRS)

Weaver, E. A.; Bilbro, J. W.; Dunkin, J. A.; Jeffreys, H. B.

1976-01-01

Carbon dioxide laser Doppler ground wind data were very favorably compared with data from standard anemometers. As a result of these measurements, two breadboard systems were developed for taking research data: a continuous wave velocimeter and a pulsed Doppler system. The scanning continuous wave laser Doppler velocimeter developed for detecting, tracking and measuring aircraft wake vortices was successfully tested at an airport where it located vortices to an accuracy of 3 meters at a range of 150 meters. The airborne pulsed laser Doppler system was developed to detect and measure clear air turbulence (CAT). This system was tested aboard an aircraft, but jet stream CAT was not encountered. However, low altitude turbulence in cumulus clouds near a mountain range was detected by the system and encountered by the aircraft at the predicted time.

Ultrasonic Doppler measurement of renal artery blood flow

NASA Technical Reports Server (NTRS)

Freund, W. R.; Beaver, W. L.; Meindl, J. D.

1976-01-01

Studies were made of (1) blood flow redistribution during lower body negative pressure (LBNP), (2) the profile of blood flow across the mitral annulus of the heart (both perpendicular and parallel to the commissures), (3) testing and evaluation of a number of pulsed Doppler systems, (4) acute calibration of perivascular Doppler transducers, (5) redesign of the mitral flow transducers to improve reliability and ease of construction, and (6) a frequency offset generator designed for use in distinguishing forward and reverse components of blood flow by producing frequencies above and below the offset frequency. Finally methodology was developed and initial results were obtained from a computer analysis of time-varying Doppler spectra.

Interferometric millimeter wave and THz wave doppler radar

DOEpatents

Liao, Shaolin; Gopalsami, Nachappa; Bakhtiari, Sasan; Raptis, Apostolos C.; Elmer, Thomas

2015-08-11

A mixerless high frequency interferometric Doppler radar system and methods has been invented, numerically validated and experimentally tested. A continuous wave source, phase modulator (e.g., a continuously oscillating reference mirror) and intensity detector are utilized. The intensity detector measures the intensity of the combined reflected Doppler signal and the modulated reference beam. Rigorous mathematics formulas have been developed to extract bot amplitude and phase from the measured intensity signal. Software in Matlab has been developed and used to extract such amplitude and phase information from the experimental data. Both amplitude and phase are calculated and the Doppler frequency signature of the object is determined.

Phased Array Beamforming and Imaging in Composite Laminates Using Guided Waves

NASA Technical Reports Server (NTRS)

Tian, Zhenhua; Leckey, Cara A. C.; Yu, Lingyu

2016-01-01

This paper presents the phased array beamforming and imaging using guided waves in anisotropic composite laminates. A generic phased array beamforming formula is presented, based on the classic delay-and-sum principle. The generic formula considers direction-dependent guided wave properties induced by the anisotropic material properties of composites. Moreover, the array beamforming and imaging are performed in frequency domain where the guided wave dispersion effect has been considered. The presented phased array method is implemented with a non-contact scanning laser Doppler vibrometer (SLDV) to detect multiple defects at different locations in an anisotropic composite plate. The array is constructed of scan points in a small area rapidly scanned by the SLDV. Using the phased array method, multiple defects at different locations are successfully detected. Our study shows that the guided wave phased array method is a potential effective method for rapid inspection of large composite structures.

The application of coded excitation technology in medical ultrasonic Doppler imaging

NASA Astrophysics Data System (ADS)

Li, Weifeng; Chen, Xiaodong; Bao, Jing; Yu, Daoyin

2008-03-01

Medical ultrasonic Doppler imaging is one of the most important domains of modern medical imaging technology. The application of coded excitation technology in medical ultrasonic Doppler imaging system has the potential of higher SNR and deeper penetration depth than conventional pulse-echo imaging system, it also improves the image quality, and enhances the sensitivity of feeble signal, furthermore, proper coded excitation is beneficial to received spectrum of Doppler signal. Firstly, this paper analyzes the application of coded excitation technology in medical ultrasonic Doppler imaging system abstractly, showing the advantage and bright future of coded excitation technology, then introduces the principle and the theory of coded excitation. Secondly, we compare some coded serials (including Chirp and fake Chirp signal, Barker codes, Golay's complementary serial, M-sequence, etc). Considering Mainlobe Width, Range Sidelobe Level, Signal-to-Noise Ratio and sensitivity of Doppler signal, we choose Barker codes as coded serial. At last, we design the coded excitation circuit. The result in B-mode imaging and Doppler flow measurement coincided with our expectation, which incarnated the advantage of application of coded excitation technology in Digital Medical Ultrasonic Doppler Endoscope Imaging System.

Long-term clinical results of double-pursestring stapled hemorrhoidopexy in a selected group of patients for the treatment of chronic hemorrhoids.

PubMed

Arroyo, Antonio; Pérez-Legaz, Juan; Miranda, Elena; Moya, Pedro; Ruiz-Tovar, Jaime; Lacueva, Francisco-Javier; Candela, Fernando; Calpena, Rafael

2011-05-01

The aim of this prospective controlled trial was to evaluate the long-term clinical and manometric results of stapled hemorrhoidopexy performed by expert surgeons in a selected group of patients for the treatment of chronic hemorrhoids. This study took place in the outpatient clinic and at the Day Surgery Unit attached to the University Hospital of Elche. From March 2003 to May 2005, 200 consecutive patients with third-degree hemorrhoids and treated with double-pursestring stapled hemorrhoidopexy with a PPH33-03 stapler were included in the study. Demographic, manometric, and clinical features were analyzed, as well as the variables related to surgery, postoperative course, and follow-up. Manometry was repeated at the 6-month, 1-year, and 5-year follow-up. Median follow-up was 110 months. Four patients (2%) reported daily rectal bleeding. One patient with active rectal bleeding was taken for reoperation within the first 12 postoperative hours. Seventy percent of patients reported pain ≤ 2 on the first postoperative day, 85% on the fourth postoperative day, and 95% on the seventh postoperative day. Pain was measured with a linear analog scale from 0 to 10 (0 = no pain; 10 = unbearable pain). Seventeen patients (8.5%) reported tenesmus during the first week. Eight patients (4%) reported persistent pain: in 5 patients, the pain resolved within the next 6 months; 2 patients presented with anal fissure; and 1 patient required the removal of the staples. Two patients (1%) reported residual soiling at the 5-year revision. Fourteen patients (7%) experienced recurrence with symptomatic prolapse. Six (3%) underwent further surgery: stapled hemorrhoidopexy was indicated again in 2 patients, and 4 patients underwent a Milligan-Morgan open hemorrhoidectomy, because they did not have a uniform prolapse. Six patients required treatment with rubber band ligation. There were no statistically significant differences between preoperative and postoperative manometric values. The new

Doppler ultrasound evaluation in preeclampsia

PubMed Central

2013-01-01

Background Worldwide preeclampsia (PE) is the leading cause of maternal death and affects 5 to 8% of pregnant women. PE is characterized by elevated blood pressure and proteinuria. Doppler Ultrasound (US) evaluation has been considered a useful method for prediction of PE; however, there is no complete data about the most frequently altered US parameters in the pathology. The aim of this study was to evaluate the uterine, umbilical, and the middle cerebral arteries using Doppler US parameters [resistance index (RI), pulsatility index (PI), notch (N), systolic peak (SP) and their combinations] in pregnant women, in order to make a global evaluation of hemodynamic repercussion caused by the established PE. Results A total of 102 pregnant Mexican women (65 PE women and 37 normotensive women) were recruited in a cases and controls study. Blood velocity waveforms from uterine, umbilical, and middle cerebral arteries, in pregnancies from 24 to 37 weeks of gestation were recorded by trans-abdominal examination with a Toshiba Ultrasound Power Vision 6000 SSA-370A, with a 3.5 MHz convex transducer. Abnormal general Doppler US profile showed a positive association with PE [odds ratio (OR) = 2.93, 95% confidence interval (CI) = 1.2 - 7.3, P = 0.021)], and a specificity and predictive positive value of 89.2% and 88.6%, respectively. Other parameters like N presence, RI and PI of umbilical artery, as well as the PI of middle cerebral artery, showed differences between groups (P values < 0.05). Conclusion General Doppler US result, as well as N from uterine vessel, RI from umbilical artery, and PI from umbilical and middle cerebral arteries in their individual form, may be considered as tools to determine hemodynamic repercussion caused by PE. PMID:24252303

An interactive Doppler velocity dealiasing scheme

NASA Astrophysics Data System (ADS)

Pan, Jiawen; Chen, Qi; Wei, Ming; Gao, Li

2009-10-01

Doppler weather radars are capable of providing high quality wind data at a high spatial and temporal resolution. However, operational application of Doppler velocity data from weather radars is hampered by the infamous limitation of the velocity ambiguity. This paper reviews the cause of velocity folding and presents the unfolding method recently implemented for the CINRAD systems. A simple interactive method for velocity data, which corrects de-aliasing errors, has been developed and tested. It is concluded that the algorithm is very efficient and produces high quality velocity data.

Doppler imaging using spectrally-encoded endoscopy

PubMed Central

Yelin, Dvir; Bouma, B. E.; Rosowsky, J. J.; Tearney, G. J.

2009-01-01

The capability to image tissue motion such as blood flow through an endoscope could have many applications in medicine. Spectrally encoded endoscopy (SEE) is a recently introduced technique that utilizes a single optical fiber and miniature diffractive optics to obtain endoscopic images through small diameter probes. Using spectral-domain interferometry, SEE is furthermore capable of three-dimensional volume imaging at video rates. Here we show that by measuring relative spectral phases, this technology can additionally measure Doppler shifts. Doppler SEE is demonstrated in flowing Intralipid phantoms and vibrating middle ear ossicles. PMID:18795020

DOPPLER SIGNATURES OF THE ATMOSPHERIC CIRCULATION ON HOT JUPITERS

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

Showman, Adam P.; Lewis, Nikole K.; Fortney, Jonathan J.

2013-01-01

The meteorology of hot Jupiters has been characterized primarily with thermal measurements, but recent observations suggest the possibility of directly detecting the winds by observing the Doppler shift of spectral lines seen during transit. Motivated by these observations, we show how Doppler measurements can place powerful constraints on the meteorology. We show that the atmospheric circulation-and Doppler signature-of hot Jupiters splits into two regimes. Under weak stellar insolation, the day-night thermal forcing generates fast zonal jet streams from the interaction of atmospheric waves with the mean flow. In this regime, air along the terminator (as seen during transit) flows towardmore » Earth in some regions and away from Earth in others, leading to a Doppler signature exhibiting superposed blueshifted and redshifted components. Under intense stellar insolation, however, the strong thermal forcing damps these planetary-scale waves, inhibiting their ability to generate jets. Strong frictional drag likewise damps these waves and inhibits jet formation. As a result, this second regime exhibits a circulation dominated by high-altitude, day-to-night airflow, leading to a predominantly blueshifted Doppler signature during transit. We present state-of-the-art circulation models including non-gray radiative transfer to quantify this regime shift and the resulting Doppler signatures; these models suggest that cool planets like GJ 436b lie in the first regime, HD 189733b is transitional, while planets hotter than HD 209458b lie in the second regime. Moreover, we show how the amplitude of the Doppler shifts constrains the strength of frictional drag in the upper atmospheres of hot Jupiters. If due to winds, the {approx}2 km s{sup -1} blueshift inferred on HD 209458b may require drag time constants as short as 10{sup 4}-10{sup 6} s, possibly the result of Lorentz-force braking on this planet's hot dayside.« less

Comments on Doppler radar applications

NASA Technical Reports Server (NTRS)

Kessler, E.

1969-01-01

The application of Doppler methods to theoretical or meteorological problems is discussed. Research for using radar to study and monitor severe thunderstorms, turbulence, and tornadoes is recommended.

Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta

PubMed Central

Abdel Moniem, Alaa M.; Ibrahim, Ahmed; Akl, Sherif A.; Aboul-Enen, Loay; Abdelazim, Ibrahim A.

2015-01-01

Objective To detect the accuracy of the three-dimensional multislice view (3D MSV) Doppler in the diagnosis of morbid adherent placenta (MAP). Material and Methods Fifty pregnant women at ≥28 weeks gestation with suspected MAP were included in this prospective study. Two dimensional (2D) trans-abdominal gray-scale ultrasound scan was performed for the subjects to confirm the gestational age, placental location, and findings suggestive of MAP, followed by the 3D power Doppler and then the 3D MSV Doppler to confirm the diagnosis of MAP. Intraoperative findings and histopathology results of removed uteri in cases managed by emergency hysterectomy were compared with preoperative sonographic findings to detect the accuracy of the 3D MSV Doppler in the diagnosis of MAP. Results The 3D MSV Doppler increased the accuracy and predictive values of the diagnostic criteria of MAP compared with the 3D power Doppler. The sensitivity and negative predictive value (NPV) (79.6% and 82.2%, respectively) of crowded vessels over the peripheral sub-placental zone to detect difficult placental separation and considerable intraoperative blood loss in cases of MAP using the 3D power Doppler was increased to 82.6% and 84%, respectively, using the 3D MSV Doppler. In addition, the sensitivity, specificity, and positive predictive value (PPV) (90.9%, 68.8%, and 47%, respectively) of the disruption of the uterine serosa-bladder interface for the detection of emergency hysterectomy in cases of MAP using the 3D power Doppler was increased to 100%, 71.8%, and 50%, respectively, using the 3D MSV Doppler. Conclusion The 3D MSV Doppler is a useful adjunctive tool to the 3D power Doppler or color Doppler to refine the diagnosis of MAP. PMID:26401104

Spectroscopic Doppler analysis for visible-light optical coherence tomography

NASA Astrophysics Data System (ADS)

Shu, Xiao; Liu, Wenzhong; Duan, Lian; Zhang, Hao F.

2017-12-01

Retinal oxygen metabolic rate can be effectively measured by visible-light optical coherence tomography (vis-OCT), which simultaneously quantifies oxygen saturation and blood flow rate in retinal vessels through spectroscopic analysis and Doppler measurement, respectively. Doppler OCT relates phase variation between sequential A-lines to the axial flow velocity of the scattering medium. The detectable phase shift is between -π and π due to its periodicity, which limits the maximum measurable unambiguous velocity without phase unwrapping. Using shorter wavelengths, vis-OCT is more vulnerable to phase ambiguity since flow induced phase variation is linearly related to the center wavenumber of the probing light. We eliminated the need for phase unwrapping using spectroscopic Doppler analysis. We split the whole vis-OCT spectrum into a series of narrow subbands and reconstructed vis-OCT images to extract corresponding Doppler phase shifts in all the subbands. Then, we quantified flow velocity by analyzing subband-dependent phase shift using linear regression. In the phantom experiment, we showed that spectroscopic Doppler analysis extended the measurable absolute phase shift range without conducting phase unwrapping. We also tested this method to quantify retinal blood flow in rodents in vivo.

Trans-skull ultrasonic Doppler system aided by fuzzy logic

NASA Astrophysics Data System (ADS)

Hata, Yutaka; Nakamura, Masato; Yagi, Naomi; Ishikawa, Tomomoto

2012-06-01

This paper describes a trans-skull ultrasonic Doppler system for measuring the blood flow direction in brain under skull. In this system, we use an ultrasonic array probe with the center frequency of 1.0 MHz. The system determines the fuzzy degree of blood flow by Doppler Effect, thereby it locates blood vessel. This Doppler Effect is examined by the center of gravity shift of the frequency magnitudes. In in-vitro experiment, a cow bone was employed as the skull, and three silicon tubes were done as blood vessels, and bubble in water as blood. We received the ultrasonic waves through a protein, the skull and silicon tubes in order. In the system, fuzzy degrees are determined with respect to the Doppler shift, amplitude of the waves and attenuation of the tissues. The fuzzy degrees of bone and blood direction are calculated by them. The experimental results showed that the system successfully visualized the skull and flow direction, compared with the location and flow direction of the phantom. Thus, it detected the flow direction by Doppler Effect under skull, and automatically extracted the region of skull and blood vessel.

Designing clutter rejection filters with complex coefficients for airborne pulsed Doppler weather radar

NASA Technical Reports Server (NTRS)

Jamora, Dennis A.

1993-01-01

Ground clutter interference is a major problem for airborne pulse Doppler radar operating at low altitudes in a look-down mode. With Doppler zero set at the aircraft ground speed, ground clutter rejection filtering is typically accomplished using a high-pass filter with real valued coefficients and a stopband notch centered at zero Doppler. Clutter spectra from the NASA Wind Shear Flight Experiments of l991-1992 show that the dominant clutter mode can be located away from zero Doppler, particularly at short ranges dominated by sidelobe returns. Use of digital notch filters with complex valued coefficients so that the stopband notch can be located at any Doppler frequency is investigated. Several clutter mode tracking algorithms are considered to estimate the Doppler frequency location of the dominant clutter mode. From the examination of night data, when a dominant clutter mode away from zero Doppler is present, complex filtering is able to significantly increase clutter rejection over use of a notch filter centered at zero Doppler.

Doppler ultrasonography and single-fiber laser Doppler flowmetry for measurement of hind limb blood flow in anesthetized horses.

PubMed

Raisis, A L; Young, L E; Taylor, P M; Walsh, K P; Lekeux, P

2000-03-01

To use Doppler ultrasonography and single-fiber laser Doppler flowmetry (LDF) to evaluate blood flow in the dependent and nondependent hind limbs of anesthetized horses and to evaluate changes in femoral arterial blood flow and microvascular skeletal muscle perfusion in response to administration of phenylephrine hydrochloride or dobutamine hydrochloride. 6 healthy adult horses. Horses were anesthetized and positioned in left lateral recumbency. Doppler ultrasonography was used to measure velocity and volumetric flow in the femoral vessels. Single-fiber LDF was used to measure relative microvascular perfusion at a single site in the semimembranosus muscles. Phenylephrine or dobutamine was then administered to decrease or increase femoral arterial blood flow, and changes in blood flow and microvascular perfusion were recorded. Administration of phenylephrine resulted in significant decreases in femoral arterial and venous blood flows and cardiac output and significant increases in mean aortic blood pressure, systemic vascular resistance, and PCV. Administration of dobutamine resulted in significant increases in femoral arterial blood flow, mean aortic blood pressure, and PCV. Significant changes in microvascular perfusion were not detected. Results suggest that Doppler ultrasonography and single-fiber LDF can be used to study blood flows in the hind limbs of anesthetized horses. However, further studies are required to determine why changes in femoral arterial blood flows were not associated with changes in microvascular perfusion.

Laser Doppler systems in pollution monitoring

NASA Technical Reports Server (NTRS)

Miller, C. R.; Sonnenschein, C. M.; Herget, W. F.; Huffaker, R. M.

1976-01-01

The paper reports on a program undertaken to determine the feasibility of using a laser Doppler velocimeter (LDV) to measure smoke-stack gas exit velocity, particulate concentration, and mass flow. Measurements made with a CO2 laser Doppler radar system at a coal-burning power plant are compared with in-stack measurements made by a pitot tube. The operational principles of a LDV are briefly described along with the system employed in the present study. Data discussed include typical Doppler spectra from smoke-stack effluents at various laser elevation angles, the measured velocity profile across the stack exit, and the LDV-measured exit velocity as a function of the exit velocity measured by the in-stack instrument. The in-stack velocity is found to be about 14% higher than the LDV velocity, but this discrepancy is regarded as a systematic error. In general, linear relationships are observed between the laser data, the exit velocity, and the particulate concentration. It is concluded that an LDV has the capability of determining both the mass concentration and the mass flow from a power-plant smoke stack.

Non-intrusive Shock Measurements Using Laser Doppler Vibrometers

NASA Technical Reports Server (NTRS)

Statham, Shannon M.; Kolaini, Ali R.

