Efficacy of removal of cariogenic bacteria and carious dentin by ablation using different modes of Er:YAG lasers

PubMed Central

Baraba, A.; Kqiku, L.; Gabrić, D.; Verzak, Ž.; Hanscho, K.; Miletić, I.

2018-01-01

The primary objective of this in vitro study was to evaluate the efficiency of removal of cariogenic bacteria and carious dentin by ablation using two lasers: fluorescence-feedback controlled (FFC) Er:YAG laser and different pulses of Er:YAG laser based on variable square pulse technology (VSPt). The secondary objective was to measure the temperature during laser ablation of carious tissue. Seventy-two extracted human molars were used in this study. Sixty teeth with carious dentin were randomly divided into four experimental groups according to the treatment for caries removal: group 1: 400 µs (FFC group); group 2: super short pulse (SSP group, 50 µs pulse); group 3: medium short pulse (MSP group, 100 µs pulse); group 4: short pulse (SP group, 300 µs pulse) and one positive control group with no treatment. Twelve teeth without carious lesion were used as a negative control group. After caries removal, swabs were taken with cotton pellets and real-time PCR analysis was performed. During caries ablation, a thermal infrared camera was used to measure the temperature changes. In all experimental groups, specimens were free of bacterial contamination after the treatment. In the SSP, MSP and SP groups, temperatures measured during caries ablation were significantly higher compared to temperatures in the FFC group (P<0.001). In this in vitro study, laser treatment for removal of carious dentin and cariogenic bacteria was an efficient treatment modality without causing excessive temperatures that might adversely affect pulp vitality. PMID:29340524

Efficacy of removal of cariogenic bacteria and carious dentin by ablation using different modes of Er:YAG lasers.

PubMed

Baraba, A; Kqiku, L; Gabrić, D; Verzak, Ž; Hanscho, K; Miletić, I

2018-01-11

The primary objective of this in vitro study was to evaluate the efficiency of removal of cariogenic bacteria and carious dentin by ablation using two lasers: fluorescence-feedback controlled (FFC) Er:YAG laser and different pulses of Er:YAG laser based on variable square pulse technology (VSPt). The secondary objective was to measure the temperature during laser ablation of carious tissue. Seventy-two extracted human molars were used in this study. Sixty teeth with carious dentin were randomly divided into four experimental groups according to the treatment for caries removal: group 1: 400 µs (FFC group); group 2: super short pulse (SSP group, 50 µs pulse); group 3: medium short pulse (MSP group, 100 µs pulse); group 4: short pulse (SP group, 300 µs pulse) and one positive control group with no treatment. Twelve teeth without carious lesion were used as a negative control group. After caries removal, swabs were taken with cotton pellets and real-time PCR analysis was performed. During caries ablation, a thermal infrared camera was used to measure the temperature changes. In all experimental groups, specimens were free of bacterial contamination after the treatment. In the SSP, MSP and SP groups, temperatures measured during caries ablation were significantly higher compared to temperatures in the FFC group (P<0.001). In this in vitro study, laser treatment for removal of carious dentin and cariogenic bacteria was an efficient treatment modality without causing excessive temperatures that might adversely affect pulp vitality.

Comparison of transient measurements of infrared radiation and stress waves for practical ablation monitoring during photorefractive keratectomy

NASA Astrophysics Data System (ADS)

Ishihara, Miya; Arai, Tsunenori; Kikuchi, Makoto; Nakano, Hironori; Kawauchi, Satoko; Obara, Minoru

1998-05-01

We compared infrared radiation measurement with stress wave measurement for real-time ablation monitoring during photorefractive keratectomy (PRK). We estimated temperature elevation which may be one of the most effective parameter for PRK monitoring, because the ablation mechanism is mainly attributed to thermal kinetics. The temperature elevation of ablated cornea was evaluated by the infrared radiation and the stress wave. The thermal radiation from irradiated cornea was detected by a MCT detector. The measured signal increased sharply just after the laser irradiation and decreased quasi- exponentially. We could calculate the temperature elevation by observed signal using Stefan-Boltzmann radiation law. In the case of the gelatin gel (15% wt) ablation in vitro, the temperature elevation was 97 deg. at 208 mJ/cm2 in the laser fluence. We also measured transient stress wave by the acoustic transducer which was made by polyvinylidene fluoride (PVDF) film. The temperature elevation could be calculated from the peak stress amplitude based on the short pulsed laser ablation theory. The good agreement on the temperature elevation was obtained between the infrared and the stress based estimations. Due to non-contact and non-invasive method, our infrared measurements for temperature elevation monitoring may be available to accomplish the feedback control on the PRK.

Development of a force-reflecting robotic platform for cardiac catheter navigation.

PubMed

Park, Jun Woo; Choi, Jaesoon; Pak, Hui-Nam; Song, Seung Joon; Lee, Jung Chan; Park, Yongdoo; Shin, Seung Min; Sun, Kyung

2010-11-01

Electrophysiological catheters are used for both diagnostics and clinical intervention. To facilitate more accurate and precise catheter navigation, robotic cardiac catheter navigation systems have been developed and commercialized. The authors have developed a novel force-reflecting robotic catheter navigation system. The system is a network-based master-slave configuration having a 3-degree of freedom robotic manipulator for operation with a conventional cardiac ablation catheter. The master manipulator implements a haptic user interface device with force feedback using a force or torque signal either measured with a sensor or estimated from the motor current signal in the slave manipulator. The slave manipulator is a robotic motion control platform on which the cardiac ablation catheter is mounted. The catheter motions-forward and backward movements, rolling, and catheter tip bending-are controlled by electromechanical actuators located in the slave manipulator. The control software runs on a real-time operating system-based workstation and implements the master/slave motion synchronization control of the robot system. The master/slave motion synchronization response was assessed with step, sinusoidal, and arbitrarily varying motion commands, and showed satisfactory performance with insignificant steady-state motion error. The current system successfully implemented the motion control function and will undergo safety and performance evaluation by means of animal experiments. Further studies on the force feedback control algorithm and on an active motion catheter with an embedded actuation mechanism are underway. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Feedback-controlled laser fabrication of micromirror substrates.

PubMed

Petrak, Benjamin; Konthasinghe, Kumarasiri; Perez, Sonia; Muller, Andreas

2011-12-01

Short (40-200 μs) single focused CO(2) laser pulses of energy ≳100 μJ were used to fabricate high quality concave micromirror templates on silica and fluoride glass. The ablated features have diameters of ≈20-100 μm and average root-mean-square (RMS) surface microroughness near their center of less than 0.2 nm. Temporally monitoring the fabrication process revealed that it proceeds on a time scale shorter than the laser pulse duration. We implement a fast feedback control loop (≈20 kHz bandwidth) based on the light emitted by the sample that ensures an RMS size dispersion of less than 5% in arrays on chips or in individually fabricated features on an optical fiber tip, a significant improvement over previous approaches using longer pulses and open loop operation.

Real-time FDG PET Guidance during Biopsies and Radiofrequency Ablation Using Multimodality Fusion with Electromagnetic Navigation

PubMed Central

Kadoury, Samuel; Abi-Jaoudeh, Nadine; Levy, Elliot B.; Maass-Moreno, Roberto; Krücker, Jochen; Dalal, Sandeep; Xu, Sheng; Glossop, Neil; Wood, Bradford J.

2011-01-01

Purpose: To assess the feasibility of combined electromagnetic device tracking and computed tomography (CT)/ultrasonography (US)/fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) fusion for real-time feedback during percutaneous and intraoperative biopsies and hepatic radiofrequency (RF) ablation. Materials and Methods: In this HIPAA-compliant, institutional review board–approved prospective study with written informed consent, 25 patients (17 men, eight women) underwent 33 percutaneous and three intraoperative biopsies of 36 FDG-avid targets between November 2007 and August 2010. One patient underwent biopsy and RF ablation of an FDG-avid hepatic focus. Targets demonstrated heterogeneous FDG uptake or were not well seen or were totally inapparent at conventional imaging. Preprocedural FDG PET scans were rigidly registered through a semiautomatic method to intraprocedural CT scans. Coaxial biopsy needle introducer tips and RF ablation electrode guider needle tips containing electromagnetic sensor coils were spatially tracked through an electromagnetic field generator. Real-time US scans were registered through a fiducial-based method, allowing US scans to be fused with intraprocedural CT and preacquired FDG PET scans. A visual display of US/CT image fusion with overlaid coregistered FDG PET targets was used for guidance; navigation software enabled real-time biopsy needle and needle electrode navigation and feedback. Results: Successful fusion of real-time US to coregistered CT and FDG PET scans was achieved in all patients. Thirty-one of 36 biopsies were diagnostic (malignancy in 18 cases, benign processes in 13 cases). RF ablation resulted in resolution of targeted FDG avidity, with no local treatment failure during short follow-up (56 days). Conclusion: Combined electromagnetic device tracking and image fusion with real-time feedback may facilitate biopsies and ablations of focal FDG PET abnormalities that would be challenging with conventional image guidance. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101985/-/DC1 PMID:21734159

Bimodal albedo distributions in the ablation zone of the southwestern Greenland Ice Sheet

NASA Astrophysics Data System (ADS)

Moustafa, S. E.; Rennermalm, A. K.; Smith, L. C.; Miller, M. A.; Mioduszewski, J. R.

2014-09-01

Surface albedo is a key variable controlling solar radiation absorbed at the Greenland Ice Sheet (GrIS) surface, and thus, meltwater production. Recent decline in surface albedo over the GrIS has been linked to enhanced snow grain metamorphic rates and amplified ice-albedo feedback from atmospheric warming. However, the importance of distinct surface types on ablation zone albedo and meltwater production is still relatively unknown, and excluded in surface mass balance models. In this study, we analyze albedo and ablation rates using in situ and remotely-sensed data. Observations include: (1) a new high-quality in situ spectral albedo dataset collected with an Analytical Spectral Devices (ASD) spectroradiometer measuring at 325-1075 nm, along a 1.25 km transect during three days in June 2013; (2) broadband albedo at two automatic weather stations; and (3) daily MODerate Resolution Imaging Spectroradiometer (MODIS) albedo (MOD10A1) between 31 May and 30 August. We find that seasonal ablation zone albedos have a bimodal distribution, with two alternate states. This suggests that an abrupt switch from high to low albedo can be triggered by a modest melt event, resulting in amplified surface ablation rates. Our results show that such a shift corresponds to an observed melt rate percent difference increase of 51.6% during peak melt season (between 10-14 and 20-24 July 2013). Furthermore, our findings demonstrate that seasonal changes in GrIS ablation zone albedo are not exclusively a function of a darkening surface from ice crystal growth, but rather are controlled by changes in the fractional coverage of snow, bare ice, and impurity-rich surface types. As the climate continues to warm, regional climate models should consider the seasonal evolution of ice surface types in Greenland's ablation zone to improve projections of mass loss contributions to sea level rise.

Bimodal Albedo Distributions in the Ablation Zone of the Southwestern Greenland Ice Sheet

NASA Astrophysics Data System (ADS)

Moustafa, S.; Rennermalm, A. K.; Smith, L. C.; Miller, M. A.; Mioduszewski, J.; Koenig, L.

2014-12-01

Surface albedo is a key variable controlling solar radiation absorbed at the Greenland Ice Sheet (GrIS) surface, and thus meltwater production. Recent decline in surface albedo over the GrIS has been linked to enhanced snow grain metamorphic rates and amplified ice-albedo feedback from atmospheric warming. However, the importance of distinct surface types on ablation zone albedo and meltwater production is still relatively unknown, and excluded in surface mass balance models. In this study, we analyze albedo and ablation rates (m d-1) using in situ and remotely-sensed data. Observations include: 1) a new high-quality in situ spectral albedo dataset collected with an Analytical Spectral Devices (ASD) spectroradiometer measuring at 325-1075 nm, along a 1.25 km transect during three days in June 2013; 2) broadband albedo at two automatic weather stations; and 3) daily MODerate Resolution Imaging Spectroradiometer (MODIS) albedo (MOD10A1) between 31 May and 30 August. We find that seasonal ablation zone albedos have a bimodal distribution, with two alternate states. This suggests that an abrupt switch from high to low albedo can be triggered by a modest melt event, resulting in amplified ablation rates. Our results show that such a shift corresponds to an observed melt rate percent difference increase of 51.6% during peak melt season (between 10-14 July and 20-24 July, 2013). Furthermore, our findings demonstrate that seasonal changes in GrIS ablation zone albedo are not exclusively a function of a darkening surface from ice crystal growth, but rather are controlled by changes in the fractional coverage of snow, bare ice, and impurity-rich surface types. As the climate continues to warm, regional climate models should consider the seasonal evolution of ice surface types in Greenland's ablation zone to improve projections of mass loss contributions to sea level rise.

Real-time iterative monitoring of radiofrequency ablation tumor therapy with 15O-water PET imaging.

PubMed

Bao, Ande; Goins, Beth; Dodd, Gerald D; Soundararajan, Anuradha; Santoyo, Cristina; Otto, Randal A; Davis, Michael D; Phillips, William T

2008-10-01

A method that provides real-time image-based monitoring of solid tumor therapy to ensure complete tumor eradication during image-guided interventional therapy would be a valuable tool. The short, 2-min half-life of (15)O makes it possible to perform repeated PET imaging at 20-min intervals at multiple time points before and after image-guided therapy. In this study, (15)O-water PET was evaluated as a tool to provide real-time feedback and iterative image guidance to rapidly monitor the intratumoral coverage of radiofrequency (RF) ablation therapy. Tumor RF ablation therapy was performed on head and neck squamous cell carcinoma (SCC) xenograft tumors (length, approximately 23 mm) in 6 nude rats. The tumor in each animal was ablated with RF (1-cm active size ablation catheter, 70 degrees C for 5 min) twice in 2 separate tumor regions with a 20-min separation. The (15)O-water PET images were acquired before RF ablation and after the first RF and second RF ablations using a small-animal PET scanner. In each PET session, approximately 100 MBq of (15)O-water in 1.0 mL of saline were injected intravenously into each animal. List-mode PET images were acquired for 7 min starting 20 s before injection. PET images were reconstructed by 2-dimensional ordered-subset expectation maximization into single-frame images and dynamic images at 10 s/frame. PET images were displayed and analyzed with software. Pre-RF ablation images demonstrate that (15)O-water accumulates in tumors with (15)O activity reaching peak levels immediately after administration. After RF ablation, the ablated region had almost zero activity, whereas the unablated tumor tissue continued to have a high (15)O-water accumulation. Using image feedback, the RF probe was repositioned to a tumor region with residual (15)O-water uptake and then ablated. The second RF ablation in this new region of the tumor resulted in additional ablation of the solid tumor, with a corresponding decrease in activity on the (15)O-water PET image. (15)O-water PET clearly demonstrated the ablated tumor region, whereas the unablated tumor continued to show high (15)O-water accumulation. (15)O-water imaging shows promise as a tool for on-site, real-time monitoring of image-guided interventional cancer therapy.

Investigation of Laser Induced Breakdown Spectroscopy (LIBS) for the Differentiation of Nerve and Gland Tissue—A Possible Application for a Laser Surgery Feedback Control Mechanism

NASA Astrophysics Data System (ADS)

Mehari, F.; Rohde, M.; Knipfer, C.; Kanawade, R.; Klämpfl, F.; W., Adler; Oetter, N.; Stelzle, F.; Schmidt, M.

2016-06-01

Laser surgery provides clean, fast and accurate modeling of tissue. However, the inability to determine what kind of tissue is being ablated at the bottom of the cut may lead to the iatrogenic damage of structures that were meant to be preserved. In this context, nerve preservation is one of the key challenges in any surgical procedure. One example is the treatment of parotid gland pathologies, where the facial nerve (N. VII) and its main branches run through and fan out inside the glands parenchyma. A feedback system that automatically stops the ablation to prevent nerve-tissue damage could greatly increase the applicability and safety of surgical laser systems. In the present study, Laser Induced Breakdown Spectroscopy (LIBS) is used to differentiate between nerve and gland tissue of an ex-vivo pig animal model. The LIBS results obtained in this preliminary experiment suggest that the measured spectra, containing atomic and molecular emissions, can be used to differentiate between the two tissue types. The measurements and differentiation were performed in open air and under normal stray light conditions.

Near-infrared image-guided laser ablation of artificial caries lesions.

PubMed

Tao, You-Chen; Fan, Kenneth; Fried, Daniel

2007-01-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two-dimensional NIR images of demineralized tooth surfaces can be used to guide CO(2) laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 × 5 mm(2) bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO(2) laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO(2) laser ablation system for the selective removal of dental caries.

Near-infrared image-guided laser ablation of artificial caries lesions

PubMed Central

Tao, You-Chen; Fan, Kenneth; Fried, Daniel

2012-01-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two–dimensional NIR images of demineralized tooth surfaces can be used to guide CO2 laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 × 5 mm2 bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO2 laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO2 laser ablation system for the selective removal of dental caries. PMID:22866210

Near-infrared image-guided laser ablation of artificial caries lesions

NASA Astrophysics Data System (ADS)

Tao, You-Chen; Fan, Kenneth; Fried, Daniel

2007-02-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two-dimensional NIR images of demineralized tooth surfaces can be used to guide CO II laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 x 5 mm2 bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO II laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO II laser ablation system for the selective removal of dental caries.

Feasibility of Intraoperative Nerve Monitoring in Preventing Thermal Damage to the “Nerve at Risk” During Image-Guided Ablation of Tumors

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

Marshall, Richard H., E-mail: rmars1@lsuhsc.edu; Avila, Edward K., E-mail: avilae@mskcc.org; Solomon, Stephen B., E-mail: solomons@mskcc.org

PurposeTo assess feasibility of intraoperative neurophysiologic monitoring (IONM) during image-guided, percutaneous thermal ablation of tumors.Materials and MethodsFrom February 2009 to October 2013, a retrospective review of all image-guided percutaneous thermal ablation interventions using IONM was performed and data was compiled using electronic medical records and imaging studies.ResultsTwelve patients were treated in 13 ablation interventions. In 4 patients, real-time feedback from the monitoring neurologist was used to adjust applicator placement and ablation settings. IONM was technically feasible in all procedures and there were no complications related to monitoring or ablation. All nerves at risk remained intact and of the 11 patientsmore » who could be followed, none developed new nerve deficit up to a minimum of 2 months after ablation.ConclusionIONM is safe and feasible for use during image-guided thermal ablation of tumors in the vicinity of nerves. Outcomes in this study demonstrate its potential utility in image-guided ablation interventions.« less

Soft tissue differentiation by diffuse reflectance spectroscopy

NASA Astrophysics Data System (ADS)

Zam, Azhar; Stelzle, Florian; Nkenke, Emeka; Tangermann-Gerk, Katja; Schmidt, Michael; Adler, Werner; Douplik, Alexandre

2009-07-01

Laser surgery gives the possibility to work remotely which leads to high precision, little trauma and high level sterility. However these advantages are coming with the lack of haptic feedback during the laser ablation of tissue. Therefore additional means are required to control tissue-specific ablation during laser surgery supporting the surgeon regardless of experience and skills. Diffuse Reflectance Spectroscopy provides a straightforward and simple approach for optical tissue differentiation. We measured diffuse reflectance from four various tissue types ex vivo. We applied Linear Discriminant Analysis (LDA) to differentiate the four tissue types and computed the area under the ROC curve (AUC). Special emphasis was taken on the identification of nerve as the most crucial tissue for maxillofacial surgery. The results show a promise for differentiating soft tissues as guidance for tissue-specific laser surgery by means of the diffuse reflectance.

Towards a Teleoperated Needle Driver Robot with Haptic Feedback for RFA of Breast Tumors under Continuous MRI1

PubMed Central

Kokes, Rebecca; Lister, Kevin; Gullapalli, Rao; Zhang, Bao; MacMillan, Alan; Richard, Howard; Desai, Jaydev P.

2009-01-01

Objective The purpose of this paper is to explore the feasibility of developing a MRI-compatible needle driver system for radiofrequency ablation (RFA) of breast tumors under continuous MRI imaging while being teleoperated by a haptic feedback device from outside the scanning room. The developed needle driver prototype was designed and tested for both tumor targeting capability as well as RFA. Methods The single degree-of-freedom (DOF) prototype was interfaced with a PHANToM haptic device controlled from outside the scanning room. Experiments were performed to demonstrate MRI-compatibility and position control accuracy with hydraulic actuation, along with an experiment to determine the PHANToM’s ability to guide the RFA tool to a tumor nodule within a phantom breast tissue model while continuously imaging within the MRI and receiving force feedback from the RFA tool. Results Hydraulic actuation is shown to be a feasible actuation technique for operation in an MRI environment. The design is MRI-compatible in all aspects except for force sensing in the directions perpendicular to the direction of motion. Experiments confirm that the user is able to detect healthy vs. cancerous tissue in a phantom model when provided with both visual (imaging) feedback and haptic feedback. Conclusion The teleoperated 1-DOF needle driver system presented in this paper demonstrates the feasibility of implementing a MRI-compatible robot for RFA of breast tumors with haptic feedback capability. PMID:19303805

Quasi-dynamical analysis and real-time tissue temperature monitoring during laser vaporization

NASA Astrophysics Data System (ADS)

Wang, Hui; Ray, Aditi; Jebens, Dave; Chia, Ray; Hasenberg, Tom

2014-03-01

Vaporization and coagulation are two fundamental processes that can be performed during laser-tissue ablation. We demonstrated a method allowing quasi-dynamically observing of the cross-sectional images of tissue response during ablation. The results showed that coagulation depth is relatively constant during vaporization, which supports the excellent hemostasis of green laser benign prostate hyperplasia (BPH) treatment. We also verified a new technology for real-time, in situ tissue temperature monitoring, which may be promising for in vivo tissue vaporization degree feedback during laser ablation to improve the vaporization efficiency and avoid complications.

Control of intrauterine fluid pressure during operative hysteroscopy.

PubMed

Shirk, G J; Gimpelson, R J

1994-05-01

To evaluate the safety of a commonly used piston pump that controls the infusion pressure of low-viscosity fluids in a continuous-flow hysteroscopic system during operative hysteroscopy. Consecutive patients requiring operative hysteroscopy. Three hospital facilities in the Midwest. Sequential sample of 250 women who underwent operative hysteroscopy. Endometrial ablations, resection of submucosal or pedunculated uterine leiomyomata with or without endometrial ablation, polyp resections, metroplasty, and lysis of synechiae. The most serious complication of operative hysteroscopy is fluid overload due to intravasation into the patient's vascular system. Low-viscosity fluids were infused by the Zimmer Controlled Distention Irrigation System. The instrument uses a closed-feedback loop to monitor cavity pressure and automatically regulates the flow to maintain the set point pressure. It is designed to operate in a pressure range of 0 to 80 mm Hg and at flows in excess of 450 ml/minute. In 250 operative hysteroscopies no fluid complications occurred when intrauterine pressure was maintained below 80 mm Hg. No clinically significant differences in intravasation were seen in any type of operative hysteroscopy. This controlled mechanical pump system with exact intrauterine pressure measurement reduced many technical difficulties associated with low-viscosity media, and created a safe environment for the media's use in operative hysteroscopy.

Laser ablation of basal cell carcinomas guided by confocal microscopy

NASA Astrophysics Data System (ADS)

Sierra, Heidy; Cordova, Miguel; Nehal, Kishwer; Rossi, Anthony; Chen, Chih-Shan Jason; Rajadhyaksha, Milind

2016-02-01

Laser ablation offers precise and fast removal of superficial and early nodular types of basal cell carcinomas (BCCs). Nevertheless, the lack of histological confirmation has been a limitation. Reflectance confocal microscopy (RCM) imaging combined with a contrast agent can offer cellular-level histology-like feedback to detect the presence (or absence) of residual BCC directly on the patient. We conducted an ex vivo bench-top study to provide a set of effective ablation parameters (fluence, number of passes) to remove superficial BCCs while also controlling thermal coagulation post-ablation to allow uptake of contrast agent. The results for an Er:YAG laser (2.9 um and pulse duration 250us) show that with 6 passes of 25 J/cm2, thermal coagulation can be effectively controlled, to allow both the uptake of acetic acid (contrast agent) and detection of residual (or absence) BCCs. Confirmation was provided with histological examination. An initial in vivo study on 35 patients shows that the uptake of contrast agent aluminum chloride) and imaging quality is similar to that observed in the ex vivo study. The detection of the presence of residual tumor or complete clearance was confirmed in 10 wounds with (additional) histology and in 25 lesions with follow-up imaging. Our results indicate that resolution is sufficient but further development and use of appropriate contrast agent are necessary to improve sensitivity and specificity. Advances in RCM technology for imaging of lateral and deep margins directly on the patient may provide less invasive, faster and less expensive image-guided approaches for treatment of BCCs.

Multi-modal albedo distributions in the ablation area of the southwestern Greenland Ice Sheet

NASA Astrophysics Data System (ADS)

Moustafa, S. E.; Rennermalm, A. K.; Smith, L. C.; Miller, M. A.; Mioduszewski, J. R.; Koenig, L. S.; Hom, M. G.; Shuman, C. A.

2015-05-01

Surface albedo is a key variable controlling solar radiation absorbed at the Greenland Ice Sheet (GrIS) surface and, thus, meltwater production. Recent decline in surface albedo over the GrIS has been linked to enhanced snow grain metamorphic rates, earlier snowmelt, and amplified melt-albedo feedback from atmospheric warming. However, the importance of distinct surface types on ablation area albedo and meltwater production is still relatively unknown. In this study, we analyze albedo and ablation rates using in situ and remotely sensed data. Observations include (1) a new high-quality in situ spectral albedo data set collected with an Analytical Spectral Devices Inc. spectroradiometer measuring at 325-1075 nm along a 1.25 km transect during 3 days in June 2013; (2) broadband albedo at two automatic weather stations; and (3) daily MODerate Resolution Imaging Spectroradiometer (MODIS) albedo (MOD10A1) between 31 May and 30 August 2012 and 2013. We find that seasonal ablation area albedos in 2013 have a bimodal distribution, with snow and ice facies characterizing the two peaks. Our results show that a shift from a distribution dominated by high to low albedos corresponds to an observed melt rate increase of 51.5% (between 10-14 July and 20-24 July 2013). In contrast, melt rate variability caused by albedo changes before and after this shift was much lower and varied between ~10 and 30% in the melting season. Ablation area albedos in 2012 exhibited a more complex multimodal distribution, reflecting a transition from light to dark-dominated surface, as well as sensitivity to the so called "dark-band" region in southwest Greenland. In addition to a darkening surface from ice crystal growth, our findings demonstrate that seasonal changes in GrIS ablation area albedos are controlled by changes in the fractional coverage of snow, bare ice, and impurity-rich surface types. Thus, seasonal variability in ablation area albedos appears to be regulated primarily as a function of bare ice expansion at the expense of snow, surface meltwater ponding, and melting of outcropped ice layers enriched with mineral materials, enabling dust and impurities to accumulate. As climate change continues in the Arctic region, understanding the seasonal evolution of ice sheet surface types in Greenland's ablation area is critical to improve projections of mass loss contributions to sea level rise.

Development of a 3D patient-specific planning platform for interstitial and transurethral ultrasound thermal therapy

NASA Astrophysics Data System (ADS)

Prakash, Punit; Diederich, Chris J.

2010-03-01

Interstitial and transurethral catheter-based ultrasound devices are under development for treatment of prostate cancer and BPH, uterine fibroids, liver tumors and other soft tissue disease. Accurate 3D thermal modeling is essential for designing site-specific applicators, exploring treatment delivery strategies, and integration of patient-specific treatment planning of thermal ablations. We are developing a comprehensive 3D modeling and treatment planning platform for ultrasound ablation of tissue using catheter-based applicators. We explored the applicability of assessing thermal effects in tissue using critical temperature, thermal dose and Arrhenius thermal damage thresholds and performed a comparative analysis of dynamic tissue properties critical to accurate modeling. We used the model to assess the feasibility of automatic feedback control with MR thermometry, and demonstrated the utility of the modeling platform for 3D patient-specific treatment planning. We have identified critical temperature, thermal dose and thermal damage thresholds for assessing treatment endpoint. Dynamic changes in tissue attenuation/absorption and perfusion must be included for accurate prediction of temperature profiles and extents of the ablation zone. Lastly, we demonstrated use of the modeling platform for patient-specific treatment planning.

Magnetic resonance-guided focused ultrasound treatment of facet joint pain: summary of preclinical phase

PubMed Central

2014-01-01

Study design A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted to test the feasibility, safety, and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for treating facet joint pain. Objective The goal of the current study was to develop a novel method for accurate and safe noninvasive facet joint ablation using MRgFUS. Summary of background data Facet joints are a common source of chronic back pain. Direct facet joint interventions include medial branch nerve ablation and intra-articular injections, which are widely used, but limited in the short and long term. MRgFUS is a breakthrough technology that enables accurate delivery of high-intensity focused ultrasound energy to create a localized temperature rise for tissue ablation, using MR guidance for treatment planning and real-time feedback. Methods We validated the feasibility, safety, and efficacy of MRgFUS for facet joint ablation using the ExAblate 2000® System (InSightec Ltd., Tirat Carmel, Israel) and confirmed the system's ability to ablate the edge of the facet joint and all terminal nerves innervating the joint. A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted. Results The experiments showed that targeting the facet joint with energies of 150–450 J provides controlled and accurate heating at the facet joint edge without penetration to the vertebral body, spinal canal, or root foramina. Treating with reduced diameter of the acoustic beam is recommended since a narrower beam improves access to the targeted areas. Conclusions MRgFUS can safely and effectively target and ablate the facet joint. These results are highly significant, given that this is the first study to demonstrate the potential of MRgFUS to treat facet joint pain. PMID:24921048

Microwave Ablation of Porcine Kidneys in vivo: Effect of two Different Ablation Modes ('Temperature Control' and 'Power Control') on Procedural Outcome

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

Sommer, C. M., E-mail: christof.sommer@med.uni-heidelberg.de; Arnegger, F.; Koch, V.

2012-06-15

Purpose: This study was designed to analyze the effect of two different ablation modes ('temperature control' and 'power control') of a microwave system on procedural outcome in porcine kidneys in vivo. Methods: A commercially available microwave system (Avecure Microwave Generator; MedWaves, San Diego, CA) was used. The system offers the possibility to ablate with two different ablation modes: temperature control and power control. Thirty-two microwave ablations were performed in 16 kidneys of 8 pigs. In each animal, one kidney was ablated twice by applying temperature control (ablation duration set point at 60 s, ablation temperature set point at 96 Degree-Signmore » C, automatic power set point; group I). The other kidney was ablated twice by applying power control (ablation duration set point at 60 s, ablation temperature set point at 96 Degree-Sign C, ablation power set point at 24 W; group II). Procedural outcome was analyzed: (1) technical success (e.g., system failures, duration of the ablation cycle), and (2) ablation geometry (e.g., long axis diameter, short axis diameter, and circularity). Results: System failures occurred in 0% in group I and 13% in group II. Duration of the ablation cycle was 60 {+-} 0 s in group I and 102 {+-} 21 s in group II. Long axis diameter was 20.3 {+-} 4.6 mm in group I and 19.8 {+-} 3.5 mm in group II (not significant (NS)). Short axis diameter was 10.3 {+-} 2 mm in group I and 10.5 {+-} 2.4 mm in group II (NS). Circularity was 0.5 {+-} 0.1 in group I and 0.5 {+-} 0.1 in group II (NS). Conclusions: Microwave ablations performed with temperature control showed fewer system failures and were finished faster. Both ablation modes demonstrated no significant differences with respect to ablation geometry.« less

Prostate tissue ablation with MRI guided transurethral therapeutic ultrasound and intraoperative assessment of the integrity of the neurovascular bundle

NASA Astrophysics Data System (ADS)

Sammet, Steffen; Partanen, Ari; Yousuf, Ambereen; Wardrip, Craig; Niekrasz, Marek; Antic, Tatjana; Razmaria, Aria; Sokka, Sham; Karczmar, Gregory; Oto, Aytekin

2017-03-01

OBJECTIVES: Evaluation of the precision of prostate tissue ablation with MRI guided therapeuticultrasound by intraoperative objective assessment of the neurovascular bundle in canines in-vivo. METHODS: In this ongoing IACUC approved study, eight male canines were scanned in a clinical 3T Achieva MRI scanner (Philips) before, during, and after ultrasound therapy with a prototype MR-guided ultrasound therapy system (Philips). The system includes a therapy console to plan treatment, to calculate real-time temperature maps, and to control ultrasound exposures with temperature feedback. Atransurethral ultrasound applicator with eight transducer elements was used to ablate canine prostate tissue in-vivo. Ablated prostate tissue volumes were compared to the prescribed target volumes to evaluate technical effectiveness. The ablated volumes determined by MRI (T1, T2, diffusion, dynamic contrast enhanced and 240 CEM43 thermal dose maps) were compared to H&E stained histological slides afterprostatectomy. Potential nerve damage of the neurovascular bundle was objectively assessed intraoperativelyduring prostatectomy with a CaverMap Surgical Aid nerve stimulator (Blue Torch Medical Technologies). RESULTS: Transurethral MRI -guided ultrasound therapy can effectively ablate canine prostate tissue invivo. Coronal MR-imaging confirmed the correct placement of the HIFU transducer. MRI temperature maps were acquired during HIFU treatment, and subsequently used for calculating thermal dose. Prescribed target volumes corresponded to the 240 CEM43 thermal dose maps during HIFU treatment in all canines. Ablated volumes on high resolution anatomical, diffusion weighted, and contrast enhanced MR images matched corresponding histological slides after prostatectomy. MRI guidance with realtime temperature monitoring showed no damage to surrounding tissues, especially to the neurovascular bundle (assessed intra-operatively with a nerve stimulator) or to the rectum wall. CONCLUSIONS: Our study demonstrates the effectiveness and precision of transurethral ultrasound ablation of prostatic tissue in canines with MRI monitoring and guidance. The canine prostate is an excellent model for the human prostate with similar anatomical characteristics and diseases. MRI guidance with real-time, intraoperative temperature monitoring reduces the risk of damaging critical surrounding anatomical structures in ultrasound therapy of the prostate.

Thermal modelling using discrete vasculature for thermal therapy: a review

PubMed Central

Kok, H.P.; Gellermann, J.; van den Berg, C.A.T.; Stauffer, P.R.; Hand, J.W.; Crezee, J.

2013-01-01

Reliable temperature information during clinical hyperthermia and thermal ablation is essential for adequate treatment control, but conventional temperature measurements do not provide 3D temperature information. Treatment planning is a very useful tool to improve treatment quality and substantial progress has been made over the last decade. Thermal modelling is a very important and challenging aspect of hyperthermia treatment planning. Various thermal models have been developed for this purpose, with varying complexity. Since blood perfusion is such an important factor in thermal redistribution of energy in in vivo tissue, thermal simulations are most accurately performed by modelling discrete vasculature. This review describes the progress in thermal modelling with discrete vasculature for the purpose of hyperthermia treatment planning and thermal ablation. There has been significant progress in thermal modelling with discrete vasculature. Recent developments have made real-time simulations possible, which can provide feedback during treatment for improved therapy. Future clinical application of thermal modelling with discrete vasculature in hyperthermia treatment planning is expected to further improve treatment quality. PMID:23738700

Magnetic Resonance Thermometry-Guided Stereotactic Laser Ablation of Cavernous Malformations in Drug-Resistant Epilepsy: Imaging and Clinical Results

PubMed Central

McCracken, D. Jay; Willie, Jon T.; Fernald, Brad; Saindane, Amit M.; Drane, Daniel L.; Barrow, Daniel L.; Gross, Robert E.

2016-01-01

BACKGROUND Surgery is indicated for cerebral cavernous malformations (CCM) that cause medically refractory epilepsy. Real-time magnetic resonance thermography (MRT)-guided stereotactic laser ablation (SLA) is a minimally invasive approach to treating focal brain lesions. SLA of CCM has not previously been described. OBJECTIVE To describe MRT-guided SLA, a novel approach to treating CCM-related epilepsy, with respect to feasibility, safety, imaging, and seizure control in 5 consecutive patients. METHODS Five patients with medically refractory epilepsy undergoing standard presurgical evaluation were found to have corresponding lesions fulfilling imaging characteristics of CCM and were prospectively enrolled. Each underwent stereotactic placement of a saline-cooled cannula containing an optical fiber to deliver 980-nm diode laser energy via twist drill craniostomy. MR anatomic imaging was used to evaluate targeting prior to ablation. MR imaging provided evaluation of targeting and near real-time feedback regarding extent of tissue thermocoagulation. Patients maintained seizure diaries, and remote imaging (6–21 months post-ablation) was obtained in all patients. RESULTS Imaging revealed no evidence of acute hemorrhage following fiber placement within presumed CCM. MRT during treatment and immediate post-procedure imaging confirmed desired extent of ablation. We identified no adverse events or neurological deficits. Four of 5 (80%) patients achieved freedom from disabling seizures after SLA alone (Engel class 1 outcome), with follow-up ranging 12–28 months. Reimaging of all subjects (6–21 months) indicated lesion diminution with surrounding liquefactive necrosis, consistent with the surgical goal of extended lesionotomy. CONCLUSION Minimally invasive MRT-guided SLA of epileptogenic CCM is a potentially safe and effective alternative to open resection. Additional experience and longer follow-up are needed. PMID:27959970

Magnetic resonance image guided transurethral ultrasound prostate ablation: a preclinical safety and feasibility study with 28-day followup.

PubMed

Burtnyk, Mathieu; Hill, Tracy; Cadieux-Pitre, Heather; Welch, Ian

2015-05-01

We determine the safety and feasibility of magnetic resonance image guided transurethral ultrasound prostate ablation using active temperature feedback control in a preclinical canine model with 28-day followup. After a long acclimatization period we performed ultrasound treatment in 8 subjects using the magnetic resonance image guided TULSA-PRO™ transurethral ultrasound prostate ablation system. Comprehensive examinations and observations were done before and throughout the 28-day followup, including assessment of clinically significant treatment related adverse events. In addition to gross pathology evaluation, extensive histopathological analysis was done to assess cell kill inside and outside the prostate. We evaluated prostate conformal heating by comparing the spatial difference between the treatment plan and the 55C isotherm measured on magnetic resonance imaging thermometry acquired during treatment. These findings were confirmed on contrast enhanced magnetic resonance imaging immediately after treatment and at 28 days. Clinically there were no adverse events in any of the 8 subjects throughout the 28-day followup. All subjects had normal urinary and bowel function. Gross necropsy and histology confirmed that the intended thermal cell kill was confined to the prostate. No surrounding tissue was damaged, including the rectum and the external urinary sphincter. Conformal heating was achieved with an average -0.9 mm accuracy and 0.9 mm precision. Contrast enhanced magnetic resonance imaging and histological analysis confirmed tissue ablation in targeted areas of the prostate. Urethral tissue was spared from thermal damage. Magnetic resonance image guided transurethral ultrasound is a safe, feasible procedure for accurate and precise conformal thermal ablation of prostate tissue, as demonstrated in a preclinical model with 28-day followup. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Automated ablation of dental composite using an IR pulsed laser coupled to a plume emission spectral feedback system.

PubMed

Jang, Andrew T; Chan, Kenneth H; Fried, Daniel

2017-09-01

The purpose of this study is to assemble a laser system for the selective removal of dental composite from tooth surfaces, that is feasible for clinical use incorporating a spectral feedback system, a scanning system, articulating arm and a clinical hand-piece, and evaluate the performance of that system on extracted teeth. Ten extracted teeth were collected and small fillings were placed on the occlusal surface of each tooth. A clinical system featuring a CO 2 laser operating at 50 Hz and spectral optical feedback was used to remove the composite. Removal was confirmed using a cross polarized optical coherence tomography (CP-OCT) system designed for clinical use. The system was capable of rapidly removing composite from small preparations on tooth occlusal surfaces with a mean loss of enamel of less than 20 μm. We have demonstrated that spectral feedback can be successfully employed in an automated system for composite removal by incorporating dual photodiodes and a galvanometer controlled CO 2 laser. Additionally, the use of registered OCT images presents as a viable method for volumetric benchmarking. Overall, this study represents the first implementation of spectral feedback into a clinical hand-piece and serves as a benchmark for a future clinical study. Lasers Surg. Med. 49:658-665, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Optical emission and nanoparticle generation in Al plasmas using ultrashort laser pulses temporally optimized by real-time spectroscopic feedback

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

Guillermin, M.; Colombier, J. P.; Audouard, E.

2010-07-15

With an interest in pulsed laser deposition and remote spectroscopy techniques, we explore here the potential of laser pulses temporally tailored on ultrafast time scales to control the expansion and the excitation degree of various ablation products including atomic species and nanoparticulates. Taking advantage of automated pulse-shaping techniques, an adaptive procedure based on spectroscopic feedback is applied to regulate the irradiance and enhance the optical emission of monocharged aluminum ions with respect to the neutral signal. This leads to optimized pulses usually consisting in a series of femtosecond peaks distributed on a longer picosecond sequence. The ablation features induced bymore » the optimized pulse are compared with those determined by picosecond pulses generated by imposed second-order dispersion or by double pulse sequences with adjustable picosecond separation. This allows to analyze the influence of fast- and slow-varying envelope features on the material heating and the resulting plasma excitation degree. Using various optimal pulse forms including designed asymmetric shapes, we analyze the establishment of surface pre-excitation that enables conditions of enhanced radiation coupling. Thin films elaborated by unshaped femtosecond laser pulses and by optimized, stretched, or double pulse sequences are compared, indicating that the nanoparticles generation efficiency is strongly influenced by the temporal shaping of the laser irradiation. A thermodynamic scenario involving supercritical heating is proposed to explain enhanced ionization rates and lower particulates density for optimal pulses. Numerical one-dimensional hydrodynamic simulations for the excited matter support the interpretation of the experimental results in terms of relative efficiency of various relaxation paths for excited matter above or below the thermodynamic stability limits. The calculation results underline the role of the temperature and density gradients along the ablated plasma plume which lead to the spatial distinct locations of excited species. Moreover, the nanoparticles sizes are computed based on liquid layer ejection followed by a Rayleigh and Taylor instability decomposition, in good agreement with the experimental findings.« less

Image-based modeling and characterization of RF ablation lesions in cardiac arrhythmia therapy

NASA Astrophysics Data System (ADS)

Linte, Cristian A.; Camp, Jon J.; Rettmann, Maryam E.; Holmes, David R.; Robb, Richard A.

2013-03-01

In spite of significant efforts to enhance guidance for catheter navigation, limited research has been conducted to consider the changes that occur in the tissue during ablation as means to provide useful feedback on the progression of therapy delivery. We propose a technique to visualize lesion progression and monitor the effects of the RF energy delivery using a surrogate thermal ablation model. The model incorporates both physical and physiological tissue parameters, and uses heat transfer principles to estimate temperature distribution in the tissue and geometry of the generated lesion in near real time. The ablation model has been calibrated and evaluated using ex vivo beef muscle tissue in a clinically relevant ablation protocol. To validate the model, the predicted temperature distribution was assessed against that measured directly using fiberoptic temperature probes inserted in the tissue. Moreover, the model-predicted lesions were compared to the lesions observed in the post-ablation digital images. Results showed an agreement within 5°C between the model-predicted and experimentally measured tissue temperatures, as well as comparable predicted and observed lesion characteristics and geometry. These results suggest that the proposed technique is capable of providing reasonably accurate and sufficiently fast representations of the created RF ablation lesions, to generate lesion maps in near real time. These maps can be used to guide the placement of successive lesions to ensure continuous and enduring suppression of the arrhythmic pathway.

Fs-laser ablation of teeth is temperature limited and provides information about the ablated components.

PubMed

de Menezes, Rebeca Ferraz; Harvey, Catherine Malinda; de Martínez Gerbi, Marleny Elizabeth Márquez; Smith, Zachary J; Smith, Dan; Ivaldi, Juan C; Phillips, Alton; Chan, James W; Wachsmann-Hogiu, Sebastian

2017-10-01

The goal of this work is to investigate the thermal effects of femtosecond laser (fs-laser) ablation for the removal of carious dental tissue. Additional studies identify different tooth tissues through femtosecond laser induced breakdown spectroscopy (fsLIBS) for the development of a feedback loop that could be utilized during ablation in a clinical setting. Scanning Election Microscope (SEM) images reveal that minimal morphological damages are incurred at repetition rates below the carbonization threshold of each tooth tissue. Thermal studies measure the temperature distribution and temperature decay during laser ablation and after laser cessation, and demonstrate that repetition rates at or below 10kHz with a laser fluence of 40 J/cm 2 would inflict minimal thermal damage on the surrounding nerve tissues and provide acceptable clinical removal rates. Spectral analysis of the different tooth tissues is also conducted and differences between the visible wavelength fsLIBS spectra are evident, though more robust classification studies are needed for clinical translation. These results have initiated a set of precautionary recommendations that would enable the clinician to utilize femtosecond laser ablation for the removal of carious lesions while ensuring that the solidity and utility of the tooth remain intact. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Characteristics of Cavotricuspid Isthmus Ablation for Atrial Flutter Guided by Novel Parameters Using a Contact Force Catheter.

PubMed

Gould, Paul A; Booth, Cameron; Dauber, Kieran; Ng, Kevin; Claughton, Andrew; Kaye, Gerald C

2016-12-01

This study sought to investigate specific contact force (CF) parameters to guide cavotricuspid isthmus (CTI) ablation and compare the outcome with a historical control cohort. Patients (30) undergoing CTI ablation were enrolled prospectively in the Study cohort and compared with a retrospective Control cohort of 30 patients. Ablation in the Study cohort was performed using CF parameters >10 g and <40 g and a Force Time Integral (FTI) of 800 ± 10 g. The Control cohort underwent traditionally guided CTI ablation. Traditional parameters (electrogram and impedance change) were assessed in both cohorts. All ablations regardless of achieving targets were included in data analysis. Bidirectional CTI block was achieved in all of the Study and 27 of the Control cohort. Atrial flutter recurred in 3 (10%) patients (follow-up 564 ± 212 days) in the study cohort and in 3 (10%) patients (follow-up 804 ± 540 days) in the Control cohort. There were no major complications in either cohort. Traditional parameters correlated poorly with CF parameters. In the Study cohort, flutter recurrence was associated with significantly lower FTI and ablation duration, but was not associated with total average CF. CTI ablation can be safely performed using CF parameters guiding ablation, with similar long-term results to a historical ablation control group. Potentially CF parameters may provide adjunctive information to enable a more efficient CTI ablation. Further research is required to confirm this. © 2016 Wiley Periodicals, Inc.

Toward guidance of epicardial cardiac radiofrequency ablation therapy using optical coherence tomography

NASA Astrophysics Data System (ADS)

Fleming, Christine P.; Quan, Kara J.; Rollins, Andrew M.

2010-07-01

Radiofrequency ablation (RFA) is the standard of care to cure many cardiac arrhythmias. Epicardial ablation for the treatment of ventricular tachycardia has limited success rates due in part to the presence of epicardial fat, which prevents proper rf energy delivery, inadequate contact of ablation catheter with tissue, and increased likelihood of complications with energy delivery in close proximity to coronary vessels. A method to directly visualize the epicardial surface during RFA could potentially provide feedback to reduce complications and titrate rf energy dose by detecting critical structures, assessing probe contact, and confirming energy delivery by visualizing lesion formation. Currently, there is no technology available for direct visualization of the heart surface during epicardial RFA therapy. We demonstrate that optical coherence tomography (OCT) imaging has the potential to fill this unmet need. Spectral domain OCT at 1310 nm is employed to image the epicardial surface of freshly excised swine hearts using a microscope integrated bench-top scanner and a forward imaging catheter probe. OCT image features are observed that clearly distinguish untreated myocardium, ablation lesions, epicardial fat, and coronary vessels, and assess tissue contact with catheter-based imaging. These results support the potential for real-time guidance of epicardial RFA therapy using OCT imaging.

The analysis of harmonic generation coefficients in the ablative Rayleigh-Taylor instability

NASA Astrophysics Data System (ADS)

Lu, Yan; Fan, Zhengfeng; Lu, Xinpei; Ye, Wenhua; Zou, Changlin; Zhang, Ziyun; Zhang, Wen

2017-10-01

In this research, we use the numerical simulation method to investigate the generation coefficients of the first three harmonics and the zeroth harmonic in the Ablative Rayleigh-Taylor Instability. It is shown that the interface shifts to the low temperature side during the ablation process. In consideration of the third-order perturbation theory, the first three harmonic amplitudes of the weakly nonlinear regime are calculated and then the harmonic generation coefficients are obtained by curve fitting. The simulation results show that the harmonic generation coefficients changed with time and wavelength. Using the higher-order perturbation theory, we find that more and more harmonics are generated in the later weakly nonlinear stage, which is caused by the negative feedback of the later higher harmonics. Furthermore, extending the third-order theory to the fifth-order theory, we find that the second and the third harmonics coefficients linearly depend on the wavelength, while the feedback coefficients are almost constant. Further analysis also shows that when the fifth-order theory is considered, the normalized effective amplitudes of second and third harmonics can reach about 25%-40%, which are only 15%-25% in the frame of the previous third-order theory. Therefore, the third order perturbation theory is needed to be modified by the higher-order theory when ηL reaches about 20% of the perturbation wavelength.

Real-time temperature monitoring during radiofrequency treatments on ex-vivo animal model by fiber Bragg grating sensors

NASA Astrophysics Data System (ADS)

Palumbo, Giovanna; Tosi, Daniele; Schena, Emiliano; Massaroni, Carlo; Ippolito, Juliet; Verze, Paolo; Carlomagno, Nicola; Tammaro, Vincenzo; Iadicicco, Agostino; Campopiano, Stefania

2017-05-01

Fiber Bragg Grating (FBG) sensors applied to bio-medical procedures such as surgery and rehabilitation are a valid alternative to traditional sensing techniques due to their unique characteristics. Herein we propose the use of FBG sensor arrays for accurate real-time temperature measurements during multi-step RadioFrequency Ablation (RFA) based thermal tumor treatment. Real-time temperature monitoring in the RF-applied region represents a valid feedback for the success of the thermo-ablation procedure. In order to create a thermal multi-point map around the tumor area to be treated, a proper sensing configuration was developed. In particular, the RF probe of a commercial medical instrumentation, has been equipped with properly packaged FBGs sensors. Moreover, in order to discriminate the treatment areas to be ablated as precisely as possible, a second array 3.5 cm long, made by several FBGs was used. The results of the temperature measurements during the RFA experiments conducted on ex-vivo animal liver and kidney tissues are presented herein. The proposed FBGs based solution has proven to be capable of distinguish different and consecutive discharges and for each of them, to measure the temperature profile with a resolution of 0.1 °C and a minimum spatial resolution of 5mm. Based upon our experiments, it is possible to confirm that the temperature decreases with distance from a RF peak ablation, in accordance with RF theory. The proposed solution promises to be very useful for the surgeon because a real-time temperature feedback allows for the adaptation of RFA parameters during surgery and better delineates the area under treatment.

Comparison of control and quality of bone cutting by using optical topographical imaging guided mechanical drill and 1070 nm laser with in-line coherent imaging

NASA Astrophysics Data System (ADS)

Razani, Marjan; Soudagar, Yasaman; Yu, Karen; Galbraith, Christopher M.; Webster, Paul J. L.; Van Vlack, Cole; Sun, Cuiru; Mariampillai, Adrian; Leung, Michael K. K.; Standish, Beau; Kiehl, Tim-Rasmus; Fraser, James M.; Yang, Victor X. D.

2013-03-01

Precision depth control of bone resection is necessary for safe surgical procedures in the spine. In this paper, we compare the control and quality of cutting bovine tail bone, as an ex vivo model of laminectomy and bony resection simulating spinal surgery, planned with micro-CT data and executed using two approaches: (a) mechanical milling guided by optical topographical imaging (OTI) and (b) optical milling using closed-loop inline coherent imaging (ICI) to monitor and control the incision depth of a high-power 1070 nm fiber laser in situ. OTI provides the in situ topology of the 2-dimensional surface of the bone orientation in the mechanical mill which is registered with the treatment plan derived from the micro-CT data. The coregistration allows the plan to be programmed into the mill which is then used as a benchmark of current surgical techniques. For laser cutting, 3D optical land marking with coaxial camera vision and the ICI system is used to coregister the treatment plan. The unstable, carbonization-mediated ablation behaviour of 1070 nm light and the unknown initial geometry of bone leads to unpredictable ablation which substantially limits the depth accuracy of open-loop cutting. However, even with such a non-ideal cutting laser, we demonstrate that ICI provides in situ high-speed feedback that automatically and accurately limits the laser's cut depth to effectively create an all-optical analogue to the mechanical mill.

MRI-guided Therapeutic Ultrasound : In vitro Validation of a New MR Compatible, Phased Array, Contact Endorectal Ultrasound Transducer with Active Feedback Control of Temperature Evolution

NASA Astrophysics Data System (ADS)

Salomir, Rares; Rata, Mihaela; Lafon, Cyril; Melodelima, David; Chapelon, Jean-Yves; Mathias, Adrien; Cotton, François; Bonmartin, Alain; Cathignol, Dominique

2006-05-01

Contact application of high intensity ultrasound was demonstrated to be suitable for thermal ablation of sectorial tumours of the digestive duct. Experimental validation of a new MR compatible ultrasonic device is described here, dedicated to the minimal invasive therapy of localized colorectal cancer. This is a cylindrical 1D 64-element phased array transducer of 14 mm diameter and 25 mm height (Imasonic, France) allowing electronic rotation of the acoustic beam. Operating frequency ranges from 3.5 to 4.0 MHz and up to 5 effective electrical watts per element are available. A plane wave is reconstructed by simultaneous excitation of eigth adjacent elements with an appropriate phase law. Driving electronics operates outside the Faraday cage of the scanner and provides fast switching capabilities. Excellent passive and active compatibility with the MRI data acquisition has been demonstrated. In addition, feasibility of active temperature control has been demonstrated based on real-time data export out of the MR scanner and a PID feedback algorithm. Further studies will address the in-vivo validation and the integration of a miniature NMR coil for increased SNR in the near field.

OCDR guided laser ablation device

DOEpatents

Dasilva, Luiz B.; Colston, Jr., Bill W.; James, Dale L.

2002-01-01

A guided laser ablation device. The device includes a mulitmode laser ablation fiber that is surrounded by one or more single mode optical fibers that are used to image in the vicinity of the laser ablation area to prevent tissue damage. The laser ablation device is combined with an optical coherence domain reflectometry (OCDR) unit and with a control unit which initializes the OCDR unit and a high power laser of the ablation device. Data from the OCDR unit is analyzed by the control unit and used to control the high power laser. The OCDR images up to about 3 mm ahead of the ablation surface to enable a user to see sensitive tissue such as a nerve or artery before damaging it by the laser.

Direct writing of tunable multi-wavelength polymer lasers on a flexible substrate.

PubMed

Zhai, Tianrui; Wang, Yonglu; Chen, Li; Zhang, Xinping

2015-08-07

Tunable multi-wavelength polymer lasers based on two-dimensional distributed feedback structures are fabricated on a transparent flexible substrate using interference ablation. A scalene triangular lattice structure was designed to support stable tri-wavelength lasing emission and was achieved through multiple exposure processes. Three wavelengths were controlled by three periods of the compound cavity. Mode competition among different cavity modes was observed by changing the pump fluence. Both a redshift and blueshift of the laser wavelength could be achieved by bending the soft substrate. These results not only provide insight into the physical mechanisms behind co-cavity polymer lasers but also introduce new laser sources and laser designs for white light lasers.

STAT3 is a negative regulator of granulopoiesis but is not required for G-CSF-dependent differentiation.

PubMed

Lee, Chien-kuo; Raz, Regina; Gimeno, Ramon; Gertner, Rachel; Wistinghausen, Birte; Takeshita, Kenichi; DePinho, Ronald A; Levy, David E

2002-07-01

STAT3 has been described as an essential component of G-CSF-driven cell proliferation and granulopoiesis. This notion was tested by conditional gene ablation in transgenic mice. Contrary to expectation, granulocytes developed from STAT3 null bone marrow progenitors, and STAT3 null neutrophils displayed mature effector functions. Rather than a deficit in granulopoiesis, mice lacking STAT3 in their hematopoietic progenitors developed neutrophilia, and bone marrow cells were hyperresponsive to G-CSF stimulation. These studies provide direct evidence for STAT3-independent granulopoiesis and suggest that STAT3 directs a negative feedback loop necessary for controlling neutrophil numbers, possibly through induced expression of the signaling inhibitor, SOCS3.

Towards endoscopic ultrafast laser microsurgery of vocal folds

NASA Astrophysics Data System (ADS)

Hoy, Christopher L.; Everett, W. Neil; Yildirim, Murat; Kobler, James; Zeitels, Steven M.; Ben-Yakar, Adela

2012-03-01

Vocal fold scarring is a predominant cause of voice disorders yet lacks a reliable treatment method. The injection of soft biomaterials to improve mechanical compliance of the vocal folds has emerged as a promising treatment. Here, we study the use of precise femtosecond laser microsurgery to ablate subsurface voids, with a goal of eventually creating a plane in dense subepithelial scar tissue into which biomaterials can be injected for their improved localization. Specifically, we demonstrate the ablation of small subepithelial voids in porcine vocal fold tissue up to 120 µm below the surface such that larger voids in the active area of vocal fold mucosa (~3×10 mm2) can eventually be ablated in about 3 min. We use sub-µJ, 776-nm pulses from a compact femtosecond fiber laser system operating at a 500-kHz repetition rate. The use of relatively high repetition rates, with a small number of overlapping pulses, is critical to achieving ablation in a very short time while still avoiding significant heat deposition. Additionally, we use the same laser for nonlinear optical imaging to provide visual feedback of tissue structure and to confirm successful ablation. The ablation parameters, including pulse duration, pulse energy, spot size, and scanning speed, are comparable to the specifications in our recently developed miniaturized femtosecond laser surgery probes, illustrating the feasibility of developing an ultrafast laser surgical instrument.

Post-procedural evaluation of catheter contact force characteristics

NASA Astrophysics Data System (ADS)

Koch, Martin; Brost, Alexander; Kiraly, Atilla; Strobel, Norbert; Hornegger, Joachim

2012-03-01

Minimally invasive catheter ablation of electric foci, performed in electrophysiology labs, is an attractive treatment option for atrial fibrillation (AF) - in particular if drug therapy is no longer effective or tolerated. There are different strategies to eliminate the electric foci inducing the arrhythmia. Independent of the particular strategy, it is essential to place transmural lesions. The impact of catheter contact force on the generated lesion quality has been investigated recently, and first results are promising. There are different approaches to measure catheter-tissue contact. Besides traditional haptic feedback, there are new technologies either relying on catheter tip-to-tissue contact force or on local impedance measurements at the tip of the catheter. In this paper, we present a novel tool for post-procedural ablation point evaluation and visualization of contact force characteristics. Our method is based on localizing ablation points set during AF ablation procedures. The 3-D point positions are stored together with lesion specific catheter contact force (CF) values recorded during the ablation. The force records are mapped to the spatial 3-D positions, where the energy has been applied. The tracked positions of the ablation points can be further used to generate a 3-D mesh model of the left atrium (LA). Since our approach facilitates visualization of different force characteristics for post-procedural evaluation and verification, it has the potential to improve outcome by highlighting areas where lesion quality may be less than desired.

Acoustic Droplet Vaporization for Enhancement of Thermal Ablation by High Intensity Focused Ultrasound

PubMed Central

Zhang, Man; Fabiilli, Mario L.; Haworth, Kevin J.; Padilla, Frederic; Swanson, Scott D.; Kripfgans, Oliver D.; Carson, Paul L.; Fowlkes, J. Brian

2011-01-01

Rationale and Objectives Acoustic droplet vaporization (ADV) shows promise for spatial control and acceleration of thermal lesion production. Our hypothesis was that microbubbles generated by ADV could enhance high intensity focused ultrasound (HIFU) thermal ablation by controlling and increasing local energy absorption. Materials and Methods Thermal lesions were produced in tissue-mimicking phantoms using focused ultrasound (1.44 MHz) with a focal intensity of 4000 W·cm-2 in degassed water at 37°C. The average lesion volume was measured by visible change in optical opacity and by T2-weighted MRI. In addition, in vivo HIFU lesions were generated in a canine liver before and after an intravenous injection of droplets with a similar acoustic setup. Results Thermal lesions were seven-fold larger in phantoms containing droplets (3×105 droplets/mL) compared to phantoms without droplets. The mean lesion volume with a 2 s HIFU exposure in droplet-containing phantoms was comparable to that made by a 5 s exposure in phantoms without droplets. In the in vivo study, the average lesion volumes without and with droplets were 0.017 ± 0.006 cm3 (n = 4, 5 s exposure) and 0.265 ± 0.005 cm3 (n = 3, 5 s exposure), respectively – a factor of 15 difference. The shape of ADV bubbles imaged with B-mode ultrasound was very similar to the actual lesion shape as measured optically and by MRI. Conclusion ADV bubbles may facilitate clinical HIFU ablation by reducing treatment time or requisite in situ total acoustic power, and provide ultrasonic imaging feedback of the thermal therapy. PMID:21703883

Selective removal of esthetic composite restorations with spectral guided laser ablation

NASA Astrophysics Data System (ADS)

Yi, Ivana; Chan, Kenneth H.; Tsuji, Grant H.; Staninec, Michal; Darling, Cynthia L.; Fried, Daniel

2016-02-01

Dental composites are used for a wide range of applications such as fillings for cavities, adhesives for orthodontic brackets, and closure of gaps (diastemas) between teeth by esthetic bonding. Anterior restorations are used to replace missing, diseased and unsightly tooth structure for both appearance and function. When these restorations must be replaced, they are difficult to remove mechanically without causing excessive removal or damage to enamel because dental composites are color matched to teeth. Previous studies have shown that CO2 lasers have high ablation selectivity and are well suited for removal of composite on occlusal surfaces while minimizing healthy tissue loss. A spectral feedback guidance system may be used to discriminate between dental composite and dental hard tissue for selective ablation of composite material. The removal of composite restorations filling diastemas is more challenging due to the esthetic concern for anterior teeth. The objective of this study is to determine if composite spanning a diastema between anterior teeth can be removed by spectral guided laser ablation at clinically relevant rates with minimal damage to peripheral healthy tissue and with higher selectivity than a high speed dental handpiece.

Fast Conformal Thermal Ablation in the Prostate with Transurethral Multi-Sectored Ultrasound Devices and MR Guidance

NASA Astrophysics Data System (ADS)

Kinsey, Adam M.; Diederich, Chris J.; Nau, William H.; Ross, Anthony B.; Pauly, Kim Butts; Rieke, Viola; Sommer, Graham

2007-05-01

Transurethral ultrasound applicators incorporating an array of multisectored tubular transducers were evaluated in theoretical simulations and in vivo canine prostates under MR guidance as a method for fast, conformal thermal therapy of the prostate. Comprehensive simulations with a biothermal model investigated the effect on lesion creation of sector size, perfusion, treatment time, rectal cooling, prostate target dimensions, and feedback controller parameters (maximum temperature, pilot points at boundary, update times). In vivo canine prostates (n = 4) were treated with trisectored ultrasound transducers (3 mm OD) under MR temperature monitoring to contour the ablation zone (>52 C for 1-2 min) to the boundary of the prostate. Contiguous thermal lesions extended 2 cm in radius from the urethra in less than 15 min and independent sector control simultaneously allowed for conformal treatment in the angular dimension. Experiments investigated sequential translation of the transducer assembly within the catheter for tailoring heat treatments to different partitions in the prostate (base, apex) without changing the initial setup. This treatment method offered greater lesion shape control in three dimensions and slightly lengthened the overall treatment time. The MR temperature images correlated with post-treatment histology and accurately controlled the heating to the target boundary. MR-based control of transurethral ultrasound devices appeared more practical with multisectored transducers compared to rotating curvilinear and planar applicators due to less stringent requirements on spatial and temporal MR parameters. This study demonstrated the applicability of these devices in the prostate for anterior-lateral BPH treatment, and whole gland or quadrant target volumes for cancer treatment.

Chemoattraction and chemorepulsion of Strongyloides stercoralis infective larvae on a sodium chloride gradient is mediated by amphidial neuron pairs ASE and ASH, respectively.

PubMed

Forbes, W M; Ashton, F T; Boston, R; Zhu, X; Schad, G A

2004-03-25

Depending on its concentration, sodium chloride acts as either an attractant or a repellant to the infective larvae (L3i) of Strongyloides stercoralis. On a concentration gradient, L3i are attracted to 0.05 M NaCl, but repelled by 2.8M. To test the hypothesis that amphidial neurons ASE and ASH might mediate attraction and repulsion, respectively, these neurons, and control neurons as well, were ablated in hatchling larvae with a laser microbeam. After the larvae attained infectivity (L3i), they were tested on a NaCl gradient. When placed at low salinity, 73.5% of normal controls migrated "up" the gradient, while 26.4% crawled randomly. In contrast, only 20.6% of ASE-ablated L3i migrated "up" the gradient, while 79.4% migrated randomly. Ablation-control ASK-ablated L3i (58.8%) migrated "up" the gradient while 41.1% crawled randomly. When placed at a region of high salinity, 100% of normal control L3i migrated "down" the gradient, whereas 62.5% of ASH-ablated L3i migrated randomly, the remaining 37.5% migrating "down" the gradient. In sharp contrast with ASH-ablated L3i, 94.1% of ablation-control larvae, i.e. ASK-ablated L3i, migrated "down" the gradient. Migration behavior of ASE- and ASH-ablated L3i was significantly different (P < 0.001) from that of ASK-ablated L3i and normal controls. It is noteworthy that 87.5% of ASE-ablated L3i that failed to exhibit chemoattractive behavior were actively chemorepelled from high salinity. Also, 70.0% of ASH-ablated L3i that failed to be chemorepelled from high salinity were capable of chemoattractive behavior, indicating that the worms had retained their behavioral responses except for those associated with the targeted neurons.

Reflectance confocal microscopy-guided laser ablation of basal cell carcinomas: initial in vivo results

NASA Astrophysics Data System (ADS)

Sierra, Heidy; Cordova, Miguel; Yelamos, Oriol; Chen, Chih-Shan Jason; Rajadhyaksha, Milind

2017-02-01

Laser ablation offers a procedure for precise, fast and minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histopathological confirmation has been a limitation toward widespread use in the clinic. A reflectance confocal microscopy (RCM) imaging-guided laser ablation approach offers cellular-level histopathology-like feedback directly on the patient, which may guide and help improve the efficacy of this procedure. We performed an initial study on 44 BCCs on 21 patients in vivo (based in an ex vivo bench-top study reported in our earlier papers), using a pulsed erbium: ytterbium aluminum garnet laser and a contrast agent (aluminum chloride). Initial 10 lesions, the RCM imaging-guided detection of either presence of residual tumor or complete clearance was immediately confirmed with histopathology. Additionally, 34 BCCs on 15 patients were treated with RCM imaging-guided laser ablation, and the clearance of tumor is currently being monitored with follow-up imaging (i. e., no histopathology) at 3, 6 and 18 months. Thus far, the imaging resolution appears to be sufficient and consistent for monitoring efficacy in the wound, both immediately post-ablation and subsequently during recovery. The efficacy appears to be promising. However, further investigation and optimization to image over the entire wound (without missing any areas) need to be investigated.

In vitro parameter optimization for spatial control of focused ultrasound ablation when using low boiling point phase-change nanoemulsions.