2012-01-01

Stud mount accelerometers are widely used by the aerospace industry to measure shock environments during hardware qualification. The commonly used contact-based sensors, however, interfere with the shock waves and distort the acquired signature, which is a concern not actively discussed in the community. To alleviate these interference issues, engineers at the Jet Propulsion Laboratory are investigating the use of non-intrusive sensors, specifically Laser Doppler Vibrometers, as alternatives to the stud mounted accelerometers. This paper will describe shock simulation tests completed at the Jet Propulsion Laboratory, compare the measurements from stud mounted accelerometers and Laser Doppler Vibrometers, and discuss the advantages and disadvantages of introducing Laser Doppler Vibrometers as alternative sensors for measuring shock environments.

Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study.

PubMed

Sureshkumar, Sathasivam; Vignesh, Narayan; Venkatachalam, J; Vijayakumar, Chellappa; Sudharsanan, Sundaramurthi

2018-01-05

Background The color Doppler, a better investigation to identify the perforators objectively has replaced the clinical examination for the same. However, this has led to a significant number of negative explorations and cosmetic disfigurement. Objective To compare the efficacy of the clinical tests combined with the color Doppler versus color Doppler alone to identify the perforator incompetence during the surgery for primary varicose veins of the lower limb. Methods This was a prospective analytical study, including 61 lower limb varicose vein patients who belonged to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) class four-six, planned for the surgical treatment for perforator incompetence, excluding those requiring additional vascular or nonvascular procedure, recurrent varicose veins and those who had injection sclerotherapy prior to the surgery. The clinical tests, including Trendelenburg's test, multiple tourniquet tests and, the Fegan's tests were performed and incompetent perforators were marked on a template as 'C' to indicate the clinically positive perforator incompetence. The patients were then examined with the color Doppler ultrasound and the pathological incompetent perforators were marked as 'D'. The surgical management of the perforator incompetence was done by stab ligation. The incision was made in the color Doppler 'D' marked sites as it has been the standard protocol. The number of incompetent perforators identified during the surgical exploration were categorized as 'D' positive or 'C' and 'D' positive and were recorded in the specified proforma. Results It was found that the mean number of the perforator incompetence identified by the color Doppler alone was 8.2 whereas during the surgery, only a mean of six perforators was identified, leading to 20 unnecessary explorations per 10 patients (8.2 vs. 6; mean difference 2.229; P <0.001). The mean number of the perforator incompetence identified by the color Doppler combined with the

Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study

PubMed Central

Vignesh, Narayan; Venkatachalam, J; Vijayakumar, Chellappa; Sudharsanan, Sundaramurthi

2018-01-01

Background The color Doppler, a better investigation to identify the perforators objectively has replaced the clinical examination for the same. However, this has led to a significant number of negative explorations and cosmetic disfigurement. Objective To compare the efficacy of the clinical tests combined with the color Doppler versus color Doppler alone to identify the perforator incompetence during the surgery for primary varicose veins of the lower limb. Methods This was a prospective analytical study, including 61 lower limb varicose vein patients who belonged to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) class four-six, planned for the surgical treatment for perforator incompetence, excluding those requiring additional vascular or nonvascular procedure, recurrent varicose veins and those who had injection sclerotherapy prior to the surgery. The clinical tests, including Trendelenburg’s test, multiple tourniquet tests and, the Fegan’s tests were performed and incompetent perforators were marked on a template as ‘C’ to indicate the clinically positive perforator incompetence. The patients were then examined with the color Doppler ultrasound and the pathological incompetent perforators were marked as ‘D’. The surgical management of the perforator incompetence was done by stab ligation. The incision was made in the color Doppler ‘D’ marked sites as it has been the standard protocol. The number of incompetent perforators identified during the surgical exploration were categorized as ‘D’ positive or ’C’ and ‘D’ positive and were recorded in the specified proforma. Results It was found that the mean number of the perforator incompetence identified by the color Doppler alone was 8.2 whereas during the surgery, only a mean of six perforators was identified, leading to 20 unnecessary explorations per 10 patients (8.2 vs. 6; mean difference 2.229; P <0.001). The mean number of the perforator incompetence identified by the color

Rectal Problems

MedlinePlus

... should always be thoroughly evaluated by your doctor. Hemorrhoids What are hemorrhoids? Hemorrhoids are veins in the ... only 10-20 grams. Endoscopic & Surgical Treatment for Hemorrhoids When hemorrhoids bleed excessively or are very painful ...

The Multiple Doppler Radar Workshop, November 1979.

NASA Astrophysics Data System (ADS)

Carbone, R. E.; Harris, F. I.; Hildebrand, P. H.; Kropfli, R. A.; Miller, L. J.; Moninger, W.; Strauch, R. G.; Doviak, R. J.; Johnson, K. W.; Nelson, S. P.; Ray, P. S.; Gilet, M.

1980-10-01

The findings of the Multiple Doppler Radar Workshop are summarized by a series of six papers. Part I of this series briefly reviews the history of multiple Doppler experimentation, fundamental concepts of Doppler signal theory, and organization and objectives of the Workshop. Invited presentations by dynamicists and cloud physicists are also summarized.Experimental design and procedures (Part II) are shown to be of critical importance. Well-defined and limited experimental objectives are necessary in view of technological limitations. Specified radar scanning procedures that balance temporal and spatial resolution considerations are discussed in detail. Improved siting for suppression of ground clutter as well as scanning procedures to minimize errors at echo boundaries are discussed. The need for accelerated research using numerically simulated proxy data sets is emphasized.New technology to eliminate various sampling limitations is cited as an eventual solution to many current problems in Part III. Ground clutter contamination may be curtailed by means of full spectral processing, digital filters in real time, and/or variable pulse repetition frequency. Range and velocity ambiguities also may be minimized by various pulsing options as well as random phase transmission. Sidelobe contamination can be reduced through improvements in radomes, illumination patterns, and antenna feed types. Radar volume-scan time can be sharply reduced by means of wideband transmission, phased array antennas, multiple beam antennas, and frequency agility.Part IV deals with synthesis of data from several radars in the context of scientific requirements in cumulus clouds, widespread precipitation, and severe convective storms. The important temporal and spatial scales are examined together with the accuracy required for vertical air motion in each phenomenon. Factors that introduce errors in the vertical velocity field are identified and synthesis techniques are discussed separately for

Evaluation of transcatheter arterial embolization therapy on hepatocellular carcinomas using contrast-enhanced harmonic power Doppler sonography: comparison with CT, power Doppler sonography, and dynamic MRI.

PubMed

Shima, Toshihide; Mizuno, Masayuki; Otsuji, Hideaki; Mizuno, Chiemi; Obata, Hirozumi; Park, Hyohun; Nakajo, Shinobu; Okanoue, Takeshi

2005-09-01

The aim of this study was to assess and compare the sensitivity of power Doppler sonography, contrast-enhanced sonography, plain computed tomography (CT), and dynamic magnetic resonance imaging (MRI) for detecting hepatocellular carcinoma (HCC) nodules incompletely treated with transcatheter arterial embolization (TAE). A total of 63 unresectable HCC nodules were examined in this study. The HCCs were treated with TAE. All patients underwent plain CT, power Doppler sonography, contrast-enhanced harmonic power Doppler sonography, and dynamic MRI 1 week after TAE. The sensitivity of each modality to incompletely treated HCC nodules was compared. Detection of the residual viable HCC on angiography or tumor biopsy was regarded as the gold standard for the diagnosis of incomplete treatment. Twenty-four nodules (38%) were diagnosed as incompletely treated. The sensitivities of plain CT, power Doppler sonography, contrast-enhanced harmonic power Doppler sonography, and dynamic MRI to these incompletely treated nodules were 42% (10/24), 46% (11/24), 88% (21/24), and 79% (19/24), respectively. Eighty percent (19 nodules) of the 24 incompletely treated nodules were located within a depth of less than 8 cm. The sensitivities of plain CT, power Doppler sonography, contrast-enhanced harmonic power Doppler sonography, and dynamic MRI to these superficial incompletely treated nodules were 37% (7/19), 53% (10/19), 100% (19/19), and 74% (14/19), respectively. In contrast, the sensitivities of each modality to deeply located nodules were 60% (3/5), 20% (1/5), 40% (2/5), and 100% (5/5), respectively. Plain CT and power Doppler sonography had a low sensitivity to HCC nodules incompletely treated with TAE. Except for those that were deeply located, contrast-enhanced harmonic sonography showed the highest sensitivity in detecting incompletely treated HCC nodules.

Three-dimensional power Doppler sonography in screening for carotid artery disease.

PubMed

Keberle, M; Jenett, M; Beissert, M; Jahns, R; Haerten, R; Hahn, D

2000-01-01

Color Doppler sonography has gained considerable recognition as a noninvasive method to detect carotid artery disease and to assess the degree of carotid artery stenosis. However, results are highly operator-dependent and cannot be presented as survey images. The purpose of this study was to evaluate real-time 3-dimensional (3D) power Doppler sonography as a method for screening for atherosclerosis in the carotid arteries. We prospectively screened 75 patients for carotid artery disease using both conventional color Doppler sonography and 3D power Doppler sonography, and the results from the 2 modalities were compared. A total of 150 common carotid arteries, 150 internal carotid arteries, and 150 external carotid arteries were examined utilizing a 7.5-MHz linear-array transducer combined with tissue harmonic imaging. Color Doppler sonography detected 297 normal or atherosclerotic arteries without stenosis, 57 arteries with mild (1-49%) stenosis, 41 with moderate (50-69%) stenosis, 32 with severe (70-99%) stenosis, and 9 with occlusions. The degree of stenosis determined by color Doppler sonography correlated with that determined by 3D power Doppler sonography (r = 0.982-0.998). Moreover, there was a good correlation between the measurements for both the length of the lesion and its distance from the bulb as determined by the 3D volume surveys and by color Doppler sonography (r = 0.986). The interobserver variability rate was 3.7% +/- 0.5%. Generally, the acquisition and reconstruction of the 3D data took less than 5 minutes. 3D power Doppler sonography is easy to perform and is an accurate method in screening for atherosclerotic lesions of the carotid arteries. Moreover, it provides excellent 3D volume surveys that may be helpful in the planning of surgical treatment. Copyright 2000 John Wiley & Sons, Inc.

Laser measurements of unsteady flow field in a radial turbine guide vanes

NASA Astrophysics Data System (ADS)

Pasin, M.; Tabakoff, W.

1992-01-01

Detailed measurements of a unsteady flow field within the inlet guide vanes (IGV) of a radial inflow turbine were performed using a three component Laser Doppler Velocimeter (LDV) system. The mean velocity, the flow angle and the turbulence results are presented at the midspan plane for different rotor positions. These results are compared with the measurements obtained in the same passage in the absence of the rotor.

Color doppler in clinical cardiology

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

Duncan, W.J.

1987-01-01

A presentation of color doppler, which enables physicians to pinpoint problems and develop effective treatment. State-of-the-art illustrations and layout, with color images and explanatory text are included.

Laser Doppler velocimeter aerial spray measurements

NASA Technical Reports Server (NTRS)

Zalay, A. D.; Eberle, W. R.; Howle, R. E.; Shrider, K. R.

1978-01-01

An experimental research program for measuring the location, spatial extent, and relative concentration of airborne spray clouds generated by agricultural aircraft is described. The measurements were conducted with a ground-based laser Doppler velocimeter. The remote sensing instrumentation, experimental tests, and the results of the flight tests are discussed. The cross section of the aerial spray cloud and the observed location, extent, and relative concentration of the airborne particulates are presented. It is feasible to use a mobile laser Doppler velocimeter to track and monitor the transport and dispersion of aerial spray generated by an agricultural aircraft.

Long-range, noncoherent laser Doppler velocimeter.

PubMed

Bloom, S H; Kremer, R; Searcy, P A; Rivers, M; Menders, J; Korevaar, E

1991-11-15

An experimental demonstration of a long-range, noncoherent laser Doppler velocimeter (LDV) is presented. The LDV detects incoming Doppler-shifted signal photons by using the sharp spectral absorption features in atomic or molecular vapors. The edge of the absorption feature is used to convert changes in frequency to large changes in transmission. Preliminary measurements of wind velocity using seeded aerosols showed that the LDV results agreed with mechanical anemometer measurements to within the accuracy of the LDV measurements. With optimization the LDV will provide accurate range-resolved and vibration-tolerant wind-speed measurements at large distances.

Software For Clear-Air Doppler-Radar Display

NASA Technical Reports Server (NTRS)

Johnston, Bruce W.

1990-01-01

System of software developed to present plan-position-indicator scans of clear-air Doppler radar station on color graphical cathode-ray-tube display. Designed to incorporate latest accepted standards for equipment, computer programs, and meteorological data bases. Includes use of Ada programming language, of "Graphical-Kernel-System-like" graphics interface, and of Common Doppler Radar Exchange Format. Features include portability and maintainability. Use of Ada software packages produced number of software modules reused on other related projects.

Planetary Radio Interferometry and Doppler Experiment (PRIDE) technique: A test case of the Mars Express Phobos Flyby. II. Doppler tracking: Formulation of observed and computed values, and noise budget

NASA Astrophysics Data System (ADS)

Bocanegra-Bahamón, T. M.; Molera Calvés, G.; Gurvits, L. I.; Duev, D. A.; Pogrebenko, S. V.; Cimò, G.; Dirkx, D.; Rosenblatt, P.

2018-01-01

Context. Closed-loop Doppler data obtained by deep space tracking networks, such as the NASA Deep Space Network (DSN) and the ESA tracking station network (Estrack), are routinely used for navigation and science applications. By shadow tracking the spacecraft signal, Earth-based radio telescopes involved in the Planetary Radio Interferometry and Doppler Experiment (PRIDE) can provide open-loop Doppler tracking data only when the dedicated deep space tracking facilities are operating in closed-loop mode. Aims: We explain the data processing pipeline in detail and discuss the capabilities of the technique and its potential applications in planetary science. Methods: We provide the formulation of the observed and computed values of the Doppler data in PRIDE tracking of spacecraft and demonstrate the quality of the results using an experiment with the ESA Mars Express spacecraft as a test case. Results: We find that the Doppler residuals and the corresponding noise budget of the open-loop Doppler detections obtained with the PRIDE stations compare to the closed-loop Doppler detections obtained with dedicated deep space tracking facilities.

Micro-Doppler classification of riders and riderless horses

NASA Astrophysics Data System (ADS)

Tahmoush, David

2014-05-01

Micro-range Micro-Doppler can be used to isolate particular parts of the radar signature, and in this case we demonstrate the differences in the signature between a walking horse versus a walking horse with a rider. Using micro-range micro-Doppler, we can distinguish the radar returns from the rider as separate from the radar returns of the horse.

Multigigahertz range-Doppler correlative processing in crystals

NASA Astrophysics Data System (ADS)

Harris, Todd L.; Babbitt, Wm. R.; Merkel, Kristian D.; Mohan, R. Krishna; Cole, Zachary; Olson, Andy

2004-06-01

Spectral-spatial holographic crystals have the unique ability to resolve fine spectral features (down to kilohertz) in an optical waveform over a broad bandwidth (over 10 gigahertz). This ability allows these crystals to record the spectral interference between spread spectrum waveforms that are temporally separated by up to several microseconds. Such crystals can be used for performing radar range-Doppler processing with fine temporal resolution. An added feature of these crystals is the long upper state lifetime of the absorbing rare earth ions, which allows the coherent integration of multiple recorded spectra, yielding integration gain and significant processing gain enhancement for selected code sets, as well as high resolution Doppler processing. Parallel processing of over 10,000 beams could be achieved with a crystal the size of a sugar cube. Spectral-spatial holographic processing and coherent integration of up to 2.5 Gigabit per second coded waveforms and of lengths up to 2047 bits has previously been reported. In this paper, we present the first demonstration of Doppler processing with these crystals. Doppler resolution down to a few hundred Hz for broadband radar signals can be achieved. The processing can be performed directly on signals modulated onto IF carriers (up to several gigahertz) without having to mix the signals down to baseband and without having to employ broadband analog to digital conversion.

Comparison of the Diagnostic Performance of Power Doppler Ultrasound and a New Microvascular Doppler Ultrasound Technique (AngioPLUS) for Differentiating Benign and Malignant Breast Masses.

PubMed

Jung, Hae Kyoung; Park, Ah Young; Ko, Kyung Hee; Koh, Jieun

2018-03-12

This study was performed to compare the diagnostic performance of power Doppler ultrasound (US) and a new microvascular Doppler US technique (AngioPLUS; SuperSonic Imagine, Aix-en-Provence, France) for differentiating benign and malignant breast masses. Power Doppler US and AngioPLUS findings were available in 124 breast masses with confirmed pathologic results (benign, 80 [64.5%]; malignant, 44 [35.5%]). The diagnostic performance of each tool was calculated to distinguish benign from malignant masses using a receiver operating characteristic curve analysis and compared. The area under the curve showed that AngioPLUS was superior to power Doppler US in differentiating benign from malignant breast masses, but the difference was not statistically significant. © 2018 by the American Institute of Ultrasound in Medicine.

Doppler electron velocimetry : notes on creating a practical tool.

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

Reu, Phillip L.; Milster, Tom

2008-11-01

The Doppler electron velocimeter (DEV) has been shown to be theoretically possible. This report attempts to answer the next logical question: Is it a practical instrument? The answer hinges upon whether enough electrons are available to create a time-varying Doppler current to be measured by a detector with enough sensitivity and bandwidth. The answer to both of these questions is a qualified yes. A target Doppler frequency of 1 MHz was set as a minimum rate of interest. At this target a theoretical beam current signal-to-noise ratio of 25-to-1 is shown for existing electron holography equipment. A detector is alsomore » demonstrated with a bandwidth of 1-MHz at a current of 10 pA. Additionally, a Linnik-type interferometer that would increase the available beam current is shown that would offer a more flexible arrangement for Doppler electron measurements over the traditional biprism.« less

Christian Andreas Doppler--the man and his legacy.

PubMed

Coman, I M

2005-01-01

Reminding the life and legacy of the Austrian Scientist who discovered the famous 'Doppler Effect'. C.A. Doppler was born the 29th of November 1803 in Salzburg. After studies in Linz and Vienna, he graduated in mathematics, became assistant at the University and later worked as a professor in Prague. Back to Vienna, he was appointed as professor at the Polytechnic School and --in 1850--as first director of the new Institute of Physics. C.A. Doppler did publish on magnetism, electricity, optics, and astronomy. He remains in the history of science due to the discovery presented (May 25, 1842) at the Royal Bohemian Society of Science entitled "On the colored light of the double stars and certain other stars of the heavens"; the paper described (applied to light) the shift of frequency which bears nowadays his name. The theory was later experimentally proven and--extended for any electromagnetic and acoustic waves--got myriads if applications in astronomy, physics, aviation, meteorology, and health science. Satomura in Japan (1955) published it's first ultrasound vascular application--with successive achievements in the next decades. Doppler ultrasonagraphy became the main noninvasive instrument for functional assesment of heart and vessels.

Space-based detection of spoofing AIS signals using Doppler frequency

NASA Astrophysics Data System (ADS)

Guo, Shanzeng

2014-05-01

The Automatic Identification System (AIS) is a self-reporting system based on VHF radio to transmit a vessel's identity, position, speed, heading and other parameters to improve maritime domain awareness. However, AIS information can be programmatically spoofed by terrorists or other criminals, who often choose to masquerade as innocent civilians and exploit the vulnerabilities of military and civilian infrastructures for their purposes. Therefore, detecting and localizing a spoofing AIS ship become a critical and challenging issue for maritime security. This paper presents an algorithm to detect and geolocalize a spoofing AIS emitter using space-based AIS signals with its Doppler frequency. With an AIS signal sensor on a fast orbiting satellite, the measured AIS Doppler frequency of an AIS emitter can be used to define a double-napped cone of which the satellite is at its vertex and satellite velocity coincides with its axis, such that the theoretical Doppler frequency derived from the radial velocity to the AIS emitter matches the measured Doppler frequency. All such matches can only lie on either cone extending out from the satellite, which cuts the Earth's surface in two curves, so we know that the AIS emitter must lie somewhere on these curves. Two such AIS Doppler frequency measurements for the same stationary AIS emitter produce two valid curves which intersect at the position of the AIS emitter. Multiple Doppler frequency measurements can be used to better estimate the position fix of an AIS emitter, hence determine the spoofing AIS ship if the estimated position fix unreasonably differs from the position carried in its AIS message. A set of formulas are derived which relate an AIS emitter position to its Doppler frequency measurements.

Doppler and range determination for deep space vehicles using active optical transponders.

PubMed

Kinman, P W; Gagliardi, R M

1988-11-01

This paper describes and analyzes two types of laser system employing active transponders that could accurately determine Doppler and range to deep space vehicles from earth-orbiting satellites. The first is a noncoherent optical system in which the Doppler effect on an intensity-modulating subcarrier is measured. The second is a coherent optical system in which the Doppler effect of the optical carrier itself is measured. Doppler and range measurement errors are mathematically modeled and, for three example systems, numerically evaluated.

Doppler and range determination for deep space vehicles using active optical transponders

NASA Technical Reports Server (NTRS)

Kinman, Peter W.; Gagliardi, Robert M.

1988-01-01

This paper describes and analyzes two types of laser system employing active transponders that could accurately determine Doppler and range to deep space vehicles from earth-orbiting satellites. The first is a noncoherent optical system in which the Doppler effect on an intensity-modulating subcarrier is measured. The second is a coherent optical system in which the Doppler effect of the optical carrier itself is measured. Doppler and range measurement errors are mathematically modeled and, for three example systems, numerically evaluated.

Applications of Doppler optical coherence tomography

NASA Astrophysics Data System (ADS)

Xu, Zhiqiang

A major development in biomedical imaging in the last decade has been optical coherence tomography (OCT). This technique enables microscale resolution, depth resolved imaging of the detailed morphology of transparent and nontransparent biological tissue in a noncontact and quasi-noninvasive way. In the first part of this dissertation, we will describe the development and the performance of our home-made OCT systems working with different wavelength regions based on free-space and optical fiber Michelson interferometers. The second part will focus on Doppler OCT (DOCT), an important extension of OCT, which enables the simultaneous evaluation of the structural information and of the fluid flow distribution at a localized position beneath the sample surface. Much effort has been spent during the past few years in our laboratory aimed at providing more accurate velocity measurements with an extended dynamic range. We also applied our technique in different research areas such as microfluidics and hemodynamics. Investigations on the optical properties of the biological tissues (such as absorption and scattering) corresponding to different center wavelengths, have been performed in our laboratory. We used a 10 femtosecond Ti:sapphire laser centered at about 810 nm associated with a free-space Michelson interferometer. The infrared sources were centered at about 1310 and 1560 nm with all-fiber interferometers. Comparative studies using three different sources for several in vitro biological tissues based on a graphical method illustrated how the optical properties affect the quality of the OCT images in terms of the penetration depth and backscattering intensity. We have shown the advantage of working with 810-nm emission wavelength for good backscattering amplitude and contrast, while sources emitting at 1570 nm give good penetration depth. The 1330-nm sources provide a good compromise between the two. Therefore, the choice of the source will ultimately determine the

Laser-sodium interaction for the polychromatic laser guide star project

NASA Astrophysics Data System (ADS)

Bellanger, Veronique; Petit, Alain D.

2002-02-01

We developed a code aimed at determining the laser parameters leading to the maximum return flux of photons at 0.33 micrometers for a polychromatic sodium Laser Guide Star. This software relies upon a full 48-level collisionless and magnetic-field-free density-matrix description of the hyperfine structure of Na and includes Doppler broadening and Zeeman degeneracy. Experimental validation of BEACON was conducted on the SILVA facilities and will also be discussed in this paper.

21 CFR 892.1550 - Ultrasonic pulsed doppler imaging system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ultrasonic pulsed doppler imaging system. 892.1550... system. (a) Identification. An ultrasonic pulsed doppler imaging system is a device that combines the... determine stationary body tissue characteristics, such as depth or location of tissue interfaces or dynamic...

Wavelet analysis of the Laser Doppler signal to assess skin perfusion.

PubMed

Bagno, Andrea; Martini, Romeo

2015-01-01

The hemodynamics of skin microcirculation can be clinically assessed by means of Laser Doppler Fluxmetry. Laser Doppler signals show periodic oscillations because of fluctuations of microvascular perfusion (flowmotion), which are sustained by contractions and relaxations of arteriolar walls rhythmically changing vessels diameter (vasomotion). The wavelet analysis applied to Laser Doppler signals displays six characteristic frequency intervals, from 0.005 to 2 Hz. Each interval is assigned to a specific structure of the cardiovascular system: heart, respiration, vascular myocites, sympathetic terminations, and endothelial cells (dependent and independent on nitric oxide). Therefore, mechanisms of skin perfusion can be investigated through wavelet analysis. In the present work, examples of methods and results of wavelet analysis applied to Laser Doppler signals are reported. Laser Doppler signals were acquired in two groups of patients to check possible changes in vascular activities, before and after occlusive reactive hyperaemia, and before and after revascularization.

Estimation of physiological sub-millimeter displacement with CW Doppler radar.

PubMed

Jia Xu; Xiaomeng Gao; Padasdao, Bryson E; Boric-Lubecke, Olga

2015-01-01

Doppler radar physiological sensing has been studied for non-contact detection of vital signs including respiratory and heartbeat rates. This paper presents the first micrometer resolution Wi-Fi band Doppler radar for sub-millimeter physiological displacement measurement. A continuous-wave Doppler radar working at 2.4GHz is used for the measurement. It is intended for estimating small displacements on the body surface resulting from physiological activity. A mechanical mover was used as target, and programmed to conduct sinusoidal motions to simulate pulse motions. Measured displacements were compared with a reference system, which indicates a superior performance in accuracy for having absolute errors less than 10μm, and relative errors below 4%. It indicates the feasibility of highly accurate non-contact monitoring of physiological movements using Doppler radar.

An elementary approach to the gravitational Doppler shift

NASA Astrophysics Data System (ADS)

Wörner, C. H.; Rojas, Roberto

2017-01-01

In college physics courses, treatment of the Doppler effect is usually done far from the first introduction to kinematics. This paper aims to apply a graphical treatment to describe the gravitational redshift, by considering the Doppler effect in two accelerated reference frames and exercising the equivalence principle. This approach seems appropriate to discuss with beginner students and could serve to enrich the didactic processes.

Doppler Processing with Ultra-Wideband (UWB) Radar Revisited

DTIC Science & Technology

2018-01-01

grating lobes as compared to the conventional Doppler processing counterpart. 15. SUBJECT TERMS Doppler radar, UWB radar, matched filter , ambiguity...maps by the matched filter method, illustrating the radar data support in (a) the frequency-slow time domain and (b) the ρ-u domain. The samples...example, obtained by the matched filter method, for a 1.2-s CPI centered at t = 1.5 s

A New Active Cavitation Mapping Technique for Pulsed HIFU Applications – Bubble Doppler

PubMed Central

Li, Tong; Khokhlova, Tatiana; Sapozhnikov, Oleg; Hwang, Joo Ha; Sapozhnikov, Oleg; O’Donnell, Matthew

2015-01-01

In this work, a new active cavitation mapping technique for pulsed high-intensity focused ultrasound (pHIFU) applications termed bubble Doppler is proposed and its feasibility tested in tissue-mimicking gel phantoms. pHIFU therapy uses short pulses, delivered at low pulse repetition frequency, to cause transient bubble activity that has been shown to enhance drug and gene delivery to tissues. The current gold standard for detecting and monitoring cavitation activity during pHIFU treatments is passive cavitation detection (PCD), which provides minimal information on the spatial distribution of the bubbles. B-mode imaging can detect hyperecho formation, but has very limited sensitivity, especially to small, transient microbubbles. The bubble Doppler method proposed here is based on a fusion of the adaptations of three Doppler techniques that had been previously developed for imaging of ultrasound contrast agents – color Doppler, pulse inversion Doppler, and decorrelation Doppler. Doppler ensemble pulses were interleaved with therapeutic pHIFU pulses using three different pulse sequences and standard Doppler processing was applied to the received echoes. The information yielded by each of the techniques on the distribution and characteristics of pHIFU-induced cavitation bubbles was evaluated separately, and found to be complementary. The unified approach - bubble Doppler – was then proposed to both spatially map the presence of transient bubbles and to estimate their sizes and the degree of nonlinearity. PMID:25265178

Automatic extraction of disease-specific features from Doppler images

NASA Astrophysics Data System (ADS)

Negahdar, Mohammadreza; Moradi, Mehdi; Parajuli, Nripesh; Syeda-Mahmood, Tanveer

2017-03-01

Flow Doppler imaging is widely used by clinicians to detect diseases of the valves. In particular, continuous wave (CW) Doppler mode scan is routinely done during echocardiography and shows Doppler signal traces over multiple heart cycles. Traditionally, echocardiographers have manually traced such velocity envelopes to extract measurements such as decay time and pressure gradient which are then matched to normal and abnormal values based on clinical guidelines. In this paper, we present a fully automatic approach to deriving these measurements for aortic stenosis retrospectively from echocardiography videos. Comparison of our method with measurements made by echocardiographers shows large agreement as well as identification of new cases missed by echocardiographers.

Velocity precision measurements using laser Doppler anemometry

NASA Astrophysics Data System (ADS)

Dopheide, D.; Taux, G.; Narjes, L.

1985-07-01

A Laser Doppler Anemometer (LDA) was calibrated to determine its applicability to high pressure measurements (up to 10 bars) for industrial purposes. The measurement procedure with LDA and the experimental computerized layouts are presented. The calibration procedure is based on absolute accuracy of Doppler frequency and calibration of interference strip intervals. A four-quadrant detector allows comparison of the interference strip distance measurements and computer profiles. Further development of LDA is recommended to increase accuracy (0.1% inaccuracy) and to apply the method industrially.

Superharmonic microbubble Doppler effect in ultrasound therapy

NASA Astrophysics Data System (ADS)

Pouliopoulos, Antonios N.; Choi, James J.

2016-08-01

The introduction of microbubbles in focused ultrasound therapies has enabled a diverse range of non-invasive technologies: sonoporation to deliver drugs into cells, sonothrombolysis to dissolve blood clots, and blood-brain barrier opening to deliver drugs into the brain. Current methods for passively monitoring the microbubble dynamics responsible for these therapeutic effects can identify the cavitation position by passive acoustic mapping and cavitation mode by spectral analysis. Here, we introduce a new feature that can be monitored: microbubble effective velocity. Previous studies have shown that echoes from short imaging pulses had a Doppler shift that was produced by the movement of microbubbles. Therapeutic pulses are longer (>1 000 cycles) and thus produce a larger alteration of microbubble distribution due to primary and secondary acoustic radiation force effects which cannot be monitored using pulse-echo techniques. In our experiments, we captured and analyzed the Doppler shift during long therapeutic pulses using a passive cavitation detector. A population of microbubbles (5  ×  104-5  ×  107 microbubbles ml-1) was embedded in a vessel (inner diameter: 4 mm) and sonicated using a 0.5 MHz focused ultrasound transducer (peak-rarefactional pressure: 75-366 kPa, pulse length: 50 000 cycles or 100 ms) within a water tank. Microbubble acoustic emissions were captured with a coaxially aligned 7.5 MHz passive cavitation detector and spectrally analyzed to measure the Doppler shift for multiple harmonics above the 10th harmonic (i.e. superharmonics). A Doppler shift was observed on the order of tens of kHz with respect to the primary superharmonic peak and is due to the axial movement of the microbubbles. The position, amplitude and width of the Doppler peaks depended on the acoustic pressure and the microbubble concentration. Higher pressures increased the effective velocity of the microbubbles up to 3 m s-1, prior to the onset of

Superharmonic microbubble Doppler effect in ultrasound therapy

PubMed Central

Pouliopoulos, Antonios N; Choi, James J

2016-01-01

Abstract The introduction of microbubbles in focused ultrasound therapies has enabled a diverse range of non-invasive technologies: sonoporation to deliver drugs into cells, sonothrombolysis to dissolve blood clots, and blood-brain barrier opening to deliver drugs into the brain. Current methods for passively monitoring the microbubble dynamics responsible for these therapeutic effects can identify the cavitation position by passive acoustic mapping and cavitation mode by spectral analysis. Here, we introduce a new feature that can be monitored: microbubble effective velocity. Previous studies have shown that echoes from short imaging pulses had a Doppler shift that was produced by the movement of microbubbles. Therapeutic pulses are longer (>1 000 cycles) and thus produce a larger alteration of microbubble distribution due to primary and secondary acoustic radiation force effects which cannot be monitored using pulse-echo techniques. In our experiments, we captured and analyzed the Doppler shift during long therapeutic pulses using a passive cavitation detector. A population of microbubbles (5  ×  104–5  ×  107 microbubbles ml−1) was embedded in a vessel (inner diameter: 4 mm) and sonicated using a 0.5 MHz focused ultrasound transducer (peak-rarefactional pressure: 75–366 kPa, pulse length: 50 000 cycles or 100 ms) within a water tank. Microbubble acoustic emissions were captured with a coaxially aligned 7.5 MHz passive cavitation detector and spectrally analyzed to measure the Doppler shift for multiple harmonics above the 10th harmonic (i.e. superharmonics). A Doppler shift was observed on the order of tens of kHz with respect to the primary superharmonic peak and is due to the axial movement of the microbubbles. The position, amplitude and width of the Doppler peaks depended on the acoustic pressure and the microbubble concentration. Higher pressures increased the effective velocity of the microbubbles up to 3 m s−1, prior to

Technical Note: A new phantom design for routine testing of Doppler ultrasound.

PubMed

Grice, J V; Pickens, D R; Price, R R

2016-07-01

The objective of this project is to demonstrate the principle and operation for a simple, inexpensive, and highly portable Doppler ultrasound quality assurance (QA) phantom intended for routine QA testing. A prototype phantom has been designed, fabricated, and evaluated. The phantom described here is powered by gravity alone, requires no external equipment for operation, and produces a stable fluid velocity useful for quality assurance. Many commercially available Doppler ultrasound testing systems can suffer from issues such as a lengthy setup, prohibitive cost, nonportable size, or difficulty in use. This new phantom design aims to address some of these problems and create a phantom appropriate for assessing Doppler ultrasound stability. The phantom was fabricated using a 3D printer. The basic design of the phantom is to provide gravity-powered flow of a Doppler fluid between two reservoirs. The printed components were connected with latex tubing and then seated in a tissue mimicking gel. Spectral Doppler waveforms were sampled to evaluate variations in the data, and the phantom was evaluated using high frame rate video to find an alternate measure of mean fluid velocity flowing in the phantom. The current system design maintains stable flow from one reservoir to the other for approximately 7 s. Color Doppler imaging of the phantom was found to be qualitatively consistent with laminar flow. Using pulsed spectral Doppler, the average fluid velocity from a sample volume approximately centered in the synthetic vessel was measured to be 56 cm/s with a standard deviation of 3.2 cm/s across 118 measurements. An independent measure of the average fluid velocity was measured to be 51.9 cm/s with a standard deviation of 0.7 cm/s over 4 measurements. The developed phantom provides stable fluid flow useful for frequent clinical Doppler ultrasound testing and attempts to address several obstacles facing Doppler phantom testing. Such an ultrasound phantom can make routine

A model for gravity-wave spectra observed by Doppler sounding systems

NASA Technical Reports Server (NTRS)

Vanzandt, T. E.

1986-01-01

A model for Mesosphere - Stratosphere - Troposphere (MST) radar spectra is developed following the formalism presented by Pinkel (1981). Expressions for the one-dimensional spectra of radial velocity versus frequency and versus radial wave number are presented. Their dependence on the parameters of the gravity-wave spectrum and on the experimental parameters, radar zenith angle and averaging time are described and the conditions for critical tests of the gravity-wave hypothesis are discussed. The model spectra is compared with spectra observed in the Arctic summer mesosphere by the Poker Flat radar. This model applies to any monostatic Doppler sounding system, including MST radar, Doppler lidar and Doppler sonar in the atmosphere, and Doppler sonar in the ocean.

Doppler synthetic aperture radar interferometry: a novel SAR interferometry for height mapping using ultra-narrowband waveforms

NASA Astrophysics Data System (ADS)

Yazıcı, Birsen; Son, Il-Young; Cagri Yanik, H.

2018-05-01

This paper introduces a new and novel radar interferometry based on Doppler synthetic aperture radar (Doppler-SAR) paradigm. Conventional SAR interferometry relies on wideband transmitted waveforms to obtain high range resolution. Topography of a surface is directly related to the range difference between two antennas configured at different positions. Doppler-SAR is a novel imaging modality that uses ultra-narrowband continuous waves (UNCW). It takes advantage of high resolution Doppler information provided by UNCWs to form high resolution SAR images. We introduce the theory of Doppler-SAR interferometry. We derive an interferometric phase model and develop the equations of height mapping. Unlike conventional SAR interferometry, we show that the topography of a scene is related to the difference in Doppler frequency between two antennas configured at different velocities. While the conventional SAR interferometry uses range, Doppler and Doppler due to interferometric phase in height mapping; Doppler-SAR interferometry uses Doppler, Doppler-rate and Doppler-rate due to interferometric phase in height mapping. We demonstrate our theory in numerical simulations. Doppler-SAR interferometry offers the advantages of long-range, robust, environmentally friendly operations; low-power, low-cost, lightweight systems suitable for low-payload platforms, such as micro-satellites; and passive applications using sources of opportunity transmitting UNCW.

Assessment of ureterovesical jet dynamics in obstructed ureter by urinary stone with color Doppler and duplex Doppler examinations.

PubMed

Jandaghi, Ali Babaei; Falahatkar, Siavash; Alizadeh, Ahmad; Kanafi, Alireza Rajabzadeh; Pourghorban, Ramin; Shekarchi, Babak; Zirak, Amin Keshavarz; Esmaeili, Samaneh

2013-04-01

This study was designed to evaluate ureterovesical jet dynamics in obstructed ureter and to compare it with those of contralateral unobstructed side. Forty-six patients with diagnosis of ureteral stone, based on imaging findings in computed tomography were enrolled in this study. The gray-scale ultrasound exam from both kidneys and urinary bladder was performed. Then, ureterovesical jet characteristics including ureteral jet frequency, duration and peak velocity were assessed by color Doppler and duplex Doppler studies in both obstructed and unobstructed ureters by a radiologist, 15-30 min after oral hydration with 750-1,000 mL of water. When compared with contralateral normal side, the ureterovesical jet in obstructed ureter showed less frequency (0.59 vs. 3.04 jets/min; P < 0.05), shorter duration (1.24 vs. 5.26 s; P < 0.05) and lower peak velocity (5.41 vs. 32.09 cm/s; P < 0.05). The cut-off points of 1.5 jets/min, 2.5 s and 19.5 cm/s for difference of ureteral jet frequency, duration and peak velocity between obstructed and contralateral normal ureters yielded sensitivities of 97.8, 95.6 and 100 % and specificities of 87, 87.9 and 97.8 %, respectively for diagnosis of ureteral obstruction. Given the safety of Doppler study and significant differences in flow dynamics of obstructed versus unobstructed ureters, our findings demonstrated the utility of Doppler ultrasound examination as a useful adjunct to gray-scale ultrasound by improving the accuracy of ultrasound exam in diagnosis of ureteral obstruction.

A visual demo of the Doppler effect

NASA Astrophysics Data System (ADS)

Papacosta, Pangratios

2010-09-01

Most physics teachers are familiar with the standard classroom demonstration of the Doppler effect. We invite students to explain the periodic variation of the pitch produced when we swirl a sounding buzzer over our heads. Students are quick to connect this phenomenon to everyday life experiences such as listening to the sound of the siren of a fast-approaching police car or the bell of an approaching train. In addition to these aural experiences, our understanding of the Doppler effect can be strengthened with a useful visual metaphor.