PubMed

Puett, Connor; Phillips, Linsey C; Sheeran, Paul S; Dayton, Paul A

2013-01-01

Phase-shift nanoemulsions (PSNEs) provide cavitation sites when the perfluorocarbon (PFC) nanodroplets (ND) are vaporized to microbubbles by acoustic energy. Their presence lowers the power required to ablate tissue by high-intensity focused ultrasound (HIFU), potentially making it a safer option for a broader range of treatment sites. However, spatial control over the ablation region can be problematic when cavitation is used to enhance heating. This study explored relationships between vaporization, ablation, and the PSNE concentration in vitro to optimize the acoustic intensity and insonation time required for spatially controlled ablation enhancement using a PSNE that included a volatile PFC component. HIFU (continuous wave at 1 MHz; insonation times of 5, 10, 15, and 20 s; cool-down times of 2, 4, and 6 s; peak negative pressures of 2, 3, and 4 MPa) was applied to albumin-acrylamide gels containing PFC agents (1:1 mix of volatile decafluorobutane and more stable dodecafluoropentane at 10(5) to 10(8) PFC ND per milliliter) or agent-free controls. Vaporization fields (microbubble clouds) were imaged by conventional ultrasound, and ablation lesions were measured directly by calipers. Controlled ablation was defined as the production of 'cigar'-shaped lesions corresponding with the acoustic focal zone. This control was considered to be lost when ablation occurred in prefocal vaporization fields having a predominantly 'tadpole' or oblong shape. Changes in the vaporization field shape and location occurred on a continuum with increasing PSNE concentration and acoustic intensity. Working with the maximum concentration-intensity combinations resulting in controlled ablation demonstrated a dose-responsive relationship between insonation time and volumes of both the vaporization fields (approximately 20 to 240 mm(3)) and the ablation lesions (1 to 135 mm(3)) within them. HIFU ablation was enhanced by this PSNE and could be achieved using intensities ≤650 W/cm(2). Although the ablation lesions were located within much larger microbubble clouds, optimum insonation times and intensities could be selected to achieve an ablation lesion of desired size and location for a given PSNE concentration. This demonstration of controllable enhancement using a PSNE that contained a volatile PFC component is another step toward developing phase-shift nanotechnology as a potential clinical tool to improve HIFU.

Optoacoustic monitoring of cutting efficiency and thermal damage during laser ablation.

PubMed

Bay, Erwin; Douplik, Alexandre; Razansky, Daniel

2014-05-01

Successful laser surgery is characterized by a precise cut and effective hemostasis with minimal collateral thermal damage to the adjacent tissues. Consequently, the surgeon needs to control several parameters, such as power, pulse repetition rate, and velocity of movements. In this study we propose utilizing optoacoustics for providing the necessary real-time feedback of cutting efficiency and collateral thermal damage. Laser ablation was performed on a bovine meat slab using a Q-switched Nd-YAG laser (532 nm, 4 kHz, 18 W). Due to the short pulse duration of 7.6 ns, the same laser has also been used for generation of optoacoustic signals. Both the shockwaves, generated due to tissue removal, as well as the normal optoacoustic responses from the surrounding tissue were detected using a single broadband piezoelectric transducer. It has been observed that the rapid reduction in the shockwave amplitude occurs as more material is being removed, indicating decrease in cutting efficiency, whereas gradual decrease in the optoacoustic signal likely corresponds to coagulation around the ablation crater. Further heating of the surrounding tissue leads to carbonization accompanied by a significant shift in the optoacoustic spectra. Our results hold promise for real-time monitoring of cutting efficiency and collateral thermal damage during laser surgery. In practice, this could eventually facilitate development of automatic cut-off mechanisms that will guarantee an optimal tradeoff between cutting and heating while avoiding severe thermal damage to the surrounding tissues.

Impact of Tricuspid Regurgitation on the Success of Atrioventricular Node Ablation for Rate Control in Patients With Atrial Fibrillation: The Node Blast Study.

PubMed

Reddy, Yeruva Madhu; Gunda, Sampath; Vallakati, Ajay; Kanmanthareddy, Arun; Pillarisetti, Jayasree; Atkins, Donita; Bommana, Sudharani; Emert, Martin P; Pimentel, Rhea; Dendi, Raghuveer; Berenbom, Loren D; Lakkireddy, Dhanunjaya

2015-09-15

Atrioventricular node (AVN) ablation is an effective treatment for symptomatic patients with atrial arrhythmias who are refractory to rhythm and rate control strategies where optimal ventricular rate control is desired. There are limited data on the predictors of failure of AVN ablation. Our objective was to identify the predictors of failure of AVN ablation. This is an observational single-center study of consecutive patients who underwent AVN ablation in a large academic center. Baseline characteristics, procedural variables, and outcomes of AVN ablation were collected. AVN "ablation failure" was defined as resumption of AVN conduction resulting in recurrence of either rapid ventricular response or suboptimal biventricular pacing. A total of 247 patients drug refractory AF who underwent AVN ablation at our center with a mean age of 71 ± 12 years with 46% being males were included. Ablation failure was seen in 11 (4.5%) patients. There were no statistical differences between patients with "ablation failure" versus "ablation success" in any of the baseline clinical variables. Patients with moderate-to-severe tricuspid regurgitation (TR) were much more likely to have ablation failure than those with ablation success (8 [73%] vs 65 [27%]; p = 0.003). All 11 patients with ablation failure had a successful redo procedure, 9 with right and 2 with the left sided approach. On multivariate analysis, presence of moderate-to-severe TR was found to be the only predictor of failure of AVN ablation (odds ratio 9.1, confidence interval 1.99 to 42.22, p = 0.004). In conclusion, moderate-to-severe TR is a strong and independent predictor of failure of AVN ablation. Copyright © 2015 Elsevier Inc. All rights reserved.

Controlling dental enamel-cavity ablation depth with optimized stepping parameters along the focal plane normal using a three axis, numerically controlled picosecond laser.

PubMed

Yuan, Fusong; Lv, Peijun; Wang, Dangxiao; Wang, Lei; Sun, Yuchun; Wang, Yong

2015-02-01

The purpose of this study was to establish a depth-control method in enamel-cavity ablation by optimizing the timing of the focal-plane-normal stepping and the single-step size of a three axis, numerically controlled picosecond laser. Although it has been proposed that picosecond lasers may be used to ablate dental hard tissue, the viability of such a depth-control method in enamel-cavity ablation remains uncertain. Forty-two enamel slices with approximately level surfaces were prepared and subjected to two-dimensional ablation by a picosecond laser. The additive-pulse layer, n, was set to 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70. A three-dimensional microscope was then used to measure the ablation depth, d, to obtain a quantitative function relating n and d. Six enamel slices were then subjected to three dimensional ablation to produce 10 cavities, respectively, with additive-pulse layer and single-step size set to corresponding values. The difference between the theoretical and measured values was calculated for both the cavity depth and the ablation depth of a single step. These were used to determine minimum-difference values for both the additive-pulse layer (n) and single-step size (d). When the additive-pulse layer and the single-step size were set 5 and 45, respectively, the depth error had a minimum of 2.25 μm, and 450 μm deep enamel cavities were produced. When performing three-dimensional ablating of enamel with a picosecond laser, adjusting the timing of the focal-plane-normal stepping and the single-step size allows for the control of ablation-depth error to the order of micrometers.

Multiple target laser ablation system

DOEpatents

Mashburn, Douglas N.

1996-01-01

A laser ablation apparatus and method are provided in which multiple targets consisting of material to be ablated are mounted on a movable support. The material transfer rate is determined for each target material, and these rates are stored in a controller. A position detector determines which target material is in a position to be ablated, and then the controller controls the beam trigger timing and energy level to achieve a desired proportion of each constituent material in the resulting film.

Comparison of acoustic shock waves generated by micro and nanosecond lasers for a smart laser surgery system

NASA Astrophysics Data System (ADS)

Nguendon Kenhagho, Hervé K.; Rauter, Georg; Guzman, Raphael; C. Cattin, Philippe; Zam, Azhar

2018-02-01

Characterization of acoustic shock wave will guarantee efficient tissue differentiation as feedback to reduce the probability of undesirable damaging (i.e. cutting) of tissues in laser surgery applications. We ablated hard (bone) and soft (muscle) tissues using a nanosecond pulsed Nd:YAG laser at 532 nm and a microsecond pulsed Er:YAG laser at 2.94 μm. When the intense short ns-pulsed laser is applied to material, the energy gain causes locally a plasma at the ablated spot that expands and propagates as an acoustic shock wave with a rarefaction wave behind the shock front. However, when using a μs-pulsed Er:YAG laser for material ablation, the acoustic shock wave is generated during the explosion of the ablated material. We measured and compared the emitted acoustic shock wave generated by a ns-pulsed Nd:YAG laser and a μs-pulsed Er:YAG laser measured by a calibrated microphone. As the acoustic shock wave attenuates as it propagates through air, the distance between ablation spots and a calibrated microphone was at 5 cm. We present the measurements on the propagation characteristics of the laser generated acoustic shock wave by measuring the arrival time-of-flight with a calibrated microphone and the energy-dependent evolution of acoustic parameters such as peak-topeak pressure, the ratio of the peak-to-peak pressures for the laser induced breakdown in air, the ablated muscle and the bone, and the spectral energy.

Multiple target laser ablation system

DOEpatents

Mashburn, D.N.

1996-01-09

A laser ablation apparatus and method are provided in which multiple targets consisting of material to be ablated are mounted on a movable support. The material transfer rate is determined for each target material, and these rates are stored in a controller. A position detector determines which target material is in a position to be ablated, and then the controller controls the beam trigger timing and energy level to achieve a desired proportion of each constituent material in the resulting film. 3 figs.

Practical issues in laser cleaning of stone and painted artefacts: optimisation procedures and side effects

NASA Astrophysics Data System (ADS)

Pouli, Paraskevi; Oujja, Mohamed; Castillejo, Marta

2012-02-01

In the last twenty years lasers have acquired an important role in the study and the preservation of Cultural Heritage (CH) objects and Monuments, as they have effectively illuminated a number of complex diagnostic and restoration problems. Their unique properties have enabled their use in a wide range of conservation applications, since they ensure interventions with precise control, material selectivity and immediate feedback. Surface cleaning, based on laser ablation, is a delicate, critical and irreversible process, which, given the multitude of materials that may be present on a CH object and the often fragile or precarious condition of the original surfaces, is fraught with many potential complications. Therefore it is crucial to choose the best possible laser cleaning methodology for each individual case, which involves optimising the laser parameters according to material properties, as well as the thorough knowledge of the ablation mechanisms involved. In this context the systematic investigation and elucidation of potential damage or side effects occurring upon cleaning is essential, as it delineates the possibilities and limitations of laser ablation and allows the fine-tuning of the operating parameters for a successful cleaning intervention. This paper is an overview of studies investigating the mechanisms which are responsible for the laser-induced discoloration effects. Emphasis is given on the yellowing coloration observed on stonework upon infrared (IR) ablation of pollution encrustations, while the various theories introduced to approach the different physical and/or chemical processes and mechanisms responsible for such side effects are discussed. In this respect the different laser cleaning methodologies, which are based on the use of laser systems with different pulse durations and wavelength characteristics, introduced in order to rectify or prevent discoloration on stonework are presented. In parallel, the darkening phenomena which occur upon laser irradiation of painted surfaces are also considered. Studies on series of model paints performed in order to understand the sensitivity of pigments to laser irradiation are critically reviewed. In this respect the importance of the optimal wavelength and pulse-duration selection for a safe and controlled laser cleaning intervention is also addressed.

Biomarkers in Persistent AF and Heart Failure: Impact of Catheter Ablation Compared with Rate Control.

PubMed

Jones, David G; Haldar, Shouvik K; Donovan, Jacqueline; McDonagh, Theresa A; Sharma, Rakesh; Hussain, Wajid; Markides, Vias; Wong, Tom

2016-09-01

To investigate the effects of catheter ablation and rate control strategies on cardiac and inflammatory biomarkers in patients with heart failure and persistent atrial fibrillation (AF). Patients were recruited from the ARC-HF trial (catheter Ablation vs Rate Control for management of persistent AF in Heart Failure, NCT00878384), which compared ablation with rate control for persistent AF in heart failure. B-type natriuretic peptide (BNP), midregional proatrial natriuretic peptide (MR-proANP), apelin, and interleukin-6 (IL-6) were assayed at baseline, 3 months, 6 months, and 12 months. The primary end point, analyzed per-protocol, was changed from baseline at 12 months. Of 52 recruited patients, 24 ablation and 25 rate control subjects were followed to 12 months. After 1.2 ± 0.5 procedures, sinus rhythm was present in 22 (92%) ablation patients; under rate control, rate criteria were achieved in 23 (96%) of 24 patients remaining in AF. At 12 months, MR-proANP fell significantly in the ablation arm (-106.0 pmol/L, interquartile range [IQR] -228.2 to -60.6) compared with rate control (-28.7 pmol/L, IQR -69 to +9.5, P = 0.028). BNP showed a similar trend toward reduction (P = 0.051), with no significant difference in apelin (P = 0.13) or IL-6 (P = 0.68). Changes in MR-proANP and BNP correlated with peak VO2 and ejection fraction, and MR-proANP additionally with quality-of-life score. Catheter ablation, compared with rate control, in patients with heart failure and persistent AF was associated with significant reduction in MR-proANP, which correlated with physiological and symptomatic improvement. Ablation-based rhythm control may induce beneficial cardiac remodeling, unrelated to changes in inflammatory state. This may have prognostic implications, which require confirmation by event end point studies. © 2016 Wiley Periodicals, Inc.

Catheter ablation in patients with persistent atrial fibrillation

PubMed Central

Kirchhof, Paulus; Calkins, Hugh

2017-01-01

Catheter ablation is increasingly offered to patients who suffer from symptoms due to atrial fibrillation (AF), based on a growing body of evidence illustrating its efficacy compared with antiarrhythmic drug therapy. Approximately one-third of AF ablation procedures are currently performed in patients with persistent or long-standing persistent AF. Here, we review the available information to guide catheter ablation in these more chronic forms of AF. We identify the following principles: Our clinical ability to discriminate paroxysmal and persistent AF is limited. Pulmonary vein isolation is a reasonable and effective first approach for catheter ablation of persistent AF. Other ablation strategies are being developed and need to be properly evaluated in controlled, multicentre trials. Treatment of concomitant conditions promoting recurrent AF by life style interventions and medical therapy should be a routine adjunct to catheter ablation of persistent AF. Early rhythm control therapy has a biological rationale and trials evaluating its value are underway. There is a clear need to generate more evidence for the best approach to ablation of persistent AF beyond pulmonary vein isolation in the form of adequately powered controlled multi-centre trials. PMID:27389907

Interactive Volumetry Of Liver Ablation Zones.

PubMed

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

2015-10-20

Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique that destroys cancer cells by heat. The heat results from focusing energy in the radiofrequency spectrum through a needle. Amongst others, this can enable the treatment of patients who are not eligible for an open surgery. However, the possibility of recurrent liver cancer due to incomplete ablation of the tumor makes post-interventional monitoring via regular follow-up scans mandatory. These scans have to be carefully inspected for any conspicuousness. Within this study, the RF ablation zones from twelve post-interventional CT acquisitions have been segmented semi-automatically to support the visual inspection. An interactive, graph-based contouring approach, which prefers spherically shaped regions, has been applied. For the quantitative and qualitative analysis of the algorithm's results, manual slice-by-slice segmentations produced by clinical experts have been used as the gold standard (which have also been compared among each other). As evaluation metric for the statistical validation, the Dice Similarity Coefficient (DSC) has been calculated. The results show that the proposed tool provides lesion segmentation with sufficient accuracy much faster than manual segmentation. The visual feedback and interactivity make the proposed tool well suitable for the clinical workflow.

Interactive Volumetry Of Liver Ablation Zones

PubMed Central

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

2015-01-01

Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique that destroys cancer cells by heat. The heat results from focusing energy in the radiofrequency spectrum through a needle. Amongst others, this can enable the treatment of patients who are not eligible for an open surgery. However, the possibility of recurrent liver cancer due to incomplete ablation of the tumor makes post-interventional monitoring via regular follow-up scans mandatory. These scans have to be carefully inspected for any conspicuousness. Within this study, the RF ablation zones from twelve post-interventional CT acquisitions have been segmented semi-automatically to support the visual inspection. An interactive, graph-based contouring approach, which prefers spherically shaped regions, has been applied. For the quantitative and qualitative analysis of the algorithm’s results, manual slice-by-slice segmentations produced by clinical experts have been used as the gold standard (which have also been compared among each other). As evaluation metric for the statistical validation, the Dice Similarity Coefficient (DSC) has been calculated. The results show that the proposed tool provides lesion segmentation with sufficient accuracy much faster than manual segmentation. The visual feedback and interactivity make the proposed tool well suitable for the clinical workflow. PMID:26482818

Interactive Volumetry Of Liver Ablation Zones

NASA Astrophysics Data System (ADS)

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

2015-10-01

Percutaneous radiofrequency ablation (RFA) is a minimally invasive technique that destroys cancer cells by heat. The heat results from focusing energy in the radiofrequency spectrum through a needle. Amongst others, this can enable the treatment of patients who are not eligible for an open surgery. However, the possibility of recurrent liver cancer due to incomplete ablation of the tumor makes post-interventional monitoring via regular follow-up scans mandatory. These scans have to be carefully inspected for any conspicuousness. Within this study, the RF ablation zones from twelve post-interventional CT acquisitions have been segmented semi-automatically to support the visual inspection. An interactive, graph-based contouring approach, which prefers spherically shaped regions, has been applied. For the quantitative and qualitative analysis of the algorithm’s results, manual slice-by-slice segmentations produced by clinical experts have been used as the gold standard (which have also been compared among each other). As evaluation metric for the statistical validation, the Dice Similarity Coefficient (DSC) has been calculated. The results show that the proposed tool provides lesion segmentation with sufficient accuracy much faster than manual segmentation. The visual feedback and interactivity make the proposed tool well suitable for the clinical workflow.

Theoretical and experimental analysis of amplitude control ablation and bipolar ablation in creating linear lesion and discrete lesions for treating atrial fibrillation.

PubMed

Yan, Shengjie; Wu, Xiaomei; Wang, Weiqi

2017-09-01

Radiofrequency (RF) energy is often used to create a linear lesion or discrete lesions for blocking the accessory conduction pathways for treating atrial fibrillation. By using finite element analysis, we study the ablation effect of amplitude control ablation mode (AcM) and bipolar ablation mode (BiM) in creating a linear lesion and discrete lesions in a 5-mm-thick atrial wall; particularly, the characteristic of lesion shape has been investigated in amplitude control ablation. Computer models of multipolar catheter were developed to study the lesion dimensions in atrial walls created through AcM, BiM and special electrodes activated ablation methods in AcM and BiM. To validate the theoretical results in this study, an in vitro experiment with porcine cardiac tissue was performed. At 40 V/20 V root mean squared (RMS) of the RF voltage for AcM, the continuous and transmural lesion was created by AcM-15s, AcM-5s and AcM-ad-20V ablation in 5-mm-thick atrial wall. At 20 V RMS for BiM, the continuous but not transmural lesion was created. AcM ablation yielded asymmetrical and discrete lesions shape, whereas the lesion shape turned to more symmetrical and continuous as the electrodes alternative activated period decreased from 15 s to 5 s. Two discrete lesions were created when using AcM, AcM-ad-40V, BiM-ad-20V and BiM-ad-40V. The experimental and computational thermal lesion shapes created in cardiac tissue were in agreement. Amplitude control ablation technology and bipolar ablation technology are feasible methods to create continuous lesion or discrete for pulmonary veins isolation.

Improved Ablation Resistance of Silicone Rubber Composites by Introducing Montmorillonite and Silicon Carbide Whisker

PubMed Central

Zhang, Guangwu; Wang, Fuzhong; Huang, Zhixiong; Dai, Jing; Shi, Minxian

2016-01-01

Montmorillonite (MMT) was added to silicone rubber (SR) to improve the ablation resistance of the silicone. Following this, different quantities of silicon carbide whiskers (SiCw) were incorporated into the MMT/SR to yield a hybrid, ablative composite. The tensile strength and elongation at break of the composite increased after the addition of MMT. The ablation test results showed that MMT helped to form a covering layer by bonding with the silica and other components on the ablated surface. The linear and mass ablation rates exhibited decreases of 22.5% and 18.2%, respectively, in comparison to a control sample. After further incorporation of SiCw as the second filler, the resulting composites exhibited significantly higher tensile strength and ablation resistance, but not particularly lower elongation at break in comparison to the control sample. The SiCw/MMT fillers were beneficial in forming a dense and compact covering layer that delayed the heat and oxygen diffusion into the inner layers, which improved the ablation properties effectively. The remaining whiskers acted as a micro skeleton to maintain the composite’s char strength. Compared to the control sample, the linear and mass ablation rates of the composite after incorporating 6 phr SiCw and 10 phr MMT decreased by 59.2% and 43.6%, respectively. These experimental results showed that the fabricated composites exhibited outstanding mechanical properties and excellent ablation resistance. PMID:28773846

Improved Ablation Resistance of Silicone Rubber Composites by Introducing Montmorillonite and Silicon Carbide Whisker.

PubMed

Zhang, Guangwu; Wang, Fuzhong; Huang, Zhixiong; Dai, Jing; Shi, Minxian

2016-08-24

Montmorillonite (MMT) was added to silicone rubber (SR) to improve the ablation resistance of the silicone. Following this, different quantities of silicon carbide whiskers (SiCw) were incorporated into the MMT/SR to yield a hybrid, ablative composite. The tensile strength and elongation at break of the composite increased after the addition of MMT. The ablation test results showed that MMT helped to form a covering layer by bonding with the silica and other components on the ablated surface. The linear and mass ablation rates exhibited decreases of 22.5% and 18.2%, respectively, in comparison to a control sample. After further incorporation of SiCw as the second filler, the resulting composites exhibited significantly higher tensile strength and ablation resistance, but not particularly lower elongation at break in comparison to the control sample. The SiCw/MMT fillers were beneficial in forming a dense and compact covering layer that delayed the heat and oxygen diffusion into the inner layers, which improved the ablation properties effectively. The remaining whiskers acted as a micro skeleton to maintain the composite's char strength. Compared to the control sample, the linear and mass ablation rates of the composite after incorporating 6 phr SiCw and 10 phr MMT decreased by 59.2% and 43.6%, respectively. These experimental results showed that the fabricated composites exhibited outstanding mechanical properties and excellent ablation resistance.

Heart failure and atrial fibrillation: current concepts and controversies.

PubMed Central

Van den Berg, M. P.; Tuinenburg, A. E.; Crijns, H. J.; Van Gelder, I. C.; Gosselink, A. T.; Lie, K. I.

1997-01-01

Heart failure and atrial fibrillation are very common, particularly in the elderly. Owing to common risk factors both disorders are often present in the same patient. In addition, there is increasing evidence of a complex, reciprocal relation between heart failure and atrial fibrillation. Thus heart failure may cause atrial fibrillation, with electromechanical feedback and neurohumoral activation playing an important mediating role. In addition, atrial fibrillation may promote heart failure; in particular, when there is an uncontrolled ventricular rate, tachycardiomyopathy may develop and thereby heart failure. Eventually, a vicious circle between heart failure and atrial fibrillation may form, in which neurohumoral activation and subtle derangement of rate control are involved. Treatment should aim at unloading of the heart, adequate control of ventricular rate, and correction of neurohumoral activation. Angiotensin converting enzyme inhibitors may help to achieve these goals. Treatment should also include an attempt to restore sinus rhythm through electrical cardioversion, though appropriate timing of cardioversion is difficult. His bundle ablation may be used to achieve adequate rate control in drug refractory cases. PMID:9155607

Role of Contact Force Sensing in Catheter Ablation of Cardiac Arrhythmias: Evolution or History Repeating Itself?

PubMed

Ariyarathna, Nilshan; Kumar, Saurabh; Thomas, Stuart P; Stevenson, William G; Michaud, Gregory F

2018-06-01

Adequate catheter-tissue contact facilitates efficient heat energy transfer to target tissue. Tissue contact is thus critical to achieving lesion transmurality and success of radiofrequency (RF) ablation procedures, a fact recognized more than 2 decades ago. The availability of real-time contact force (CF)-sensing catheters has reinvigorated the field of ablation biophysics and optimized lesion formation. The ability to measure and display CF came with the promise of dramatic improvement in safety and efficacy; however, CF quality was noted to have just as important an influence on lesion formation as absolute CF quantity. Multiple other factors have emerged as key elements influencing effective lesion formation, including catheter stability, lesion contiguity and continuity, lesion density, contact homogeneity across a line of ablation, spatiotemporal dynamics of contact governed by cardiac and respiratory motion, contact directionality, and anatomic wall thickness, in addition to traditional ablation indices of power and RF duration. There is greater appreciation of surrogate markers as a guide to lesion formation, such as impedance fall, loss of pace capture, and change in unipolar electrogram morphology. In contrast, other surrogates such as tactile feedback, catheter motion, and electrogram amplitude are notably poor predictors of actual contact and lesion formation. This review aims to contextualize the role of CF sensing in lesion formation with respect of the fundamental principles of biophysics of RF ablation and summarize the state-of-the-art evidence behind the role of CF in optimizing lesion formation. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Magnetic resonance-guided focused ultrasound surgery for treatment of painful osseous metastases

NASA Astrophysics Data System (ADS)

Hurwitz, Mark; Machtinger, Ronit; Fennessy, Fiona

2011-03-01

Magnetic resonance guided focused ultrasound surgery (MRgFUS) is an emerging technology that can non-invasively heat and ablate targeted tissue utilizing ultrasound energy. Use of MR imaging for treatment guidance provides several key advantages over more widely used ultrasound guidance for focused ultrasound ablation. MR allows for precise targeting, detailed beam path visualization, real time non-invasive temperature measurement, and treatment feedback to ensure therapeutic goals are achieved. In the realm of oncology, management of painful bone metastases is a common and daunting clinical problem. The Insightec ExAblate System has been shown in phase I/II trials for treatment of bone metastases to have an excellent safety profile and high rates of pain response. An international multi-center phase III trial for patients with painful bone metastases or multiple myeloma who are not candidates for radiation therapy is currently open. Patients are randomized 3:1 to MRgFUS or sham treatment with crossover to study treatment allowed for sham failures. The primary study endpoint is assessment of pain control over 3 months following treatment. In addition safety, quality of life, cost effectiveness analysis, and patient perceived clinical benefit are also being assessed. Details of the MRgFUS system, technical and clinical therapeutic parameters, use of real time non-invasive MR thermometry, and examples of patient treatments with use of MRgFUS to treat bone metastases will be discussed. New directions in use of MRgFUS including an update on development of a new mobile applicator and integration of MRgFUS in multimodality oncologic care will also be presented.

Ultrafast Outflows: Galaxy-scale Active Galactic Nucleus Feedback

NASA Astrophysics Data System (ADS)

Wagner, A. Y.; Umemura, M.; Bicknell, G. V.

2013-01-01

We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves in the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.

ULTRAFAST OUTFLOWS: GALAXY-SCALE ACTIVE GALACTIC NUCLEUS FEEDBACK

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

Wagner, A. Y.; Umemura, M.; Bicknell, G. V., E-mail: ayw@ccs.tsukuba.ac.jp

We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves inmore » the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.« less

Using High Resolution Regional Climate Models to Quantify the Snow Albedo Feedback in a Region of Complex Terrain

NASA Astrophysics Data System (ADS)

Letcher, T.; Minder, J. R.

2015-12-01

High resolution regional climate models are used to characterize and quantify the snow albedo feedback (SAF) over the complex terrain of the Colorado Headwaters region. Three pairs of 7-year control and pseudo global warming simulations (with horizontal grid spacings of 4, 12, and 36 km) are used to study how the SAF modifies the regional climate response to a large-scale thermodynamic perturbation. The SAF substantially enhances warming within the Headwaters domain, locally as much as 5 °C in regions of snow loss. The SAF also increases the inter-annual variability of the springtime warming within Headwaters domain under the perturbed climate. Linear feedback analysis is used quantify the strength of the SAF. The SAF attains a maximum value of 4 W m-2 K-1 during April when snow loss coincides with strong incoming solar radiation. On sub-seasonal timescales, simulations at 4 km and 12 km horizontal grid-spacing show good agreement in the strength and timing of the SAF, whereas a 36km simulation shows greater discrepancies that are tired to differences in snow accumulation and ablation caused by smoother terrain. An analysis of the regional energy budget shows that transport by atmospheric motion acts as a negative feedback to regional warming, damping the effects of the SAF. On the mesoscale, this transport causes non-local warming in locations with no snow. The methods presented here can be used generally to quantify the role of the SAF in other regional climate modeling experiments.

Method and Apparatus for Creating a Topography at a Surface

DOEpatents

Adams, David P.; Sinclair, Michael B.; Mayer, Thomas M.; Vasile, Michael J.; Sweatt, William C.

2008-11-11

Methods and apparatus whereby an optical interferometer is utilized to monitor and provide feedback control to an integrated energetic particle column, to create desired topographies, including the depth, shape and/or roughness of features, at a surface of a specimen. Energetic particle columns can direct energetic species including, ions, photons and/or neutral particles to a surface to create features having in-plane dimensions on the order of 1 micron, and a height or depth on the order of 1 nanometer. Energetic processes can include subtractive processes such as sputtering, ablation, focused ion beam milling and, additive processes, such as energetic beam induced chemical vapor deposition. The integration of interferometric methods with processing by energetic species offers the ability to create desired topographies at surfaces, including planar and curved shapes.

Recent advances in rhythm control for atrial fibrillation

PubMed Central

Bond, Richard; Olshansky, Brian; Kirchhof, Paulus

2017-01-01

Atrial fibrillation (AF) remains a difficult management problem. The restoration and maintenance of sinus rhythm—rhythm control therapy—can markedly improve symptoms and haemodynamics for patients who have paroxysmal or persistent AF, but some patients fare well with rate control alone. Sinus rhythm can be achieved with anti-arrhythmic drugs or electrical cardioversion, but the maintenance of sinus rhythm without recurrence is more challenging. Catheter ablation of the AF triggers is more effective than anti-arrhythmic drugs at maintaining sinus rhythm. Whilst pulmonary vein isolation is an effective strategy, other ablation targets are being evaluated to improve sinus rhythm maintenance, especially in patients with chronic forms of AF. Previously extensive ablation strategies have been used for patients with persistent AF, but a recent trial has shown that pulmonary vein isolation without additional ablation lesions is associated with outcomes similar to those of more extensive ablation. This has led to an increase in catheter-based technology to achieve durable pulmonary vein isolation. Furthermore, a combination of anti-arrhythmic drugs and catheter ablation seems useful to improve the effectiveness of rhythm control therapy. Two large ongoing trials evaluate whether a modern rhythm control therapy can improve prognosis in patients with AF. PMID:29043080

Percutaneous Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Nonresectable Malignant Biliary Obstruction Improves Stent Patency but not Survival.

PubMed

Wang, Jianfeng; Zhao, Lizhen; Zhou, Chuanguo; Gao, Kun; Huang, Qiang; Wei, Baojie; Gao, Jun

2016-04-01

Although radiofrequency (RF) ablation has been accepted as a curative treatment modality for solid organ tumors, intraductal RF ablation for malignant biliary obstruction has not been widely described. The aim of this study was to evaluate the feasibility, safety, and efficacy (in terms of stent patency and survival) of intraductal RF ablation combined with biliary stent placement for nonresectable malignant biliary obstruction. A search of the nonresectable malignant extrahepatic biliary obstruction database (179 patients) identified 18 consecutive patients who were treated with biliary intraluminal RF ablation during percutaneous transhepatic cholangiodrainage and inner stent placement (RF ablation group) and 18 patients who underwent inner stent placement without biliary intraluminal RF ablation (control group). The patients were matched for tumor type, location of obstruction, tumor stage, and Child-Pugh class status. Primary endpoints included safety, stent patency time, and survival rates. The secondary endpoint was effectiveness of the technique. The RF ablation and control groups were closely matched in terms of age, diagnosis, presence of metastases, presence of locally advanced tumor, American Society of Anesthesiologists (ASA) grade, and chemotherapy regimen (all P > 0.05). The technical success rate for both groups was 100%. The median time of stent patency in the RF ablation and control groups were 5.8 (2.8-11.5) months and 4.5 (2.4-8.0) months, respectively (Kaplan-Meier analysis: P = 0.03). The median survival times in the RF ablation and control groups were 6.1 (4.8-15.2) months and 5.8 (4.2-16.5) months, with no significant difference according to Kaplan-Meier analysis (P = 0.45). In univariate and multivariate analyses, poorer overall survival was associated with advanced age and presence of metastases (P < 0.05). Intraductal RF ablation combined with biliary stent placement for nonresectable malignant biliary obstruction is safe and feasible and effectively increases stent patency time. However, it does not improve patient survival.

Endometrial Ablation

MedlinePlus

... or lighter levels. If ablation does not control heavy bleeding, further treatment or surgery may be needed. ... ablation is used to treat many causes of heavy bleeding. In most cases, women with heavy bleeding ...

One-Dimensional Ablation with Pyrolysis Gas Flow Using a Full Newton's Method and Finite Control Volume Procedure

NASA Technical Reports Server (NTRS)

Amar, Adam J.; Blackwell, Ben F.; Edwards, Jack R.

2007-01-01

The development and verification of a one-dimensional material thermal response code with ablation is presented. The implicit time integrator, control volume finite element spatial discretization, and Newton's method for nonlinear iteration on the entire system of residual equations have been implemented and verified for the thermochemical ablation of internally decomposing materials. This study is a continuation of the work presented in "One-Dimensional Ablation with Pyrolysis Gas Flow Using a Full Newton's Method and Finite Control Volume Procedure" (AIAA-2006-2910), which described the derivation, implementation, and verification of the constant density solid energy equation terms and boundary conditions. The present study extends the model to decomposing materials including decomposition kinetics, pyrolysis gas flow through the porous char layer, and a mixture (solid and gas) energy equation. Verification results are presented for the thermochemical ablation of a carbon-phenolic ablator which involves the solution of the entire system of governing equations.

A Comparison of Real-time Feedback and Tissue Response to Ultrasound-Guided High Intensity Focused Ultrasound (HIFU) Ablation using Scanned Track Exposure Regimes

NASA Astrophysics Data System (ADS)

Gray, Robert H. R.; Leslie, Thomas A.; Civale, John; Kennedy, James E.; ter Haar, Gail

2007-05-01

Real time ultrasound monitoring of tissue ablation in clinical HIFU treatments currently depends on the observation of the appearance of new hyperechoic regions within the target volume, allowing visually directed treatment. These grey-scale changes are attributed to the formation of gas or vapour bubbles. In this study, scanned track lesions have been formed in ex vivo bovine liver samples at a range of ablative intensities (free field spatial peak intensities 7 - 47 kW cm-2), and tracking speeds (1-2 mms-1). Their appearance on conventional B-mode ultrasound images has been assessed using digital imaging techniques over the first 60 seconds following HIFU exposure. The size of the lesion as seen on the ultrasound scan is compared to the macroscopic size of the lesion at dissection. It is seen that the lesion size is highly dependent on the intensity and scanning speed of the transducer. Reliable lesions can be created using scanned tracks at the lowest powers, with increased numbers of cycles, and grey-scale changes correlated strongly with the histological findings. Although not a highly sensitive indication of ablated area, ultrasound monitoring of treatment is highly specific thus confirming its clinical utility.

Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF): study protocol for a randomised controlled trial.

PubMed

Khan, Habib Rehman; Kralj-Hans, Ines; Haldar, Shouvik; Bahrami, Toufan; Clague, Jonathan; De Souza, Anthony; Francis, Darrel; Hussain, Wajid; Jarman, Julian; Jones, David Gareth; Mediratta, Neeraj; Mohiaddin, Raad; Salukhe, Tushar; Jones, Simon; Lord, Joanne; Murphy, Caroline; Kelly, Joanna; Markides, Vias; Gupta, Dhiraj; Wong, Tom

2018-02-20

Atrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation. The main purpose of this trial is to compare the effectiveness and safety of these two interventions. Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF) is a prospective, multi-centre, randomised controlled trial within three NHS tertiary cardiovascular centres specialising in treatment of atrial fibrillation. Eligible adults (n = 120) with symptomatic, long-standing, persistent atrial fibrillation will be randomly allocated to either catheter ablation or thoracoscopic ablation in a 1:1 ratio. Pre-determined lesion sets will be delivered in each treatment arm with confirmation of appropriate conduction block. All patients will have an implantable loop recorder (ILR) inserted subcutaneously immediately following ablation to enable continuous heart rhythm monitoring for at least 12 months. The devices will be programmed to detect episodes of atrial fibrillation and atrial tachycardia ≥ 30 s in duration. The patients will be followed for 12 months, completing appropriate clinical assessments and questionnaires every 3 months. The ILR data will be wirelessly transmitted daily and evaluated every month for the duration of the follow-up. The primary endpoint in the study is freedom from atrial fibrillation and atrial tachycardia at the end of the follow-up period. The CASA-AF Trial is a National Institute for Health Research-funded study that will provide first-class evidence on the comparative efficacy, safety and cost-effectiveness of thoracoscopic surgical ablation and conventional percutaneous catheter ablation for long-standing persistent atrial fibrillation. In addition, the results of the trial will provide information on the effects on patients' quality of life. ISRCTN Registry, ISRCTN18250790 . Registered on 24 April 2015.

A Miniature Forward-imaging B-scan Optical Coherence Tomography Probe to Guide Real-time Laser Ablation

PubMed Central

Li, Zhuoyan; Shen, Jin H.; Kozub, John A.; Prasad, Ratna; Lu, Pengcheng; Joos, Karen M.

2014-01-01

Background and Objective Investigations have shown that pulsed lasers tuned to 6.1 μm in wavelength are capable of ablating ocular and neural tissue with minimal collateral damage. This study investigated whether a miniature B-scan forward-imaging optical coherence tomography (OCT) probe can be combined with the laser to provide real-time visual feedback during laser incisions. Study Design/Methods and Materials A miniature 25-gauge B-scan forward-imaging OCT probe was developed and combined with a 250 μm hollow-glass waveguide to permit delivery of 6.1 μm laser energy. A gelatin mixture and both porcine corneal and retinal tissues were simultaneously imaged and lased (6.1 μm, 10 Hz, 0.4-0.7 mJ) through air. The ablation studies were observed and recorded in real time. The crater dimensions were measured using OCT imaging software (Bioptigen, Durham, NC). Histological analysis was performed on the ocular tissues. Results The combined miniature forward-imaging OCT and mid-infrared laser-delivery probe successfully imaged real-time tissue ablation in gelatin, corneal tissue, and retinal tissue. Application of a constant number of 60 pulses at 0.5 mJ/pulse to the gelatin resulted in a mean crater depth of 123 ± 15 μm. For the corneal tissue, there was a significant correlation between the number of pulses used and depth of the lased hole (Pearson correlation coefficient = 0.82; P = 0.0002). Histological analysis of the cornea and retina tissues showed discrete holes with minimal thermal damage. Conclusions A combined miniature OCT and laser -delivery probe can monitor real-time tissue laser ablation. With additional testing and improvements, this novel instrument has the future possibility of effectively guiding surgeries by simultaneously imaging and ablating tissue. PMID:24648326

CT-guided bipolar and multipolar radiofrequency ablation (RF ablation) of renal cell carcinoma: specific technical aspects and clinical results.

PubMed

Sommer, C M; Lemm, G; Hohenstein, E; Bellemann, N; Stampfl, U; Goezen, A S; Rassweiler, J; Kauczor, H U; Radeleff, B A; Pereira, P L

2013-06-01

This study was designed to evaluate the clinical efficacy of CT-guided bipolar and multipolar radiofrequency ablation (RF ablation) of renal cell carcinoma (RCC) and to analyze specific technical aspects between both technologies. We included 22 consecutive patients (3 women; age 74.2 ± 8.6 years) after 28 CT-guided bipolar or multipolar RF ablations of 28 RCCs (diameter 2.5 ± 0.8 cm). Procedures were performed with a commercially available RF system (Celon AG Olympus, Berlin, Germany). Technical aspects of RF ablation procedures (ablation mode [bipolar or multipolar], number of applicators and ablation cycles, overall ablation time and deployed energy, and technical success rate) were analyzed. Clinical results (local recurrence-free survival and local tumor control rate, renal function [glomerular filtration rate (GFR)]) and complication rates were evaluated. Bipolar RF ablation was performed in 12 procedures and multipolar RF ablation in 16 procedures (2 applicators in 14 procedures and 3 applicators in 2 procedures). One ablation cycle was performed in 15 procedures and two ablation cycles in 13 procedures. Overall ablation time and deployed energy were 35.0 ± 13.6 min and 43.7 ± 17.9 kJ. Technical success rate was 100 %. Major and minor complication rates were 4 and 14 %. At an imaging follow-up of 15.2 ± 8.8 months, local recurrence-free survival was 14.4 ± 8.8 months and local tumor control rate was 93 %. GFR did not deteriorate after RF ablation (50.8 ± 16.6 ml/min/1.73 m(2) before RF ablation vs. 47.2 ± 11.9 ml/min/1.73 m(2) after RF ablation; not significant). CT-guided bipolar and multipolar RF ablation of RCC has a high rate of clinical success and low complication rates. At short-term follow-up, clinical efficacy is high without deterioration of the renal function.

Contact force monitoring during catheter ablation of intraatrial reentrant tachycardia in patients with congenital heart disease.

PubMed

Krause, Ulrich; Backhoff, David; Klehs, Sophia; Schneider, Heike E; Paul, Thomas

2016-08-01

Monitoring of catheter contact force during catheter ablation of atrial fibrillation has been shown to increase efficacy and safety. However, almost no data exists on the use of this technology in catheter ablation of intraatrial reentrant tachycardia in patients with congenital heart disease. The aim of the present study was to evaluate the impact of contact force monitoring during catheter ablation of intraatrial reentrant tachycardia in those patients. Catheter ablation of intraatrial reentrant tachycardia using monitoring of catheter contact force was performed in 28 patients with congenital heart disease (CHD). Thirty-two patients matched according to gender, age, and body weight with congenital heart disease undergoing catheter ablation without contact force monitoring served as control group. Parameters reflecting acute procedural success, long-term efficacy, and safety were compared. Acute procedural success was statistically not different in both groups (contact force 93 % vs. control 84 %, p = 0.3). Likewise the recurrence rate 1 year after ablation as shown by Kaplan-Meier analysis did not differ (contact force 28 % vs. control 37 %, p = 0.63). Major complications were restricted to groin vessel injuries and occurred in 3 out of 60 patients (contact force n = 1; control n = 2). Complications related to excessive catheter contact force were not observed. The present study did not show superiority of catheter contact force monitoring during ablation of intraatrial reentrant tachycardia in patients with CHD in terms of efficacy and safety. Higher contact force compared to pulmonary vein isolation might therefore be required to increase the efficacy of catheter ablation of intraatrial reentrant tachycardia in patients with congenital heart disease.

Long-Term Natural History of Adult Wolff-Parkinson-White Syndrome Patients Treated With and Without Catheter Ablation.

PubMed

Bunch, T Jared; May, Heidi T; Bair, Tami L; Anderson, Jeffrey L; Crandall, Brian G; Cutler, Michael J; Jacobs, Victoria; Mallender, Charles; Muhlestein, Joseph B; Osborn, Jeffrey S; Weiss, J Peter; Day, John D

2015-12-01

There are a paucity of data about the long-term natural history of adult Wolff-Parkinson-White syndrome (WPW) patients in regard to risk of mortality and atrial fibrillation. We sought to describe the long-term outcomes of WPW patients and ascertain the impact of ablation on the natural history. Three groups of patients were studied: 2 WPW populations (ablation: 872, no ablation: 1461) and a 1:5 control population (n=11 175). Long-term mortality and atrial fibrillation rates were determined. The average follow-up for the WPW group was 7.9±5.9 (median: 6.9) years and was similar between the ablation and nonablation groups. Death rates were similar between the WPW group versus the control group (hazard ratio, 0.96; 95% confidence interval, 0.83-1.11; P=0.56). Nonablated WPW patients had a higher long-term death risk compared with ablated WPW patients (hazard ratio, 2.10; 95% confidence interval: 1.50-20.93; P<0.0001). Incident atrial fibrillation risk was higher in the WPW group compared with the control population (hazard ratio, 1.55; 95% confidence interval, 1.29-1.87; P<0.0001). Nonablated WPW patients had lower risk than ablated patients (hazard ratio, 0.39; 95% confidence interval, 0.28-0.53; P<0.0001). Long-term mortality rates in WPW patients are low and similar to an age-matched and gender-matched control population. WPW patients that underwent the multifactorial process of ablation had a lower mortality compared to nonablated WPW patients. Atrial fibrillation rates are high long-term, and ablation does not reduce this risk. © 2015 American Heart Association, Inc.

Quantitative ultrasound backscatter for pulsed cavitational ultrasound therapy- histotripsy.

PubMed

Wang, Tzu-yin; Xu, Zhen; Winterroth, Frank; Hall, Timothy L; Fowlkes, J Brian; Rothman, Edward D; Roberts, William W; Cain, Charles A

2009-05-01

Histotripsy is a well-controlled ultrasonic tissue ablation technology that mechanically and progressively fractionates tissue structures using cavitation. The fractionated tissue volume can be monitored with ultrasound imaging because a significant ultrasound backscatter reduction occurs.This paper correlates the ultrasound backscatter reduction with the degree of tissue fractionation characterized by the percentage of remaining normal-appearing cell nuclei on histology.Different degrees of tissue fractionation were generated in vitro in freshly excised porcine kidneys by varying the number of therapeutic ultrasound pulses from 100 to 2000 pulses per treatment location. All ultrasound pulses were 15 cycles at 1 MHz delivered at 100 Hz pulse repetition frequency and 19 MPa peak negative pressure. The results showed that the normalized backscatter intensity decreased exponentially with increasing number of pulses. Correspondingly, the percentage of normal appearing nuclei in the treated area decreased exponentially as well. A linear correlation existed between the normalized backscatter intensity and the percentage of normal appearing cell nuclei in the treated region. This suggests that the normalized backscatter intensity may be a potential quantitative real-time feedback parameter for histotripsy-induced tissue fractionation. This quantitative feedback may allow the prediction of local clinical outcomes, i.e., when a tissue volume has been sufficiently treated.

Magnetic versus manual catheter navigation for mapping and ablation of right ventricular outflow tract ventricular arrhythmias: a randomized controlled study.

PubMed

Zhang, Fengxiang; Yang, Bing; Chen, Hongwu; Ju, Weizhu; Kojodjojo, Pipin; Cao, Kejiang; Chen, Minglong

2013-08-01

No randomized controlled study has prospectively compared the performance and clinical outcomes of remote magnetic control (RMC) vs manual catheter control (MCC) during ablation of right ventricular outflow tract (RVOT) ventricular premature complexes (VPC) or ventricular tachycardia (VT). The purpose of this study was to prospectively evaluate the efficacy and safety of using either RMC vs MCC for mapping and ablation of RVOT VPC/VT. Thirty consecutive patients with idiopathic RVOT VPC/VT were referred for catheter ablation and randomized into either the RMC or MCC group. A noncontact mapping system was deployed in the RVOT to identify origins of VPC/VT. Conventional activation and pace-mapping was performed to guide ablation. If ablation performed using 1 mode of catheter control was acutely unsuccessful, the patient crossed over to the other group. The primary endpoints were patients' and physicians' fluoroscopic exposure and times. Mean procedural times were similar between RMC and MCC groups. The fluoroscopic exposure and times for both patients and physicians were much lower in the RMC group than in the MCC group. Ablation was acutely successful in 14 of 15 patients in the MCC group and 10 of 15 in the RMC group. Following crossover, acute success was achieved in all patients. No major complications occurred in either group. During 22 months of follow-up, RVOT VPC recurred in 2 RMC patients. RMC navigation significantly reduces patients' and physicians' fluoroscopic times by 50.5% and 68.6%, respectively, when used in conjunction with a noncontact mapping system to guide ablation of RVOT VPC/VT. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

The benefit of tissue contact monitoring with an electrical coupling index during ablation of typical atrial flutter--a prospective randomised control trial.

PubMed

Jones, Michael A; Webster, David; Wong, Kelvin C K; Hayes, Christopher; Qureshi, Norman; Rajappan, Kim; Bashir, Yaver; Betts, Timothy R

2014-12-01

We sought to investigate the use of tissue contact monitoring by means of the electrical coupling index (ECI) in a prospective randomised control trial of patients undergoing cavotricuspid isthmus (CTI) ablation for atrial flutter. Patients with ECG-documented typical flutter undergoing their first CTI ablation were randomised to ECI™-guided or non-ECI™-guided ablation. An irrigated-tip ablation catheter was used in all cases. Consecutive 50-W, 60-s radiofrequency lesions were applied to the CTI, from the tricuspid valve to inferior vena cava, with no catheter movement permitted during radiofrequency (RF) delivery. The ablation endpoint was durable CTI block at 20 min post-ablation. Patients underwent routine clinic follow-up post-operatively. A total of 101 patients (79 male), mean age 66 (+/-11), 50 ECI-guided and 51 control cases were enrolled in the study. CTI block was achieved in all. There were no acute complications. All patients were alive at follow-up. CTI block was achieved in a single pass in 36 ECI-guided and 30 control cases (p = 0.16), and at 20 min post-ablation, re-conduction was seen in 5 and 12 cases, respectively (p = 0.07). There was no significant difference in total procedure time (62.7 ± 33 vs. 62.3 ± 33 min, p = 0.92), RF requirement (580 ± 312 vs. 574 ± 287 s, p = 0.11) or fluoroscopy time (718 ± 577 vs. 721 ± 583 s, p = 0.78). After 6 ± 4 months, recurrence of flutter had occurred in 1 (2 %) ECI vs. 8 (16 %) control cases (OR 0.13, 95 % CI 0.01-1.08, p = 0.06). ECI-guided CTI ablation demonstrated a non-statistically significant reduction in late recurrence of atrial flutter, at no cost to procedural time, radiation exposure or RF requirement.

Analysis of the change in peak corneal temperature during excimer laser ablation in porcine eyes

NASA Astrophysics Data System (ADS)

Mosquera, Samuel Arba; Verma, Shwetabh

2015-07-01

The objective is to characterize the impact of different ablation parameters on the thermal load during corneal refractive surgery by means of excimer laser ablation on porcine eyes. One hundred eleven ablations were performed in 105 porcine eyes. Each ablation was recorded using infrared thermography and analyzed mainly based on the two tested local frequencies (40 Hz, clinical local frequency; 1000 Hz, no local frequency). The change in peak corneal temperature was analyzed with respect to varying ablation parameters [local frequency, system repetition rate, pulse energy, optical zone (OZ) size, and refractive correction]. Transepithelial ablations were also compared to intrastromal ablations. The average of the baseline temperature across all eyes was 20.5°C±1.1 (17.7°C to 22.2°C). Average of the change in peak corneal temperature for all clinical local frequency ablations was 5.8°C±0.8 (p=3.3E-53 to baseline), whereas the average was 9.0°C±1.5 for all no local frequency ablations (p=1.8E-35 to baseline, 1.6E-16 to clinical local frequency ablations). A logarithmic relationship was observed between the changes in peak corneal temperature with increasing local frequency. For clinical local frequency, change in peak corneal temperature was comparatively flat (r2=0.68 with a range of 1.5°C) with increasing system repetition rate and increased linearly with increasing OZ size (r2=0.95 with a range of 2.4°C). Local frequency controls help maintain safe corneal temperature increase during excimer laser ablations. Transepithelial ablations induce higher thermal load compared to intrastromal ablations, indicating a need for stronger thermal controls in transepithelial refractive procedures.

Temperature monitoring by infrared radiation measurements during ArF excimer laser ablation with cornea

NASA Astrophysics Data System (ADS)

Ishihara, Miya; Arai, Tsunenori; Sato, Shunichi; Nakano, Hironori; Obara, Minoru; Kikuchi, Makoto

1999-06-01

We measured infrared thermal radiation from porcine cornea during various fluences ArF excimer laser ablations with 1 microsecond(s) rise time. To obtain absolute temperature by means of Stefan-Boltzman law of radiation, we carried out a collection efficiency and detective sensitivity by a pre-experiment using panel heater. We measured the time course of the thermal radiation intensity with various laser fluences. We studied the relation between the peak cornea temperature during the ablation and irradiation fluences. We found the ablation situations, i.e., sub-ablation threshold, normal thermal ablation, and over-heated ablation, may be judged by both of the measured temperature transient waveforms and peak temperature. The boundary fluences corresponding to normal thermal ablation were 90 and 160 mJ/cm2. Our fast remote temperature monitoring during cornea ablation might be useful to control ablation quality/quantity of the cornea ArF laser ablation, that is PRK.

Acoustic radiation force impulse imaging for real-time observation of lesion development during radiofrequency ablation procedures

NASA Astrophysics Data System (ADS)

Fahey, Brian J.; Trahey, Gregg E.

2005-04-01

When performing radiofrequency ablation (RFA) procedures, physicians currently have little or no feedback concerning the success of the treatment until follow-up assessments are made days to weeks later. To be successful, RFA must induce a thermal lesion of sufficient volume to completely destroy a target tumor or completely isolate an aberrant cardiac pathway. Although ultrasound, computed tomography (CT), and CT-based fluoroscopy have found use in guiding RFA treatments, they are deficient in giving accurate assessments of lesion size or boundaries during procedures. As induced thermal lesion size can vary considerably from patient to patient, the current lack of real-time feedback during RFA procedures is troublesome. We have developed a technique for real-time monitoring of thermal lesion size during RFA procedures utilizing acoustic radiation force impulse (ARFI) imaging. In both ex vivo and in vivo tissues, ARFI imaging provided better thermal lesion contrast and better overall appreciation for lesion size and boundaries relative to conventional sonography. The thermal safety of ARFI imaging for use at clinically realistic depths was also verified through the use of finite element method models. As ARFI imaging is implemented entirely on a diagnostic ultrasound scanner, it is a convenient, inexpensive, and promising modality for monitoring RFA procedures in vivo.

Effect of a poloxamer 407-based thermosensitive gel on minimization of thermal injury to diaphragm during microwave ablation of the liver.

PubMed

Zhang, Li-Li; Xia, Gui-Min; Liu, Yu-Jiang; Dou, Rui; Eisenbrey, John; Liu, Ji-Bin; Wang, Xiao-Wei; Qian, Lin-Xue

2017-03-28

To assess the insulating effect of a poloxamer 407 (P407)-based gel during microwave ablation of liver adjacent to the diaphragm. We prepared serial dilutions of P407, and 22.5% (w/w) concentration was identified as suitable for ablation procedures. Subsequently, microwave ablations were performed on the livers of 24 rabbits (gel, saline, control groups, n = 8 in each). The P407 solution and 0.9% normal saline were injected into the potential space between the diaphragm and liver in experimental groups. No barriers were applied to the controls. After microwave ablations, the frequency, size and degree of thermal injury were compared histologically among the three groups. Subsequently, another 8 rabbits were injected with the P407 solution and microwave ablation was performed. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and creatinine (Cr) in serum were tested at 1 d before microwave ablation and 3 and 7 d after operation. In vivo ablation thermal injury to the adjacent diaphragm was evaluated in the control, saline and 22.5% P407 gel groups ( P = 0.001-0.040). However, there was no significant difference in the volume of ablation zone among the three groups ( P > 0.05). Moreover, there were no statistical differences among the preoperative and postoperative gel groups according to the levels of ALT, AST, BUN and Cr in serum (all P > 0.05). Twenty-two point five percent P407 gel could be a more effective choice during microwave ablation of hepatic tumors adjacent to the diaphragm. Further studies for clinical translation are warranted.

Usage of Magnetic Resonance Guided Focused Ultrasound Surgery (mrgfus) in Oncology

NASA Astrophysics Data System (ADS)

Bauer, Yair

2011-09-01

Magnetic resonance guided focused ultrasound surgery (MRgFUS) is a non-invasive incision-less surgical approach which limits the tissue destruction to the targeted tumor. Acoustic energy penetrates through intact skin and through the tissues surrounding the tumor without causing any significant bio-effects. Energy deposition takes place mainly at the focal spot where heat induced thermal coagulation of the targeted tissue is accomplished. Real time targeting and image guidance is provided by MRI tumor margin definition and real time thermometry provides closed loop feedback control of energy deposition. The patient lies in the MRI scanner throughout the treatment planning and treatment, and the physician conducts the treatment from the MRgFUS workstation in the adjacent MR control room. The ExAblate system for MRgFUS is commercially available in many countries for treatment of uterine fibroids. The system has also received CE and KFDA approval for pain palliation of bone metastases, and research of other oncologic applications is underway.

Precision of Discrete and Rhythmic Forelimb Movements Requires a Distinct Neuronal Subpopulation in the Interposed Anterior Nucleus.

PubMed

Low, Aloysius Y T; Thanawalla, Ayesha R; Yip, Alaric K K; Kim, Jinsook; Wong, Kelly L L; Tantra, Martesa; Augustine, George J; Chen, Albert I

2018-02-27

The deep cerebellar nuclei (DCN) represent output channels of the cerebellum, and they transmit integrated sensorimotor signals to modulate limb movements. But the functional relevance of identifiable neuronal subpopulations within the DCN remains unclear. Here, we examine a genetically tractable population of neurons in the mouse interposed anterior nucleus (IntA). We show that these neurons represent a subset of glutamatergic neurons in the IntA and constitute a specific element of an internal feedback circuit within the cerebellar cortex and cerebello-thalamo-cortical pathway associated with limb control. Ablation and optogenetic stimulation of these neurons disrupt efficacy of skilled reach and locomotor movement and reveal that they control positioning and timing of the forelimb and hindlimb. Together, our findings uncover the function of a distinct neuronal subpopulation in the deep cerebellum and delineate the anatomical substrates and kinematic parameters through which it modulates precision of discrete and rhythmic limb movements. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Radiofrequency ablation of accessory pathways in patients with the Wolff-Parkinson-White syndrome: the long-term mortality and risk of atrial fibrillation.

PubMed

Borregaard, Rune; Lukac, Peter; Gerdes, Christian; Møller, Dorthe; Mortensen, Peter Thomas; Pedersen, Lars; Nielsen, Jens Cosedis; Jensen, Henrik Kjærulf

2015-01-01

To assess the long-term mortality and occurrence of post-ablation atrial fibrillation in patients undergoing a radiofrequency ablation for the Wolff-Parkinson-White (WPW) syndrome. A retrospective cohort study of patients (N = 362) subjected to radiofrequency ablation of the WPW syndrome at Aarhus University Hospital from 1990 to 2011. A comparison cohort (N = 3619) was generated from the Danish National Board of Health Central Population Registry. We found no significant difference in all-cause mortality when comparing the WPW group with the control group [hazard ratio (HR): 0.77 and confidence interval (CI): 0.47-1.25]. After radiofrequency ablation, the WPW group had a significantly higher risk of atrial fibrillation than the control group (HR: 4.77 and CI: 3.05-7.43). Atrial fibrillation prior to ablation (HR: 4.66 and CI: 2.09-10.41) and age over 50 years (HR: 9.79 and CI: 4.29-22.36) at the time of ablation were independent risk factors for post-ablation atrial fibrillation in the WPW group. Patients with radiofrequency ablation-treated WPW syndrome have a post-ablation mortality that is similar to the background population. The risk of atrial fibrillation remains high after radiofrequency ablation of the WPW syndrome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Advances in local ablation of malignant liver lesions

PubMed Central

Eisele, Robert M

2016-01-01

Local ablation of liver tumors matured during the recent years and is now proven to be an effective tool in the treatment of malignant liver lesions. Advances focus on the improvement of local tumor control by technical innovations, individual selection of imaging modalities, more accurate needle placement and the free choice of access to the liver. Considering data found in the current literature for conventional local ablative treatment strategies, virtually no single technology is able to demonstrate an unequivocal superiority. Hints at better performance of microwave compared to radiofrequency ablation regarding local tumor control, duration of the procedure and potentially achievable larger size of ablation areas favour the comparably more recent treatment modality; image fusion enables more patients to undergo ultrasound guided local ablation; magnetic resonance guidance may improve primary success rates in selected patients; navigation and robotics accelerate the needle placement and reduces deviation of needle positions; laparoscopic thermoablation results in larger ablation areas and therefore hypothetically better local tumor control under acceptable complication rates, but seems to be limited to patients with no, mild or moderate adhesions following earlier surgical procedures. Apart from that, most techniques appear technically feasible, albeit demanding. Which technology will in the long run become accepted, is subject to future work. PMID:27099433

A multimodality imaging-compatible insertion robot with a respiratory motion calibration module designed for ablation of liver tumors: a preclinical study.

PubMed

Li, Dongrui; Cheng, Zhigang; Chen, Gang; Liu, Fangyi; Wu, Wenbo; Yu, Jie; Gu, Ying; Liu, Fengyong; Ren, Chao; Liang, Ping

2018-04-03

To test the accuracy and efficacy of the multimodality imaging-compatible insertion robot with a respiratory motion calibration module designed for ablation of liver tumors in phantom and animal models. To evaluate and compare the influences of intervention experience on robot-assisted and ultrasound-controlled ablation procedures. Accuracy tests on rigid body/phantom model with a respiratory movement simulation device and microwave ablation tests on porcine liver tumor/rabbit liver cancer were performed with the robot we designed or with the traditional ultrasound-guidance by physicians with or without intervention experience. In the accuracy tests performed by the physicians without intervention experience, the insertion accuracy and efficiency of robot-assisted group was higher than those of ultrasound-guided group with statistically significant differences. In the microwave ablation tests performed by the physicians without intervention experience, better complete ablation rate was achieved when applying the robot. In the microwave ablation tests performed by the physicians with intervention experience, there was no statistically significant difference of the insertion number and total ablation time between the robot-assisted group and the ultrasound-controlled group. The evaluation by the NASA-TLX suggested that the robot-assisted insertion and microwave ablation process performed by physicians with or without experience were more comfortable. The multimodality imaging-compatible insertion robot with a respiratory motion calibration module designed for ablation of liver tumors could increase the insertion accuracy and ablation efficacy, and minimize the influence of the physicians' experience. The ablation procedure could be more comfortable with less stress with the application of the robot.

Accurate Depth of Radiofrequency-Induced Lesions in Renal Sympathetic Denervation Based on a Fine Histological Sectioning Approach in a Porcine Model

PubMed Central

Terao, Hisako; Nakamura, Shintaro; Hagiwara, Hitomi; Furukawa, Toshihito; Matsumura, Kiyoshi; Sakakura, Kenichi

2018-01-01

Background— Ablation lesion depth caused by radiofrequency-based renal denervation (RDN) was limited to <4 mm in previous animal studies, suggesting that radiofrequency-RDN cannot ablate a substantial percentage of renal sympathetic nerves. We aimed to define the true lesion depth achieved with radiofrequency-RDN using a fine sectioning method and to investigate biophysical parameters that could predict lesion depth. Methods and Results— Radiofrequency was delivered to 87 sites in 14 renal arteries from 9 farm pigs at various ablation settings: 2, 4, 6, and 9 W for 60 seconds and 6 W for 120 seconds. Electric impedance and electrode temperature were recorded during ablation. At 7 days, 2470 histological sections were obtained from the treated arteries. Maximum lesion depth increased at 2 to 6 W, peaking at 6.53 (95% confidence interval, 4.27–8.78) mm under the 6 W/60 s condition. It was not augmented by greater power (9 W) or longer duration (120 seconds). There were statistically significant tendencies at 6 and 9 W, with higher injury scores in the media, nerves, arterioles, and fat. Maximum lesion depth was positively correlated with impedance reduction and peak electrode temperature (Pearson correlation coefficients were 0.59 and 0.53, respectively). Conclusions— Lesion depth was 6.5 mm for radiofrequency-RDN at 6 W/60 s. The impedance reduction and peak electrode temperature during ablation were closely associated with lesion depth. Hence, these biophysical parameters could provide prompt feedback during radiofrequency-RDN procedures in the clinical setting. PMID:29440276

Accurate Depth of Radiofrequency-Induced Lesions in Renal Sympathetic Denervation Based on a Fine Histological Sectioning Approach in a Porcine Model.

PubMed

Sakaoka, Atsushi; Terao, Hisako; Nakamura, Shintaro; Hagiwara, Hitomi; Furukawa, Toshihito; Matsumura, Kiyoshi; Sakakura, Kenichi

2018-02-01

Ablation lesion depth caused by radiofrequency-based renal denervation (RDN) was limited to <4 mm in previous animal studies, suggesting that radiofrequency-RDN cannot ablate a substantial percentage of renal sympathetic nerves. We aimed to define the true lesion depth achieved with radiofrequency-RDN using a fine sectioning method and to investigate biophysical parameters that could predict lesion depth. Radiofrequency was delivered to 87 sites in 14 renal arteries from 9 farm pigs at various ablation settings: 2, 4, 6, and 9 W for 60 seconds and 6 W for 120 seconds. Electric impedance and electrode temperature were recorded during ablation. At 7 days, 2470 histological sections were obtained from the treated arteries. Maximum lesion depth increased at 2 to 6 W, peaking at 6.53 (95% confidence interval, 4.27-8.78) mm under the 6 W/60 s condition. It was not augmented by greater power (9 W) or longer duration (120 seconds). There were statistically significant tendencies at 6 and 9 W, with higher injury scores in the media, nerves, arterioles, and fat. Maximum lesion depth was positively correlated with impedance reduction and peak electrode temperature (Pearson correlation coefficients were 0.59 and 0.53, respectively). Lesion depth was 6.5 mm for radiofrequency-RDN at 6 W/60 s. The impedance reduction and peak electrode temperature during ablation were closely associated with lesion depth. Hence, these biophysical parameters could provide prompt feedback during radiofrequency-RDN procedures in the clinical setting. © 2018 The Authors.

Prophylactic Catheter Ablation for the Prevention of Defibrillator Therapy

PubMed Central

Reddy, Vivek Y.; Reynolds, Matthew R.; Neuzil, Petr; Richardson, Allison W.; Taborsky, Milos; Jongnarangsin, Krit; Kralovec, Stepan; Sediva, Lucie; Ruskin, Jeremy N.; Josephson, Mark E.

2008-01-01

BACKGROUND For patients who have a ventricular tachyarrhythmic event, implantable cardioverter–defibrillators (ICDs) are a mainstay of therapy to prevent sudden death. However, ICD shocks are painful, can result in clinical depression, and do not offer complete protection against death from arrhythmia. We designed this randomized trial to examine whether prophylactic radiofrequency catheter ablation of arrhythmogenic ventricular tissue would reduce the incidence of ICD therapy. METHODS Eligible patients with a history of a myocardial infarction underwent defibrillator implantation for spontaneous ventricular tachycardia or fibrillation. The patients did not receive antiarrhythmic drugs. Patients were randomly assigned to defibrillator implantation alone or defibrillator implantation with adjunctive catheter ablation (64 patients in each group). Ablation was performed with the use of a substrate-based approach in which the myocardial scar is mapped and ablated while the heart remains predominantly in sinus rhythm. The primary end point was survival free from any appropriate ICD therapy. RESULTS The mortality rate 30 days after ablation was zero, and there were no significant changes in ventricular function or functional class during the mean (±SD) follow-up period of 22.5±5.5 months. Twenty-one patients assigned to defibrillator implantation alone (33%) and eight patients assigned to defibrillator implantation plus ablation (12%) received appropriate ICD therapy (antitachycardia pacing or shocks) (hazard ratio in the ablation group, 0.35; 95% confidence interval, 0.15 to 0.78, P = 0.007). Among these patients, 20 in the control group (31%) and 6 in the ablation group (9%) received shocks (P = 0.003). Mortality was not increased in the group assigned to ablation as compared with the control group (9% vs. 17%, P = 0.29). CONCLUSIONS In this randomized trial, prophylactic substrate-based catheter ablation reduced the incidence of ICD therapy in patients with a history of myocardial infarction who received ICDs for the secondary prevention of sudden death. (Current Controlled Trials number, ISRCTN62488166.) PMID:18160685

Clinical Implications of Ablation of Drivers for Atrial Fibrillation: A Systematic Review and Meta-Analysis.