Spread-Spectrum Beamforming and Clutter Filtering for Plane-Wave Color Doppler Imaging.

PubMed

Mansour, Omar; Poepping, Tamie L; Lacefield, James C

2016-07-21

Plane-wave imaging is desirable for its ability to achieve high frame rates, allowing the capture of fast dynamic events and continuous Doppler data. In most implementations of plane-wave imaging, multiple low-resolution images from different plane wave tilt angles are compounded to form a single high-resolution image, thereby reducing the frame rate. Compounding improves the lateral beam profile in the high-resolution image, but it also acts as a low-pass filter in slow time that causes attenuation and aliasing of signals with high Doppler shifts. This paper introduces a spread-spectrum color Doppler imaging method that produces high-resolution images without the use of compounding, thereby eliminating the tradeoff between beam quality, maximum unaliased Doppler frequency, and frame rate. The method uses a long, random sequence of transmit angles rather than a linear sweep of plane wave directions. The random angle sequence randomizes the phase of off-focus (clutter) signals, thereby spreading the clutter power in the Doppler spectrum, while keeping the spectrum of the in-focus signal intact. The ensemble of randomly tilted low-resolution frames also acts as the Doppler ensemble, so it can be much longer than a conventional linear sweep, thereby improving beam formation while also making the slow-time Doppler sampling frequency equal to the pulse repetition frequency. Experiments performed using a carotid artery phantom with constant flow demonstrate that the spread-spectrum method more accurately measures the parabolic flow profile of the vessel and outperforms conventional plane-wave Doppler in both contrast resolution and estimation of high flow velocities. The spread-spectrum method is expected to be valuable for Doppler applications that require measurement of high velocities at high frame rates.

Real-time high-velocity resolution color Doppler OCT

NASA Astrophysics Data System (ADS)

Westphal, Volker; Yazdanfar, Siavash; Rollins, Andrew M.; Izatt, Joseph A.

2001-05-01

Color Doppler optical coherence tomography (CDOCT), also called Optical Doppler Tomography) is a noninvasive optical imaging technique, which allows for micron-scale physiological flow mapping simultaneous with morphological OCT imaging. Current systems for real-time endoscopic optical coherence tomography (EOCT) would be enhanced by the capability to visualize sub-surface blood flow for applications in early cancer diagnosis and the management of bleeding ulcers. Unfortunately, previous implementations of CDOCT have either been sufficiently computationally expensive (employing Fourier or Hilbert transform techniques) to rule out real-time imaging of flow, or have been restricted to imaging of excessively high flow velocities when used in real time. We have developed a novel Doppler OCT signal-processing strategy capable of imaging physiological flow rates in real time. This strategy employs cross-correlation processing of sequential A-scans in an EOCT image, as opposed to autocorrelation processing as described previously. To measure Doppler shifts in the kHz range using this technique, it was necessary to stabilize the EOCT interferometer center frequency, eliminate parasitic phase noise, and to construct a digital cross correlation unit able to correlate signals of megahertz bandwidth by a fixed lag of up to a few ms. The performance of the color Doppler OCT system was demonstrated in a flow phantom, demonstrating a minimum detectable flow velocity of ~0.8 mm/s at a data acquisition rate of 8 images/second (with 480 A-scans/image) using a handheld probe. Dynamic flow as well as using it freehanded was shown. Flow was also detectable in a phantom in combination with a clinical usable endoscopic probe.

Doppler Acoustic Vortex Sensing System

DOT National Transportation Integrated Search

1978-10-01

This is the final report on the Doppler Acoustic Vortex Sensing System, (DAVSS) program carried out by Avco Corporation's Systems Division for the U.S. Department of Transportation, Transportation Systems Center. The objective of the program was the ...

Three-dimensional laser cooling at the Doppler limit

NASA Astrophysics Data System (ADS)

Chang, R.; Hoendervanger, A. L.; Bouton, Q.; Fang, Y.; Klafka, T.; Audo, K.; Aspect, A.; Westbrook, C. I.; Clément, D.

2014-12-01

Many predictions of Doppler-cooling theory of two-level atoms have never been verified in a three-dimensional geometry, including the celebrated minimum achievable temperature ℏ Γ /2 kB , where Γ is the transition linewidth. Here we show that, despite their degenerate level structure, we can use helium-4 atoms to achieve a situation in which these predictions can be verified. We make measurements of atomic temperatures, magneto-optical trap sizes, and the sensitivity of optical molasses to a power imbalance in the laser beams, finding excellent agreement with Doppler theory. We show that the special properties of helium, particularly its small mass and narrow transition linewidth, prevent effective sub-Doppler cooling with red-detuned optical molasses. This discussion can be generalized to identify when a given species is likely to be subject to the same limitation.

[Contrast enhanced power Doppler and color Doppler ultrasound in breast masses: Efficiency in diagnosis and contributions to differential diagnosis].

PubMed

Algül, Ali; Balci, Pinar; Seçil, Mustafa; Canda, Tülay

2003-06-01

To compare ability of detection of vascular structures by utilizing ultrasonographic contrast agent (Levovist) prior to and following power Doppler ultrasound (PDUS) and colour Doppler ultrasound (CDUS) and to determine useful parameters in the differentiation of malignant and benign breast masses by means of verified data. Vascularisation characteristics of 38 breast masses (22 malignant, 16 benign) which were confirmed by mammography and B-mode sonography were evaluated by both CDUS and PDUS following and prior to intravenous contrast application. In addition, Vmax and RI values of vascular structures were calculated by Doppler spectral evaluation. Malignant lesions showed more vascularity than benign lesions both with and without contrast enhancement. With both methods, by utilizing contrast agent, central, penetrating and tortuous vascular structures became more significant in malignant lesions when compared with benign lesions. PDUS was able to detect vascular structures better than CDUS; however, the difference was not statistically significant. Presence of peripheral vascularity was not useful in differentiating malignant from benign lesions. Vmax and RI values were higher in malignant lesions and the difference was statistically significant. In both methods, Vmax > 15 cm/sec and RI > 0.80 (CDUS), and RI > 0.70 (PDUS) were accepted as malignancy parameters. Vascular patterns of breast masses as determined with PDUS and CDUS with contrast enhancement and Doppler spectral examinations enabled differentiation of malignant and benign breast lesions. Thus, it is possible to decrease the number of unnecessary surgical interventions.

Zero Autocorrelation Waveforms: A Doppler Statistic and Multifunction Problems

DTIC Science & Technology

2006-01-01

by ANSI Std Z39-18 It is natural to refer to A as the ambiguity function of u, since in the usual setting on the real line R, the analogue ambiguity...Doppler statistic |Cu,uek(j)| is excellent and provable for detecting deodorized Doppler frequency shift [11] (see Fig. 2). Also, if one graphs only

Analysing Simple Motions Using the Doppler Effect--"Seeing" Sound

ERIC Educational Resources Information Center

Stonawski, Tamás; Gálik, Tamás

2017-01-01

The Doppler effect has seen widespread use in the past hundred years. It is used for medical imaging, for measuring speed, temperature, direction, etc, and it makes the spatial relations of motion easy to map. The Doppler effect also allows GPS receivers to measure the speed of a vehicle significantly more accurately than dashboard speedometers.…

Apparatus and method for noninvasive particle detection using doppler spectroscopy

DOEpatents

Sinha, Dipen N.

2016-05-31

An apparatus and method for noninvasively detecting the presence of solid particulate matter suspended in a fluid flowing through a pipe or an oil and gas wellbore are described. Fluid flowing through a conduit containing the particulate solids is exposed to a fixed frequency (>1 MHz) of ultrasonic vibrations from a transducer attached to the outside of the pipe. The returning Doppler frequency shifted signal derived from the scattering of sound from the moving solid particles is detected by an adjacent transducer. The transmitted signal and the Doppler signal are combined to provide sensitive particulate detection. The magnitude of the signal and the Doppler frequency shift are used to determine the particle size distribution and the velocity of the particles. Measurement of the phase shift between the applied frequency and the detected Doppler shifted may be used to determine the direction of motion of the particles.

Guided wave and damage detection in composite laminates using different fiber optic sensors.

PubMed

Li, Fucai; Murayama, Hideaki; Kageyama, Kazuro; Shirai, Takehiro

2009-01-01

Guided wave detection using different fiber optic sensors and their applications in damage detection for composite laminates were systematically investigated and compared in this paper. Two types of fiber optic sensors, namely fiber Bragg gratings (FBG) and Doppler effect-based fiber optic (FOD) sensors, were addressed and guided wave detection systems were constructed for both types. Guided waves generated by a piezoelectric transducer were propagated through a quasi-isotropic carbon fiber reinforced plastic (CFRP) laminate and acquired by these fiber optic sensors. Characteristics of these fiber optic sensors in ultrasonic guided wave detection were systematically compared. Results demonstrated that both the FBG and FOD sensors can be applied in guided wave and damage detection for the CFRP laminates. The signal-to-noise ratio (SNR) of guided wave signal captured by an FOD sensor is relatively high in comparison with that of the FBG sensor because of their different physical principles in ultrasonic detection. Further, the FOD sensor is sensitive to the damage-induced fundamental shear horizontal (SH(0)) guided wave that, however, cannot be detected by using the FBG sensor, because the FOD sensor is omnidirectional in ultrasound detection and, in contrast, the FBG sensor is severely direction dependent.

Doppler ultrasound of the central retinal artery in microgravity.

PubMed

Sirek, Adam S; Garcia, Kathleen; Foy, Millennia; Ebert, Doug; Sargsyan, Ashot; Wu, Jimmy H; Dulchavsky, Scott A

2014-01-01

Ocular changes have been noted during long-duration spaceflight; we studied central retinal artery (CRA) blood flow using Doppler before, during, and after long-term microgravity exposure in astronauts compared with data from a control group of nonastronauts subjected to head-down tilt (HDT). Available Doppler spectra of International Space Station (ISS) crewmembers were obtained from the NASA Lifetime Surveillance of Astronaut Health database, along with 2D ultrasound-derived measurements of the optic nerve sheath diameter (ONSD). CRA Doppler spectra and optic nerve sheath images were also obtained from healthy test subjects in an acute HDT experiment at 20 min of exposure (the ground-based analogue). HDT CRA peak systolic velocity in the ground-based analogue group increased by an average of 3 cm -s(-1) (33%) relative to seated values. ONSD at 300 of HDT increased by 0.5 mm relative to supine values. CRA Doppler spectra obtained on orbit were of excellent quality and demonstrated in-flight changes of +5 cm x s(-1) (50%) compared to preflight. ONSD increased in ISS crewmembers during flight relative to before flight, with some reversal postflight. A significant ONSD response to acute postural change and to spaceflight was demonstrated in this preliminary study. Increases in Doppler peak flow velocities correlated with increases in ONSD. Further investigations are warranted to corroborate the relationship between ONSD, intracranial pressure, and central retinal blood flow for occupational surveillance and research purposes.

A new Doppler-echo method to quantify regurgitant volume.

PubMed

Wang, S S; Rubenstein, J J; Goldman, M; Sidd, J J

1992-01-01

An in vitro technique using color flow imaging and continuous wave Doppler was developed to measure the initial regurgitant flow jet diameter and velocity integral to yield the parameters for a volume calculation. Jets were produced by volume-controlled injection through tubes of various diameters (1.3, 1.9, 2.8, and 3.5 mm) to deliver volumes from 1 to 7 ml over 100 to 300 msec at pressures from 40 to 200 mm Hg. One hundred forty-five samples were obtained. Flow jet diameter consistently overestimated tube diameter by 2 mm when injected volume was 1.5 to 7 ml and by 1.5 mm when injected volume was less than 1.5 ml. This offset was stable with various transducers (2.5, 3.5, 5.0 MHz) at normal gain setting (just under noise). Therefore, corrected flow jet diameter (FJD) = FJD - 2 mm, and Doppler volume = corrected flow jet area x velocity integral. A range of injectates from 1.1 to 7 ml generated Doppler volume of 1.0 to 8.2 ml. The relation between Doppler volume (DV) and injected volume (IV) was DV = 1.079 IV - 0.22, r2 = 0.945, p less than 0.01. This relation was not altered by tube diameter. Thus a method combining color flow imaging and continuous wave Doppler provides a reliable and accurate measure of in vitro flow volume.

Doppler velocity measurements from large and small arteries of mice

PubMed Central

Reddy, Anilkumar K.; Madala, Sridhar; Entman, Mark L.; Michael, Lloyd H.; Taffet, George E.

2011-01-01

With the growth of genetic engineering, mice have become increasingly common as models of human diseases, and this has stimulated the development of techniques to assess the murine cardiovascular system. Our group has developed nonimaging and dedicated Doppler techniques for measuring blood velocity in the large and small peripheral arteries of anesthetized mice. We translated technology originally designed for human vessels for use in smaller mouse vessels at higher heart rates by using higher ultrasonic frequencies, smaller transducers, and higher-speed signal processing. With these methods one can measure cardiac filling and ejection velocities, velocity pulse arrival times for determining pulse wave velocity, peripheral blood velocity and vessel wall motion waveforms, jet velocities for the calculation of the pressure drop across stenoses, and left main coronary velocity for the estimation of coronary flow reserve. These noninvasive methods are convenient and easy to apply, but care must be taken in interpreting measurements due to Doppler sample volume size and angle of incidence. Doppler methods have been used to characterize and evaluate numerous cardiovascular phenotypes in mice and have been particularly useful in evaluating the cardiac and vascular remodeling that occur following transverse aortic constriction. Although duplex ultrasonic echo-Doppler instruments are being applied to mice, dedicated Doppler systems are more suitable for some applications. The magnitudes and waveforms of blood velocities from both cardiac and peripheral sites are similar in mice and humans, such that much of what is learned using Doppler technology in mice may be translated back to humans. PMID:21572013

Acute Effects of Lateral Thigh Foam Rolling on Arterial Tissue Perfusion Determined by Spectral Doppler and Power Doppler Ultrasound.

PubMed

Hotfiel, Thilo; Swoboda, Bernd; Krinner, Sebastian; Grim, Casper; Engelhardt, Martin; Uder, Michael; Heiss, Rafael U

2017-04-01

Hotfiel, T, Swoboda, B, Krinner, S, Grim, C, Engelhardt, M, Uder, M, and Heiss, R. Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral Doppler and power Doppler ultrasound. J Strength Cond Res 31(4): 893-900, 2017-Foam rolling has been developed as a popular intervention in training and rehabilitation. However, evidence on its effects on the cellular and physiological level is lacking. The aim of this study was to assess the effect of foam rolling on arterial blood flow of the lateral thigh. Twenty-one healthy participants (age, 25 ± 2 years; height, 177 ± 9 cm; body weight, 74 ± 9 kg) were recruited from the medical and sports faculty. Arterial tissue perfusion was determined by spectral Doppler and power Doppler ultrasound, represented as peak flow (Vmax), time average velocity maximum (TAMx), time average velocity mean (TAMn), and resistive index (RI), and with semiquantitative grading that was assessed by 4 blindfolded investigators. Measurement values were assessed under resting conditions and twice after foam rolling exercises of the lateral thigh (0 and 30 minutes after intervention). The trochanteric region, mid portion, and distal tibial insertion of the lateral thigh were representative for data analysis. Arterial blood flow of the lateral thigh increased significantly after foam rolling exercises compared with baseline (p ≤ 0.05). We detected a relative increase in Vmax of 73.6% (0 minutes) and 52.7% (30 minutes) (p < 0.001), in TAMx of 53.2% (p < 0.001) and 38.3% (p = 0.002), and in TAMn of 84.4% (p < 0.001) and 68.2% (p < 0.001). Semiquantitative power Doppler scores at all portions revealed increased average grading of 1.96 after intervention and 2.04 after 30 minutes compared with 0.75 at baseline. Our results may contribute to the understanding of local physiological reactions to self-myofascial release.

Topical Allium ampeloprasum subsp Iranicum (Leek) extract cream in patients with symptomatic hemorrhoids: a pilot randomized and controlled clinical trial.

PubMed

Mosavat, Seyed Hamdollah; Ghahramani, Leila; Sobhani, Zahra; Haghighi, Ehsan Rahmanian; Heydari, Mojtaba

2015-04-01

Allium ampeloprasum subsp iranicum (Leek) has been traditionally used in antihemorrhoidal topical herbal formulations. This study aimed to evaluate its safety and efficacy in a pilot randomized controlled clinical trial. Twenty patients with symptomatic hemorrhoids were randomly allocated to receive the topical leek extract cream or standard antihemorrhoid cream for 3 weeks. The patients were evaluated before and after the intervention in terms of pain, defecation discomfort, bleeding severity, anal itching severity, and reported adverse events. A significant decrease was observed in the grade of bleeding severity and defecation discomfort in both the leek and antihemorrhoid cream groups after the intervention, while no significant change was observed in pain scores. There was no significant difference between the leek and antihemorrhoid cream groups with regard to mean changes in outcome measures. This pilot study showed that the topical use of leek cream can be as effective as a standard antihemorrhoid cream. © The Author(s) 2015.

[Color Doppler ultrasonography--a new imaging procedure in maxillofacial surgery].

PubMed

Reinert, S; Lentrodt, J

1991-01-01

Colour Doppler ultrasonography shows blood flow in real time and colour by combining the features of real time B mode ultrasound and Doppler. At each point in the image the returning signal is interrogated for both amplitude and frequency information. The resulting image shows all non-moving structures in shades of gray and moving structures in shades of red or blue depending on direction and velocity. The technique of colour Doppler ultrasonography and our experiences in 63 examinations are described. The clinical application of this new simple non-invasive method in maxillo-facial surgery is discussed.

The Doppler Pendulum Experiment

ERIC Educational Resources Information Center

Lee, C. K.; Wong, H. K.

2011-01-01

An experiment to verify the Doppler effect of sound waves is described. An ultrasonic source is mounted at the end of a simple pendulum. As the pendulum swings, the rapid change of frequency can be recorded by a stationary receiver using a simple frequency-to-voltage converter. The experimental results are in close agreement with the Doppler…

Analysis of Doppler Lidar Data Acquired During the Pentagon Shield Field Campaign

DTIC Science & Technology

2011-04-01

two coherent Doppler lidars deployed during the Pentagon Shield field campaign are analyzed in conjunction with other sensors to characterize the...Observations from two coherent Doppler lidars deployed during the Pentagon Shield field campaign are analyzed in conjunction with other sensors to... coherent Doppler lidars deployed during the Pentagon Shield field campaign are analyzed in conjunction with other sensors to characterize the overall

Separation of Doppler radar-based respiratory signatures.

PubMed

Lee, Yee Siong; Pathirana, Pubudu N; Evans, Robin J; Steinfort, Christopher L

2016-08-01

Respiration detection using microwave Doppler radar has attracted significant interest primarily due to its unobtrusive form of measurement. With less preparation in comparison with attaching physical sensors on the body or wearing special clothing, Doppler radar for respiration detection and monitoring is particularly useful for long-term monitoring applications such as sleep studies (i.e. sleep apnoea, SIDS). However, motion artefacts and interference from multiple sources limit the widespread use and the scope of potential applications of this technique. Utilising the recent advances in independent component analysis (ICA) and multiple antenna configuration schemes, this work investigates the feasibility of decomposing respiratory signatures into each subject from the Doppler-based measurements. Experimental results demonstrated that FastICA is capable of separating two distinct respiratory signatures from two subjects adjacent to each other even in the presence of apnoea. In each test scenario, the separated respiratory patterns correlate closely to the reference respiration strap readings. The effectiveness of FastICA in dealing with the mixed Doppler radar respiration signals confirms its applicability in healthcare applications, especially in long-term home-based monitoring as it usually involves at least two people in the same environment (i.e. two people sleeping next to each other). Further, the use of FastICA to separate involuntary movements such as the arm swing from the respiratory signatures of a single subject was explored in a multiple antenna environment. The separated respiratory signal indeed demonstrated a high correlation with the measurements made by a respiratory strap used currently in clinical settings.

Stapled hemorrhoidopexy, an innovative surgical procedure for hemorrhoidal prolapse: cost-utility analysis.

PubMed

Ribarić, Goran; Kofler, Justus; Jayne, David G

2011-08-15

To undertake full economic evaluation of stapled hemorrhoidopexy (PPH) to establish its cost-effectiveness and investigate whether PPH can become cost-saving compared to conventional excisional hemorrhoidectomy (CH). A cost-utility analysis in hospital and health care system (UK) was undertaken using a probabilistic, cohort-based decision tree to compare the use of PPH with CH. Sensitivity analyses allowed showing outcomes in regard to the variations in clinical practice of PPH procedure. The participants were patients undergoing initial surgical treatment of third and fourth degree hemorrhoids within a 1-year time-horizon. Data on clinical effectiveness were obtained from a systematic review of the literature. Main outcome measures were the cost per procedure at the hospital level, total direct costs from the health care system perspective, quality adjusted life years (QALY) gained and incremental cost per QALY gained. A decrease in operating theater time and hospital stay associated with PPH led to a cost saving compared to CH of GBP 27 (US $43.11, €30.50) per procedure at the hospital level and to an incremental cost of GBP 33 (US $52.68, €37.29) after one year from the societal perspective. Calculation of QALYs induced an incremental QALY of 0.0076 and showed an incremental cost-effective ratio (ICER) of GBP 4316 (US $6890.47, €4878.37). Taking into consideration recent literature on clinical outcomes, PPH becomes cost saving compared to CH for the health care system. PPH is a cost-effective procedure with an ICER of GBP 4136 and it seems that an innovative surgical procedure could be cost saving in routine clinical practice.

Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction.

PubMed

Pedroso, Marianna Amaral; Palmer, Kirsten Rebecca; Hodges, Ryan James; Costa, Fabricio da Silva; Rolnik, Daniel Lorber

2018-05-01

 To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials.  A search of the literature was conducted using Medline, PubMed, MeSH and ScienceDirect. Combinations of the search terms "preeclampsia," "screening," "prediction," "Doppler," "Doppler velocimetry," "fetal growth restriction," "small for gestational age" and "uterine artery" were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included.  Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ∼ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants.  The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

[Per partum acidosis: Interest and feasibility of cerebral Doppler during labor].

PubMed

Barrois, M; Chartier, M; Lecarpentier, E; Goffinet, F; Tsatsaris, V

2016-09-01

To evaluate feasibility and interest of fetal cerebral Doppler during labor and the link with fetal pH to predict perinatal fetal asphyxia. Our prospective study in a university perinatal center, included patients during labor. There were no risk factors during pregnancy and patients were included after 37 weeks of pregnancy. For each patient an ultrasound with cerebral Doppler was done concomitant to a fetal scalp blood sample. We collected maternal and fetal characteristics as well as cervix dilatation, fetal heart rate analysis and fetal presentation. Among 49 patients included over a period of 4 months, cerebral Doppler failed in 7 cases (11%). Majority of failure occurred at 10cm of dilatation (P=0.007, OR=14.1 [1.483; 709.1275]). Others factors like: maternal age, body mass index, parity, history of C-Section were not associated with higher rate of failure. We did not found either significant correlation between cerebral fetal Doppler and pH on fetal scalp blood sample (r=0.15) nor pH at cord blood sample (r=0.13). No threshold of cerebral Doppler is significant for fetal asphyxia prediction. Fetal cerebral Doppler is feasible during labor with a low rate of failure but not a good exam to predict fetal acidosis and asphyxia. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Fixed Delay Interferometry for Doppler Extrasolar Planet Detection

NASA Astrophysics Data System (ADS)

Ge, Jian

2002-06-01

We present a new technique based on fixed delay interferometry for high-throughput, high-precision, and multiobject Doppler radial velocity (RV) surveys for extrasolar planets. The Doppler measurements are conducted by monitoring the stellar fringe phase shifts of the interferometer instead of absorption-line centroid shifts as in state-of-the-art echelle spectroscopy. High Doppler sensitivity is achieved through optimizing the optical delay in the interferometer and reducing photon noise by measuring multiple fringes over a broad band. This broadband operation is performed by coupling the interferometer with a low- to medium-resolution postdisperser. The resulting fringing spectra over the bandpass are recorded on a two-dimensional detector, with fringes sampled in the slit spatial direction and the spectrum sampled in the dispersion direction. The resulting total Doppler sensitivity is, in theory, independent of the dispersing power of the postdisperser, which allows for the development of new-generation RV machines with much reduced size, high stability, and low cost compared to echelles. This technique has the potential to improve RV survey efficiency by 2-3 orders of magnitude over the cross-dispersed echelle spectroscopy approach, which would allow a full-sky RV survey of hundreds of thousands of stars for planets, brown dwarfs, and stellar companions once the instrument is operated as a multiobject instrument and is optimized for high throughput. The simple interferometer response potentially allows this technique to be operated at other wavelengths independent of popular iodine reference sources, being actively used in most of the current echelles for Doppler planet searches, to search for planets around early-type stars, white dwarfs, and M, L, and T dwarfs for the first time. The high throughput of this instrument could also allow investigation of extragalactic objects for RV variations at high precision.

Power M-mode Doppler (PMD) for observing cerebral blood flow and tracking emboli.

PubMed

Moehring, Mark A; Spencer, Merrill P

2002-01-01

Difficulties in location of transcranial ultrasound (US) windows and blood flow in cerebral vessels, and unambiguous detection of microemboli, have limited expansion of transcranial Doppler US. We developed a new transcranial Doppler modality, power M-mode Doppler (PMD), for addressing these issues. A 2-MHz digital Doppler (Spencer Technologies TCD100M) having 33 sample gates placed with 2-mm spacing was configured to display Doppler signal power, colored red and blue for directionality, in an M-mode format. The spectrogram from a user-selected depth was displayed simultaneously. This system was then explored on healthy subjects and patients presenting with varying cerebrovascular pathology. PMD facilitated window location and alignment of the US beam to view blood flow from multiple vessels simultaneously, without sound or spectral clues. Microemboli appeared as characteristic sloping high-power tracks in the PMD image. Power M-mode Doppler is a new paradigm facilitating vessel location, diagnosis, monitoring and microembolus detection.

One way Doppler Extractor. Volume 2: Digital VCO technique

NASA Technical Reports Server (NTRS)

Nossen, E. J.; Starner, E. R.

1974-01-01

A feasibility analysis and trade-offs for a one-way Doppler extractor using digital VCO techniques is presented. The method of Doppler measurement involves the use of a digital phase lock loop; once this loop is locked to the incoming signal, the precise frequency and hence the Doppler component can be determined directly from the contents of the digital control register. The only serious error source is due to internally generated noise. Techniques are presented for minimizing this error source and achieving an accuracy of 0.01 Hz in a one second averaging period. A number of digitally controlled oscillators were analyzed from a performance and complexity point of view. The most promising technique uses an arithmetic synthesizer as a digital waveform generator.

Comparison of transrectal photoacoustic, Doppler, and magnetic resonance imaging for prostate cancer detection

NASA Astrophysics Data System (ADS)

Ishihara, Miya; Horiguchi, Akio; Shinmoto, Hiroshi; Tsuda, Hitoshi; Irisawa, Kaku; Wada, Takatsugu; Asano, Tomohiko

2016-03-01

Transrectal ultrasonography (TRUS) is the most popular imaging modality for diagnosing and treating prostate cancer. TRUS-guided prostate biopsy is mandatory for the histological diagnosis of patients with elevated serum prostatespecific antigen (PSA), but its diagnostic accuracy is not satisfactory due to TRUS's low resolution. As a result, a considerable number of patients are required to undergo an unnecessary repeated biopsy. Photoacoustic imaging (PAI) can be used to provide microvascular network imaging using hemoglobin as an intrinsic, optical absorption molecule. We developed an original TRUS-type PAI probe consisting of a micro-convex array transducer with an optical illumination system to provide superimposed PAI and ultrasound images. TRUS-type PAI has the advantage of having much higher resolution and greater contrast than does Doppler TRUS. The purpose of this study was to demonstrate the clinical feasibility of the transrectal PAI system. We performed a clinical trial to compare the image of the cancerous area obtained by transrectal PAI with that obtained by TRUS Doppler during prostate biopsy. The obtained prostate biopsy cores were stained with anti-CD34 antibodies to provide a microvascular distribution map. We also confirmed its consistency with PAI and pre-biopsy MRI findings. Our study demonstrated that transrectal identification of tumor angiogenesis under superimposed photoacoustic and ultrasound images was easier than that under TRUS alone. We recognized a consistent relationship between PAI and MRI findings in most cases. However, there were no correspondences in some cases.

The Martian rotation from Doppler measurements: Simulations of future radioscience experiments

NASA Astrophysics Data System (ADS)

Péters, Marie-Julie; Yseboodt, Marie; Dehant, Véronique; Le Maistre, Sebastien; Marty, Jean-Charles

2016-10-01

The radioscience experiment onboard the future InSight and ExoMars missions consists in two-way Doppler shift measurement from a X-band radio link between a lander on Mars and the ground stations on Earth. The Doppler effect on the radio signal is related to the revolution of the planets around the Sun and to the variations of the orientation and the rotation of Mars. The variations of the orientation of the rotation axis are the precession and nutations, related to the deep interior of Mars and the variations of the rotation rate are the length-of-day variation, related to the dynamic of the atmosphere.We perform numerical simulations of the Doppler measurements in order to quantify the precision that can be achieved on the determination of the Mars rotation and orientation parameters (MOP). For this purpose, we use the GINS (Géodésie par Intégrations Numériques Simultanées) software developed by the CNES and further adapted at the Royal Observatory of Belgium for planetary geodesy applications. This software enables to simulate the relative motion of the lander at the surface of Mars relative to the ground stations and to compute the MOP signature on the Doppler shift. The signature is the difference between the Doppler observable estimated taking into account a MOP and the Doppler estimated without this parameter.The objective is to build a strategy to be applied to future data processing in order to improve our estimation of the MOP. We study the effect of the elevation of the Earth in the sky of the lander, of the tracking duration and number of pass per week, of the tracking time, of the lander position and of Doppler geometry on the signatures. Indeed, due to the geometry, the Doppler data are highly sensitive to the position variations along the line of sight.

Doppler echocardiographic evaluation of midventricular obstruction in cats with hypertrophic cardiomyopathy.

PubMed

MacLea, H B; Boon, J A; Bright, J M

2013-01-01

Hypertrophic cardiomyopathy (HCM) is heterogeneous in both people and cats, with variability in the distribution of hypertrophy, hemodynamic characteristics, and Doppler echocardiographic findings. To document the Doppler echocardiographic characteristics of midventricular obstruction in some cats with HCM. Eight cats with hypertrophic cardiomyopathy. Retrospective case series. The medical records of cats presenting to the cardiology service at Colorado State University between February 2009 and January 2012 were reviewed. All cats had a physical examination; Doppler systolic blood pressure measurement; and transthoracic two-dimensional (2D), M-mode, and Doppler echocardiography were performed. A more thorough evaluation of the echocardiographic images and measurements was performed. Cats included in this study had echocardiograms of adequate quality to confirm the diagnosis of midventricular obstruction by documentation of left midventricular concentric hypertrophy; a midventricular turbulent Doppler color flow pattern; and high velocity, late-peaking flow at the area of turbulence. Cats with evidence of systemic hypertension defined as a systolic Doppler blood pressure of greater than 170 mmHg were excluded. All 8 cats had left ventricular hypertrophy at the level of the papillary muscles; left, midventricular hypertrophy; and in 4/8 cats there was apical hypertrophy or basilar hypertrophy of the interventricular septum. Color flow Doppler revealed turbulent flow in 8/8 cats and spectral Doppler (continuous and pulsed wave) revealed increased flow velocities and late-peaking flow profiles at the level of the left midventricle. Two of 8 cats had a bifid midventricular flow profile in which there was a midsystolic decline in left ventricular velocities with elevated velocities extending into early diastole. The peak left ventricular outflow velocity in all 8 cats was normal. A variant of HCM characterized by hypertrophy at the level of the papillary muscles with

Wave Field Characterization Using Dual-Polarized Pulse-Doppler X-Band Radar

DTIC Science & Technology

2012-06-01

spectrum (frequencies higher than that associated with the wind wave peak) are similar for the buoy and Doppler, and likewise for the ultrasound array and...values of the RCS and ultrasound array relative to the buoy and Doppler are due to the formers’ larger energy levels at high frequencies. NSWCCD-50-TR...pp. 199- 203, 2008. [II] W. J. Plant, W. C. Keller, A. B. Reeves, E. A. Uliana, and J. W. Johnson, " Airborne microwave Doppler measurements of

Clutter attenuation using the Doppler effect in standoff electromagnetic quantum sensing

NASA Astrophysics Data System (ADS)

Lanzagorta, Marco; Jitrik, Oliverio; Uhlmann, Jeffrey; Venegas, Salvador

2016-05-01

In the context of traditional radar systems, the Doppler effect is crucial to detect and track moving targets in the presence of clutter. In the quantum radar context, however, most theoretical performance analyses to date have assumed static targets. In this paper we consider the Doppler effect at the single photon level. In particular, we describe how the Doppler effect produced by clutter and moving targets modifies the quantum distinguishability and the quantum radar error detection probability equations. Furthermore, we show that Doppler-based delayline cancelers can reduce the effects of clutter in the context of quantum radar, but only in the low-brightness regime. Thus, quantum radar may prove to be an important technology if the electronic battlefield requires stealthy tracking and detection of moving targets in the presence of clutter.

Laser Doppler vibrometry for assessment of arteriosclerosis: A first step towards validation

NASA Astrophysics Data System (ADS)

Campo, Adriaan; Dirckx, Joris

2014-05-01

It has been shown that in cardiovascular risk management, stiffness of large arteries has a very good predictive value for cardiovascular disease and mortality. This parameter can be estimated from the pulse wave velocity (PWV) measured between the common carotid artery (CCA) in the neck and femoral artery (FA) in the groin. However PWV can also be measured locally in the CCA, using non-invasive methods such as ultrasound (US) or laser Doppler vibrometry (LDV). Potential of the latter approach was already explored in previous research, and in this work a first step towards clinical validation is made. 50 hypertension II/III patients aged between 30 and 65 participate in the study. Patients were asked to remain sober for 4 hours prior to the measurements. The trajectory of the CCA in the neck was determined by a trained clinician guided by an US probe. 3 laser Doppler vibrometer (LDV) systems were aimed along the CCA. PWV was then calculated from the distance between beams and the time-shift between waveforms. Immediately after LDV measurements, PWV was measured with US. Additionally, carotid-femoral PWV was measured. As a validation, PWV results of the different techniques were compared with each other, and with medical background of the test subjects. Since data acquisition is still ongoing, data from only 20 patients will be discussed. No trends between measurement methods for PWV are apparent. However, a positive trend was detected between PWV as measured with LDV and blood pressure. More data, including additional experiments will be needed to verify this observation.

Laser Doppler vibrometry for assessment of arteriosclerosis: A first step towards validation

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

Campo, Adriaan; Dirckx, Joris

2014-05-27

It has been shown that in cardiovascular risk management, stiffness of large arteries has a very good predictive value for cardiovascular disease and mortality. This parameter can be estimated from the pulse wave velocity (PWV) measured between the common carotid artery (CCA) in the neck and femoral artery (FA) in the groin. However PWV can also be measured locally in the CCA, using non-invasive methods such as ultrasound (US) or laser Doppler vibrometry (LDV). Potential of the latter approach was already explored in previous research, and in this work a first step towards clinical validation is made. 50 hypertension II/IIImore » patients aged between 30 and 65 participate in the study. Patients were asked to remain sober for 4 hours prior to the measurements. The trajectory of the CCA in the neck was determined by a trained clinician guided by an US probe. 3 laser Doppler vibrometer (LDV) systems were aimed along the CCA. PWV was then calculated from the distance between beams and the time-shift between waveforms. Immediately after LDV measurements, PWV was measured with US. Additionally, carotid-femoral PWV was measured. As a validation, PWV results of the different techniques were compared with each other, and with medical background of the test subjects. Since data acquisition is still ongoing, data from only 20 patients will be discussed. No trends between measurement methods for PWV are apparent. However, a positive trend was detected between PWV as measured with LDV and blood pressure. More data, including additional experiments will be needed to verify this observation.« less

Clinical diagnosis by transcutaneous Doppler ultrasound

PubMed Central

Wyse, R. K. H.

1982-01-01

Transcutaneous Doppler ultrasound represents a convenient, reliable technique for the non-invasive diagnosis and assessment of a rapidly increasing number of diverse circulatory disorders. ImagesFig. 2Fig. 3 PMID:7050948

Chronic musculoskeletal pain: ultrasound guided pain control.

PubMed

Chiou, Hong-Jen; Chou, Yi-Hong; Wang, Hsin-Kai; Lai, Yi-Chen

2014-09-01

The review demonstrates the unique advantages of ultrasonography in pain control. Several imaging modalities can be used to guide pain control, such as computed tomography, magnetic resonance imaging, and radiography. Ultrasonography has unique advantages over these other modalities in terms of its non-ionizing radiation, real-time imaging, portability, and cost-effectiveness. Ultrasonography with color Doppler and elastography can provide safer guidance to avoid blood vessels and the nerve trunk when using steroid or xylocaine infusions to encase the nerve trunk. This review focuses on the control of chronic pain in the upper limbs, lower limbs, and trunk. Copyright © 2014. Published by Elsevier B.V.

Integrated system for production of neutronics and photonics calculational constants. Program SIGMA1 (Version 77-1): Doppler broaden evaluated cross sections in the Evaluated Nuclear Data File/Version B (ENDF/B) format

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

Cullen, D.E.

1977-01-12

A code, SIGMA1, has been designed to Doppler broaden evaluated cross sections in the ENDF/B format. The code can only be applied to tabulated data that vary linearly in energy and cross section between tabulated points. This report describes the methods used in the code and serves as a user's guide to the code.

[Doppler echocardiography of tricuspid insufficiency. Methods of quantification].

PubMed

Loubeyre, C; Tribouilloy, C; Adam, M C; Mirode, A; Trojette, F; Lesbre, J P

1994-01-01

Evaluation of tricuspid incompetence has benefitted considerably from the development of Doppler ultrasound. In addition to direct analysis of the valves, which provides information about the mechanism involved, this method is able to provide an accurate evaluation, mainly through use of the Doppler mode. In addition to new criteria being evaluated (mainly the convergence zone of the regurgitant jet), some indices are recognised as good quantitative parameters: extension of the regurgitant jet into the right atrium, anterograde tricuspid flow, laminar nature of the regurgitant flow, analysis of the flow in the supra-hepatic veins, this is only semi-quantitative, since the calculation of the regurgitation fraction from the pulsed Doppler does not seem to be reliable; This accurate semi-quantitative evaluation is made possible by careful and consistent use of all the criteria available. The authors set out to discuss the value of the various evaluation criteria mentioned in the literature and try to define a practical approach.

A Doppler centroid estimation algorithm for SAR systems optimized for the quasi-homogeneous source

NASA Technical Reports Server (NTRS)

Jin, Michael Y.

1989-01-01

Radar signal processing applications frequently require an estimate of the Doppler centroid of a received signal. The Doppler centroid estimate is required for synthetic aperture radar (SAR) processing. It is also required for some applications involving target motion estimation and antenna pointing direction estimation. In some cases, the Doppler centroid can be accurately estimated based on available information regarding the terrain topography, the relative motion between the sensor and the terrain, and the antenna pointing direction. Often, the accuracy of the Doppler centroid estimate can be improved by analyzing the characteristics of the received SAR signal. This kind of signal processing is also referred to as clutterlock processing. A Doppler centroid estimation (DCE) algorithm is described which contains a linear estimator optimized for the type of terrain surface that can be modeled by a quasi-homogeneous source (QHS). Information on the following topics is presented: (1) an introduction to the theory of Doppler centroid estimation; (2) analysis of the performance characteristics of previously reported DCE algorithms; (3) comparison of these analysis results with experimental results; (4) a description and performance analysis of a Doppler centroid estimator which is optimized for a QHS; and (5) comparison of the performance of the optimal QHS Doppler centroid estimator with that of previously reported methods.