PubMed

Baykaner, Tina; Rogers, Albert J; Meckler, Gabriela L; Zaman, Junaid; Navara, Rachita; Rodrigo, Miguel; Alhusseini, Mahmood; Kowalewski, Christopher A B; Viswanathan, Mohan N; Narayan, Sanjiv M; Clopton, Paul; Wang, Paul J; Heidenreich, Paul A

2018-05-01

The outcomes from pulmonary vein isolation (PVI) for atrial fibrillation (AF) are suboptimal, but the benefits of additional lesion sets remain unproven. Recent studies propose ablation of AF drivers improves outcomes over PVI, yet with conflicting reports in the literature. We undertook a systematic literature review and meta-analysis to determine outcomes from ablation of AF drivers in addition to PVI or as a stand-alone procedure. Database search was done using the terms atrial fibrillation and ablation or catheter ablation and driver or rotor or focal impulse or FIRM (Focal Impulse and Rotor Modulation). We pooled data using random effects model and assessed heterogeneity with I 2 statistic. Seventeen studies met inclusion criteria, in a cohort size of 3294 patients. Adding AF driver ablation to PVI reported freedom from AF of 72.5% (confidence interval [CI], 62.1%-81.8%; P <0.01) and from all arrhythmias of 57.8% (CI, 47.5%-67.7%; P <0.01). AF driver ablation when added to PVI or as stand-alone procedure compared with controls produced an odds ratio of 3.1 (CI, 1.3-7.7; P =0.02) for freedom from AF and an odds ratio of 1.8 (CI, 1.2-2.7; P <0.01) for freedom from all arrhythmias in 4 controlled studies. AF termination rate was 40.5% (CI, 30.6%-50.9%) and predicted favorable outcome from ablation( P <0.05). In controlled studies, the addition of AF driver ablation to PVI supports the possible benefit of a combined approach of AF driver ablation and PVI in improving single-procedure freedom from all arrhythmias. However, most studies are uncontrolled and are limited by substantial heterogeneity in outcomes. Large multicenter randomized trials are needed to precisely define the benefits of adding driver ablation to PVI. © 2018 American Heart Association, Inc.

Radiofrequency ablation of bone with cooled probes and impedance control energy delivery in a pig model: MR imaging features.

PubMed

Cantwell, Colin P; Flavin, Robert; Deane, Richard; Sheehan, Katherine; Dervan, Peter; O'Byrne, John; Eustace, Stephen

2007-08-01

To determine the coronal marrow ablation length and detect cortical thinning after radiofrequency ablation (RFA) of bone in a pig model. Twelve pigs underwent RFA with a 1- or 2-cm single internally cooled electrode placed at the mid-diaphyseal point of their long bones at 1, 7, or 28 days before euthanasia. Twelve minutes of impedance control radiofrequency energy was delivered at maximum output from a 200-W generator. Pigs were imaged with axial and coronal turbo spin-echo (SE) T1- and T2-weighted frequency-selective fat suppression sequences by using spectral presaturation with inversion recovery (SPIR). A radiologist blinded to the timing of the treatment and the results of other imaging sequences measured the coronal ablation zone length and cortical thickness. The pigs were euthanized, and the ablated bone underwent histologic examination. At SPIR imaging, the zone of marrow ablation was defined as an area of low signal intensity surrounded by a high-signal-intensity band. At T1-weighted imaging, the zone of marrow ablation was defined as a heterogeneously isointense area surrounded by a low-signal-intensity band. The mean (+/-standard deviation) coronal marrow ablation zone measurement with SPIR imaging at 28 days was 47 mm +/- 9 (range, 34-73 mm) for the 1-cm electrode and 51 mm +/- 7 (range, 33-67 mm) for the 2-cm electrode. Two humeral fractures occurred at 21 and 28 days after therapy. Thinning of the cortex adjacent to the electrode insertion site was identified in the humeral group only. The change in the marrow signal intensity with impedance-controlled RFA is larger than that reported for temperature-controlled protocols. RFA leads to bone weakening.

Six-month follow-up of isthmus-dependent right atrial flutter ablation using a remote magnetic catheter navigation system: a case-control study.

PubMed

Huo, Yan; Hindricks, Gerhard; Piorkowski, Christopher; Bollmann, Andreas; Wetzel, Ulrike; Sommer, Phillip; Gaspar, Thomas; Kottkamp, Hans; Arya, Arash

2010-06-01

The objective of this study was to compare results between the magnetic navigation system (MNS) and conventional catheter ablation of cavo-tricuspid isthmus (CTI)-dependent right atrial flutter (AFL) in a case control study. A remote MNS has been used for ablation of various arrhythmias including CTI-dependent AFL but comparative results between MNS and conventional ablation are not available. Between May and September 2007, a total of 51 consecutive patients (45 men, mean age 65.4 +/- 9.4 years) had undergone catheter ablation for CTI-dependent AFL. The catheter ablation (70 degrees C, 70 W, 90 s) was performed with either an 8-mm-tip magnetic catheter using MNS (case group, n = 26, 23 men, mean age 64.6 +/- 9.6 y) or a conventional 8-mm catheter (case group, n = 25, 22 men, mean age 65.4 +/- 9.1 y). Acute procedural success was defined as complete bidirectional isthmus block and success at six months was defined as absence of AFL during the six months follow-up. With respect to baseline characteristics there were no differences between the two groups. The procedure time in MNS and conventional group was [median (range)] 53 (30-130) min and 45 (30-100) min, respectively (P = 0.12). Acute success was achieved by MNS and conventional ablation in 25/26 (96.2%) and 25/25 (100%) of patients, respectively (P = 0.53). During the six months of follow-up 4 patients, 2 in each group, experienced recurrence (P = 0.90). No major complication occurred during the procedure. Charring on the catheter tip occurred in 5 patients (19.2%) in MNS and none of the patients in the control group (P <0.05). This case-control study demonstrated the acute and mid-term efficacy and safety of catheter ablation by MNS for CTI-dependent AFL, similar to rates achieved by conventional radiofrequency catheter ablation.

Magnetic navigation and catheter ablation of right atrial ectopic tachycardia in the presence of a hemi-azygos continuation: a magnetic navigation case using 3D electroanatomical mapping.

PubMed

Ernst, Sabine; Chun, Julian K R; Koektuerk, Buelent; Kuck, Karl-Heinz

2009-01-01

We report on a 63-year-old female patient in whom an electrophysiologic study discovered a hemi-azygos continuation. Using the magnetic navigation system, remote-controlled ablation was performed in conjunction with the 3D electroanatomical mapping system. Failing the attempt to advance a diagnostic catheter from the femoral vein, a diagnostic catheter was advanced via the left subclavian vein into the coronary sinus. The soft magnetic catheter was positioned in the right atrium via the hemi-azygos vein, and 3D mapping demonstrated an ectopic atrial tachycardia. Successful ablation was performed entirely remote controlled. Fluoroscopy time was only 7.1 minutes, of which 45 seconds were required during remote navigation. Remote-controlled catheter ablation using magnetic navigation in conjunction with the electroanatomical mapping system proved to be a valuable tool to perform successful ablation in the presence of a hemi-azygos continuation.

The effect of augmented real-time image guidance on task workload during endoscopic sinus surgery.

PubMed

Dixon, Benjamin J; Chan, Harley; Daly, Michael J; Vescan, Allan D; Witterick, Ian J; Irish, Jonathan C

2012-01-01

Due to proximity to critical structures, the need for spatial awareness during endoscopic sinus surgery (ESS) is essential. We have developed an augmented, real-time image-guided surgery (ART-IGS) system that provides live navigational data and proximity alerts to the operating surgeon during ablation. We wished to test the hypothesis that task workload would be reduced when using this technology. A trial involved 8 otolaryngology residents and fellows performing ESS on cadaveric specimens; 1 side in a conventional method (control) and 1 side with ART-IGS. After computed tomography scanning, anatomical contouring, and registration of the head, a three-dimensional (3D) virtual endoscopic view, ablative tool tracking, and proximity alerts were enabled. Each subject completed ESS tasks and rated their workload during and after the exercise using the National Aeronautics and Space Administration (NASA) Task Load Index (TLX). A questionnaire and open feedback interview were completed after the procedure. There was a significant reduction in mental demand, temporal demand, effort, and frustration when using the ART-IGS system in comparison to the control (p < 0.02). Perceived performance was increased (p = 0.02). Most subjects agreed that the system was sufficiently accurate, caused minimal interruption, and increased confidence. Optical tracking line-of-sight issues were frequently cited as the main limitation early in the study; however, this was largely resolved. ART-IGS reduces task workload for trainees performing ESS. Live navigation and alert zones may be a valuable intraoperative teaching aid. Copyright © 2012 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

Automatic control of finite element models for temperature-controlled radiofrequency ablation.

PubMed

Haemmerich, Dieter; Webster, John G

2005-07-14

The finite element method (FEM) has been used to simulate cardiac and hepatic radiofrequency (RF) ablation. The FEM allows modeling of complex geometries that cannot be solved by analytical methods or finite difference models. In both hepatic and cardiac RF ablation a common control mode is temperature-controlled mode. Commercial FEM packages don't support automating temperature control. Most researchers manually control the applied power by trial and error to keep the tip temperature of the electrodes constant. We implemented a PI controller in a control program written in C++. The program checks the tip temperature after each step and controls the applied voltage to keep temperature constant. We created a closed loop system consisting of a FEM model and the software controlling the applied voltage. The control parameters for the controller were optimized using a closed loop system simulation. We present results of a temperature controlled 3-D FEM model of a RITA model 30 electrode. The control software effectively controlled applied voltage in the FEM model to obtain, and keep electrodes at target temperature of 100 degrees C. The closed loop system simulation output closely correlated with the FEM model, and allowed us to optimize control parameters. The closed loop control of the FEM model allowed us to implement temperature controlled RF ablation with minimal user input.

Surgical ablation of atrial fibrillation during mitral-valve surgery.

PubMed

Gillinov, A Marc; Gelijns, Annetine C; Parides, Michael K; DeRose, Joseph J; Moskowitz, Alan J; Voisine, Pierre; Ailawadi, Gorav; Bouchard, Denis; Smith, Peter K; Mack, Michael J; Acker, Michael A; Mullen, John C; Rose, Eric A; Chang, Helena L; Puskas, John D; Couderc, Jean-Philippe; Gardner, Timothy J; Varghese, Robin; Horvath, Keith A; Bolling, Steven F; Michler, Robert E; Geller, Nancy L; Ascheim, Deborah D; Miller, Marissa A; Bagiella, Emilia; Moquete, Ellen G; Williams, Paula; Taddei-Peters, Wendy C; O'Gara, Patrick T; Blackstone, Eugene H; Argenziano, Michael

2015-04-09

Among patients undergoing mitral-valve surgery, 30 to 50% present with atrial fibrillation, which is associated with reduced survival and increased risk of stroke. Surgical ablation of atrial fibrillation has been widely adopted, but evidence regarding its safety and effectiveness is limited. We randomly assigned 260 patients with persistent or long-standing persistent atrial fibrillation who required mitral-valve surgery to undergo either surgical ablation (ablation group) or no ablation (control group) during the mitral-valve operation. Patients in the ablation group underwent further randomization to pulmonary-vein isolation or a biatrial maze procedure. All patients underwent closure of the left atrial appendage. The primary end point was freedom from atrial fibrillation at both 6 months and 12 months (as assessed by means of 3-day Holter monitoring). More patients in the ablation group than in the control group were free from atrial fibrillation at both 6 and 12 months (63.2% vs. 29.4%, P<0.001). There was no significant difference in the rate of freedom from atrial fibrillation between patients who underwent pulmonary-vein isolation and those who underwent the biatrial maze procedure (61.0% and 66.0%, respectively; P=0.60). One-year mortality was 6.8% in the ablation group and 8.7% in the control group (hazard ratio with ablation, 0.76; 95% confidence interval, 0.32 to 1.84; P=0.55). Ablation was associated with more implantations of a permanent pacemaker than was no ablation (21.5 vs. 8.1 per 100 patient-years, P=0.01). There were no significant between-group differences in major cardiac or cerebrovascular adverse events, overall serious adverse events, or hospital readmissions. The addition of atrial fibrillation ablation to mitral-valve surgery significantly increased the rate of freedom from atrial fibrillation at 1 year among patients with persistent or long-standing persistent atrial fibrillation, but the risk of implantation of a permanent pacemaker was also increased. (Funded by the National Institutes of Health and the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00903370.).

Use of asymmetric bidirectional catheters with different curvature radius for catheter ablation of cardiac arrhythmias.

PubMed

Mantziari, Lilian; Suman-Horduna, Irina; Gujic, Marko; Jones, David G; Wong, Tom; Markides, Vias; Foran, John P; Ernst, Sabine

2013-06-01

The impact of recently introduced asymmetric bidirectional ablation catheters on procedural parameters and acute success rates of ablation procedures is unknown. We retrospectively analyzed data regarding ablations using a novel bidirectional catheter in a tertiary cardiac center and compared these in 1:5 ratio with a control group of procedures matched for age, gender, operator, and ablation type. A total of 50 cases and 250 controls of median age 60 (50-68) years were studied. Structural heart disease was equally prevalent in both groups (39%) while history of previous ablations was more common in the study arm (54% vs 30%, P = 0.001). Most of the ablation cases were for atrial fibrillation (46%), followed by atrial tachycardia (28%), supraventricular tachycardia (12%), and ventricular tachycardia (14%). Median procedure duration was 128 (52-147) minutes with the bidirectional, versus 143 (105-200) minutes with the conventional catheter (P = 0.232), and median fluoroscopy time was 17 (10-34) minutes versus 23 (12-39) minutes, respectively (P = 0.988). There was a trend toward a lower procedure duration for the atrial tachycardia ablations, 89 (52-147) minutes versus 130 (100-210) minutes, P = 0.064. The procedure was successfully completed in 96% of the bidirectional versus 84% of the control cases (P = 0.151). A negative correlation was observed between the relative fluoroscopy duration and the case number (r = -0.312, P = 0.028), reflecting the learning curve for the bidirectional catheter. The introduction of the bidirectional catheter resulted in no prolongation of procedure parameters and similar success rates, while there was a trend toward a lower procedure duration for atrial tachycardia ablations. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

A review of randomised controlled trials comparing ultrasound-guided foam sclerotherapy with endothermal ablation for the treatment of great saphenous varicose veins.

PubMed

Davies, Huw Ob; Popplewell, Matthew; Darvall, Katy; Bate, Gareth; Bradbury, Andrew W

2016-05-01

The last 10 years have seen the introduction into everyday clinical practice of a wide range of novel non-surgical treatments for varicose veins. In July 2013, the UK National Institute for Health and Care Excellence recommended the following treatment hierarchy for varicose veins: endothermal ablation, ultrasound-guided foam sclerotherapy, surgery and compression hosiery. The aim of this paper is to review the randomised controlled trials that have compared endothermal ablation and ultrasound-guided foam sclerotherapy to determine if the level 1 evidence base still supports an "endothermal ablation first" strategy for the treatment of varicose veins. A PubMed and OVID literature search (until 31 January 2015) was performed and randomised controlled trials comparing endothermal ablation and ultrasound-guided foam sclerotherapy were obtained. Although anatomical success appeared higher with endothermal ablation than ultrasound-guided foam sclerotherapy, clinical success and patient-reported outcomes measures were similar. Morbidity and complication rates were very low and not significantly different between endothermal ablation and ultrasound-guided foam sclerotherapy. Ultrasound-guided foam sclerotherapy was consistently less expensive that endothermal ablation. All endovenous modalities appear to be successful and have a role in modern day practice. Although further work is required to optimise ultrasound-guided foam sclerotherapy technique to maximise anatomical success and minimise retreatment, the present level 1 evidence base shows there is no significant difference in clinical important outcomes between ultrasound-guided foam sclerotherapy and endothermal ablation. As ultrasound-guided foam sclerotherapy is less expensive, it is likely to be a more cost-effective option in most patients in most healthcare settings. Strict adherence to the treatment hierarchy recommended by National Institute for Health and Care Excellence seems unjustified. © The Author(s) 2015.

Recent Advances in Tumor Ablation for Hepatocellular Carcinoma

PubMed Central

Kang, Tae Wook; Rhim, Hyunchul

2015-01-01

Image-guided tumor ablation for early stage hepatocellular carcinoma (HCC) is an accepted non-surgical treatment that provides excellent local tumor control and favorable survival benefit. This review summarizes the recent advances in tumor ablation for HCC. Diagnostic imaging and molecular biology of HCC has recently undergone marked improvements. Second-generation ultrasonography (US) contrast agents, new computed tomography (CT) techniques, and liver-specific contrast agents for magnetic resonance imaging (MRI) have enabled the early detection of smaller and inconspicuous HCC lesions. Various imaging-guidance tools that incorporate imaging-fusion between real-time US and CT/MRI, that are now common for percutaneous tumor ablation, have increased operator confidence in the accurate targeting of technically difficult tumors. In addition to radiofrequency ablation (RFA), various therapeutic modalities including microwave ablation, irreversible electroporation, and high-intensity focused ultrasound ablation have attracted attention as alternative energy sources for effective locoregional treatment of HCC. In addition, combined treatment with RFA and chemoembolization or molecular agents may be able to overcome the limitation of advanced or large tumors. Finally, understanding of the biological mechanisms and advances in therapy associated with tumor ablation will be important for successful tumor control. All these advances in tumor ablation for HCC will result in significant improvement in the prognosis of HCC patients. In this review, we primarily focus on recent advances in molecular tumor biology, diagnosis, imaging-guidance tools, and therapeutic modalities, and refer to the current status and future perspectives for tumor ablation for HCC. PMID:26674766

Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease: a randomised controlled phase 2 trial.

PubMed

Vietti Violi, Naïk; Duran, Rafael; Guiu, Boris; Cercueil, Jean-Pierre; Aubé, Christophe; Digklia, Antonia; Pache, Isabelle; Deltenre, Pierre; Knebel, Jean-François; Denys, Alban

2018-05-01

Radiofrequency ablation is the recommended treatment for patients with hepatocellular carcinoma who have lesions smaller than 3 cm and are therefore not candidates for surgery. Microwave ablation is a more recent technique with certain theoretical advantages that have not yet been confirmed clinically. We aimed to compare the efficacy of both techniques in the treatment of hepatocellular carcinoma lesions of 4 cm or smaller. We did a randomised controlled, single-blinded phase 2 trial at four tertiary university centres in France and Switzerland. Patients with chronic liver disease and hepatocellular carcinoma with up to three lesions of 4 cm or smaller who were not eligible for surgery were randomised to receive microwave ablation (experimental group) or radiofrequency ablation (control group). Randomisation was centralised and done by use of a fixed block method (block size 4). Patients were randomly assigned by a co-investigator by use of the sealed opaque envelope method and were masked to the treatment; physicians were not masked to treatment, since the devices used were different. The primary outcome was the proportion of lesions with local tumour progression at 2 years of follow-up. Local tumour progression was defined as the appearance of a new nodule with features typical of hepatocellular carcinoma in the edge of the ablation zone. All analyses were done in the per-protocol population. The study is completed, but patients will continue to be followed up for 5 years. This study is registered with ClinicalTrials.gov, number NCT02859753. Between Nov 15, 2011, and Feb 27, 2015, 152 patients were randomly assigned: 76 patients to receive microwave ablation and 76 patients to receive radiofrequency ablation. For the per-protocol analysis, five patients were excluded from the microwave ablation group as were three patients from the radiofrequency ablation group. Median follow-up was 26 months (IQR 18-29) in the microwave ablation group and 25 months (18-34) in the radiofrequency ablation group. At 2 years, six (6%) of 98 lesions had local tumour progression in the microwave ablation group as did 12 (12%) of 104 in the radiofrequency ablation group (risk ratio 1·62, 95% CI 0·66-3·94; p=0·27). Complications were infrequent, with only two grade 4 complications (two events of arterial bleeding requiring embolisation, both in the microwave ablation group) and three grade 3 complications (pneumothorax; lesion of the umbilical vein; and intrahepatic segmental necrosis, all in the radiofrequency ablation group). No treatment-related deaths were reported. Although we did not find that microwave ablation was more effective than radiofrequency ablation for treatment of hepatocellular carcinoma lesions of 4 cm or smaller, our results show that the proportion of lesions with local tumour progression at 2 years of follow-up was low with both tested percutaneous methods. Microsulis (AngioDynamics). Copyright © 2018 Elsevier Ltd. All rights reserved.

High-speed scanning ablation of dental hard tissues with a λ=9.3-μm CO2 laser: heat accumulation and peripheral thermal damage

NASA Astrophysics Data System (ADS)

Nguyen, Daniel; Staninec, Michal; Lee, Chulsung; Fried, Daniel

2010-02-01

A mechanically scanned CO2 laser operated at high laser pulse repetition rates can be used to rapidly and precisely remove dental decay. This study aims to determine whether these laser systems can safely ablate enamel and dentin without excessive heat accumulation and peripheral thermal damage. Peripheral thermal damage can adversely impact the mechanical strength of the irradiated tissue, particularly for dentin, and reduce the adhesion characteristics of the modified surfaces. Samples were derived from noncarious extracted molars. Pulpal temperatures were recorded using microthermocouples situated at the pulp chamber roof of samples (n=12), which were occlusally ablated using a rapid-scanning, water-cooled 300 Hz CO2 laser over a two minute time course. The mechanical strength of facially ablated dentin (n=10) was determined via four-point bend test and compared to control samples (n=10) prepared with 320 grit wet sand paper to simulate conventional preparations. Composite-to-enamel bond strength was measured via single-plane shear test for ablated/non-etched (n=10) and ablated/acid-etched (n=8) samples and compared to control samples (n=9) prepared by 320 grit wet sanding. Thermocouple measurements indicated that the temperature remained below ambient temperature at 19.0°C (s.d.=0.9) if water-cooling was used. There was no discoloration of either dentin and enamel, the treated surfaces were uniformly ablated and there were no cracks observable on the laser treated surfaces. Fourpoint bend tests yielded mean mechanical strengths of 18.2 N (s.d.=4.6) for ablated dentin and 18.1 N (s.d.=2.7) for control (p>0.05). Shear tests yielded mean bond strengths of 31.2 MPa (s.d.=2.5, p<0.01) for ablated/acid-etched samples, 5.2 MPa (s.d.=2.4, p<0.001) for ablated/non-etched samples, and 37.0 MPa (s.d.=3.6) for control. The results indicate that a rapid-scanning 300 Hz CO2 laser can effectively ablate dentin and enamel without excessive heat accumulation and with minimal thermal damage. It is not clear whether the small (16%) but statistically significant reduction in the shear bond strength to enamel is clinically significant since the mean shear bond strength exceeded 30 MPa.

In Vivo Arthroscopic Temperatures: A Comparison Between 2 Types of Radiofrequency Ablation Systems in Arthroscopic Anterior Cruciate Ligament Reconstruction-A Randomized Controlled Trial.

PubMed

Matthews, Brent; Wilkinson, Matthew; McEwen, Peter; Hazratwala, Kaushik; Doma, Kenji; Manoharan, Varaguna; Bahho, Zaid; McEwen, Shannon

2017-01-01

To compare a plasma ablation device with a standard ablation device in anterior cruciate ligament (ACL) reconstruction to determine which system is superior in terms of intra-articular heat generation and diathermy efficiency. This was a prospective, randomized controlled trial. The inclusion criteria were adult patients undergoing primary ACL reconstruction. Patients were randomized preoperatively to the standard ablation group or the plasma ablation group. A thermometer was inserted into the inferior suprapatellar pouch, and the temperature, time, and duration of radiofrequency ablation were measured continually. No significant differences were found between the standard ablation system and the plasma ablation system for maximum temperature (29.77°C and 29.34°C, respectively; P = .95), mean temperature (26.16°C and 26.99°C, respectively; P = .44), minimum temperature (22.66°C and 23.94°C, respectively; P = .54), and baseline temperature (26.80°C and 27.93°C, respectively; P = .35). Similarly, no significant differences were found for operative time (82.90 minutes and 80.50 minutes, respectively; P = .72) and mean diathermy activation times (2.6 minutes for both systems; P = .90). The between-system coefficient of variation for the measured parameters ranged from 0.12% to 3.69%. No intra-articular readings above the temperature likely to damage chondrocytes were recorded. The mean irrigation fluid temperature had a significant correlation with the maximum temperature reached during the procedure (Spearman rank correlation, r = 0.87; P < .01). No difference in temperature was observed between the standard ablation and plasma ablation probes during ACL reconstruction. Temperatures did not exceed critical temperatures associated with chondrocyte death. Level I, randomized controlled trial. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Evaluation of a Thermoprotective Gel for Hydrodissection During Percutaneous Microwave Ablation: In Vivo Results

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

Moreland, Anna J., E-mail: ajmoreland@gmail.com; Lubner, Meghan G., E-mail: mlubner@uwhealth.org; Ziemlewicz, Timothy J., E-mail: tziemlewicz@uwhealth.org

2015-06-15

PurposeTo evaluate whether thermoreversible poloxamer 407 15.4 % in water (P407) can protect non-target tissues adjacent to microwave (MW) ablation zones in a porcine model.Materials and MethodsMW ablation antennas were placed percutaneously into peripheral liver, spleen, or kidney (target tissues) under US and CT guidance in five swine such that the expected ablation zones would extend into adjacent diaphragm, body wall, or bowel (non-target tissues). For experimental ablations, P407 (a hydrogel that transitions from liquid at room temperature to semi-solid at body temperature) was injected into the potential space between target and non-target tissues, and the presence of a gel barriermore » was verified on CT. No barrier was used for controls. MW ablation was performed at 65 W for 5 min. Thermal damage to target and non-target tissues was evaluated at dissection.ResultsAntennas were placed 7 ± 3 mm from the organ surface for both control and gel-protected ablations (p = 0.95). The volume of gel deployed was 49 ± 27 mL, resulting in a barrier thickness of 0.8 ± 0.5 cm. Ablations extended into non-target tissues in 12/14 control ablations (mean surface area = 3.8 cm{sup 2}) but only 4/14 gel-protected ablations (mean surface area = 0.2 cm{sup 2}; p = 0.0005). The gel barrier remained stable at the injection site throughout power delivery.ConclusionWhen used as a hydrodissection material, P407 protected non-targeted tissues and was successfully maintained at the injection site for the duration of power application. Continued investigations to aid clinical translation appear warranted.« less

Three-Catheter Technique for Ablation of Left-Sided Accessory Pathways in Wolff-Parkinson-White is Less Expensive and Equally Successful When Compared to a Five-Catheter Technique.

PubMed

Capone, Christine A; Ceresnak, Scott R; Nappo, Lynn; Gates, Gregory J; Schechter, Clyde B; Pass, Robert H

2015-12-01

To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed. The three-catheter group was compared to a control group who underwent a standard five-catheter (ablation, RV apical, CS decapolar, His catheter, and right atrial catheter) ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes, and costs were compared between groups. Twenty-eight patients met inclusion criteria with 28 control patients. The groups did not differ in gender, age, weight, or body surface area. Locations of the AP on the mitral annulus were similar between the groups. All patients were ablated via transseptal approach. Note that 28 of 28 in the three-catheter group (100%) and 27 of 28 (96%) controls were acutely successfully ablated (P = 0.31). No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or number of RF applications. Use of the three-catheter technique resulted in a total savings of $2,465/case, which includes the $680 savings from using fewer catheters as well as the savings from a shortened procedure time. Ablation in patients with WPW and a left-sided AP can be performed using three catheters with similar efficacy and safety while offering significant cost savings compared to a conventional five-catheter approach. © 2015 Wiley Periodicals, Inc.

In Vitro and In Vivo Investigation of High-Intensity Focused Ultrasound (HIFU) Hat-Type Ablation Mode

PubMed Central

Dai, Hongya; Chen, Fei; Yan, Sijing; Ding, Xiaoya; Ma, Dazhao; Wen, Jing; Xu, Die; Zou, Jianzhong

2017-01-01

Background The aim of this study was to investigate the feasibility of the application of high-intensity focused ultrasound (HIFU) hat-type ablation mode in in vitro and in vivo models, and to compare the ablation effects of different parameter combinations. Material/Methods HIFU hat-type ablation was performed in isolated bovine liver tissue and in the liver tissue in living rabbits, and the coagulative necrosis for different parameter combinations (plane angles and irradiation order) was investigated. We also analyzed and compared the ablation effects of traditional ablation and hat-type ablation modes. Coagulative necrosis morphology was detected with TTC staining, and the coagulative necrosis volume and energy efficiency factor (EEF) were calculated and compared. Results Coagulative necrosis was observed in all the ablated groups, and the coagulative necrosis volume was much larger than the irradiation area. The coagulative necrosis induced by the hat-type ablation was more regular and controllable than the traditional ablation. The angles between the ablation planes determined the coagulative necrosis morphology, but did not affect the coagulative necrosis volume. Moreover, the irradiation order significantly influenced the coagulative necrosis. Importantly, under certain conditions, hat-type ablation achieved higher efficiency compared with the traditional ablation mode. Conclusions Compared with the traditional ablation mode, HIFU hat-type ablation effectively shortened the irradiation time, reduced the over-accumulation of energy, and increased the HIFU ablation efficiency. PMID:28699626

In Vitro and In Vivo Investigation of High-Intensity Focused Ultrasound (HIFU) Hat-Type Ablation Mode.

PubMed

Dai, Hongya; Chen, Fei; Yan, Sijing; Ding, Xiaoya; Ma, Dazhao; Wen, Jing; Xu, Die; Zou, Jianzhong

2017-07-12

BACKGROUND The aim of this study was to investigate the feasibility of the application of high-intensity focused ultrasound (HIFU) hat-type ablation mode in in vitro and in vivo models, and to compare the ablation effects of different parameter combinations. MATERIAL AND METHODS HIFU hat-type ablation was performed in isolated bovine liver tissue and in the liver tissue in living rabbits, and the coagulative necrosis for different parameter combinations (plane angles and irradiation order) was investigated. We also analyzed and compared the ablation effects of traditional ablation and hat-type ablation modes. Coagulative necrosis morphology was detected with TTC staining, and the coagulative necrosis volume and energy efficiency factor (EEF) were calculated and compared. RESULTS Coagulative necrosis was observed in all the ablated groups, and the coagulative necrosis volume was much larger than the irradiation area. The coagulative necrosis induced by the hat-type ablation was more regular and controllable than the traditional ablation. The angles between the ablation planes determined the coagulative necrosis morphology, but did not affect the coagulative necrosis volume. Moreover, the irradiation order significantly influenced the coagulative necrosis. Importantly, under certain conditions, hat-type ablation achieved higher efficiency compared with the traditional ablation mode. CONCLUSIONS Compared with the traditional ablation mode, HIFU hat-type ablation effectively shortened the irradiation time, reduced the over-accumulation of energy, and increased the HIFU ablation efficiency.

Diet-induced obesity mediated by the JNK/DIO2 signal transduction pathway

PubMed Central

Vernia, Santiago; Cavanagh-Kyros, Julie; Barrett, Tamera; Jung, Dae Young; Kim, Jason K.; Davis, Roger J.

2013-01-01

The cJun N-terminal kinase (JNK) signaling pathway is a key mediator of metabolic stress responses caused by consuming a high-fat diet, including the development of obesity. To test the role of JNK, we examined diet-induced obesity in mice with targeted ablation of Jnk genes in the anterior pituitary gland. These mice exhibited an increase in the pituitary expression of thyroid-stimulating hormone (TSH), an increase in the blood concentration of thyroid hormone (T4), increased energy expenditure, and markedly reduced obesity compared with control mice. The increased amount of pituitary TSH was caused by reduced expression of type 2 iodothyronine deiodinase (Dio2), a gene that is required for T4-mediated negative feedback regulation of TSH expression. These data establish a molecular mechanism that accounts for the regulation of energy expenditure and the development of obesity by the JNK signaling pathway. PMID:24186979

Efficient and controllable thermal ablation induced by short-pulsed HIFU sequence assisted with perfluorohexane nanodroplets.

PubMed

Chang, Nan; Lu, Shukuan; Qin, Dui; Xu, Tianqi; Han, Meng; Wang, Supin; Wan, Mingxi

2018-07-01

A HIFU sequence with extremely short pulse duration and high pulse repetition frequency can achieve thermal ablation at a low acoustic power using inertial cavitation. Because of its cavitation-dependent property, the therapeutic outcome is unreliable when the treatment zone lacks cavitation nuclei. To overcome this intrinsic limitation, we introduced perfluorocarbon nanodroplets as extra cavitation nuclei into short-pulsed HIFU-mediated thermal ablation. Two types of nanodroplets were used with perfluorohexane (PFH) as the core material coated with bovine serum albumin (BSA) or an anionic fluorosurfactant (FS) to demonstrate the feasibility of this study. The thermal ablation process was recorded by high-speed photography. The inertial cavitation activity during the ablation was revealed by sonoluminescence (SL). The high-speed photography results show that the thermal ablation volume increased by ∼643% and 596% with BSA-PFH and FS-PFH, respectively, than the short-pulsed HIFU alone at an acoustic power of 19.5 W. Using nanodroplets, much larger ablation volumes were created even at a much lower acoustic power. Meanwhile, the treatment time for ablating a desired volume significantly reduced in the presence of nanodroplets. Moreover, by adjusting the treatment time, lesion migration towards the HIFU transducer could also be avoided. The SL results show that the thermal lesion shape was significantly dependent on the inertial cavitation in this short-pulsed HIFU-mediated thermal ablation. The inertial cavitation activity became more predictable by using nanodroplets. Therefore, the introduction of PFH nanodroplets as extra cavitation nuclei made the short-pulsed HIFU thermal ablation more efficient by increasing the ablation volume and speed, and more controllable by reducing the acoustic power and preventing lesion migration. Copyright © 2018. Published by Elsevier B.V.

Long-Term Outcome With Catheter Ablation of Ventricular Tachycardia in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy.

PubMed

Santangeli, Pasquale; Zado, Erica S; Supple, Gregory E; Haqqani, Haris M; Garcia, Fermin C; Tschabrunn, Cory M; Callans, David J; Lin, David; Dixit, Sanjay; Hutchinson, Mathew D; Riley, Michael P; Marchlinski, Francis E

2015-12-01

Catheter ablation of ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy improves short-term VT-free survival. We sought to determine the long-term outcomes of VT control and need for antiarrhythmic drug therapy after endocardial (ENDO) and adjuvant epicardial (EPI) substrate modification in patients with arrhythmogenic right ventricular cardiomyopathy. We examined 62 consecutive patients with Task Force criteria for arrhythmogenic right ventricular cardiomyopathy referred for VT ablation with a minimum follow-up of 1 year. Catheter ablation was guided by activation/entrainment mapping for tolerated VT and pacemapping/targeting of abnormal substrate for unmappable VT. Adjuvant EPI ablation was performed when recurrent VT or persistent inducibility after ENDO-only ablation. Endocardial plus adjuvant EPI ablation was performed in 39 (63%) patients, including 13 who crossed over to ENDO-EPI after VT recurrence during follow-up, after ENDO-only ablation. Before ablation, 54 of 62 patients failed a mean of 2.4 antiarrhythmic drugs, including amiodarone in 29 (47%) patients. During follow-up of 56±44 months after the last ablation, VT-free survival was 71% with only a single VT episode in additional 9 patients (15%). At last follow-up, 39 (64%) patients were only on β-blockers or no treatment, 21 were on class 1 or 3 antiarrhythmic drugs (11 for atrial arrhythmias), and 2 were on amiodarone as a bridge to heart transplantation. The long-term outcome after ENDO and adjuvant EPI substrate ablation of VT in arrhythmogenic right ventricular cardiomyopathy is good. Most patients have complete VT control without amiodarone therapy and limited need for antiarrhythmic drugs. © 2015 American Heart Association, Inc.

Quantitative Ultrasound Backscatter for Pulsed Cavitational Ultrasound Therapy—Histotripsy

PubMed Central

Wang, Tzu-Yin; Xu, Zhen; Winterroth, Frank; Hall, Timothy L.; Fowlkes, J. Brian; Rothman, Edward D.; Roberts, William W.; Cain, Charles A.

2011-01-01

Histotripsy is a well-controlled ultrasonic tissue ablation technology that mechanically and progressively fractionates tissue structures using cavitation. The fractionated tissue volume can be monitored with ultrasound imaging because a significant ultrasound backscatter reduction occurs. This paper correlates the ultrasound backscatter reduction with the degree of tissue fractionation characterized by the percentage of remaining normal-appearing cell nuclei on histology. Different degrees of tissue fractionation were generated in vitro in freshly excised porcine kidneys by varying the number of therapeutic ultrasound pulses from 100 to 2000 pulses per treatment location. All ultrasound pulses were 15 cycles at 1 MHz delivered at 100 Hz pulse repetition frequency and 19 MPa peak negative pressure. The results showed that the normalized backscatter intensity decreased exponentially with increasing number of pulses. Correspondingly, the percentage of normal appearing nuclei in the treated area decreased exponentially as well. A linear correlation existed between the normalized backscatter intensity and the percentage of normal appearing cell nuclei in the treated region. This suggests that the normalized backscatter intensity may be a potential quantitative real-time feedback parameter for histotripsy-induced tissue fractionation. This quantitative feedback may allow the prediction of local clinical outcomes, i.e., when a tissue volume has been sufficiently treated. PMID:19750596

Selective Ablation of GIRK Channels in Dopamine Neurons Alters Behavioral Effects of Cocaine in Mice.

PubMed

McCall, Nora M; Kotecki, Lydia; Dominguez-Lopez, Sergio; Marron Fernandez de Velasco, Ezequiel; Carlblom, Nicholas; Sharpe, Amanda L; Beckstead, Michael J; Wickman, Kevin

2017-02-01

The increase in dopamine (DA) neurotransmission stimulated by in vivo cocaine exposure is tempered by G protein-dependent inhibitory feedback mechanisms in DA neurons of the ventral tegmental area (VTA). G protein-gated inwardly rectifying K + (GIRK/Kir3) channels mediate the direct inhibitory effect of GABA B receptor (GABA B R) and D 2 DA receptor (D 2 R) activation in VTA DA neurons. Here we examined the effect of the DA neuron-specific loss of GIRK channels on D 2 R-dependent regulation of VTA DA neuron excitability and on cocaine-induced, reward-related behaviors. Selective ablation of Girk2 in DA neurons did not alter the baseline excitability of VTA DA neurons but significantly reduced the magnitude of D 2 R-dependent inhibitory somatodendritic currents and blunted the impact of D 2 R activation on spontaneous activity and neuronal excitability. Mice lacking GIRK channels in DA neurons exhibited increased locomotor activation in response to acute cocaine administration and an altered locomotor sensitization profile, as well as increased responding for and intake of cocaine in an intravenous self-administration test. These mice, however, showed unaltered cocaine-induced conditioned place preference. Collectively, our data suggest that feedback inhibition to VTA DA neurons, mediated by GIRK channel activation, tempers the locomotor stimulatory effect of cocaine while also modulating the reinforcing effect of cocaine in an operant-based self-administration task.

Laser tumor treatment in oral and maxillofacial surgery

NASA Astrophysics Data System (ADS)

Neukam, F. W.; Stelzle, F.

Cancer treatment is an integral part of oral and maxillofacial surgery. Oral cancer in particular is a highly prevalent neoplasm. Standard treatment for most of the tumors is radical surgery combined with stage-based neo-/adjuvant therapy. Laser surgery has become a reliable treatment option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. However, laser surgery has some major drawbacks: In contrast to conventional incisions with scalpels, the surgeon gets no feedback during laser ablation. There is no depth sensation and no tissue specificity with a laser incision, increasing the risk of iatrogenic damage to nerves and major blood vessels. Future prospects may solve these problems by means of an optical feedback mechanism that provides a tissue-specific laser ablation. First attempts have been made to perform remote optical tissue differentiation. Additionally, real time optical tumor detection during laser surgery would allow for a very precise and straight forward cancer resection, enhancing organ preservation and hence the quality of life for patients with cancer in the head and neck region.

Automatic control of finite element models for temperature-controlled radiofrequency ablation

PubMed Central

Haemmerich, Dieter; Webster, John G

2005-01-01

Background The finite element method (FEM) has been used to simulate cardiac and hepatic radiofrequency (RF) ablation. The FEM allows modeling of complex geometries that cannot be solved by analytical methods or finite difference models. In both hepatic and cardiac RF ablation a common control mode is temperature-controlled mode. Commercial FEM packages don't support automating temperature control. Most researchers manually control the applied power by trial and error to keep the tip temperature of the electrodes constant. Methods We implemented a PI controller in a control program written in C++. The program checks the tip temperature after each step and controls the applied voltage to keep temperature constant. We created a closed loop system consisting of a FEM model and the software controlling the applied voltage. The control parameters for the controller were optimized using a closed loop system simulation. Results We present results of a temperature controlled 3-D FEM model of a RITA model 30 electrode. The control software effectively controlled applied voltage in the FEM model to obtain, and keep electrodes at target temperature of 100°C. The closed loop system simulation output closely correlated with the FEM model, and allowed us to optimize control parameters. Discussion The closed loop control of the FEM model allowed us to implement temperature controlled RF ablation with minimal user input. PMID:16018811

Afferent Neural Feedback Overrides the Modulating Effects of Arousal, Hypercapnia and Hypoxemia on Neonatal Cardio-respiratory Control.

PubMed

Lumb, Kathleen J; Schneider, Jennifer M; Ibrahim, Thowfique; Rigaux, Anita; Hasan, Shabih U

2018-04-20

Evidence at whole animal, organ-system, and cellular and molecular levels suggests that afferent volume feedback is critical for establishment of adequate ventilation at birth. Due to the irreversible nature of vagal ablation studies to date, it was difficult to quantify the roles of afferent volume input, arousal and changes in blood gas tensions on neonatal respiratory control. During reversible perineural vagal block, profound apneas, and hypoxemia and hypercarbia were observed necessitating termination of perineural blockade. Respiratory depression and apneas were independent of the sleep states. We demonstrate that profound apneas and life-threatening respiratory failure in vagally denervated animals do not result from lack of arousal or hypoxemia. Change in sleep state and concomitant respiratory depression result from lack of afferent volume feedback, which appears to be critical for the maintenance of normal breathing patterns and adequate gas exchange during the early postnatal period. Afferent volume feedback plays a vital role in neonatal respiratory control. Mechanisms for the profound respiratory depression and life-threatening apneas observed in vagally denervated neonatal animals remain unclear. We investigated the roles of sleep states, hypoxic-hypercapnia and afferent volume feedback on respiratory depression using reversible perineural vagal block during early postnatal period. Seven lambs were instrumented during the first 48h of life to record/analyze sleep states, diaphragmatic electromyograph, arterial blood gas tensions, systemic arterial blood pressure and rectal temperature. Perineural cuffs were placed around the vagi to attain reversible blockade. Post-operatively, during the awake state, both vagi were blocked using 2% xylocaine for up to 30 minutes. Compared with baseline values, pHa, PaO 2 and SaO 2 decreased and PaCO 2 increased during perineural blockade (P < 0.05). Four of seven animals exhibited apneas of ≥20 sec requiring immediate termination of perineural blockade. Breathing rates decreased from the baseline value of 53 ± 12 to 24 ± 20 breaths/min during blockade despite an increased PaCO 2 (P < 0.001). Following blockade, breathing patterns returned to baseline values despite marked hypocapnia (PaCO 2 33 ± 3 torr; P = 0.03). Respiratory depression and apneas were independent of sleep states. This study provides the much needed physiologic evidence that profound apneas and life-threatening respiratory failure in vagally denervated animals do not result from lack of arousal or hypoxemia. Rather, change in sleep state and concomitant respiratory depression result from lack of afferent volume feedback, which appears to be critical for the maintenance of normal breathing patterns and adequate gas exchange during the early postnatal period. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Alternate energy sources for catheter ablation.

PubMed

Wang, P J; Homoud, M K; Link, M S; Estes III, N A

1999-07-01

Because of the limitations of conventional radiofrequency ablation in creating large or linear lesions, alternative energy sources have been used as possible methods of catheter ablation. Modified radiofrequency energy, cryoablation, and microwave, laser, and ultrasound technologies may be able to create longer, deeper, and more controlled lesions and may be particularly suited for the treatment of ventricular tachycardias and for linear atrial ablation. Future studies will establish the efficacy of these new and promising technologies.

Accessory pathway ablation in a 6-year-old girl using remote magnetic navigation as an alternative to cryoablation.

PubMed

Mantziari, Lilian; Rigby, Michael; Till, Janice; Ernst, Sabine

2013-03-01

A 6-year-old girl with evidence of a parahisian accessory pathway on a baseline electrocardiogram underwent successful catheter ablation using magnetic navigation. Magnetic remote controlled ablation eliminated the parahisian pathway with the first radiofrequency application. A second anterolaterally located concealed pathway was successfully ablated in the same session, resulting in exclusively atrioventricular nodal conduction bidirectionally (total fluoroscopy, 4 min; 25 μGy).

Transgenic Reproductive Cell Ablation.

PubMed

Lawit, Shai J; Chamberlin, Mark A

2017-01-01

Numerous cell ablation technologies are available and have been used in reproductive tissues, particularly for male tissues and cells. The importance of ablation of reproductive tissues is toward a fundamental understanding reproductive tissue development and fertilization, as well as, in developing sterility lines important to breeding strategies. Here, we describe techniques for developing ablation lines for both male and female reproductive cells. Also discussed are techniques for analysis, quality control, maintenance, and the lessening of pleiotropism in such lines.

Femtosecond laser for cavity preparation in enamel and dentin: ablation efficiency related factors.

PubMed

Chen, H; Li, H; Sun, Yc; Wang, Y; Lü, Pj

2016-02-11

To study the effects of laser fluence (laser energy density), scanning line spacing and ablation depth on the efficiency of a femtosecond laser for three-dimensional ablation of enamel and dentin. A diode-pumped, thin-disk femtosecond laser (wavelength 1025 nm, pulse width 400 fs) was used for the ablation of enamel and dentin. The laser spot was guided in a series of overlapping parallel lines on enamel and dentin surfaces to form a three-dimensional cavity. The depth and volume of the ablated cavity was then measured under a 3D measurement microscope to determine the ablation efficiency. Different values of fluence, scanning line spacing and ablation depth were used to assess the effects of each variable on ablation efficiency. Ablation efficiencies for enamel and dentin were maximized at different laser fluences and number of scanning lines and decreased with increases in laser fluence or with increases in scanning line spacing beyond spot diameter or with increases in ablation depth. Laser fluence, scanning line spacing and ablation depth all significantly affected femtosecond laser ablation efficiency. Use of a reasonable control for each of these parameters will improve future clinical application.

Contrast-enhanced cardiac C-arm CT evaluation of radiofrequency ablation lesions in the left ventricle

PubMed Central

Girard, Erin E; Al-Ahmad, Amin A; Rosenberg, Jarrett; Luong, Richard; Moore, Teri; Lauritsch, Günter; Boese, Jan; Fahrig, Rebecca

2011-01-01

Objectives The purpose of this study was to evaluate use of cardiac C-arm computed tomography (CT) in the assessment of the dimensions and temporal characteristics of radiofrequency ablation (RFA) lesions. This imaging modality uses a standard C-arm fluoroscopy system rotating around the patient, providing CT-like images during the RFA procedure. Background Both magnetic resonance imaging (MRI) and CT can be used to assess myocardial necrotic tissue. Several studies have reported visualizing cardiac RF ablation lesions with MRI, however obtaining MR images during interventional procedures is not common practice. Direct visualization of RFA lesions using C-arm CT during the procedure may improve outcomes and circumvent complications associated with cardiac ablation procedures. Methods RFA lesions were created on the endocardial surface of the left ventricle of 9 swine using a 7-F RF ablation catheter. An ECG-gated C-arm CT imaging protocol was used to acquire projection images during iodine contrast injection and following the injection every 5 min for up to 30 min, with no additional contrast. Reconstructed images were analyzed offline. The mean and standard deviation of the signal intensity of the lesion and normal myocardium were measured in all images in each time series. Lesion dimensions and area were measured and compared in pathologic specimens and C-arm CT images. Results All ablation lesions (n=29) were visualized and lesion dimensions, as measured on C-arm CT, correlated well with postmortem tissue measurements (1D dimensions : concordance correlation = 0.87; area : concordance correlation = 0.90). Lesions were visualized as a perfusion defect on first-pass C-arm CT images with a signal intensity 95 HU lower than normal myocardium (95% confidence interval: -111 to -79 HU). Images acquired at 1 and 5 minutes exhibited an enhancing ring surrounding the perfusion defect in 24 (83%) lesions. Conclusions RFA lesion size, including transmurality, can be assessed using ECG-gated cardiac C-arm CT in the interventional suite. Visualization of RFA lesions using cardiac C-arm CT may facilitate the assessment of adequate lesion delivery and provide valuable feedback during cardiac ablation procedures. PMID:21414574

Modeling laser-induced periodic surface structures: Finite-difference time-domain feedback simulations

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

Skolski, J. Z. P., E-mail: j.z.p.skolski@utwente.nl; Vincenc Obona, J.; Römer, G. R. B. E.

2014-03-14

A model predicting the formation of laser-induced periodic surface structures (LIPSSs) is presented. That is, the finite-difference time domain method is used to study the interaction of electromagnetic fields with rough surfaces. In this approach, the rough surface is modified by “ablation after each laser pulse,” according to the absorbed energy profile, in order to account for inter-pulse feedback mechanisms. LIPSSs with a periodicity significantly smaller than the laser wavelength are found to “grow” either parallel or orthogonal to the laser polarization. The change in orientation and periodicity follow from the model. LIPSSs with a periodicity larger than the wavelengthmore » of the laser radiation and complex superimposed LIPSS patterns are also predicted by the model.« less

Monitoring of KrF excimer laser ablation for burn scars: a comparative study of transient reflection measurement and time-resolved photography of ablation plume

NASA Astrophysics Data System (ADS)

Nakajima, Akio; Arai, Tsunenori; Kikuchi, Makoto; Iwaya, Akimi; Arai, Katsuyuki; Inazaki, Satoshi; Takaoka, Takatsugu; Kato, Masayoshi

1995-05-01

A simple laser ablation monitoring during burn scar removal by KrF laser irradiation was studied to control laser fluence in real-time. Because, to obtain suitable surface for auto skin-graft, the laser fluence should be precisely controlled at each laser shot. We employed simple probe transmission method which could detect ejected material/phenomena from irradiated surface. The time-course of measured probe intensity contained a couple of attenuated peaks, which might corresponded to a shock wave front and debris plume. The delay time from laser irradiation to the debris plume peak appearance varied with the ablation fluence. The delay time of 1 J/cm2 (near ablation threshold) case prolonged 25% from 8 J/cm2 (far above threshold) case. Therefore, we think the delay time measurement by means of the simple probe transmission method may be available to attain the laser fluence control for nonuniform burn scar removal. The time-resolved photography and probe reflection method were also studied to understand the measured time-course of the transmitted probe intensity.

SPECIAL ISSUE DEVOTED TO THE 25th ANNIVERSARY OF THE A.M. PROKHOROV GENERAL PHYSICS INSTITUTE: High-speed ablation of ultradeep channels by a phase-conjugate dynamically controlled passively Q-switched Nd:YAG laser

NASA Astrophysics Data System (ADS)

Basiev, T. T.; Garnov, S. V.; Klimentov, S. M.; Pivovarov, P. A.; Gavrilov, A. V.; Smetanin, S. N.; Solokhin, S. A.; Fedin, A. V.

2007-10-01

Parameters of high-speed ablation of ultradeep channels by controlled pulse trains from a single-mode phase-conjugate dynamic cavity Nd:YAG laser emitting 20-200-ns, 70-250-mJ pulses at a pulse repetition rate in a train of 40-250 kHz are studied. The optimal parameters of ablation are found, for which a long-lived region of a hot rarefied gas was maintained in the ultradeep channel, which suppressed the shielding action of the surface plasma. The control of the lasing process during ablation optimises not only the heating and plasma formation, but also the removal of the processed material in the pause between laser pulses. Adaptive regulation of lasing parameters during ablation made it possible to obtain ultradeep channels of length 8-27 mm and diameters 80-300 μm of the input and output holes in metals (aluminium, steel and Inconel 718 nickel superalloy) and ultrahard ceramics (Al2O3, AlN, SiC).

Is AF Ablation Cost Effective?

PubMed Central

Martin-Doyle, William; Reynolds, Matthew R.

2010-01-01

The use of catheter ablation to treat AF is increasing rapidly, but there is presently an incomplete understanding of its cost-effectiveness. AF ablation procedures involve significant up-front expenditures, but multiple randomized trials have demonstrated that ablation is more effective than antiarrhythmic drugs at maintaining sinus rhythm in a second-line and possibly first-line rhythm control setting. Although truly long-term data are limited, ablation, as compared with antiarrrhythmic drugs, also appears associated with improved symptoms and quality of life and a reduction in downstream hospitalization and other health care resource utilization. Several groups have developed cost effectiveness models comparing AF ablation primarily to antiarrhythmic drugs and the model results suggest that ablation likely falls within the range generally accepted as cost-effective in developed nations. This paper will review available information on the cost-effectiveness of catheter ablation for the treatment of atrial fibrillation, and discuss continued areas of uncertainty where further research is required. PMID:20936083

Computational Modeling and Real-Time Control of Patient-Specific Laser Treatment of Cancer

PubMed Central

Fuentes, D.; Oden, J. T.; Diller, K. R.; Hazle, J. D.; Elliott, A.; Shetty, A.; Stafford, R. J.

2014-01-01

An adaptive feedback control system is presented which employs a computational model of bioheat transfer in living tissue to guide, in real-time, laser treatments of prostate cancer monitored by magnetic resonance thermal imaging (MRTI). The system is built on what can be referred to as cyberinfrastructure - a complex structure of high-speed network, large-scale parallel computing devices, laser optics, imaging, visualizations, inverse-analysis algorithms, mesh generation, and control systems that guide laser therapy to optimally control the ablation of cancerous tissue. The computational system has been successfully tested on in-vivo, canine prostate. Over the course of an 18 minute laser induced thermal therapy (LITT) performed at M.D. Anderson Cancer Center (MDACC) in Houston, Texas, the computational models were calibrated to intra-operative real time thermal imaging treatment data and the calibrated models controlled the bioheat transfer to within 5°C of the predetermined treatment plan. The computational arena is in Austin, Texas and managed at the Institute for Computational Engineering and Sciences (ICES). The system is designed to control the bioheat transfer remotely while simultaneously providing real-time remote visualization of the on-going treatment. Post operative histology of the canine prostate reveal that the damage region was within the targeted 1.2cm diameter treatment objective. PMID:19148754

Computational modeling and real-time control of patient-specific laser treatment of cancer.

PubMed

Fuentes, D; Oden, J T; Diller, K R; Hazle, J D; Elliott, A; Shetty, A; Stafford, R J

2009-04-01

An adaptive feedback control system is presented which employs a computational model of bioheat transfer in living tissue to guide, in real-time, laser treatments of prostate cancer monitored by magnetic resonance thermal imaging. The system is built on what can be referred to as cyberinfrastructure-a complex structure of high-speed network, large-scale parallel computing devices, laser optics, imaging, visualizations, inverse-analysis algorithms, mesh generation, and control systems that guide laser therapy to optimally control the ablation of cancerous tissue. The computational system has been successfully tested on in vivo, canine prostate. Over the course of an 18 min laser-induced thermal therapy performed at M.D. Anderson Cancer Center (MDACC) in Houston, Texas, the computational models were calibrated to intra-operative real-time thermal imaging treatment data and the calibrated models controlled the bioheat transfer to within 5 degrees C of the predetermined treatment plan. The computational arena is in Austin, Texas and managed at the Institute for Computational Engineering and Sciences (ICES). The system is designed to control the bioheat transfer remotely while simultaneously providing real-time remote visualization of the on-going treatment. Post-operative histology of the canine prostate reveal that the damage region was within the targeted 1.2 cm diameter treatment objective.

Experimental study on ablation of leiomyoma by combination high-intensity focused ultrasound and iodized oil in vitro.

PubMed

Liang, Zhi-Gang; Gao, Yi; Ren, Xiao-Yan; Sun, Cui; Gu, Heng-Fang; Mou, Meng; Xiao, Yan-Bing

2017-10-01

The aim of the current study was to investigate whether iodized oil (IO) enhances high-intensity focused ultrasound (HIFU) ablation of uterine leiomyoma and to determine the features of hyperechoic changes in the target region. Forty samples of uterine leiomyoma were randomly divided into an experimental group and a control group. In the experimental group, the leiomyoma was ablated by HIFU 30 min after 1 mL of iodized oil had been injected into the center of the myoma. The hyperechoic values and areas in the target region were observed by B-modal ultrasound after HIFU ablation. The samples were cut successively into slices and stained by triphenyltetrazolium chloride (TTC) solution within 1 h after HIFU ablation. The diameters of TTC-non-stained areas were measured and tissues in the borderline of the TTC-stained and -non-stained areas were observed pathologically. All procedures in the control group were the same as those in the experimental group except IO was replaced by physiological saline. The hyperechoic value in the target region in the experimental group was higher than that in the control group 4 min after HIFU ablation (P < 0.05). Hyperechoic areas in the target region as well as TTC-non-stained volumes in the experimental group were greater than those in the control group (P < 0.05). Routine pathologic observation showed that coagulation necrosis of leiomyoma occurred in the target region in both groups. IO causes coagulation necrosis, enlarges tissue damage, and postpones the attenuation of hyperechoic changes in the target region when HIFU ablation is carried out for leiomyoma in vitro. © 2017 Japan Society of Obstetrics and Gynecology.

Ovarian synchronisation in wood bison (Bison bison athabascae) during the anovulatory season.

PubMed

Palomino, J Manuel; McCorkell, Robert B; Woodbury, Murray R; Adams, Gregg P

2014-01-01

Two experiments were performed in wood bison during the anovulatory season to establish an effective protocol for ovarian synchronisation. In an untreated control phase, bison cows (n=19) were examined daily to establish the interval to new follicular wave emergence (4.9±0.7 days) for the purposes of comparison with the experimental treatments. In Experiment 1, bison were treated by transvaginal ultrasound-guided follicular ablation (n=9) or with 2mg, i.m., 17β-oestradiol (n=10). In Experiment 2, bison were treated by follicular ablation (n=9) or with 2mg, i.m., 17β-oestradiol +100mg, i.m., progesterone (n=10). In Experiment 1, the interval to new wave emergence for control, follicular ablation and 17β-oestradiol-treated groups was 4.9±0.7, 1.1±0.1 and 3.1±0.4 days, respectively (P<0.05). The degree of synchrony was 2.4±0.4, 0.2±0.1 and 0.8±0.2 days, respectively (P<0.05). In Experiment 2, the interval to new wave emergence for control, follicular ablation and 17β-oestradiol + progesterone-treated groups was 4.9±0.7, 1.2±0.2 and 3.3±0.3 days, respectively (P<0.05), and the degree of synchrony was 2.4±0.4, 0.2±0.1, and 0.8±0.2 days, respectively (P<0.05). The degree of synchrony did not differ between ablation and hormone treatment groups in either experiment, but was greater in treatment groups than in the untreated control phase. Both follicular ablation and hormone treatment shortened and decreased the variability in the interval to follicular wave emergence in bison, but wave emergence occurred earlier after follicular ablation.

Skin pre-ablation and laser assisted microjet injection for deep tissue penetration.

PubMed

Jang, Hun-Jae; Yeo, Seonggu; Yoh, Jack J

2017-04-01

For conventional needless injection, there still remain many unresolved issues such as the potential for cross-contamination, poor reliability of targeted delivery dose, and significantly painstaking procedures. As an alternative, the use of microjets generated with Er:YAG laser for delivering small doses with controlled penetration depths has been reported. In this study, a new system with two stages is evaluated for effective transdermal drug delivery. First, the skin is pre-ablated to eliminate the hard outer layer and second, laser-driven microjet penetrates the relatively weaker and freshly exposed epidermis. Each stage of operation shares a single Er:YAG laser that is suitable for skin ablation as well as for the generation of a microjet. In this study, pig skin is selected for quantification of the injection depth based on the two-stage procedure, namely pre-ablation and microjet injection. The three types of pre-ablation devised here consists of bulk ablation, fractional ablation, and fractional-rotational ablation. The number of laser pulses are 12, 18, and 24 for each ablation type. For fractional-rotational ablation, the fractional beams are rotated by 11.25° at each pulse. The drug permeation in the skin is evaluated using tissue marking dyes. The depth of penetration is quantified by a cross sectional view of the single spot injections. Multi-spot injections are also carried out to control the dose and spread of the drug. The benefits of a pre-ablation procedure prior to the actual microjet injection to the penetration is verified. The four possible combinations of injection are (a) microjet only; (b) bulk ablation and microjet injection; (c) fractional ablation and microjet injection; and (d) fractional-rotational ablation and microjet injection. Accordingly, the total depth increases with injection time for all cases. In particular, the total depth of penetration attained via fractional pre-ablation increased by 8 ∼ 11% and that of fractional-rotational pre-ablation increased by 13 ∼ 33%, when compared with the no pre-ablation or microjet only cases. A noticeable point is that the fraction-rotational pre-ablation and microjet result is comparable to the bulk ablation and microjet result of 11 ∼ 42%. The penetration depth underneath ablated stratum corneum (SC) is also measured in order to verify the pre-ablation effect. The penetration depths for each case are (a) 443 ± 104 µm; (b) 625 ± 98 µm; (c) 523 ± 95 µm; and (d) 595 ± 141 µm for microjet only, bulk ablation and microjet, fractional ablation and microjet, and fractional-rotational ablation and microjet, respectively. This is quite beneficial since any healing time associated with ablation is significantly reduced by avoiding hard-core bulk ablation. Thus the bulk pre-ablation and microjet may well be superseded by the less invasive fractiona-rotational ablation followed by the microjet injection. The density of micro-holes is 1.27 number/mm 2 for fractional ablation and 4.84 number/mm 2 for fractional-rotational ablation. The penetration depths measured underneath the ablated SC are 581 µm (fractional ablation and microjet) and 691 µm (fractional-rotational ablation and microjet). Fractional-rotational ablation increases number of micro-holes in a unit area, enabling fast reepithelialization and high drug delivery efficiency. Optimization of system parameters such as ablation time, number of ablations, and injection time will eventually ensure a macromolecule delivery technique with the potential to include vaccines, insulins, and growth hormones, all of which require deeper penetration into the skin. Lasers Surg. Med. 49:387-394, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Multiple-electrode radiofrequency ablation: simultaneous production of separate zones of coagulation in an in vivo porcine liver model.

PubMed

Laeseke, Paul F; Sampson, Lisa A; Haemmerich, Dieter; Brace, Chris L; Fine, Jason P; Frey, Tina M; Winter, Thomas C; Lee, Fred T

2005-12-01

A multiple-electrode radiofrequency (RF) system was developed based on switching between electrodes that allows for the simultaneous use of as many as three electrically independent electrodes. The purpose of this study was to determine if each multiple-electrode ablation zone is identical to an ablation zone created with conventional single-electrode mode. Nine female domestic pigs (mean weight, 90 kg) were used for this study. A prototype monopolar multiple-electrode RF ablation system was created with use of an RF generator and an electronic switching algorithm. A maximum of three electrodes can be used simultaneously by switching between electrodes at each impedance spike (30 omega greater than baseline levels). A total of 39 zones of ablation were created at open laparotomy in pig livers with use of a conventional single electrode (n = 9), two single electrodes simultaneously (n = 6 ablations; 12 ablation zones), or three single electrodes simultaneously (n = 6 ablations; 18 ablation zones). RF electrodes were spaced in separate lobes of the liver when multiple zones of coagulation were created simultaneously. Animals were euthanized after RF ablation, livers were removed, and ablation zones were sectioned and measured. Zones of coagulation created simultaneously with two or three electrodes were equivalent to ablation zones created with use of conventional single-electrode ablation. No significant differences were observed among control animals treated with a single electrode, those with two separate zones of ablation created simultaneously, and those with three simultaneously created ablation zones in terms of mean (+/-SD) minimum diameter (1.6 cm +/- 0.6, 1.6 cm +/- 0.5, and 1.7 cm +/- 0.4, respectively), maximum diameter (2.0 cm +/- 0.5, 2.3 cm +/- 0.5, 2.2 cm +/- 0.5, respectively), and volume (6.7 cm3 +/- 3.7, 7.4 cm3 +/- 3.8, and 7.8 cm3 +/- 3.9; P > .30, analysis of variance, pairwise t-test comparisons). A rapid-switching multiple-electrode RF system was able to simultaneously create as many as three separate ablation zones of equivalent size compared with single-electrode controls. This system would allow physicians to simultaneously treat multiple tumors, substantially reducing procedure time and anesthesia risk.

Testing and evaluation of light ablation decontamination

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

Demmer, R.L.; Ferguson, R.L.

1994-10-01

This report details the testing and evaluation of light ablation decontamination. It details WINCO contracted research and application of light ablation efforts by Ames Laboratory. Tests were conducted with SIMCON (simulated contamination) coupons and REALCON (actual radioactive metal coupons) under controlled conditions to compare cleaning effectiveness, speed and application to plant process type equipment.

Effects of 1,540-nm Fractional Nonablative Erbium and 2,940-nm Fractional Ablative Erbium on p53 Epidermal Expression After 3 months: A Split-Face Interventional Study.

PubMed

Borges, Juliano; Araújo, Luciana; de Oliveira, Rodrigo P B; Manela-Azulay, Monica

2018-04-16

Expression of p53 by keratinocytes may be important in the pathogenesis of skin cancer induced by ultraviolet light. We used side-by-side nonablative and ablative erbium fractional laser resurfacing to assess the effects on expression of p53 by facial keratinocytes. Ten female patients (age range, 50-63 years) with Fitzpatrick skin Types I-IV and clinical signs of photoaging underwent erbium fractional laser resurfacing (nonablative, 1,540-nm; ablative, 2,940-nm) on opposite sides of the face. Skin biopsies were obtained before treatment and 3 months after treatment for comparison with control biopsies of face and inner arm, quantifying p53 in immunostained tissue sections. Only ablative (2,940-nm) treatments produced a statistically significant reduction in p53 scoring after 3 months. The histologic appearance of skin after ablative resurfacing more closely resembled inner arm skin (rather than facial skin) of control subjects. Epidermal repopulation with p53-negative keratinocytes through ablative erbium fractional laser resurfacing may diminish the risk of eventual malignancy in photoaged skin.

The in vivo performance of a novel thermal accelerant agent used for augmentation of microwave energy delivery within biologic tissues during image-guided thermal ablation: a porcine study.

PubMed

Park, William Keun Chan; Maxwell, Aaron Wilhelm Palmer; Frank, Victoria Elizabeth; Primmer, Michael Patrick; Paul, Jarod Brian; Collins, Scott Andrew; Lombardo, Kara Anne; Lu, Shaolei; Borjeson, Tiffany Marie; Baird, Grayson Luderman; Dupuy, Damian Edward

2018-02-01

To investigate the effects of a novel caesium-based thermal accelerant (TA) agent on ablation zone volumes following in vivo microwave ablation of porcine liver and skeletal muscle, and to correlate the effects of TA with target organ perfusion. This prospective study was performed following institutional animal care and use committee approval. Microwave ablation was performed in liver and resting skeletal muscle in eight Sus scrofa domesticus swine following administration of TA at concentrations of 0 mg/mL (control), 100 mg/mL and 250 mg/mL. Treated tissues were explanted and stained with triphenyltetrazolium chloride (TTC) for quantification of ablation zone volumes, which were compared between TA and control conditions. Hematoxylin and eosin (H&E) staining was also performed for histologic analysis. General mixed modelling with a log-normal distribution was used for all quantitative comparisons (p = 0.05). A total of 28 ablations were performed in the liver and 18 in the skeletal muscle. The use of TA significantly increased ablation zone volumes in a dose-dependent manner in both the porcine muscle and liver (p < 0.01). Both the absolute mean ablation zone volume and percentage increase in ablation zone volume were greater in the resting skeletal muscle than in the liver. In one swine, a qualitative mitigation of heat sink effects was observed by TTC and H&E staining. Non-lethal polymorphic ventricular tachycardia was identified in one swine, treated with intravenous amiodarone. The use of a novel TA agent significantly increased mean ablation zone volumes following microwave ablation using a porcine model. The relationship between TA administration and ablation size was dose-dependent and inversely proportional to the degree of target organ perfusion, and a qualitative reduction in heat-sink effects was observed.