Diagnostic Accuracy of B-mode USG and Doppler Scan for Ovarian Lesions

PubMed Central

Agarwal, Vinish Kumar

2016-01-01

Introduction Ultrasonography (USG) is considered as the primary imaging modality for confirmation of ovarian mass and to differentiate them in to benign or malignant. Aim The present study was conducted with the aim to evaluate accuracy of B- mode USG and Doppler scan (Colour Doppler + Spectral Doppler) for ovarian lesions. Materials and Methods The patients included in the study were from those referred with either palpable adnexal mass or incidentally detected adnexal masses. Total 250 women were evaluated by USG, Doppler scan. Only fifty patients who had true ovarian mass intraoperatively and on histopathology were included in study, rest masses were excluded. Study parameters were morphological indexing on B- Mode USG, flow study, vessel arrangement, and vessel morphology and vessel location in Colour Doppler and resistive index and pulsatility index in spectral Doppler. Results Total 50 women were included in present study. Out of these 46% were pre-menopausal while 54% were menopaused women, 66.7% of post-menopausal women had malignant ovarian masses compared to 8.7% of premenopausal. Sensitivity, specificity, positive predictive value and negative predictive value of B-Mode USG for ovarian masses were 94.44%, 48.15%, 54.84% and 92.86% respectively, with p-value = 0.007, while sensitivity, specificity, positive predictive value and negative predictive value of Doppler scan were 85%, 90%, 85% and 90% respectively, with p-value = 0.0001. Conclusion USG and its different techniques are accepted as the primary imaging modality for early stage diagnosis of an ovarian malignancy. Statistical analysis suggests that Doppler Scan (Colour + Spectral) was more accurate (88%) than B-Mode USG (67%), but author is in view that both of these modalities should be used in conjunction to screen the ovarian lesions. PMID:27790544

Imaging nanoparticle flow using magneto-motive optical Doppler tomography.

PubMed

Kim, Jeehyun; Oh, Junghwan; Milner, Thomas E; Nelson, J Stuart

2007-01-24

We introduce a novel approach for imaging solutions of superparamagnetic iron oxide (SPIO) nanoparticles using magneto-motive optical Doppler tomography (MM-ODT). MM-ODT combines an externally applied temporally oscillating high-strength magnetic field with ODT to detect nanoparticles flowing through a microfluidic channel. A solenoid with a cone-shaped ferrite core extensively increased the magnetic field strength (B(max) = 1 T, [Formula: see text]) at the tip of the core and also focused the magnetic field in microfluidic channels containing nanoparticle solutions. Nanoparticle contrast was demonstrated in a microfluidic channel filled with an SPIO solution by imaging the Doppler frequency shift which was observed independently of the nanoparticle flow rate and direction. Results suggest that MM-ODT may be applied to image Doppler shift of SPIO nanoparticles in microfluidic flows with high contrast.

Application of non-coherent Doppler data types for deep space navigation

NASA Technical Reports Server (NTRS)

Bhaskaran, Shyam

1995-01-01

Recent improvements in computational capability and Deep Space Network technology have renewed interest in examining the possibility of using one-way Doppler data alone to navigate interplanetary spacecraft. The one-way data can be formulated as the standard differenced-count Doppler or as phase measurements, and the data can be received at a single station or differenced if obtained simultaneously at two stations. A covariance analysis is performed which analyzes the accuracy obtainable by combinations of one-way Doppler data and compared with similar results using standard two-way Doppler and range. The sample interplanetary trajectory used was that of the Mars Pathfinder mission to Mars. It is shown that differenced one-way data is capable of determining the angular position of the spacecraft to fairly high accuracy, but has relatively poor sensitivity to the range. When combined with single station data, the position dispersions are roughly an order of magnitude larger in range and comparable in angular position as compared to dispersions obtained with standard data two-way types. It was also found that the phase formulation is less sensitive to data weight variations and data coverage than the differenced-count Doppler formulation.

The application of noncoherent Doppler data types for Deep Space Navigation

NASA Technical Reports Server (NTRS)

Bhaskaran, S.

1995-01-01

Recent improvements in computational capability and DSN technology have renewed interest in examining the possibility of using one-way Doppler data alone to navigate interplanetary spacecraft. The one-way data can be formulated as the standard differenced-count Doppler or as phase measurements, and the data can be received at a single station or differenced if obtained simultaneously at two stations. A covariance analysis, which analyzes the accuracy obtainable by combinations of one-way Doppler data, is performed and compared with similar results using standard two-way Doppler and range. The sample interplanetary trajectory used was that of the Mars Pathfinder mission to Mars. It is shown that differenced one-way data are capable of determining the angular position of the spacecraft to fairly high accuracy, but have relatively poor sensitivity to the range. When combined with single-station data, the position dispersions are roughly an order of magnitude larger in range and comparable in angular position as compared to dispersions obtained with standard two-way data types. It was also found that the phase formulation is less sensitive to data weight variations and data coverage than the differenced-count Doppler formulation.

A Comprehensive Radial Velocity Error Budget for Next Generation Doppler Spectrometers

NASA Technical Reports Server (NTRS)

Halverson, Samuel; Ryan, Terrien; Mahadevan, Suvrath; Roy, Arpita; Bender, Chad; Stefansson, Guomundur Kari; Monson, Andrew; Levi, Eric; Hearty, Fred; Blake, Cullen;

Micro-Doppler Ambiguity Resolution for Wideband Terahertz Radar Using Intra-Pulse Interference

PubMed Central

Yang, Qi; Qin, Yuliang; Deng, Bin; Wang, Hongqiang; You, Peng

2017-01-01

Micro-Doppler, induced by micro-motion of targets, is an important characteristic of target recognition once extracted via parameter estimation methods. However, micro-Doppler is usually too significant to result in ambiguity in the terahertz band because of its relatively high carrier frequency. Thus, a micro-Doppler ambiguity resolution method for wideband terahertz radar using intra-pulse interference is proposed in this paper. The micro-Doppler can be reduced several dozen times its true value to avoid ambiguity through intra-pulse interference processing. The effectiveness of this method is proved by experiments based on a 0.22 THz wideband radar system, and its high estimation precision and excellent noise immunity are verified by Monte Carlo simulation. PMID:28468257

Micro-Doppler Ambiguity Resolution for Wideband Terahertz Radar Using Intra-Pulse Interference.

PubMed

Yang, Qi; Qin, Yuliang; Deng, Bin; Wang, Hongqiang; You, Peng

2017-04-29

Micro-Doppler, induced by micro-motion of targets, is an important characteristic of target recognition once extracted via parameter estimation methods. However, micro-Doppler is usually too significant to result in ambiguity in the terahertz band because of its relatively high carrier frequency. Thus, a micro-Doppler ambiguity resolution method for wideband terahertz radar using intra-pulse interference is proposed in this paper. The micro-Doppler can be reduced several dozen times its true value to avoid ambiguity through intra-pulse interference processing. The effectiveness of this method is proved by experiments based on a 0.22 THz wideband radar system, and its high estimation precision and excellent noise immunity are verified by Monte Carlo simulation.

Carotid Doppler ultrasound findings in patients with left ventricular assist devices.

PubMed

Cervini, Patrick; Park, Soon J; Shah, Dipesh K; Penev, Irina E; Lewis, Bradley D

2010-12-01

Left ventricular assist devices (LVADs) have been used to treat advanced heart failure refractory to medical management, as bridge therapy to myocardial recovery, as bridge therapy to cardiac transplantation, or as destination therapy for patients with unfavorable transplant candidacy. Neurologic complications are some of the most common and devastating complications in these patients. Preoperative carotid ultrasound is, therefore, a standard evaluation in patients at risk for cerebrovascular disease. Postoperative carotid artery Doppler sonography is performed in those patients with neurologic symptoms. It is likely, therefore, that sonographers, radiologists, and other physicians working in a center where LVADs are implanted will likely encounter a carotid artery Doppler study in this patient group. To our knowledge, the carotid Doppler findings in these patients have never been published. We review the Doppler ultrasound findings in 6 patients after LVAD insertion.

Doppler-multipath tolerant voice communication

NASA Astrophysics Data System (ADS)

Harris, R. M.

Line of sight communication between high performance aircraft has been found to be subject to a peculiar form of multipath radio wave propagation - Doppler multipath. It degrades analogue voice reception on the standard fit ultrahigh frequency radio, producing low frequency random noise and warbling. Various modifications were carried out on the aircraft's communications system, but the problem remained. All the evidence points to a natural phenomenon. The reported observations are corroborated by theoretical studies and laboratory simulations of multipath radio wave propagation between two points moving relative to a diffusely scattering reflector. Theoretical predictions of Rician fading have explained the disruption of speech transmitted using conventional dsb(am) modulation. This also indicated suppressing the carrier as a radical cure. Double sideband suppressed carrier radios have been developed for airborne evaluation in comparison with standard dsb(am). The air to air flying trials proved the superior performance of the suppressed carrier system under conditions of Doppler multipath.

Applications of Doppler-free saturation spectroscopy for edge physics studies (invited).

PubMed

Martin, E H; Zafar, A; Caughman, J B O; Isler, R C; Bell, G L

2016-11-01

Doppler-free saturation spectroscopy provides a very powerful method to obtain detailed information about the electronic structure of the atom through measurement of the spectral line profile. This is achieved through a significant decrease in the Doppler broadening and essentially an elimination of the instrument broadening inherent to passive spectroscopic techniques. In this paper we present the technique and associated physics of Doppler-free saturation spectroscopy in addition to how one selects the appropriate transition. Simulations of H δ spectra are presented to illustrate the increased sensitivity to both electric field and electron density measurements.

Imaging doppler lidar for wind turbine wake profiling

DOEpatents

Bossert, David J.

2015-11-19

An imaging Doppler lidar (IDL) enables the measurement of the velocity distribution of a large volume, in parallel, and at high spatial resolution in the wake of a wind turbine. Because the IDL is non-scanning, it can be orders of magnitude faster than conventional coherent lidar approaches. Scattering can be obtained from naturally occurring aerosol particles. Furthermore, the wind velocity can be measured directly from Doppler shifts of the laser light, so the measurement can be accomplished at large standoff and at wide fields-of-view.

Turbulence as observed by concurrent measurements made at NSSL using weather radar, Doppler radar, Doppler lidar and aircraft

NASA Technical Reports Server (NTRS)

Lee, Jean T.

1987-01-01

As air traffic increases and aircraft capability increases in range and operating altitude, the exposure to weather hazards increases. Turbulence and wind shears are two of the most important of these hazards that must be taken into account if safe flight operations are to be accomplished. Beginning in the early 1960's, Project Rough Rider began thunderstorm investigations. Past and present efforts at the National Severe Storm Laboratory (NSSL) to measure these flight safety hazards and to describe the use of Doppler radar to detect and qualify these hazards are summarized. In particular, the evolution of the Doppler-measured radial velocity spectrum width and its applicability to the problem of safe flight is presented.

High-definition flow Doppler ultrasonographic technique to assess hepatic vasculature compared with color or power Doppler ultrasonography: preliminary experience.

PubMed

Kim, Se Hyung; Lee, Jeong Min; Kim, Young Jun; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn

2008-10-01

The purpose of this study was to introduce a new high-definition flow (HDF) Doppler technique and to compare its performance with those of color Doppler ultrasonography (CDU) and power Doppler ultrasonography (PDU) for assessment of hepatic vasculature in native and transplanted livers. High-definition flow was invented as a high-resolution bidirectional PDU technique. We obtained CDU, PDU, and HDF images of the hepatic artery (HA), portal vein (PV), and hepatic vein from 60 patients. They were divided into 2 groups: a liver transplantation group (group 1, n = 10) and a native liver group (group 2, n = 50). Two radiologists independently reviewed the cine images and graded them using a 4-point scale in terms of the clarity of the vessel margin and degree of depiction of the HA, flow filling, and flash artifacts. The degree of differentiation between the HA and PV was also evaluated. Flow directionality was recorded, and interobserver agreement was finally analyzed. Moderate to almost perfect agreement was achieved between radiologists for all parameters of each ultrasonographic technique. High-definition flow was significantly superior to both CDU and PDU with respect to all analyzed items except the degree of flash artifacts (P < .05). With regard to flash artifacts, CDU was significantly better than either PDU or HDF. High-definition flow provided directional information, as did CDU. The HDF technique provides better resolution for depicting hepatic vessels as well as their margins with less blooming compared with conventional Doppler ultrasonography in both native and transplanted liver. It also provides solid directional flow information. One point of concern, however, is the frequency of flash artifacts compared with that on CDU.

Biventricular pacemaker optimization guided by comprehensive echocardiography-preliminary observations regarding the effects on systolic and diastolic ventricular function and third heart sound.

PubMed

Taha, Nima; Zhang, Jing; Ranjan, Rupesh; Daneshvar, Samuel; Castillo, Edilzar; Guillen, Elizabeth; Montoya, Martha C; Velasquez, Giovanna; Naqvi, Tasneem Z

2010-08-01

Doppler echocardiography of mitral inflow or aortic outflow or both has been validated and advocated to guide biventricular (Biv) pacemaker optimization. A comprehensive and tailored Doppler echocardiographic evaluation may be required in patients with heart failure to assist with Biv pacemaker optimization. The third heart sound (S(3)), an acoustic cardiographic parameter, has been demonstrated to be a highly specific finding for hemodynamic evaluation in patients with heart failure. The aims of this study were to evaluate the use of comprehensive Doppler echocardiography as a guide during Biv pacemaker optimization in patients after cardiac resynchronization therapy and to evaluate the feasibility of S(3) intensity to be a cost-efficient parameter for Biv pacemaker optimization compared with Doppler echocardiography. Comprehensive Doppler echocardiographic evaluations were performed during Biv pacemaker optimization in 44 patients referred for pacemaker optimization (mean age, 71 + or - 12 years; mean left ventricular ejection fraction, 34 + or - 11%). Blinded assessment of S(3) intensity was performed simultaneously using acoustic cardiography. The correlation and improvement in cardiac hemodynamics were analyzed between the methods. Echocardiographically guided optimization resulted in significant improvements in the left ventricular outflow velocity-time integral (15.92 + or - 4.77 to 18.51 + or - 5.19 cm, P < .001), ejection time (278 + or - 40 to 293 + or - 40 ms, P < .001), myocardial performance index (0.57 + or - 0.19 to 0.44 + or - 0.14, P < .002), and peak pulmonary artery systolic pressure (42 + or - 13 to 36 + or - 11 mm Hg, P < .04) and decreased S(3) intensity from 4.81 + or - 1.84 at baseline to 3.96 + or - 1.22 after optimization (P < .02) for the overall study group and from 6.63 + or - 1.37 to 4.85 + or - 1.13 (P < .001) in the 18 patients with baseline S(3) intensity > 5.0. The correlation between echocardiographic and acoustic cardiographic S

Development of Rayleigh Doppler lidar for measuring middle atmosphere winds

NASA Astrophysics Data System (ADS)

Raghunath, K.; Patra, A. K.; Narayana Rao, D.

Interpretation of most of the middle and upper atmospheric dynamical and chemical data relies on the climatological description of the wind field Rayleigh Doppler lidar is one instrument which monitors wind profiles continuously though continuity is limited to clear meteorological conditions in the middle atmosphere A Doppler wind lidar operating in incoherent mode gives excellent wind and temperature information at these altitudes with necessary spectral sensitivity It observes atmospheric winds by measuring the spectral shift of the scattered light due to the motions of atmospheric molecules with background winds and temperature by spectral broadening The presentation is about the design and development of Incoherent Doppler lidar to obtain wind information in the height regions of 30-65 km The paper analyses and describes various types of techniques that can be adopted viz Edge technique and Fringe Imaging technique The paper brings out the scientific objectives configuration simulations error sources and technical challenges involved in the development of Rayleigh Doppler lidar The presentation also gives a novel technique for calibrating the lidar

African Doppler Surveys (ADOS).

DTIC Science & Technology

1983-06-01

UP TO 31 MARCH 1983 MAILING DATE: 11 APRIL 1983 SURVEY STATUS DATA STATUSDOPPLER STATION L1 OR1ATION - ______(hte 1,(Whether data dis- GEOD . TIES...SURVEY STATUS DTA STATUS DOPPLER STATION INFORMATION (Whet~her data dia- GEOD . TIES patched to...data dis- GEOD . TIES patched to COUNThY STATION NAME APPROXIMAT OPPLER designated CODE AND ADOS NO. SZION ()outh Comp. Center) COORDINATES fin- Yes

Laser Doppler anemometer signal processing for blood flow velocity measurements

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

Borozdova, M A; Fedosov, I V; Tuchin, V V

A new method for analysing the signal in a laser Doppler anemometer based on the differential scheme is proposed, which provides the flow velocity measurement in strongly scattering liquids, particularly, blood. A laser Doppler anemometer intended for measuring the absolute blood flow velocity in animal and human near-surface arterioles and venules is developed. The laser Doppler anemometer signal structure is experimentally studied for measuring the flow velocity in optically inhomogeneous media, such as blood and suspensions of scattering particles. The results of measuring the whole and diluted blood flow velocity in channels with a rectangular cross section are presented. (lasermore » applications and other topics in quantum electronics)« less

Arterial and Venous Doppler in Evaluation of the "At-Risk" Fetus.

PubMed

Turan, Sifa; Turan, Ozhan M

2017-09-01

Our practice utilizes Doppler ultrasound as one of the most objective and effective methods to assess at-risk pregnancies. This review will discuss the application of arterial and venous Doppler techniques in assessing and managing various diseases and conditions for high-risk fetuses.

Dual-Doppler lidar observation of horizontal convective rolls and near-surface streaks

NASA Astrophysics Data System (ADS)

Iwai, Hironori; Ishii, Shoken; Tsunematsu, Nobumitsu; Mizutani, Kohei; Murayama, Yasuhiro; Itabe, Toshikazu; Yamada, Izumi; Matayoshi, Naoki; Matsushima, Dai; Weiming, Sha; Yamazaki, Takeshi; Iwasaki, Toshiki

2008-07-01

Dual-Doppler lidar and heliborne sensors were used to investigate the three-dimensional (3D) structure of the wind field over Sendai Airport in June 2007. The 3D structures of several-hundred-meter-scale horizontal convective rolls (HCRs) in the sea-breeze layer were observed by the dual-Doppler lidar. The scale of the HCRs determined by the heliborne sensors roughly agreed with that determined by the dual-Doppler lidar. Analysis of the dual-Doppler lidar data showed that the region of upward flow in the HCRs originated in near-surface low-speed streaks. This structure is consistent with the results of large-eddy simulations of the atmospheric boundary layer. The aspect ratios of the HCRs were close to those predicted by linear theories.

Applications of Doppler-free saturation spectroscopy for edge physics studies (invited)

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

Martin, E. H., E-mail: martineh@ornl.gov; Caughman, J. B. O.; Isler, R. C.

Doppler-free saturation spectroscopy provides a very powerful method to obtain detailed information about the electronic structure of the atom through measurement of the spectral line profile. This is achieved through a significant decrease in the Doppler broadening and essentially an elimination of the instrument broadening inherent to passive spectroscopic techniques. In this paper we present the technique and associated physics of Doppler-free saturation spectroscopy in addition to how one selects the appropriate transition. Simulations of H{sub δ} spectra are presented to illustrate the increased sensitivity to both electric field and electron density measurements.

Three-dimensional power doppler ultrasound is useful to monitor the response to treatment in a patient with primary papillary serous carcinoma of the peritoneum.