Importance of catheter contact force during irrigated radiofrequency ablation: evaluation in a porcine ex vivo model using a force-sensing catheter.

PubMed

Thiagalingam, Aravinda; D'Avila, Andre; Foley, Lori; Guerrero, J Luis; Lambert, Hendrik; Leo, Giovanni; Ruskin, Jeremy N; Reddy, Vivek Y

2010-07-01

Ablation electrode-tissue contact has been shown to be an important determinant of lesion size and safety during nonirrigated ablation but little data are available during irrigated ablation. We aimed to determine the importance of contact force during irrigated-tip ablation. Freshly excised hearts from 11 male pigs were perfused and superfused using fresh, heparinized, oxygenated swine blood in an ex vivo model. One-minute ablations were placed using one of 3 different power control strategies (impedance control-15 Omega target impedance drop, and 20 W or 30 W fixed power) and 3 different contact forces (2 g, 20 g, and 60 g) to give a grid of 9 ablation groups. The force sensing catheter (Tacticath, Endosense SA) was irrigated at 17 mL/min for all of the ablations. Of a total 101 ablations, no thrombus formation was noted but popping was seen in 17 lesions. The lesion depth and incidence of pops was 5.0 +/- 1.3 mm /0%, 5.0 +/- 1.6 mm /10% and 6.7 +/- 2.5 mm /45% for the 15 Omega, 20 W, and 30 W groups (P < 0.01), respectively, and 4.4 +/- 1.8 mm /3%, 5.8 +/- 1.6 mm /17% and 6.6 +/- 2.0 mm /37% for the 2 g, 20 g, and 60 g groups, respectively (P < 0.01). The impedance drop in the first 5 seconds was significantly correlated to catheter contact force: 9.7 +/- 9.9 Omega, 22.3 +/- 11.0 Omega, and 41.7 +/- 22.1 Omega, respectively, for the 2 g, 20 g, and 60 g groups (Pearson's r = 0.65, P < 0.01). Catheter contact force has an important impact on both ablation lesion size and the incidence of pops.

Rapid Recovery of Visual Function Associated with Blue Cone Ablation in Zebrafish

PubMed Central

Hagerman, Gordon F.; Noel, Nicole C. L.; Cao, Sylvia Y.; DuVal, Michèle G.; Oel, A. Phillip; Allison, W. Ted

2016-01-01

Hurdles in the treatment of retinal degeneration include managing the functional rewiring of surviving photoreceptors and integration of any newly added cells into the remaining second-order retinal neurons. Zebrafish are the premier genetic model for such questions, and we present two new transgenic lines allowing us to contrast vision loss and recovery following conditional ablation of specific cone types: UV or blue cones. The ablation of each cone type proved to be thorough (killing 80% of cells in each intended cone class), specific, and cell-autonomous. We assessed the loss and recovery of vision in larvae via the optomotor behavioural response (OMR). This visually mediated behaviour decreased to about 5% or 20% of control levels following ablation of UV or blue cones, respectively (P<0.05). We further assessed ocular photoreception by measuring the effects of UV light on body pigmentation, and observed that photoreceptor deficits and recovery occurred (p<0.01) with a timeline coincident to the OMR results. This corroborated and extended previous conclusions that UV cones are required photoreceptors for modulating body pigmentation, addressing assumptions that were unavoidable in previous experiments. Functional vision recovery following UV cone ablation was robust, as measured by both assays, returning to control levels within four days. In contrast, robust functional recovery following blue cone ablation was unexpectedly rapid, returning to normal levels within 24 hours after ablation. Ablation of cones led to increased proliferation in the retina, though the rapid recovery of vision following blue cone ablation was demonstrated to not be mediated by blue cone regeneration. Thus rapid visual recovery occurs following ablation of some, but not all, cone subtypes, suggesting an opportunity to contrast and dissect the sources and mechanisms of outer retinal recovery during cone photoreceptor death and regeneration. PMID:27893779

High Intensity Focused Ultrasound Ablation of Pancreatic Neuroendocrine Tumours: Report of Two Cases

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

Orgera, Gianluigi, E-mail: gianluigi.orgera@ieo.it; Krokidis, Miltiadis; Monfardini, Lorenzo

2011-04-15

We describe the use of ultrasound-guided high-intensity focused ultrasound (HIFU) for ablation of two pancreatic neuroendocrine tumours (NETs; insulinomas) in two inoperable young female patients. Both suffered from episodes of severe nightly hypoglycemia that was not efficiently controlled by medical treatment. After HIFU ablation, local disease control and symptom relief were achieved without postinterventional complications. The patients remained free of symptoms during 9-month follow-up. The lesions appeared to be decreased in volume, and there was decreased enhancing pattern in the multidetector computed tomography control (MDCT). HIFU is likely to be a valid alternative for symptoms control in patients with pancreaticmore » NETs. However, currently the procedure should be reserved for inoperable patients for whom symptoms cannot be controlled by medical therapy.« less

Network control principles predict neuron function in the Caenorhabditis elegans connectome

NASA Astrophysics Data System (ADS)

Yan, Gang; Vértes, Petra E.; Towlson, Emma K.; Chew, Yee Lian; Walker, Denise S.; Schafer, William R.; Barabási, Albert-László

2017-10-01

Recent studies on the controllability of complex systems offer a powerful mathematical framework to systematically explore the structure-function relationship in biological, social, and technological networks. Despite theoretical advances, we lack direct experimental proof of the validity of these widely used control principles. Here we fill this gap by applying a control framework to the connectome of the nematode Caenorhabditis elegans, allowing us to predict the involvement of each C. elegans neuron in locomotor behaviours. We predict that control of the muscles or motor neurons requires 12 neuronal classes, which include neuronal groups previously implicated in locomotion by laser ablation, as well as one previously uncharacterized neuron, PDB. We validate this prediction experimentally, finding that the ablation of PDB leads to a significant loss of dorsoventral polarity in large body bends. Importantly, control principles also allow us to investigate the involvement of individual neurons within each neuronal class. For example, we predict that, within the class of DD motor neurons, only three (DD04, DD05, or DD06) should affect locomotion when ablated individually. This prediction is also confirmed; single cell ablations of DD04 or DD05 specifically affect posterior body movements, whereas ablations of DD02 or DD03 do not. Our predictions are robust to deletions of weak connections, missing connections, and rewired connections in the current connectome, indicating the potential applicability of this analytical framework to larger and less well-characterized connectomes.

Network control principles predict neuron function in the Caenorhabditis elegans connectome.

PubMed

Yan, Gang; Vértes, Petra E; Towlson, Emma K; Chew, Yee Lian; Walker, Denise S; Schafer, William R; Barabási, Albert-László

2017-10-26

Recent studies on the controllability of complex systems offer a powerful mathematical framework to systematically explore the structure-function relationship in biological, social, and technological networks. Despite theoretical advances, we lack direct experimental proof of the validity of these widely used control principles. Here we fill this gap by applying a control framework to the connectome of the nematode Caenorhabditis elegans, allowing us to predict the involvement of each C. elegans neuron in locomotor behaviours. We predict that control of the muscles or motor neurons requires 12 neuronal classes, which include neuronal groups previously implicated in locomotion by laser ablation, as well as one previously uncharacterized neuron, PDB. We validate this prediction experimentally, finding that the ablation of PDB leads to a significant loss of dorsoventral polarity in large body bends. Importantly, control principles also allow us to investigate the involvement of individual neurons within each neuronal class. For example, we predict that, within the class of DD motor neurons, only three (DD04, DD05, or DD06) should affect locomotion when ablated individually. This prediction is also confirmed; single cell ablations of DD04 or DD05 specifically affect posterior body movements, whereas ablations of DD02 or DD03 do not. Our predictions are robust to deletions of weak connections, missing connections, and rewired connections in the current connectome, indicating the potential applicability of this analytical framework to larger and less well-characterized connectomes.

Left atrial concomitant surgical ablation for treatment of atrial fibrillation in cardiac surgery: A meta-analysis of randomized controlled trials

PubMed Central

Wang, Chunguo; Ye, Minhua; Lin, Jiang; Jin, Jiang; Hu, Quanteng; Zhu, Chengchu; Chen, Baofu

2018-01-01

Introduction Surgical ablation is a generally established treatment for patients with atrial fibrillation undergoing concomitant cardiac surgery. Left atrial (LA) lesion set for ablation is a simplified procedure suggested to reduce the surgery time and morbidity after procedure. The present meta-analysis aims to explore the outcomes of left atrial lesion set versus no ablative treatment in patients with AF undergoing cardiac surgery. Methods A literature research was performed in six database from their inception to July 2017, identifying all relevant randomized controlled trials (RCTs) comparing left atrial lesion set versus no ablative treatment in AF patient undergoing cardiac surgery. Data were extracted and analyzed according to predefined clinical endpoints. Results Eleven relevant RCTs were included for analysis in the present study. The prevalence of sinus rhythm in ablation group was significantly higher at discharge, 6-month and 1-year follow-up period. The morbidity including 30 day mortality, late all-cause mortality, reoperation for bleeding, permanent pacemaker implantation and neurological events were of no significant difference between two groups. Conclusions The result of our meta-analysis demonstrates that left atrial lesion set is an effective and safe surgical ablation strategy for AF patients undergoing concomitant cardiac surgery. PMID:29360851

Remodeling of sinus node function after catheter ablation of right atrial flutter.

PubMed

Daoud, Emile G; Weiss, Raul; Augostini, Ralph S; Kalbfleisch, Steven J; Schroeder, Jason; Polsinelli, Georgia; Hummel, John D

2002-01-01

The purpose of this study was to investigate the effect of ablation of right atrial flutter upon sinus node function in humans. This study enrolled 35 patients. Twenty-four patients (16 men and 8 women; age 68 +/- 11 years) were referred for ablation of persistent atrial flutter (duration 8 +/- 11 months). After ablation, there was abnormal sinus node function defined as a corrected sinus node recovery time (CSNRT) > or = 550 msec. The control group consisted of 11 patients who were undergoing pacemaker implantation for sinus node disease but did not have a history of atrial dysrhythmias or ablation. Within 24 hours of ablation or pacemaker implantation, baseline maximal CSNRT was measured through a permanent pacemaker by AAI pacing at six cycle lengths: 600, 550, 500, 450, 400, and 350 msec. CSNRT then was measured in the same manner at 48 hours, 14 days, and 3 months after ablation/pacemaker implantation. P wave amplitude and duration, and percent atrial sensing also were assessed at the same intervals. For patients undergoing atrial flutter ablation, there was progressive temporal recovery of CSNRT (1,204 +/- 671 msec at baseline vs 834 +/- 380 msec at 3 months; P < 0.001) and a significant increase in the percent atrial sensing and P wave amplitude at 3 months compared with baseline (P < 0.001). In control subjects, there was no change in the CSNRT, percent atrial pacing, or P wave amplitude. After ablation of persistent atrial flutter, there is temporal recovery of CSNRT and increase in spontaneous atrial activity. These findings suggest that atrial flutter induces reversible changes in sinus node function.

High-intensity focused ultrasound ablation of myocardium in vivo and instantaneous biological response.

PubMed

Zheng, Minjuan; Shentu, Weihui; Chen, Dingzhang; Sahn, David J; Zhou, Xiaodong

2014-10-01

This study aimed to evaluate the instantaneous biological response of canine myocardium in vivo to high-intensity focused ultrasound (HIFU) ablation, and thereby determine the feasibility of this method. Left ventricle myocardium HIFU ablation was performed on six dogs at four levels of HIFU energy (acoustic intensity was 3000 W/cm2 ; ablation durations were 1.2, 2.4, 3.6, and 4.8 sec, respectively). Gross lesion volumes were confirmed and assessed by tetrazolium chloride (TTC) staining, hematoxylin-eosin (HE) staining, and electron microscopy. Global cardiac function and focal wall motion were evaluated by echocardiography. Blood enzymes and cardiac troponin T (CTnT) were tested after ablation. HIFU ablation was repeated on another set of six fresh canine hearts in vitro at the same four energy levels. Focal maximum temperatures were detected both in vivo and in vitro. Different sizes of ablation via HIFU can be created in beating hearts using controlled energy emission. Focal maximum temperatures varied from 62 ± 4.8 °C to 81 ± 12.9 °C. The lesion sizes were significantly smaller in vivo than in vitro, as verified by TTC and HE staining. Focal wall motion immediately decreased after ablation (P < 0.05), although the ejection fraction (EF) and E/A ratio were unchanged (P > 0.05). Enzymes and CTnT immediately increased. HIFU can be used for the controllable ablation of myocardial tissue, with instantly increased serum markers, decreased regional wall motion, and unaffected left ventricular global function. © 2014, Wiley Periodicals, Inc.

Slow pathway radiofrequency ablation in patients with AVNRT: junctional rhythm is less frequent during magnetic navigation ablation than with the conventional technique.

PubMed

Ricard, Philippe; Latcu, Decebal Gabriel; Yaïci, Khelil; Zarqane, Naima; Saoudi, Nadir

2010-01-01

The occurrence of accelerated junctional rhythm (JR) during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT) is frequent. The aim of the present study was to compare the occurrence of JR during magnetic remote catheter ablation to the conventional manual ablation. Twenty six patients (males: seven; age: 51 + or - 15 years) underwent slow pathway ablation with magnetic navigation (MN) system (Niobe, Stereotaxis Inc., St. Louis, MO, USA) and were compared to a control group of 11 patients (males: three; age: 53 + or - 16 years) treated with conventional manual ablation. A 4-mm nonirrigated tip catheter was used in both groups with a maximum of 30 W and 60 degrees C. Acute success was obtained in all patients. In the MN group, three patients out of 24 had no junctional beat (JB) at all and seven patients had 10 or less JB. In contrast, in the conventional group no patient had less than 10 JB. The mean number of JB in the MN group was 66 + or - 94.9 (0-410) and 200 + or - 243.1 (43-914) in the control group (P = 0.019). In the MN group one patient had a first-degree atrioventricular block. No other complication occurred. Magnetic remote catheter ablation of AVNRT is effective and is associated with less JB than the manual conventional technique. Therefore, JB may not be considered as a mandatory indicator for successful AVNRT ablation with MN system.

Conformal needle-based ultrasound ablation using EM-tracked conebeam CT image guidance

NASA Astrophysics Data System (ADS)

Burdette, E. Clif; Banovac, Filip; Diederich, Chris J.; Cheng, Patrick; Wilson, Emmanuel; Cleary, Kevin R.

2011-03-01

Numerous studies have demonstrated the efficacy of interstitial ablative approaches for the treatment of renal and hepatic tumors. Despite these promising results, current systems remain highly dependent on operator skill, and cannot treat many tumors because there is little control of the size and shape of the zone of necrosis, and no control over ablator trajectory within tissue once insertion has taken place. Additionally, tissue deformation and target motion make it extremely difficult to accurately place the ablator device into the target. Irregularly shaped target volumes typically require multiple insertions and several sequential thermal ablation procedures. This study demonstrated feasibility of spatially tracked image-guided conformal ultrasound (US) ablation for percutaneous directional ablation of diseased tissue. Tissue was prepared by suturing the liver within a pig belly and 1mm BBs placed to serve as needle targets. The image guided system used integrated electromagnetic tracking and cone-beam CT (CBCT) with conformable needlebased high-intensity US ablation in the interventional suite. Tomographic images from cone beam CT were transferred electronically to the image-guided tracking system (IGSTK). Paired-point registration was used to register the target specimen to CT images and enable navigation. Path planning is done by selecting the target BB on the GUI of the realtime tracking system and determining skin entry location until an optimal path is selected. Power was applied to create the desired ablation extent within 7-10 minutes at a thermal dose (>300eqm43). The system was successfully used to place the US ablator in planned target locations within ex-vivo kidney and liver through percutaneous access. Targeting accuracy was 3-4 mm. Sectioned specimens demonstrated uniform ablation within the planned target zone. Subsequent experiments were conducted for multiple ablator positions based upon treatment planning simulations. Ablation zones in liver were 73cc, 84cc, and 140cc for 3, 4, and 5 placements, respectively. These experiments demonstrate the feasibility of combining real-time spatially tracked image guidance with directional interstitial ultrasound ablation. Interstitial ultrasound ablation delivered on multiple needles permit the size and shape of the ablation zone to be "sculpted" by modifying the angle and intensity of the active US elements in the array. This paper summarizes the design and development of the first system incorporating thermal treatment planning and integration of a novel interstitial acoustic ablation device with integrated 3D electromagnetic tracking and guidance strategy.

Significant effects of atrioventricular node ablation and pacemaker implantation on left ventricular function and long-term survival in patients with atrial fibrillation and left ventricular dysfunction.

PubMed

Ozcan, Cevher; Jahangir, Arshad; Friedman, Paul A; Munger, Thomas M; Packer, Douglas L; Hodge, David O; Hayes, David L; Gersh, Bernard J; Hammill, Stephen C; Shen, Win-Kuang

2003-07-01

Control of ventricular rate by atrioventricular node ablation and pacemaker implantation in patients with drug-refractory atrial fibrillation (AF) is associated with improved left ventricular (LV) function. The objective of this study was to determine the effect of atrioventricular node ablation on long-term survival in patients with AF and LV dysfunction. Survival was determined by the Kaplan-Meier method for 56 study patients with LV ejection fraction (EF) < or =40% who underwent atrioventricular node ablation and pacemaker implantation and 56 age- and gender-matched control patients with AF and LVEF >40%, and age- and gender-matched control subjects from Minnesota. Groups were compared using the log-rank test. In study patients (age 69 +/- 10 years; 45 men), LVEF was 26% +/- 8% and 34% +/- 13% (p <0.001) before and after ablation, respectively. During follow-up (40 +/- 23 months), 23 patients died. Observed survival was worse than that of normal subjects (p <0.001) and control patients (p = 0.005). After ablation, LVEF nearly normalized (> or =45%) in 16 study patients (29%), in whom observed survival was comparable to that of normal subjects (p = 0.37). Coronary artery disease, hyperlipidemia, chronic renal failure, previous myocardial infarction, and coronary artery operation were independent predictors for mortality. Near normalization of LVEF occurred in 29% of study patients, suggesting that AF-induced EF reduction is reversible in many patients. Normal survival in patients with reversible LV dysfunction highlights potential survival benefits of rate control. Poor survival in patients with persistent LV dysfunction confirms the importance of optimal medical therapy.

Microwave ablation of hepatocellular carcinoma

PubMed Central

Poggi, Guido; Tosoratti, Nevio; Montagna, Benedetta; Picchi, Chiara

2015-01-01

Although surgical resection is still the optimal treatment option for early-stage hepatocellular carcinoma (HCC) in patients with well compensated cirrhosis, thermal ablation techniques provide a valid non-surgical treatment alternative, thanks to their minimal invasiveness, excellent tolerability and safety profile, proven efficacy in local disease control, virtually unlimited repeatability and cost-effectiveness. Different energy sources are currently employed in clinics as physical agents for percutaneous or intra-surgical thermal ablation of HCC nodules. Among them, radiofrequency (RF) currents are the most used, while microwave ablations (MWA) are becoming increasingly popular. Starting from the 90s’, RF ablation (RFA) rapidly became the standard of care in ablation, especially in the treatment of small HCC nodules; however, RFA exhibits substantial performance limitations in the treatment of large lesions and/or tumors located near major heat sinks. MWA, first introduced in the Far Eastern clinical practice in the 80s’, showing promising results but also severe limitations in the controllability of the emitted field and in the high amount of power employed for the ablation of large tumors, resulting in a poor coagulative performance and a relatively high complication rate, nowadays shows better results both in terms of treatment controllability and of overall coagulative performance, thanks to the improvement of technology. In this review we provide an extensive and detailed overview of the key physical and technical aspects of MWA and of the currently available systems, and we want to discuss the most relevant published data on MWA treatments of HCC nodules in regard to clinical results and to the type and rate of complications, both in absolute terms and in comparison with RFA. PMID:26557950

Visual servoing of a laser ablation based cochleostomy

NASA Astrophysics Data System (ADS)

Kahrs, Lüder A.; Raczkowsky, Jörg; Werner, Martin; Knapp, Felix B.; Mehrwald, Markus; Hering, Peter; Schipper, Jörg; Klenzner, Thomas; Wörn, Heinz

2008-03-01

The aim of this study is a defined, visually based and camera controlled bone removal by a navigated CO II laser on the promontory of the inner ear. A precise and minimally traumatic opening procedure of the cochlea for the implantation of a cochlear implant electrode (so-called cochleostomy) is intended. Harming the membrane linings of the inner ear can result in damage of remaining organ functions (e.g. complete deafness or vertigo). A precise tissue removal by a laser-based bone ablation system is investigated. Inside the borehole the pulsed laser beam is guided automatically over the bone by using a two mirror galvanometric scanner. The ablation process is controlled by visual servoing. For the detection of the boundary layers of the inner ear the ablation area is monitored by a color camera. The acquired pictures are analyzed by image processing. The results of this analysis are used to control the process of laser ablation. This publication describes the complete system including image processing algorithms and the concept for the resulting distribution of single laser pulses. The system has been tested on human cochleae in ex-vivo studies. Further developments could lead to safe intraoperative openings of the cochlea by a robot based surgical laser instrument.

Quantification of the effect of electrical and thermal parameters on radiofrequency ablation for concentric tumour model of different sizes.

PubMed

Jamil, Muhammad; Ng, E Y K

2015-07-01

Radiofrequency ablation (RFA) has been increasingly used in treating cancer for multitude of situations in various tissue types. To perform the therapy safely and reliably, the effect of critical parameters needs to be known beforehand. Temperature plays an important role in the outcome of the therapy and any uncertainties in temperature assessment can be lethal. This study presents the RFA case of fixed tip temperature where we've analysed the effect of electrical conductivity, thermal conductivity and blood perfusion rate of the tumour and surrounding normal tissue on the radiofrequency ablation. Ablation volume was chosen as the characteristic to be optimised and temperature control was achieved via PID controller. The effect of all 6 parameters each having 3 levels was quantified with minimum number of experiments harnessing the fractional factorial characteristic of Taguchi's orthogonal arrays. It was observed that as the blood perfusion increases the ablation volume decreases. Increasing electrical conductivity of the tumour results in increase of ablation volume whereas increase in normal tissue conductivity tends to decrease the ablation volume and vice versa. Likewise, increasing thermal conductivity of the tumour results in enhanced ablation volume whereas an increase in thermal conductivity of the surrounding normal tissue has a debilitating effect on the ablation volume and vice versa. With increase in the size of the tumour (i.e., 2-3cm) the effect of each parameter is not linear. The parameter effect varies with change in size of the tumour that is manifested by the different gradient observed in ablation volume. Most important is the relative insensitivity of ablation volume to blood perfusion rate for smaller tumour size (2cm) that is also in accordance with the previous results presented in literature. These findings will provide initial insight for safe, reliable and improved treatment planning perceptively. Copyright © 2015 Elsevier Ltd. All rights reserved.

Automated microwave ablation therapy planning with single and multiple entry points

NASA Astrophysics Data System (ADS)

Liu, Sheena X.; Dalal, Sandeep; Kruecker, Jochen

2012-02-01

Microwave ablation (MWA) has become a recommended treatment modality for interventional cancer treatment. Compared with radiofrequency ablation (RFA), MWA provides more rapid and larger-volume tissue heating. It allows simultaneous ablation from different entry points and allows users to change the ablation size by controlling the power/time parameters. Ablation planning systems have been proposed in the past, mainly addressing the needs for RFA procedures. Thus a planning system addressing MWA-specific parameters and workflows is highly desirable to help physicians achieve better microwave ablation results. In this paper, we design and implement an automated MWA planning system that provides precise probe locations for complete coverage of tumor and margin. We model the thermal ablation lesion as an ellipsoidal object with three known radii varying with the duration of the ablation and the power supplied to the probe. The search for the best ablation coverage can be seen as an iterative optimization problem. The ablation centers are steered toward the location which minimizes both un-ablated tumor tissue and the collateral damage caused to the healthy tissue. We assess the performance of our algorithm using simulated lesions with known "ground truth" optimal coverage. The Mean Localization Error (MLE) between the computed ablation center in 3D and the ground truth ablation center achieves 1.75mm (Standard deviation of the mean (STD): 0.69mm). The Mean Radial Error (MRE) which is estimated by comparing the computed ablation radii with the ground truth radii reaches 0.64mm (STD: 0.43mm). These preliminary results demonstrate the accuracy and robustness of the described planning algorithm.

Pace-capture-guided ablation after contact-force-guided pulmonary vein isolation: results of the randomized controlled DRAGON trial.

PubMed

Masuda, Masaharu; Fujita, Masashi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Sunaga, Akihiro; Tsujimura, Takuya; Matsuda, Yasuhiro; Ohashi, Takuya; Uematsu, Masaaki

2017-11-17

Before the discovery of contact-force guidance, eliminating pacing capture along the pulmonary vein (PV) isolation line had been reported to improve PV isolation durability and rhythm outcomes. DRAGON (UMIN-CTR, UMIN000015332) aimed to elucidate the efficacy of pace-capture-guided ablation following contact-force-guided PV isolation ablation in paroxysmal atrial fibrillation (AF) patients. A total of 156 paroxysmal AF patients with AF-trigger ectopies from any of the four PVs induced by isoproterenol were randomly assigned to undergo pace-capture-guided ablation along a contact-force-guided isolation line around AF-trigger PVs (PC group, n = 76) or contact-force-guided PV isolation ablation alone (control group, n = 80). Follow-up of at least 1 year commenced with serial 24 h Holter and symptom-triggered ambulatory monitoring. There was no significant difference in acute PV reconnection rates during a 20 min waiting period after the last ablation or adenosine infusion testing between the PC and the control groups (per patient, 21% vs. 27%, P = 0.27; per AF-trigger PV, 5.9% vs. 7.3%, P = 0.70; and per non-AF-trigger PV, 7.1% vs. 7.4%, P = 0.92). Atrial tachyarrhythmia-free survival rates off antiarrhythmic drugs after the initial session were comparable at 19.3 ± 6.2 months between the two groups (82% vs. 80%, P = 0.80). Among 22 patients who required a second ablation procedure, there was no difference between the PC and the control groups in the PV reconnection rates at both previously AF-trigger (29% vs. 43%, P = 0.70) and non-AF-trigger PVs (18% vs. 19%, P = 0.88). Pace-capture-guided ablation performed after contact-force-guided PV isolation demonstrated no improvement in PV isolation durability or rhythm outcome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Clinical feasibility test on a minimally invasive laser therapy system in microsurgery of nerves.

PubMed

Mack, K F; Leinung, M; Stieve, M; Lenarz, T; Schwab, B

2008-01-01

The clinical feasibility test described here evaluates the basis for a laser therapy system that enables tumour tissue to be separated from nerves in a minimally invasive manner. It was first investigated whether, using an Er:YAG laser, laser-induced nerve (specifically, facial nerve) responses in the rabbit in vivo can be reliably detected with the hitherto standard monitoring techniques. Peripherally recordable neuromuscular signals (i.e. compound action potentials, CAPs) were used to monitor nerve function and to establish a feedback loop. The first occurrence of laser-evoked CAPs was taken as the criterion for deciding when to switch off the laser. When drawing up criteria governing the control and termination of the laser application, the priority was the maintenance of nerve function. Five needle-electrode arrays specially developed for this purpose, each with a miniature preamplifier, were then placed into the facial musculature instead of single-needle electrodes. The system was tested in vivo under realistic surgical conditions (i.e. facial-nerve surgery in the rabbit). This modified multi-channel electromyography (EMG) system enabled laser-evoked CAPs to be detected that have amplitudes 10 times smaller than those picked up by commercially available systems. This optimization, and the connection of the neuromuscular unit with the Er:YAG laser via the electrode array to create a feedback loop, were designed to make it possible to maintain online control of the laser ablation process in the vicinity of neuronal tissue, thus ensuring that tissue excision is both reliable and does not affect function. Our results open up new possibilities in minimally invasive surgery near neural structures.

Comparative Effectiveness Review of Cooled Versus Pulsed Radiofrequency Ablation for the Treatment of Knee Osteoarthritis: A Systematic Review.

PubMed

Gupta, Anita; Huettner, Daniel P; Dukewich, Matthew

2017-03-01

Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain in patients who have failed conservative treatment or who are not suitable candidates for surgical treatment. This systematic review aimed to analyze published studies on radiofrequency ablation to provide an overview of the current knowledge regarding variations in procedures, nerve targets, adverse events, and temporal extent of clinical benefit. A systematic review of published studies investigating conventional, pulsed, or cooled radiofrequency ablation in the setting of chronic knee pain. Medline, Google Scholar, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were reviewed for studies on radiofrequency ablation for patients with chronic knee pain through July 29, 2016. From the studies, the procedural details, outcomes after treatment, follow-up points, and complications were compiled and analyzed in this literature review. Included studies were analyzed for clinical relevance and strength of evidence was graded using either the NHLBI Quality assessment of controlled intervention studies or the NHLBI quality assessment for before-after (pre-post) studies with no control group. Seventeen total publications were identified in the search, including articles investigating conventional, pulsed, or cooled radiofrequency ablation. These studies primarily targeted either the genicular nerves or used an intraarticular approach. Of the studies, 5 were small-sized randomized controlled trials, although one involved diathermy radiofrequency ablation. There were 8 retrospective or prospective case series and 4 case reports. Utilizing the strength of evidence grading, there is a low level of certainty to suggest a superior benefit between targeting the genicular nerve, an intraarticular approach, or targeting the larger nerves such as femoral and tibial nerves. Utilizing the strength of evidence grading, there is a low level of certainty in supporting the superiority of any specific RFA procedure modality. The majority of the studies report positive patient outcomes, but the inconsistent procedural methodology, inconsistent patient assessment measures, and small study sizes limit the applicability of any specific study to clinical practice. While the wide search strategy included a variety of articles, broad conclusions and pooled data could not be obtained based on the studies analyzed. Overall, the studies showed promising results for the treatment of severe chronic knee pain by radiofrequency ablation at up to one year with minimal complications. Numerous studies, however, yielded concerns about procedural protocols, study quality, and patient follow-up. Radiofrequency ablation can offer substantial clinical and functional benefit to patients with chronic knee pain due to osteoarthritis or post total knee arthroplasty.Key words: Radiofrequency ablation, knee osteoarthritis, knee pain, genicular nerve, total knee arthroplasty (TKA), cooled radiofrequency ablation, pulsed radiofrequency ablation.

Microwave Tissue Ablation: Biophysics, Technology and Applications

PubMed Central

2010-01-01

Microwave ablation is an emerging treatment option for many cancers, cardiac arrhythmias and other medical conditions. During treatment, microwaves are applied directly to tissues to produce rapid temperature elevations sufficient to produce immediate coagulative necrosis. The engineering design criteria for each application differ, with individual consideration for factors such as desired ablation zone size, treatment duration, and procedural invasiveness. Recent technological developments in applicator cooling, power control and system optimization for specific applications promise to increase the utilization of microwave ablation in the future. This article will review the basic biophysics of microwave tissue heating, provide an overview of the design and operation of current equipment, and outline areas for future research for microwave ablation. PMID:21175404

Automated ablation of dental composite using an IR pulsed laser coupled to a plume emission spectral feedback system.

PubMed

Jang, Andrew T; Chan, Kenneth H; Fried, Daniel

2017-01-28

Dental composites are used as restorative materials for filling cavities, shaping, and covering teeth for esthetic purposes, and as adhesives. Dentists spend more time replacing existing restorations that fail than they do placing new restorations. Tooth colored restorations are difficult to differentiate from the surrounding tooth structure making them challenging to remove without damaging healthy tooth structure. Previous studies have demonstrated that CO 2 lasers in conjunction with spectral feedback can be used to selectively remove composite from tooth surfaces. The purpose of this study is to assemble a system that is feasible for clinical use incorporating a spectral feedback system, a scanning system, articulating arm and a clinical handpiece and then evaluate the performance of that system on extracted teeth. In addition, the selectivity of composite removal was analyzed using a high-speed optical coherence tomography system that is suitable for clinical use. The system was capable of rapidly removing composite from small preparations on tooth occlusal surfaces with a mean loss of enamel of less than 20-μm.

Automated ablation of dental composite using an IR pulsed laser coupled to a plume emission spectral feedback system

NASA Astrophysics Data System (ADS)

Jang, Andrew T.; Chan, Kenneth H.; Fried, Daniel

2017-02-01

Dental composites are used as restorative materials for filling cavities, shaping, and covering teeth for esthetic purposes, and as adhesives. Dentists spend more time replacing existing restorations that fail than they do placing new restorations. Tooth colored restorations are difficult to differentiate from the surrounding tooth structure making them challenging to remove without damaging healthy tooth structure. Previous studies have demonstrated that CO2 lasers in conjunction with spectral feedback can be used to selectively remove composite from tooth surfaces. The purpose of this study is to assemble a system that is feasible for clinical use incorporating a spectral feedback system, a scanning system, articulating arm and a clinical handpiece and then evaluate the performance of that system on extracted teeth. In addition, the selectivity of composite removal was analyzed using a high-speed optical coherence tomography system that is suitable for clinical use. The system was capable of rapidly removing composite from small preparations on tooth occlusal surfaces with a mean loss of enamel of less than 20-μm.

Protection of skin with subcutaneous administration of 5% dextrose in water during superficial radiofrequency ablation in a rabbit model.