PubMed

Su, Jen-Min; Huang, Yu-Fang; Chen, Helen H W; Cheng, Ya-Min; Chou, Cheng-Yang

2006-05-01

To date, this is the first report to monitor changes of intratumor vascularization and the response to radiation and Cyberknife therapy in a patient with recurrent primary papillary serous carcinoma of the peritoneum by three dimensional (3D) power Doppler ultrasonography (PDUS). Transvaginal 3D PDUS detected a recurrent presacral tumor with abundant intratumor vascularity. Serial examinations of the tumor volume and serum CA-125 level were studied before, during, and 6 mo after therapy. Meanwhile, the intratumor blood flow was measured and expressed as vascularity indices. All of the tumor volume, intratumor vascularity indices and serum CA-125 level decreased progressively following therapy. A remaining lesion with nearly absent intratumor power Doppler signals suggested a scarring lesion posttreatment. Indeed, CT-guided tissue biopsy confirmed fibrotic change. 3D PDUS is useful to monitor the response to treatments and to differentiate residual tumors from lesions of scarring change posttreatment. It provides more accurate posttreatment information than pelvic computed tomography.

Reversal of orbital angular momentum arising from an extreme Doppler shift

PubMed Central

Toninelli, Ermes; Horsley, Simon A. R.; Hendry, Euan; Phillips, David B.; Padgett, Miles J.

2018-01-01

The linear Doppler shift is familiar as the rise and fall in pitch of a siren as it passes by. Less well known is the rotational Doppler shift, proportional to the rotation rate between source and receiver, multiplied by the angular momentum carried by the beam. In extreme cases the Doppler shift can be larger than the rest-frame frequency and for a red shift, the observed frequency then becomes “negative.” In the linear case, this effect is associated with the time reversal of the received signal, but it can be observed only with supersonic relative motion between the source and receiver. However, the rotational case is different; if the radius of rotation is smaller than the wavelength, then the velocities required to observe negative frequencies are subsonic. Using an acoustic source at ≈100 Hz we create a rotational Doppler shift larger than the laboratory-frame frequency. We observe that once the red-shifted wave passes into the “negative frequency” regime, the angular momentum associated with the sound is reversed in sign compared with that of the laboratory frame. These low-velocity laboratory realizations of extreme Doppler shifts have relevance to superoscillatory fields and offer unique opportunities to probe interactions with rotating bodies and aspects of pseudorelativistic frame translation. PMID:29581257

Doppler-corrected Balmer spectroscopy of Rydberg positronium

NASA Astrophysics Data System (ADS)

Jones, A. C. L.; Hisakado, T. H.; Goldman, H. J.; Tom, H. W. K.; Mills, A. P.; Cassidy, D. B.

2014-07-01

The production of long-lived Rydberg positronium (Ps) and correction for Doppler shifts in the excitation laser frequencies are crucial elements of proposed measurements of the gravitational freefall of antimatter and for precision measurements of the optical spectrum of Ps. Using a two-step optical transition via 2P levels, we have prepared Ps atoms in Rydberg states up to the term limit. The spectra are corrected for the first-order Doppler shift using measured velocities, and the Balmer transitions are resolved for 15≤n≤31. The excitation signal amplitude begins to decrease for n >50, consistent with the onset of motional electric field ionization in the 3.5-mT magnetic field at the Ps formation target.

Doppler sonography characteristics of vertebrobasilar circulation in patients with Parkinson's disease.

PubMed

Vidović, Mirjana; Sinanović, Osman; Smajlović, Dzevdet; Burina, Adnan; Hudić, Josip

2008-08-01

The objective of the study was to analyze the doppler sonography findings of vertebrobasilar circulation (VB) in patients with Parkinson's disease. 40 patients were analyzed (25 men's and 15 women) with Parkinson's disease, average age was 61.9 years (SD=11.43), treated at the Clinic for Neurology in Tuzla. Device for doppler sonography was Multidop x 4. Doppler sonography findings of VB circulation were analyzed in order to computerized tomography (CT) findings of the brain (with or without ischemic lacunar lesions) and in order to presence of postural disturbances as one of dominant Parkinson's disease symptoms during actual hospitalization. Our results suggest that vertebrobasilar insufficiency is more frequent in patients with Parkinson's disease (no matter of type) and postural disturbances as a dominant symptom comparing to group of Parkinson's disease patients without postural disturbances. These results implicate the importance of doppler sonography findings of vertebrobasilar circulation in patients with Parkinson's disease and possibility of considering role of vertebrobasilar insufficiency in development of postural disturbances.

Application of RMS for damage detection by guided elastic waves

NASA Astrophysics Data System (ADS)

Radzieński, M.; Doliński, Ł.; Krawczuk, M.; dot Zak, A.; Ostachowicz, W.

2011-07-01

This paper presents certain results of an experimental study related with a damage detection in structural elements based on deviations in guided elastic wave propagation patterns. In order to excite guided elastic waves within specimens tested piezoelectric transducers have been applied. As excitation signals 5 sine cycles modulated by Hanning window have been used. Propagation of guided elastic waves has been monitored by a scanning Doppler laser vibrometer. The time signals recorded during measurement have been utilised to calculate the values of RMS. It has turned out that the values of RMS differed significantly in damaged areas from the values calculated for the healthy ones. In this way it has become possible to pinpoint precisely the locations of damage over the entire measured surface. All experimental investigations have been carried out for thin aluminium or composite plates. Damage has been simulated by a small additional mass attached on the plate surface or by a narrow notch cut. It has been shown that proposed method allows one to localise damage of various shapes and sizes within structural elements over the whole area under investigation.

Modeling and processing of laser Doppler reactive hyperaemia signals

NASA Astrophysics Data System (ADS)

Humeau, Anne; Saumet, Jean-Louis; L'Huiller, Jean-Pierre

2003-07-01

Laser Doppler flowmetry is a non-invasive method used in the medical domain to monitor the microvascular blood cell perfusion through tissue. Most commercial laser Doppler flowmeters use an algorithm calculating the first moment of the power spectral density to give the perfusion value. Many clinical applications measure the perfusion after a vascular provocation such as a vascular occlusion. The response obtained is then called reactive hyperaemia. Target pathologies include diabetes, hypertension and peripheral arterial occlusive diseases. In order to have a deeper knowledge on reactive hyperaemia acquired by the laser Doppler technique, the present work first proposes two models (one analytical and one numerical) of the observed phenomenon. Then, a study on the multiple scattering between photons and red blood cells occurring during reactive hyperaemia is carried out. Finally, a signal processing that improves the diagnosis of peripheral arterial occlusive diseases is presented.

Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams.

PubMed

Gilio, Daniel Bruno; Miranda Corrêa, Rosana Rosa; Souza de Oliveira Guimarães, Camila; Peres, Luiz Cesar; Marques Salge, Ana Karina; Cavellani, Camila Lourencini; de Paula Antunes Teixeira, Vicente; Costa da Cunha Castro, Eumenia

2009-08-01

One of the frequent questions in obstetric practice is to determine placental vascular changes that may account for abnormal Doppler flow velocity alterations in maternal uterine vessels from women and fetuses without pregnancy pathology. A retrospective morphometric study was realized using 27 placentas from patients submitted for Doppler flow velocity exam during pregnancy. The placentas were morphologically examined using hematoxylin-eosin staining. Measurements of villi were made with the use of a video camera coupled to a common light microscope and a computer with automatic image analyzing software. Of the 27 placentas, 13 (48%) were of patients showing unaltered Doppler and 14 (52%) showing altered Doppler. The number of stem villi vessels was significantly larger in the placentas of patients with Doppler exam alterations (P = 0.003). This group also presented greater stem villi vessel thickness, although without significant difference. The number of intermediary and terminal villi vessels was greater in the placentas of patients with altered Doppler exams (P < 0.001), and a greater terminal villi area was observed in these cases (P < 0.001). The morphological proof that uterine artery Doppler flow velocity exam alterations are associated with placental vascular alterations demonstrates the importance of this exam during prenatal care, even in the absence of maternal-fetal alterations.

Three-dimensional vascular imaging of proliferative diabetic retinopathy by Doppler optical coherence tomography.

PubMed

Miura, Masahiro; Hong, Young-Joo; Yasuno, Yoshiaki; Muramatsu, Daisuke; Iwasaki, Takuya; Goto, Hiroshi

2015-03-01

To evaluate the 3-dimensional architecture of neovascularization in proliferative diabetic retinopathy using Doppler optical coherence tomography (OCT). Prospective, nonrandomized clinical trial. Seventeen eyes of 14 patients with proliferative diabetic retinopathy were prospectively studied. Prototype Doppler OCT was used to evaluate the 3-dimensional vascular architecture at vitreoretinal adhesions. Proliferative membranes were detected in all eyes with proliferative diabetic retinopathy by standard OCT images. Doppler OCT images detected blood flow by neovascularization of the disc in 12 eyes and neovascularization elsewhere in 11 eyes. Doppler OCT images showed the 3-dimensional extent of new vessels at various stages of neovascularization, and the extent of new vessels could be clearly confirmed at vitreoretinal adhesions. Doppler OCT is useful for the detection and evaluation of the 3-dimensional vascular structure of neovascularization, and can assist in the noninvasive assessment of proliferative diabetic retinopathy. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Evaluation of arteriovenous fistulas and pseudoaneurysms in renal allografts following percutaneous needle biopsy. Color-coded Doppler sonography versus duplex Doppler sonography.

PubMed

Hübsch, P J; Mostbeck, G; Barton, P P; Gritzmann, N; Fruehwald, F X; Schurawitzki, H; Kovarik, J

1990-02-01

One hundred one patients with renal allografts were studied by two independent observers using duplex Doppler sonography (DDS) and color-coded Doppler sonography (CCDS). In all patients, single or multiple percutaneous needle biopsies of the transplant had been performed 1 to 30 days before. In 6 patients CCDS following the biopsy demonstrated an area of combined red and blue color-coded blood flow within the renal parenchyma (n = 5) or within the sinus (n = 1); the Doppler waveform was abnormal in these areas with signals above and below the zero line indicating turbulent blood flow. Consecutive intraarterial digital subtraction angiography (DSA) revealed the presence of an arteriovenous fistula (n = 4) or of a pseudoaneurysm (n = 2). In one patient, gross hematuria with obstruction of the bladder occurred as a complication of a pseudoaneurysm within the renal sinus; the bleeding could not be stopped by embolization of the lesion and the kidney had to be removed. DDS demonstrated the lesion in only one of the six patients. Thus, CCDS is the method of choice for noninvasive detection of vascular lesions due to percutaneous biopsy.

[Spectral-Doppler-Sonography - Step by Step].

PubMed

Bönhof, Leoni; Steffgen, Ludwig; Bönhof, Jörg

2018-06-07

Step by step explanation and detailed overview of the correct approach to spectral-Doppler-sonography, including several practical examples. The article provides comprehensive explanations of the appropriate settings in different situations. © Georg Thieme Verlag KG Stuttgart · New York.

Test Bed Doppler Wind Lidar and Intercomparison Facility At NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Kavaya, Michael J.; Koch, Grady J.; Petros, Mulugeta; Barnes, Bruce W.; Beyon, Jeffrey; Amzajerdian, Farzin; Yu, Ji-Rong; Singh, Upendra N.

2004-01-01

State of the art 2-micron lasers and other lidar components under development by NASA are being demonstrated and validated in a mobile test bed Doppler wind lidar. A lidar intercomparison facility has been developed to ensure parallel alignment of up to 4 Doppler lidar systems while measuring wind. Investigations of the new components; their operation in a complete system; systematic and random errors; the hybrid (joint coherent and direct detection) approach to global wind measurement; and atmospheric wind behavior are planned. Future uses of the VALIDAR (VALIDation LIDAR) mobile lidar may include comparison with the data from an airborne Doppler wind lidar in preparation for validation by the airborne system of an earth orbiting Doppler wind lidar sensor.

Tissue Doppler imaging and echo-Doppler findings associated with a mitral valve stenosis with an immobile posterior valve leaflet in a bull terrier.

PubMed

Tidholm, A; Nicolle, A P; Carlos, C; Gouni, V; Caruso, J L; Pouchelon, J L; Chetboul, V

2004-04-01

A mitral valve stenosis was diagnosed in a 2-year-old female Bull Terrier by use of two-dimensional (2-D) and M-mode echocardiography, colour-flow imaging and spectral Doppler examinations. Tissue Doppler Imaging was also performed to assess the segmental radial myocardial motion. The mitral valve stenosis was characterized by a decreased mitral orifice area/left ventricle area ratio (0.14), an increased early diastolic flow velocity (E wave = 1.9 m/s), a prolonged pressure half-time (106 ms) and a decreased E-F slope (4.5 cm/s) on pulsed-wave Doppler examination. This mitral stenosis was associated with an immobile posterior leaflet, as seen on 2-D and M-mode echocardiography. Immobility of the posterior mitral leaflet is considered to be a rare finding in humans and, to our knowledge, has not been precisely documented in dogs with mitral valve stenosis.

Observation of Doppler broadening in beta-delayed proton-gamma decay

NASA Astrophysics Data System (ADS)

Schwartz, Sarah

The Doppler broadening of gamma-ray peaks due to nuclear recoil from beta-delayed nucleon emission can be used to measure the energies of the nucleons. The purpose of this Thesis is to test and apply this Doppler broadening method using gamma-ray peaks from the 26P(betapgamma) 25Al decay sequence. A fast beam of 26P was implanted into a planar Ge detector, which was used as a 26P beta-decay trigger. The SeGA array of high-purity Ge detectors was used to detect gamma rays from the 26P(betapgamma)25Al decay sequence. Radiative Doppler broadening in beta-delayed proton-gamma decay was observed for the first time. The Doppler broadening analysis method was verified using the 1613 keV gamma-ray line for which the proton energies were previously known. The 1776 keV gamma ray de-exciting the 2720 keV 25Al level was observed in 26P(betapgamma) 25Al decay for the first time and used to determine that the center-of-mass energy of the proton emission feeding the 2720-keV level is 5.1 +/- 1.0 (stat.) +/- 0.6 (syst.) MeV, corresponding to a 26Si excitation energy of 13.3 +/- 1.0 (stat.) +/- 0.7 (syst.) MeV for the proton-emitting level. The Doppler broadening method has been demonstrated to provide practical measurements of the energies for beta-delayed nucleon emissions populating excited states of nuclear recoils at least as heavy as A = 25.

Testing the relativistic Doppler boost hypothesis for supermassive black hole binary candidates

NASA Astrophysics Data System (ADS)

Charisi, Maria; Haiman, Zoltán; Schiminovich, David; D'Orazio, Daniel J.

2018-06-01

Supermassive black hole binaries (SMBHBs) should be common in galactic nuclei as a result of frequent galaxy mergers. Recently, a large sample of sub-parsec SMBHB candidates was identified as bright periodically variable quasars in optical surveys. If the observed periodicity corresponds to the redshifted binary orbital period, the inferred orbital velocities are relativistic (v/c ≈ 0.1). The optical and ultraviolet (UV) luminosities are expected to arise from gas bound to the individual BHs, and would be modulated by the relativistic Doppler effect. The optical and UV light curves should vary in tandem with relative amplitudes which depend on the respective spectral slopes. We constructed a control sample of 42 quasars with aperiodic variability, to test whether this Doppler colour signature can be distinguished from intrinsic chromatic variability. We found that the Doppler signature can arise by chance in ˜20 per cent (˜37 per cent) of quasars in the nUV (fUV) band. These probabilities reflect the limited quality of the control sample and represent upper limits on how frequently quasars mimic the Doppler brightness+colour variations. We performed separate tests on the periodic quasar candidates, and found that for the majority, the Doppler boost hypothesis requires an unusually steep UV spectrum or an unexpectedly large BH mass and orbital velocity. We conclude that at most approximately one-third of these periodic candidates can harbor Doppler-modulated SMBHBs.

Vector Doppler: spatial sampling analysis and presentation techniques for real-time systems

NASA Astrophysics Data System (ADS)

Capineri, Lorenzo; Scabia, Marco; Masotti, Leonardo F.

2001-05-01

The aim of the vector Doppler (VD) technique is the quantitative reconstruction of a velocity field independently of the ultrasonic probe axis to flow angle. In particular vector Doppler is interesting for studying vascular pathologies related to complex blood flow conditions. Clinical applications require a real-time operating mode and the capability to perform Doppler measurements over a defined volume. The combination of these two characteristics produces a real-time vector velocity map. In previous works the authors investigated the theory of pulsed wave (PW) vector Doppler and developed an experimental system capable of producing off-line 3D vector velocity maps. Afterwards, for producing dynamic velocity vector maps, we realized a new 2D vector Doppler system based on a modified commercial echograph. The measurement and presentation of a vector velocity field requires a correct spatial sampling that must satisfy the Shannon criterion. In this work we tackled this problem, establishing a relationship between sampling steps and scanning system characteristics. Another problem posed by the vector Doppler technique is the data representation in real-time that should be easy to interpret for the physician. With this in mine we attempted a multimedia solution that uses both interpolated images and sound to represent the information of the measured vector velocity map. These presentation techniques were experimented for real-time scanning on flow phantoms and preliminary measurements in vivo on a human carotid artery.

Feasibility of UltraFast Doppler in Post-operative Evaluation of Hepatic Artery in Recipients following Liver Transplantation.

PubMed

Kim, Se-Young; Kim, Kyoung Won; Choi, Sang Hyun; Kwon, Jae Hyun; Song, Gi-Won; Kwon, Heon-Ju; Yun, Young Ju; Lee, Jeongjin; Lee, Sung-Gyu

2017-11-01

To determine the feasibility of using UltraFast Doppler in post-operative evaluation of the hepatic artery (HA) after liver transplantation (LT), we evaluated 283 simultaneous conventional and UltraFast Doppler sessions in 126 recipients over a 2-mo period after LT, using an Aixplorer scanner The Doppler indexes of the HA (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistive index [RI] and systolic acceleration time [SAT]) by retrospective analysis of retrieved waves from UltraFast Doppler clips were compared with those obtained by conventional spectral Doppler. Correlation, performance in diagnosing the pathologic wave, examination time and reproducibility were evaluated. The PSV, EDV, RI and SAT of spectral and UltraFast Doppler measurements exhibited excellent correlation with favorable diagnostic performance. During the bedside examination, the mean time spent for UltraFast clip storing was significantly shorter than that for conventional Doppler US measurements. Both conventional and UltraFast Doppler exhibited good to excellent inter-analysis consistency. In conclusion, compared with conventional spectral Doppler, UltraFast Doppler values correlated excellently and yielded acceptable pathologic wave diagnostic performance with reduced examination time at the bedside and excellent reproducibility. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

An Externally Dispersed Interferometer for Sensitive Doppler Extrasolar Planet Searches

NASA Astrophysics Data System (ADS)

Ge, Jian; Erskine, David J.; Rushford, Mike

2002-09-01

A new kind of instrument for sensitive Doppler extrasolar planet searches, called an externally dispersed interferometer, is described in this paper. It is a combination of an optical Michelson-type interferometer and an intermediate-resolution grating spectrometer. The interferometer measures Doppler radial velocity (RV) variations of starlight through the phase shifts of moiré fringes, created by multiplication of the interferometer fringes with stellar absorption lines. The intermediate-resolution spectrograph disperses the moiré fringes into thousands of parallel-wavelength channels. This increases the instrument bandwidth and fringe visibility by preventing fringe cross-talk between neighboring spectral lines. This results in a net increase in the signal-to-noise ratio over an interferometer used alone with broadband light. Compared to current echelle spectrometers for extrasolar planet searches, this instrument offers two unique instrument properties: a simple, stable, well-defined sinusoidal instrument response function (point-spread function) and magnification of Doppler motion through moiré fringe techniques. Since instrument noise is chiefly limited by the ability to characterize the instrument response, this new technique provides unprecedented low instrumental noise in an economical compact apparatus, enabling higher precision for Doppler RV measurements. In practice, the moiré magnification can be 5-10 times depending on the interferometer comb angle. This instrument has better sensitivity for smaller Doppler shifts than echelle spectrometers. The instrument can be designed with much lower spectral resolving power without losing Doppler sensitivity and optimized for higher throughput than echelle spectrometers to allow a potential survey for planets around fainter stars than current magnitude limits. Lab-based experiments with a prototype instrument with a spectral resolution of R~20,000 demonstrated ~0.7 m s-1 precision for short-term RV

Reversal of orbital angular momentum arising from an extreme Doppler shift.

PubMed

Gibson, Graham M; Toninelli, Ermes; Horsley, Simon A R; Spalding, Gabriel C; Hendry, Euan; Phillips, David B; Padgett, Miles J

2018-04-10

The linear Doppler shift is familiar as the rise and fall in pitch of a siren as it passes by. Less well known is the rotational Doppler shift, proportional to the rotation rate between source and receiver, multiplied by the angular momentum carried by the beam. In extreme cases the Doppler shift can be larger than the rest-frame frequency and for a red shift, the observed frequency then becomes "negative." In the linear case, this effect is associated with the time reversal of the received signal, but it can be observed only with supersonic relative motion between the source and receiver. However, the rotational case is different; if the radius of rotation is smaller than the wavelength, then the velocities required to observe negative frequencies are subsonic. Using an acoustic source at [Formula: see text]100 Hz we create a rotational Doppler shift larger than the laboratory-frame frequency. We observe that once the red-shifted wave passes into the "negative frequency" regime, the angular momentum associated with the sound is reversed in sign compared with that of the laboratory frame. These low-velocity laboratory realizations of extreme Doppler shifts have relevance to superoscillatory fields and offer unique opportunities to probe interactions with rotating bodies and aspects of pseudorelativistic frame translation. Copyright © 2018 the Author(s). Published by PNAS.

Flight Testing of the TWiLiTE Airborne Molecular Doppler Lidar

NASA Technical Reports Server (NTRS)

Gentry, Bruce; McGill, Matthew; Machan, Roman; Reed, Daniel; Cargo, Ryan; Wilkens, David J.; Hart, William; Yorks, John; Scott, Stan; Wake, Shane;

Ultrasonographic investigation of the Achilles tendon in elite badminton players using color Doppler.

PubMed

Boesen, Morten Ilum; Boesen, Anders; Koenig, Merete Juhl; Bliddal, Henning; Torp-Pedersen, Soren

2006-12-01

The most frequent injuries in badminton players are in the lower extremities, especially in the Achilles tendon. The game of badminton may be related to abnormal intratendinous flow in the Achilles tendon as detected by color Doppler ultrasound. To a certain extent, this blood flow might be physiological, especially when examined after match. Cohort study (prevalence); Level of evidence, 3. Seventy-two elite badminton players were interviewed regarding Achilles tendon pain (achillodynia) in the preceding 3 years. Color Doppler was used to examine the tendons of 64 players before their matches and 46 players after their matches. Intratendinous color Doppler flow was graded from 0 to 4. The Achilles tendon was divided into dominant (eg, right side for right-handed players and vice versa) and nondominant side and classified as midtendon, preinsertional, and calcaneal areas. Of 72 players, 26 had experienced achillodynia in 34 tendons, 18 on the dominant side and 16 on the nondominant side. In 62% of the players with achillodynia, the problems had begun slowly, and the median duration of symptoms was 4 months (range, 0-36 months). Thirty-five percent had ongoing pain in their tendons for a median duration of 12 months (range, 0-12 months). Achillodynia was not associated with the self-reported training load or with sex, age, weight, singles or doubles players, or racket side. Forty-six players were scanned before and after match. At baseline, color Doppler flow was present in the majority of players, and only 7 (16%) players had no color Doppler flow in either tendon. After match, all players had some color Doppler flow in 1 or both tendons. Achillodynia and color Doppler flow were related in the nondominant Achilles tendon (chi-square, P = .008). The grades of Doppler flow also increased significantly after match in the preinsertional area in both the nondominant (P = .0002) and dominant (P = .005) side tendons. A large proportion of the players had experienced

Effect of Doppler flow meter position on discharge measurement in surcharged manholes.

PubMed

Yang, Haoming; Zhu, David Z; Liu, Yanchen

2018-02-01

Determining the proper installation location of flow meters is important for accurate measurement of discharge in sewer systems. In this study, flow field and flow regimes in two types of manholes under surcharged flow were investigated using a commercial computational fluid dynamics (CFD) code. The error in measuring the flow discharge using a Doppler flow meter (based on the velocity in a Doppler beam) was then estimated. The values of the corrective coefficient were obtained for the Doppler flow meter at different locations under various conditions. Suggestions for selecting installation positions are provided.

Automated assessment of noninvasive filling pressure using color Doppler M-mode echocardiography

NASA Technical Reports Server (NTRS)

Greenberg, N. L.; Firstenberg, M. S.; Cardon, L. A.; Zuckerman, J.; Levine, B. D.; Garcia, M. J.; Thomas, J. D.

2001-01-01

Assessment of left ventricular filling pressure usually requires invasive hemodynamic monitoring to follow the progression of disease or the response to therapy. Previous investigations have shown accurate estimation of wedge pressure using noninvasive Doppler information obtained from the ratio of the wave propagation slope from color M-mode (CMM) images and the peak early diastolic filling velocity from transmitral Doppler images. This study reports an automated algorithm that derives an estimate of wedge pressure based on the spatiotemporal velocity distribution available from digital CMM Doppler images of LV filling.

Acoustic Doppler discharge-measurement system

USGS Publications Warehouse

Simpson, Michael R.; Oltmann, Richard N.; ,

1990-01-01

A discharge-measurement system that uses a vessel-mounted acoustic Doppler current profiler has been developed and tested by the U.S. Geological Survey. Discharge measurements using the system require a fraction of the time needed for conventional current-meter discharge measurements and do not require shore-based navigational aids or tag lines for positioning the vessel.

Development of Point Doppler Velocimetry for Flow Field Investigations

NASA Technical Reports Server (NTRS)

Cavone, Angelo A.; Meyers, James F.; Lee, Joseph W.

2006-01-01

A Point Doppler Velocimeter (pDv) has been developed using a vapor-limited iodine cell as the sensing medium. The iodine cell is utilized to directly measure the Doppler shift frequency of laser light scattered from submicron particles suspended within a fluid flow. The measured Doppler shift can then be used to compute the velocity of the particles, and hence the fluid. Since this approach does not require resolution of scattered light from individual particles, the potential exists to obtain temporally continuous signals that could be uniformly sampled in the manner as a hot wire anemometer. This leads to the possibility of obtaining flow turbulence power spectra without the limitations of fringe-type laser velocimetry. The development program consisted of a methodical investigation of the technology coupled with the solution of practical engineering problems to produce a usable measurement system. The paper outlines this development along with the evaluation of the resulting system as compared to primary standards and other measurement technologies.

Quantitative Doppler Analysis Using Conventional Color Flow Imaging Acquisitions.

PubMed

Karabiyik, Yucel; Ekroll, Ingvild Kinn; Eik-Nes, Sturla H; Lovstakken, Lasse

2018-05-01

Interleaved acquisitions used in conventional triplex mode result in a tradeoff between the frame rate and the quality of velocity estimates. On the other hand, workflow becomes inefficient when the user has to switch between different modes, and measurement variability is increased. This paper investigates the use of power spectral Capon estimator in quantitative Doppler analysis using data acquired with conventional color flow imaging (CFI) schemes. To preserve the number of samples used for velocity estimation, only spatial averaging was utilized, and clutter rejection was performed after spectral estimation. The resulting velocity spectra were evaluated in terms of spectral width using a recently proposed spectral envelope estimator. The spectral envelopes were also used for Doppler index calculations using in vivo and string phantom acquisitions. In vivo results demonstrated that the Capon estimator can provide spectral estimates with sufficient quality for quantitative analysis using packet-based CFI acquisitions. The calculated Doppler indices were similar to the values calculated using spectrograms estimated on a commercial ultrasound scanner.

Calibration of echocardiographic tissue doppler velocity, using simple universally applicable methods

NASA Astrophysics Data System (ADS)

Dhutia, Niti M.; Zolgharni, Massoud; Willson, Keith; Cole, Graham; Nowbar, Alexandra N.; Manisty, Charlotte H.; Francis, Darrel P.

2014-03-01

Some of the challenges with tissue Doppler measurement include: apparent inconsistency between manufacturers, uncertainty over which part of the trace to make measurements and a lack of calibration of measurements. We develop and test tools to solve these problems in echocardiography laboratories. We designed and constructed an actuator and phantom setup to produce automatic reproducible motion, and used it to compare velocities measured using 3 echocardiographic modalities: M-mode, speckle tracking, and tissue Doppler, against a non-ultrasound, optical gold standard. In the clinical phase, 25 patients underwent M-mode, speckle tracking and tissue Doppler measurements of tissue velocities. In-vitro, the M-mode and speckle tracking velocities were concordant with optical assessment. Of the three possible tissue Doppler measurement conventions (outer, middle and inner line) only the middle line agreed with the optical assessment (discrepancy -0.20 (95% confidence interval -0.44 to 0.03)cm/s, p=0.11, outer +5.19(4.65 to 5.73)cm/s, p<0.0001, inner -6.26(-6.87 to -5.65)cm/s, p<0.0001). All 4 studied manufacturers showed a similar pattern. M-mode was therefore chosen as the in-vivo gold standard. Clinical measurements of tissue velocities by speckle tracking and the middle line of the tissue Doppler were concordant with M-mode, while the outer line significantly overestimated (+1.27(0.96 to 1.59)cm/s, p<0.0001) and the inner line underestimated (-1.81(-2.11 to -1.52)cm/s, p<0.0001). Echocardiographic velocity measurements can be calibrated by simple, inexpensive tools. We found that the middle of the tissue Doppler trace represents velocity correctly. Echocardiographers requiring velocities to match between different equipment, settings or modalities should use the middle line as the "guideline".

Transcranial Doppler Ultrasound in Peninsular Arab Patients With Sickle Cell Disease.

PubMed

Adekile, Adekunle; Hassan, Meaad; Asbeutah, Akram; Al-Hinai, Mohamed; Trad, Omar; Farhan, Nayef

2018-05-06

Transcranial Doppler ultrasound is used to identify patients with sickle cell disease (SCD) at risk for stroke. We performed transcranial Doppler studies in patients from 4 countries in the Arabian Peninsula (Kuwait, Oman, Iraq, and United Arab Emirates) to document the prevalence of abnormal transcranial Doppler findings. The patients were recruited from outpatient clinics and studied in a steady state. Transcranial Doppler examinations were performed with standard equipment by experienced operators. The time-averaged maximum mean velocity (TAMMV) was documented in the arteries of the circle of Willis. The hemoglobin (Hb) genotype was confirmed, and the fetal Hb level and complete blood counts were determined. There were 415 patients in the study, aged 2 to 18 years (mean ± SD, 8.6 ± 3.5 years). None of the patients had an abnormal TAMMV (ie, > 200 cm/s), whereas only 13 (3.1%), all from Iraq, had conditional values (170-200 cm/s) in the right middle cerebral artery and 7 (1.7%) in the left middle cerebral artery. There were no consistent TAMMV differences among male and female patients or in patients with different Hb genotypes (sickle cell anemia, sickle cell β 0- thalassemia, and sickle D). The use of hydroxyurea was associated with a lower TAMMV, whereas a blood transfusion history had no influence. Total hemoglobin, reticulocyte count, serum bilirubin, and fetal Hb values showed varying degrees of association with the TAMMV in the different vessels. This study has demonstrated the rarity of abnormal transcranial Doppler findings among Peninsular Arab patients with SCD. The guidelines for transcranial Doppler screening in this population need further studies and recommendations. © 2018 by the American Institute of Ultrasound in Medicine.

The Cassini/Huygens Doppler Wind Experiment: Results from the Titan Descent

NASA Technical Reports Server (NTRS)

Bird, M. K.; Dutta-Roy, R.; Allison, M.; Asmar, S. W.; Atkinson, D. H.; Edenhofer, P.; Plettemeier, D.; Tyler, G. L.

2005-01-01

The primary objective of the Doppler Wind Experiment (DWE), one of the six scientific investigations comprising the payload of the ESA Huygens Probe, is a determination of the wind velocity in Titan's atmosphere. Measurements of the Doppler shift of the S-band (2040 MHz) carrier signal to the Cassini Orbiter and to Earth were recorded during the Probe descent in order to deduce wind-induced motion of the Probe to an accuracy better than 1 m s-1. An experiment with the same scientific goal was performed with the Galileo Probe at Jupiter. Analogous to the Galileo experience, it was anticipated that the frequency of the Huygens radio signal could be measured on Earth to obtain an additional component of the horizontal winds. Specific secondary science objectives of DWE include measurements of: (a) Doppler fluctuations to determine the turbulence spectrum and possible wave activity in the Titan atmosphere; (b) Doppler and signal level modulation to monitor Probe descent dynamics (e.g., spinrate/spinphase, parachute swing); (c) Probe coordinates and orientation during descent and after impact on Titan.

Airborne Doppler radar detection of low altitude windshear

NASA Technical Reports Server (NTRS)

Bracalente, Emedio M.; Jones, William R.; Britt, Charles L.

1990-01-01

As part of an integrated windshear program, the Federal Aviation Administration, jointly with NASA, is sponsoring a research effort to develop airborne sensor technology for the detection of low altitude windshear during aircraft take-off and landing. One sensor being considered is microwave Doppler radar operating at X-band or above. Using a Microburst/Clutter/Radar simulation program, a preliminary feasibility study was conducted to assess the performance of Doppler radars for this application. Preliminary results from this study are presented. Analysis show, that using bin-to-bin Automatic Gain Control (AGC), clutter filtering, limited detection range, and suitable antenna tilt management, windshear from a wet microburst can be accurately detected 10 to 65 seconds (.75 to 5 km) in front of the aircraft. Although a performance improvement can be obtained at higher frequency, the baseline X-band system that was simulated detected the presence of a windshear hazard for the dry microburst. Although this study indicates the feasibility of using an airborne Doppler radar to detect low altitude microburst windshear, further detailed studies, including future flight experiments, will be required to completely characterize the capabilities and limitations.

Guided Wave Propagation Study on Laminated Composites by Frequency-Wavenumber Technique

NASA Technical Reports Server (NTRS)

Tian, Zhenhua; Yu, Lingyu; Leckey, Cara A. C.

2014-01-01

Toward the goal of delamination detection and quantification in laminated composites, this paper examines guided wave propagation and wave interaction with delamination damage in laminated carbon fiber reinforced polymer (CFRP) composites using frequency-wavenumber (f-kappa) analysis. Three-dimensional elastodynamic finite integration technique (EFIT) is used to acquire simulated time-space wavefields for a CFRP composite. The time-space wavefields show trapped waves in the delamination region. To unveil the wave propagation physics, the time-space wavefields are further analyzed by using two-dimensional (2D) Fourier transforms (FT). In the analysis results, new f-k components are observed when the incident guided waves interact with the delamination damage. These new f-kappa components in the simulations are experimentally verified through data obtained from scanning laser Doppler vibrometer (SLDV) tests. By filtering the new f-kappa components, delamination damage is detected and quantified.

Doppler ultrasound study of penis in men with systemic sclerosis: a correlation with Doppler indices of renal and digital arteries.

PubMed

Rosato, E; Barbano, B; Gigante, A; Cianci, R; Molinaro, I; Quarta, S; Digiulio, M A; Messineo, D; Pisarri, S; Salsano, F

2013-01-01

Erectile dysfunction (ED) prevalence in male systemic sclerosis (SSc) is high and its pathogenesis is unclear. The aim of the study is to assess correlation between Doppler ultrasound indices of penis and kidneys or digital arteries in male systemic sclerosis. Fourteen men with systemic sclerosis were enrolled in this study. Erectile function was investigated by the International Index of Erectile Function-5. Peak systolic velocity, end diastolic velocity, resistive index, pulsative index, and systolic/diastolic ratio were measured on the cavernous arteries at the peno-scrotal junction in the flaccid state, on the interlobar artery of both kidneys and all ten proper palmar digital arteries. Ten (71 percent) patients have an International Index of Erectile Function-5 less than 21. Reduction of penis peak systolic velocity was observed in all SSc subjects. Doppler indices of cavernous arteries correlate with the International Index of Erectile Function-5. The renal and digital arteries resistive index demonstrated a good correlation (p less than 0.0001) with International Index of Erectile Function-5. A positive correlation exists between penis and kidney arteries Doppler indices: end diastolic velocity (p less than 0.05, r=0.54), resistive index (p less than 0.0001, r=0.90), systolic/diastolic ratio (p less than 0.01, r=0.69). A positive correlation was observed between penis and digital arteries Doppler indices: peak systolic velocity (p less than 0.01, r=0.68), end diastolic velocity (p less than 0.01, r=0.75), resistive index (p less than 0.001, r=0.79), systolic/diastolic ratio (p less than 0.05, r=0.59). A correlation exists between arterial impairment of penis and renal or digital arteries.

Single Mode, Extreme Precision Doppler Spectrographs

NASA Astrophysics Data System (ADS)

Schwab, Christian; Leon-Saval, Sergio G.; Betters, Christopher H.; Bland-Hawthorn, Joss; Mahadevan, Suvrath

2014-04-01

The `holy grail' of exoplanet research today is the detection of an earth-like planet: a rocky planet in the habitable zone around a main-sequence star. Extremely precise Doppler spectroscopy is an indispensable tool to find and characterize earth-like planets; however, to find these planets around solar-type stars, we need nearly one order of magnitude better radial velocity (RV) precision than the best current spectrographs provide. Recent developments in astrophotonics (Bland-Hawthorn & Horton 2006, Bland-Hawthorn et al. 2010) and adaptive optics (AO) enable single mode fiber (SMF) fed, high resolution spectrographs, which can realize the next step in precision. SMF feeds have intrinsic advantages over multimode fiber or slit coupled spectrographs: The intensity distribution at the fiber exit is extremely stable, and as a result the line spread function of a well-designed spectrograph is fully decoupled from input coupling conditions, like guiding or seeing variations (Ihle et al. 2010). Modal noise, a limiting factor in current multimode fiber fed instruments (Baudrand & Walker 2001), can be eliminated by proper design, and the diffraction limited input to the spectrograph allows for very compact instrument designs, which provide excellent optomechanical stability. A SMF is the ideal interface for new, very precise wavelength calibrators, like laser frequency combs (Steinmetz et al. 2008, Osterman et al. 2012), or SMF based Fabry-Perot Etalons (Halverson et al. 2013). At near infrared wavelengths, these technologies are ready to be implemented in on-sky instruments, or already in use. We discuss a novel concept for such a spectrograph.

Photodetachment and Doppler laser cooling of anionic molecules

NASA Astrophysics Data System (ADS)

Gerber, Sebastian; Fesel, Julian; Doser, Michael; Comparat, Daniel

2018-02-01

We propose to extend laser-cooling techniques, so far only achieved for neutral molecules, to molecular anions. A detailed computational study is performed for {{{C}}}2- molecules stored in Penning traps using GPU based Monte Carlo simulations. Two cooling schemes—Doppler laser cooling and photodetachment cooling—are investigated. The sympathetic cooling of antiprotons is studied for the Doppler cooling scheme, where it is shown that cooling of antiprotons to subKelvin temperatures could becomes feasible, with impacts on the field of antimatter physics. The presented cooling schemes also have applications for the generation of cold, negatively charged particle sources and for the sympathetic cooling of other molecular anions.

C-band radar pulse Doppler error: Its discovery, modeling, and elimination

NASA Technical Reports Server (NTRS)

Krabill, W. B.; Dempsey, D. J.

1978-01-01

The discovery of a C Band radar pulse Doppler error is discussed and use of the GEOS 3 satellite's coherent transponder to isolate the error source is described. An analysis of the pulse Doppler tracking loop is presented and a mathematical model for the error was developed. Error correction techniques were developed and are described including implementation details.

Laser Doppler Measurement of Atmopsheric Wind Velocity