PubMed

Guo, Hui; Liu, Xia-Lei; Wang, Yu-Ling; Li, Jing-Yi; Lu, Wu-Zhu; Xian, Jian-Zhong; Zhang, Bai-Meng; Li, Jian

2014-06-01

This study was to evaluate the efficacy of subcutaneous administration of 5% dextrose in water (D5W), to prevent skin injury during radiofrequency (RF) ablation. Twenty-four rabbits were divided into three groups: a pre-injection group, a perfusion group, and a control group. Ablative zones were created in the superficial part of the thigh muscle for 6 min. A needle was placed subcutaneously for injection of D5W, and a thermal sensor was positioned nearby for real-time temperature monitoring. The sizes of the ablative zones were measured by contrast-enhanced ultrasonography, and severity of the observed skin injury were scored semi-quantitatively and compared. The highest temperature, the duration of the temperature above 50 °C, and the rise time of the post-procedure temperature were all highest in the control group (p < 0.001), while these values were lower in the perfusion group than those in the pre-injection group (p < 0.001). Post-procedure skin injury was most severe in the control group (p < 0.001). On post-procedure day 1, no significant difference was found between the skin injury of the pre-injection group and the perfusion group (p = 0.091), while the skin injury of the perfusion group was less severe than that of the pre-injection group on post-procedure day 14 (p = 0.004). No significant difference was found in the sizes of the ablative zones among the groups (p = 0.720). Subcutaneous perfusion with D5W is effective in protecting the skin against burns during RF ablation without compromising the effect of ablation.

Real-time estimation of lesion depth and control of radiofrequency ablation within ex vivo animal tissues using a neural network.

PubMed

Wang, Yearnchee Curtis; Chan, Terence Chee-Hung; Sahakian, Alan Varteres

2018-01-04

Radiofrequency ablation (RFA), a method of inducing thermal ablation (cell death), is often used to destroy tumours or potentially cancerous tissue. Current techniques for RFA estimation (electrical impedance tomography, Nakagami ultrasound, etc.) require long compute times (≥ 2 s) and measurement devices other than the RFA device. This study aims to determine if a neural network (NN) can estimate ablation lesion depth for control of bipolar RFA using complex electrical impedance - since tissue electrical conductivity varies as a function of tissue temperature - in real time using only the RFA therapy device's electrodes. Three-dimensional, cubic models comprised of beef liver, pork loin or pork belly represented target tissue. Temperature and complex electrical impedance from 72 data generation ablations in pork loin and belly were used for training the NN (403 s on Xeon processor). NN inputs were inquiry depth, starting complex impedance and current complex impedance. Training-validation-test splits were 70%-0%-30% and 80%-10%-10% (overfit test). Once the NN-estimated lesion depth for a margin reached the target lesion depth, RFA was stopped for that margin of tissue. The NN trained to 93% accuracy and an NN-integrated control ablated tissue to within 1.0 mm of the target lesion depth on average. Full 15-mm depth maps were calculated in 0.2 s on a single-core ARMv7 processor. The results show that a NN could make lesion depth estimations in real-time using less in situ devices than current techniques. With the NN-based technique, physicians could deliver quicker and more precise ablation therapy.

Long-term survival after ablation of the atrioventricular node and implantation of a permanent pacemaker in patients with atrial fibrillation.

PubMed

Ozcan, C; Jahangir, A; Friedman, P A; Patel, P J; Munger, T M; Rea, R F; Lloyd, M A; Packer, D L; Hodge, D O; Gersh, B J; Hammill, S C; Shen, W K

2001-04-05

In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic approach. The effect of this procedure on long-term survival is unknown. We studied all patients who underwent ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between 1990 and 1998. Observed survival was compared with the survival rates in two control populations: age- and sex-matched members of the Minnesota population between 1970 and 1990 and consecutive patients with atrial fibrillation who received drug therapy in 1993. A total of 350 patients (mean [+/-SD] age, 68+/-11 years) were studied. During a mean of 36+/-26 months of follow-up, 78 patients died. The observed survival rate was significantly lower than the expected survival rate based on the general Minnesota population (P<0.001). Previous myocardial infarction (P<0.001), a history of congestive heart failure (P=0.02), and treatment with cardiac drugs after ablation (P=0.03) were independent predictors of death. Observed survival among patients without these three risk factors was similar to expected survival (P=0.43). None of the 26 patients with lone atrial fibrillation died during follow-up (37+/-27 months). The observed survival rate among patients who underwent ablation was similar to that among 229 controls with atrial fibrillation (mean age, 67+/-12 years) who received drug therapy (P=0.44). In the absence of underlying heart disease, survival among patients with atrial fibrillation after ablation of the atrioventricular node is similar to expected survival in the general population. Long-term survival is similar for patients with atrial fibrillation, whether they receive ablation or drug therapy. Control of the ventricular rate by ablation of the atrioventricular node and permanent pacing does not adversely affect long-term survival.

An Automatic Occlusion Device for Remote Control of Tumor Tissue Ischemia

PubMed Central

El-Dahdah, Hamid; Wang, Bei; He, Guanglong; Xu, Ronald X.

2015-01-01

We developed an automatic occlusion device for remote control of tumor tissue ischemia. The device consists of a flexible cannula encasing a shape memory alloy wire with its distal end connected to surgical suture. Regional tissue occlusion was tested on both the benchtop and the animal models. In the benchtop test, the occlusion device introduced quantitative and reproducible changes of blood flow in a tissue simulating phantom embedding a vessel simulator. In the animal test, the device generated a cyclic pattern of reversible ischemia in the right hinder leg tissue of a black male C57BL/6 mouse. We also developed a multimodal detector that integrates near infrared spectroscopy and electron paramagnetic resonance spectroscopy for continuous monitoring of tumor tissue oxygenation, blood content, and oxygen tension changes. The multimodal detector was tested on a cancer xenograft nude mouse undergoing reversible tumor ischemia. The automatic occlusion device and the multi-modal detector can be potentially integrated for closed-loop feedback control of tumor tissue ischemia. Such an integrated occlusion device may be used in multiple clinical applications such as regional hypoperfusion control in tumor resection surgeries and thermal ablation processes. In addition, the proposed occlusion device can also be used as a research tool to understand tumor oxygen transport and hemodynamic characteristics. PMID:20082532

Carbon Dioxide Laser Ablation of Basal Cell Carcinoma with Visual Guidance by Reflectance Confocal Microscopy: A Proof of Principle Pilot Study

PubMed Central

Hibler, B.P.; Sierra, H.; Cordova, M.; Phillips, W.; Rajadhyaksha, M.; Nehal, K.S.; Rossi, A.M.

2016-01-01

Background Laser ablation is an alternative, non-surgical treatment modality for low-risk basal cell carcinoma (BCC); however, lack of confirmative tumour destruction or residual tumour presence has been a limiting factor to adoption. Reflectance confocal microscopy (RCM) provides non-invasive, cellular-level resolution imaging of the skin and is capable of identifying tumour. Objective To evaluate the use of RCM to guide carbon dioxide (CO2) laser ablation of BCC, confirm destruction, and correlate findings with histology. Methods RCM was used pre-ablation to evaluate for features of BCC. Ablation was performed with a CO2 laser, and the response rapidly assessed using handheld RCM to evaluate for residual tumour. Confirmative pathology was used to verify confocal imaging. Results RCM imaging identified tumour pre-ablation with features not identified on normal, surrounding skin. Post-ablation, RCM documented complete removal of tumour in six cases and residual tumour in two. Histologic examination identified the ablated area and confirmed clearance of tumour in the six aforementioned cases and corroborated confocal findings for residual tumour in the other two cases. Conclusions We report successful treatment of superficial and nodular BCC using CO2 laser ablation augmented by RCM imaging for pre-ablation guidance and verification of tumour removal post-ablation. Akin to complete circumferential and deep margin control techniques, using RCM helps to map peripheral and deep BCC margins to hone in on areas exhibiting persistent tumour after ablation. CO2 laser ablation visually guided by RCM can help circumvent previously cited limiting factors of laser ablation for tumour destruction by providing cellular-level resolution imaging of tumour and margin assessment in between each laser pass and post-ablation. PMID:26800657

Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis.

PubMed

Meijerink, Martijn R; Puijk, Robbert S; van Tilborg, Aukje A J M; Henningsen, Kirsten Holdt; Fernandez, Llenalia Garcia; Neyt, Mattias; Heymans, Juanita; Frankema, Jacqueline S; de Jong, Koert P; Richel, Dick J; Prevoo, Warner; Vlayen, Joan

2018-04-17

To assess safety and outcome of radiofrequency ablation (RFA) and microwave ablation (MWA) as compared to systemic chemotherapy and partial hepatectomy (PH) in the treatment of colorectal liver metastases (CRLM). MEDLINE, Embase and the Cochrane Library were searched. Randomized trials and comparative observational studies with multivariate analysis and/or matching were included. Guidelines from National Guideline Clearinghouse and Guidelines International Network were assessed using the AGREE II instrument. The search revealed 3530 records; 328 were selected for full-text review; 48 were included: 8 systematic reviews, 2 randomized studies, 26 comparative observational studies, 2 guideline-articles and 10 case series; in addition 13 guidelines were evaluated. Literature to assess the effectiveness of ablation was limited. RFA + systemic chemotherapy was superior to chemotherapy alone. PH was superior to RFA alone but not to RFA + PH or to MWA. Compared to PH, RFA showed fewer complications, MWA did not. Outcomes were subject to residual confounding since ablation was only employed for unresectable disease. The results from the EORTC-CLOCC trial, the comparable survival for ablation + PH versus PH alone, the potential to induce long-term disease control and the low complication rate argue in favour of ablation over chemotherapy alone. Further randomized comparisons of ablation to current-day chemotherapy alone should therefore be considered unethical. Hence, the highest achievable level of evidence for unresectable CRLM seems reached. The apparent selection bias from previous studies and the superior safety profile mandate the setup of randomized controlled trials comparing ablation to surgery.

Remotely controlled steerable sheath improves result and procedural parameters of atrial fibrillation ablation with magnetic navigation.

PubMed

Errahmouni, Abdelkarim; Latcu, Decebal Gabriel; Bun, Sok-Sithikun; Rijo, Nicolas; Dugourd, Céline; Saoudi, Nadir

2015-07-01

The magnetic navigation (MN) system may be coupled with a new advancement system that fully controls both the catheter and a robotic deflectable sheath (RSh) or with a fixed-curve sheath and a catheter-only advancement system (CAS). We aimed to compare these approaches for atrial fibrillation (AF) ablation. Atrial fibrillation ablation patients (45, 23 paroxysmal and 22 persistent) performed with MN-RSh (RSh group) were compared with a control group (37, 18 paroxysmal and19 persistent) performed with MN-CAS (CAS group). Setup duration was measured from the procedure's start to operator transfer to control room. Ablation step duration was defined as the time from the beginning of the first radiofrequency (RF) pulse to the end of the last one and was separately acquired for the left and the right pulmonary vein (PV) pairs. Clinical characteristics, left atrial size, and AF-type distribution were similar between the groups. Setup duration as well as mapping times was also similar. Ablation step duration for the left PVs was similar, but was shorter for the right PVs in RSh group (46 ± 9 vs. 63 ± 12 min, P < 0.0001). Radiofrequency delivery time (34 ± 9 vs. 40 ± 11 min, P = 0.007) and procedure duration (227 ± 36 vs. 254 ± 62 min, P = 0.01) were shorter in RSh group. No complication occurred in RSh group. During follow-up, there were five recurrences (11%) in RSh group and 11 (29%) in CAS group (P = 0.027). The use of the RSh for AF ablation with MN is safe and improves outcome. Right PV isolation is faster, RF delivery time and procedure time are reduced. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Remotely controlled steerable sheath improves result and procedural parameters of atrial fibrillation ablation with magnetic navigation

PubMed Central

Errahmouni, Abdelkarim; Latcu, Decebal Gabriel; Bun, Sok-Sithikun; Rijo, Nicolas; Dugourd, Céline; Saoudi, Nadir

2015-01-01

Aims The magnetic navigation (MN) system may be coupled with a new advancement system that fully controls both the catheter and a robotic deflectable sheath (RSh) or with a fixed-curve sheath and a catheter-only advancement system (CAS). We aimed to compare these approaches for atrial fibrillation (AF) ablation. Methods and results Atrial fibrillation ablation patients (45, 23 paroxysmal and 22 persistent) performed with MN–RSh (RSh group) were compared with a control group (37, 18 paroxysmal and19 persistent) performed with MN–CAS (CAS group). Setup duration was measured from the procedure's start to operator transfer to control room. Ablation step duration was defined as the time from the beginning of the first radiofrequency (RF) pulse to the end of the last one and was separately acquired for the left and the right pulmonary vein (PV) pairs. Clinical characteristics, left atrial size, and AF-type distribution were similar between the groups. Setup duration as well as mapping times was also similar. Ablation step duration for the left PVs was similar, but was shorter for the right PVs in RSh group (46 ± 9 vs. 63 ± 12 min, P < 0.0001). Radiofrequency delivery time (34 ± 9 vs. 40 ± 11 min, P = 0.007) and procedure duration (227 ± 36 vs. 254 ± 62 min, P = 0.01) were shorter in RSh group. No complication occurred in RSh group. During follow-up, there were five recurrences (11%) in RSh group and 11 (29%) in CAS group (P = 0.027). Conclusion The use of the RSh for AF ablation with MN is safe and improves outcome. Right PV isolation is faster, RF delivery time and procedure time are reduced. PMID:25662989

Novel oral applications of ultra-short laser pulses

NASA Astrophysics Data System (ADS)

Wieger, V.; Wernisch, J.; Wintner, E.

2007-02-01

In the past decades, many efforts have been made to replace mechanical tools in oral applications by various laser systems. The reasons therefore are manifold: i) Friction causes high temperatures damaging adjacent tissue. ii) Smear layers and rough surfaces are produced. iii) Size and shape of traditional tools are often unsuitable for geometrically complicated incisions and for minimum invasive treatment. iv) Mechanical damage of the remaining tissue occurs. v) Online diagnosis for feedback is not available. Different laser systems in the µs and sub-&mrgs-pulse regime, among them Erbium lasers, have been tested in the hope to overcome the mentioned drawbacks and, to some extent, they represent the current state of the art with respect to commercial and hence practical application. In the present work the applicability of scanned ultrashort pulse lasers (USPLs) for biological hard tissue as well as dental restoration material removal was tested. It is shown that cavities with features superior to mechanically treated or Erbium laser ablated cavities can be generated if appropriate scan algorithms and optimum laser parameters are matched. Smooth cavity rims, no microcracks, melting or carbonisation and precise geometry are the advantages of scanned USLP ablation. For bone treatment better healing conditions are expected as the natural structure remains unaffected by the preparation procedure. The novelty of this work is represented by a comprehensive compilation of various experimental results intended to assess the performance of USPLs. In this context, various pulse durations in the picosecond and femtosecond regime were applied to dental and bone tissue as well as dental restoration materials which is considered to be indispensable for a complete assessment. Parameters like ablation rates describing the efficiency of the ablation process, and ablation thresholds were determined - some of them for the first time - and compared to the corresponding Erbium values. The morphology of the tissue surfaces remaining after laser preparation was investigated and the surface roughness was evaluateded. Selective ablation was stressed and the temperature impact induced by USPLs was analyzed. Due to the limited space only a selection of results can be presented.

The Research of Feasibility and Efficacy of Radiofrequency Ablation in Treating Uterine Fibroids

PubMed Central

Luo, Xin; Shu, Shan-rong; Ma, Xue-feng; Shuai, Han-lin

2015-01-01

Abstract To explore the feasibility and efficacy of radiofrequency ablation in treating uterine fibroids. Ninety patients with multiple uterine fibroids, who had undergone hysterectomy were included in the study. After the uterus was resected, the temperature of 60, 80, 100°C were adopted to ablate the in vitro fibroid with each temperature dealing with 30 patients. Simultaneously, 5 patients were included, whose in vivo fibroid were ablated with the temperature of 100°C before the fibroids were removed after laparotomy. After the fibroids were ablated, the smooth muscle in the ablated center (group A), the ablated edge (group B) and 1 cm away from the ablated edge (group C) were taken. Then, the samples were stained with hematoxylin and eosin (HE) to examine the histopathological changes, and immunohistochemistry was performed to detect the expression of estrogen receptor (ER) and progesterone receptor (PR). After radiofrequency ablation, the ablated lesions were round, toast tan, and dry on gross appearance. There were no obvious tissue carbonization and there were distinct boundary from periphery tissue. In vitro: On automated analysis, the average optical density of ER and PR in group A, B, and C was lower than the control group (P < 0.05), and which were gradually raised with the increased distance to electrode. In the same treatment group, ER optical density was gradually decreased with the increased temperature among 3 different groups. The PR optical density was decreased with the increased temperature under different temperatures in group A and group B, there was significant difference among groups (P < 0.05). But in group C, there was no difference in PR expression among the temperature of 60, 80, and 100°C (P > 0.05). In vivo: Compared with the control group, the average optical density of ER and PR were significantly different among group A, B, and C (P < 0.05), what's more, it was gradually raised with the increased distance to electrode. After radiofrequency ablation, the tissues displayed coagulative necrosis, and decreased ER and PR expression. Radiofrequency ablation may be considered a minimally invasive alternative for those women who wish to retain their reproductive potential. Eighty degree Celsius was expected to be the optimum temperature in radiofrequency ablation treatment of uterine fibroid. PMID:26632689

Analysis of enamel surface damage after selective laser ablation of composite from tooth surfaces.

PubMed

Chan, Kenneth H; Hirasuna, Krista; Fried, Daniel

2014-02-01

Resin-based composites are used for many applications in dentistry. They are difficult to remove without damage to the underlying enamel since they adhere strongly and are color matched to the tooth. The objective of this study was to determine if an automated laser scanning system with spectral feedback could be used for selective removal of residual orthodontic composite from tooth surfaces with minimal damage to the underlying enamel. A CO 2 laser operating at a wavelength of 9.3 μm with a pulse duration of 10-15 μs and a pulse repetition rate of ~200 Hz was used to selectively remove composite from the buccal surfaces of extracted teeth. A spectral feedback system utilizing a miniature spectrometer was used to control the laser scanning system. Pulpal temperature measurements were performed during composite removal to determine if there was excessive heat accumulation. Conventional and digital microscopes were used to assess the amount of enamel lost during removal. The amount of enamel lost averaged between 20 and 25 μm for irradiation intensities from 3.8 to 4.2 J/cm 2 , respectively. An average maximum temperature rise of 1.9±1.5°C was recorded, with no teeth approaching the critical value of 5.5°C. The average time for composite removal from an area of 5 mm 2 was 19.3±4.1 s, fast enough for clinical feasibility. Residual composite can be rapidly removed from tooth surfaces using a CO 2 laser with spectral feedback, with minimal temperature rise within the pulp and with minimal loss of sound enamel.

Bipolar radiofrequency ablation of spinal tumors: predictability, safety and outcome.

PubMed

Gazis, Angelos N; Beuing, Oliver; Franke, Jörg; Jöllenbeck, Boris; Skalej, Martin

2014-04-01

Bone metastases are often the cause of tumor-associated pain and reduction of quality of life. For patients that cannot be treated by surgery, a local minimally invasive therapy such as radiofrequency ablation can be a useful option. In cases in which tumorous masses are adjacent to vulnerable structures, the monopolar radiofrequency can cause severe neuronal damage because of the unpredictability of current flow. The aim of this study is to show that the bipolar radiofrequency ablation provides an opportunity to safely treat such spinal lesions because of precise predictability of the emerging ablation zone. Prospective cohort study of 36 patients undergoing treatment at a single institution. Thirty-six patients in advanced tumor stage with primary or secondary tumor involvement of spine undergoing radiofrequency ablation. Prediction of emerging ablation zone. Clinical outcome of treated patients. X-ray-controlled treatment of 39 lesions by bipolar radiofrequency ablation. Magnetic resonance imaging was performed pre- and postinterventionally. Patients were observed clinically during their postinterventional stay. The extent of the ablation zones was predictable to the millimeter because it did not cross the peri-interventional planned dorsal and ventral boundaries in any case. No complications were observed. Ablation of tumorous masses adjacent to vulnerable structures is feasible and predictable by using the bipolar radiofrequency ablation. Damage of neuronal structures can be avoided through precise prediction of the ablation area. Copyright © 2014 Elsevier Inc. All rights reserved.

Perioral Rejuvenation With Ablative Erbium Resurfacing.

PubMed

Cohen, Joel L

2015-11-01

Since the introduction of the scanning full-field erbium laser, misconceptions regarding ablative erbium resurfacing have resulted in its being largely overshadowed by ablative fractional resurfacing. This case report illustrates the appropriateness of full-field erbium ablation for perioral resurfacing. A patient with profoundly severe perioral photodamage etched-in lines underwent full-field ablative perioral resurfacing with an erbium laser (Contour TRL, Sciton Inc., Palo Alto, CA) that allows separate control of ablation and coagulation. The pre-procedure consultations included evaluation of the severity of etched-in lines, and discussion of patient goals, expectations, and appropriate treatment options, as well as a review of patient photos and post-treatment care required. The author generally avoids full-field erbium ablation in patients with Fitzpatrick type IV and above. For each of 2 treatment sessions (separated by approximately 4 months), the patient received (12 cc plain 2% lidodaine) sulcus blocks before undergoing 4 passes with the erbium laser at 150 μ ablation, no coagulation, and then some very focal 30 μ ablation to areas of residual lines still visualized through the pinpoint bleeding. Similarly, full-field ablative resurfacing can be very reliable for significant wrinkles and creping in the lower eyelid skin--where often a single treatment of 80 μ ablation, 50 μ coagulation can lead to a nice improvement. Standardized digital imaging revealed significant improvement in deeply etched rhytides without significant adverse events. For appropriately selected patients requiring perioral (or periorbital) rejuvenation, full-field ablative erbium resurfacing is safe, efficacious and merits consideration.

Laser Ablated Carbon Nanodots for Light Emission.

PubMed

Reyes, Delfino; Camacho, Marco; Camacho, Miguel; Mayorga, Miguel; Weathers, Duncan; Salamo, Greg; Wang, Zhiming; Neogi, Arup

2016-12-01

The synthesis of fluorescent carbon dots-like nanostructures (CNDs) obtained through the laser ablation of a carbon solid target in liquid environment is reported. The ablation process was induced in acetone with laser pulses of 1064, 532, and 355 nm under different irradiation times. Close-spherical amorphous CNDs with sizes between 5 and 20 nm, whose abundance strongly depends on the ablation parameters were investigated using electron microscopy and was confirmed using absorption and emission spectroscopies. The π- π* electronic transition at 3.76 eV dominates the absorption for all the CNDs species synthesized under different irradiation conditions. The light emission is most efficient due to excitation at 3.54 eV with the photoluminescence intensity centered at 3.23 eV. The light emission from the CNDs is most efficient due to ablation at 355 nm. The emission wavelength of the CNDs can be tuned from the near-UV to the green wavelength region by controlling the ablation time and modifying the ablation and excitation laser wavelength.

High-intensity focused ultrasound for potential treatment of polycystic ovary syndrome: toward a noninvasive surgery.

PubMed

Shehata, Islam A; Ballard, John R; Casper, Andrew J; Hennings, Leah J; Cressman, Erik; Ebbini, Emad S

2014-02-01

To investigate the feasibility of using high-intensity focused ultrasound (HIFU), under dual-mode ultrasound arrays (DMUAs) guidance, to induce localized thermal damage inside ovaries without damage to the ovarian surface. Laboratory feasibility study. University-based laboratory. Ex vivo canine and bovine ovaries. DMUA-guided HIFU. Detection of ovarian damage by ultrasound imaging, gross pathology, and histology. It is feasible to induce localized thermal damage inside ovaries without damage to the ovarian surface. DMUA provided sensitive imaging feedback regarding the anatomy of the treated ovaries and the ablation process. Different ablation protocols were tested, and thermal damage within the treated ovaries was histologically characterized. The absence of damage to the ovarian surface may eliminate many of the complications linked to current laparoscopic ovarian drilling (LOD) techniques. HIFU may be used as a less traumatic tool to perform LOD. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Design Of Combined Stochastic Feedforward/Feedback Control

NASA Technical Reports Server (NTRS)

Halyo, Nesim

1989-01-01

Methodology accommodates variety of control structures and design techniques. In methodology for combined stochastic feedforward/feedback control, main objectives of feedforward and feedback control laws seen clearly. Inclusion of error-integral feedback, dynamic compensation, rate-command control structure, and like integral element of methodology. Another advantage of methodology flexibility to develop variety of techniques for design of feedback control with arbitrary structures to obtain feedback controller: includes stochastic output feedback, multiconfiguration control, decentralized control, or frequency and classical control methods. Control modes of system include capture and tracking of localizer and glideslope, crab, decrab, and flare. By use of recommended incremental implementation, control laws simulated on digital computer and connected with nonlinear digital simulation of aircraft and its systems.

Evaluation of the smoothness and accuracy of scanning photorefractive keratectomy on PMMA by optical profilometry

NASA Astrophysics Data System (ADS)

Manns, Fabrice; Rol, Pascal O.; Parel, Jean-Marie A.; Schmid, Armin; Shen, Jin-Hui; Matsui, Takaaki; Soederberg, Per G.

1996-05-01

The smoothness and accuracy of PMMA ablations with a prototype scanning photorefractive keratectomy (SPRK) system were evaluated by optical profilometry. A prototype frequency- quintupled Nd:YAG laser (Laser Harmonic, LaserSight, Orlando, FL) was used (wavelength: 213 nm, pulse duration: 15 ns, repetition rate: 10 Hz). The laser energy was delivered through two computer-controlled galvanometer scanners that were controlled with our own hardware and software. The system was programmed to create on a block of PMMA the ablations corresponding to the correction of 6 diopters of myopia with 60%, 70%, and 80% spot overlap. The energy was 1.25 mJ. After ablation, the topography of the samples was measured with an optical profilometer (UBM Messtechnik, Ettlingen, Germany). The ablation depth was 10 to 15 micrometer larger than expected. The surfaces created with 50% to 70% overlap exhibited large saw-tooth like variations, with a maximum peak to peak variation of approximately 20 micrometer. With 80% overlap, the rms roughness was 1.3 micrometer and the central flattening was 7 diopters. This study shows that scanning PRK can produce smooth and accurate ablations.

Stress assisted selective ablation of ITO thin film by picosecond laser

NASA Astrophysics Data System (ADS)

Farid, Nazar; Chan, Helios; Milne, David; Brunton, Adam; M. O'Connor, Gerard

2018-01-01

Fast selective pattering with high precession on 175 nm ITO thin film with IR ps lasers is investigated. Ablation parameters are optimized with detailed studies on the scribed depth, topography, and particle generation using AFM and SEM. A comparison of 10 and 150 ps laser revealed that the shorter pulse (10 ps) laser is more appropriate in selective and partial ablation; up to 20 nm resolution for controlled depth with multipulses having energy below the damage threshold is demonstrated. The experimental results are interpreted to involve stress assisted ablation mechanism for the 10 ps laser while thermal ablation along with intense melting occurs for 150 ps laser. The transition between these regimes is estimated to occur at approximately 30 ps.

Observing laser ablation dynamics with sub-picosecond temporal resolution

NASA Astrophysics Data System (ADS)

Tani, Shuntaro; Kobayashi, Yohei

2017-04-01

Laser ablation is one of the most fundamental processes in laser processing, and the understanding of its dynamics is of key importance for controlling and manipulating the outcome. In this study, we propose a novel way of observing the dynamics in the time domain using an electro-optic sampling technique. We found that an electromagnetic field was emitted during the laser ablation process and that the amplitude of the emission was closely correlated with the ablated volume. From the temporal profile of the electromagnetic field, we analyzed the motion of charged particles with subpicosecond temporal resolution. The proposed method can provide new access to observing laser ablation dynamics and thus open a new way to optimize the laser processing.

Voluntarily controlled but not merely observed visual feedback affects postural sway

PubMed Central

Asai, Tomohisa; Hiromitsu, Kentaro; Imamizu, Hiroshi

2018-01-01

Online stabilization of human standing posture utilizes multisensory afferences (e.g., vision). Whereas visual feedback of spontaneous postural sway can stabilize postural control especially when observers concentrate on their body and intend to minimize postural sway, the effect of intentional control of visual feedback on postural sway itself remains unclear. This study assessed quiet standing posture in healthy adults voluntarily controlling or merely observing visual feedback. The visual feedback (moving square) had either low or high gain and was either horizontally flipped or not. Participants in the voluntary-control group were instructed to minimize their postural sway while voluntarily controlling visual feedback, whereas those in the observation group were instructed to minimize their postural sway while merely observing visual feedback. As a result, magnified and flipped visual feedback increased postural sway only in the voluntary-control group. Furthermore, regardless of the instructions and feedback manipulations, the experienced sense of control over visual feedback positively correlated with the magnitude of postural sway. We suggest that voluntarily controlled, but not merely observed, visual feedback is incorporated into the feedback control system for posture and begins to affect postural sway. PMID:29682421

Morphologic changes in the vein after different numbers of radiofrequency ablation cycles.

PubMed

Shaidakov, Evgeny V; Grigoryan, Arsen G; Korzhevskii, Dmitriy E; Ilyukhin, Evgeny A; Rosukhovski, Dmitriy A; Bulatov, Vasiliy L; Tsarev, Oleg I

2015-10-01

It has not yet been clarified whether it is possible to decrease the percentage of recurrences after radiofrequency (RF) ablation by way of increasing the number of RF ablation cycles. The aim of this study was to assess the morphologic changes in excised vein fragments after different durations of RF ablation exposure. In the first part of the study, we performed a morphologic analysis of eight cases of great saphenous vein (GSV) recanalization 6 months after RF ablation. The second part was performed on a suprafascial segment of the GSV with a length of >22 cm and a minimum diameter of 5 mm in 10 patients, who had given their consent to intraoperative excision of suprafascial GSV segments after RF ablation treatment through four 1-cm-long diametrical cuts. Prior ultrasound analysis had shown an average 6.9-mm diameter of the suprafascial segments. The segment was divided into three 7-cm-long subsegments and one control segment. The first, second, and third segments were treated with three, two, and one RF ablation cycles (ClosureFast; Covidien, Mansfield, Mass), respectively; the control segment was not exposed to RF ablation at all. Morphologic study of 160 sections of the vein (five sections of each segment and 10 control specimens) was carried out. The specimens were dyed with hematoxylin and orcein. The ensuing analysis was performed by an experienced expert with the blind study method (the specimens were numbered without any hint as to the quantity of RF ablation cycles performed on them). The intergroup comparison of the depth of venous wall damage was based on comparison of the coefficient of alteration, which is calculated as the relation of damage depth to thickness of the vein. After one RF ablation cycle, the depth of blurring of the structural elements only on some portions reached the middle of the muscle layer of the wall (coefficient of alteration, α = 26%). After two cycles, blurring of the structural elements on some portions extended to the adventitia (α = 53%). After three cycles, uniform blurring of the structural elements of all layers of the venous wall up to the adventitia was seen (α = 92%). The statistically significant difference in the alteration coefficient, depending on the number of cycles of RF ablation (P < .005), was established. The number of RF ablation cycles has an impact on the depth of vein wall damage. One and two cycles do not cause damage to all layers of the vein wall. Three cycles cause damage to all vein wall layers. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Incidence and Risk Factors for Liver Abscess After Thermal Ablation of Liver Neoplasm

PubMed Central

Su, Xiu-Feng; Li, Na; Chen, Xu-Fang; Zhang, Lei; Yan, Ming

2016-01-01

Background Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most frequently used thermal ablation methods for the treatment of liver cancer. Liver abscess is a common and severe complication of thermal ablation treatment. Objectives The objective of this study was to determine the incidence and risk factors of liver abscess formation after thermal ablation of liver cancer. Materials and Methods The clinical data of 423 patients who underwent 691 thermal ablation procedures for liver cancer were collected in order to retrospectively analyze the basic characteristics, incidence, and risk factors associated with liver abscess formation. Patients with multiple risk factors for liver abscess formation were enrolled in a risk factor group, and patients with no risk factors were enrolled in a control group. The chi-square test and multiple logistic regression analysis were used to analyze the relationship between the occurrence of liver abscesses and potential risk factors. Results Two hundred and eight patients underwent 385 RFA procedures, and 185 patients underwent 306 MWA procedures. The total incidence of liver abscesses was 1.7%, while the rates in the RFA group (1.8%) and MWA groups (1.6%) were similar (P > 0.05). The rates of liver abscesses in patients who had child-pugh class B and class C cirrhosis (P = 0.0486), biliary tract disease (P = 0.0305), diabetes mellitus (P = 0.0344), and porta hepatis tumors (P = 0.0123) were 4.0%, 6.7%, 6.5%, and 13.0%, respectively. There was a statistically significant difference between these four groups and the control group (all P < 0.05). The incidence of liver abscesses in the combined ablation and percutaneous ethanol injection (PEI) group (P = 0.0026) was significantly lower than that of the ablation group (P < 0.05). Conclusions The incidence of liver abscesses after liver cancer thermal ablation is low. Child-Pugh Class B and Class C cirrhosis, biliary tract disease, diabetes mellitus, and porta hepatis tumors are four significant risk factors. Combined ablation and PEI reduces the rate of liver abscesses. PMID:27642345

Optical fiber biocompatible sensors for monitoring selective treatment of tumors via thermal ablation

NASA Astrophysics Data System (ADS)

Tosi, Daniele; Poeggel, Sven; Dinesh, Duraibabu B.; Macchi, Edoardo G.; Gallati, Mario; Braschi, Giovanni; Leen, Gabriel; Lewis, Elfed

2015-09-01

Thermal ablation (TA) is an interventional procedure for selective treatment of tumors, that results in low-invasive outpatient care. The lack of real-time control of TA is one of its main weaknesses. Miniature and biocompatible optical fiber sensors are applied to achieve a dense, multi-parameter monitoring, that can substantially improve the control of TA. Ex vivo measurements are reported performed on porcine liver tissue, to reproduce radiofrequency ablation of hepatocellular carcinoma. Our measurement campaign has a two-fold focus: (1) dual pressure-temperature measurement with a single probe; (2) distributed thermal measurement to estimate point-by-point cells mortality.

Ablation for Atrial Fibrillation

PubMed Central

2006-01-01

Executive Summary Objective To review the effectiveness, safety, and costing of ablation methods to manage atrial fibrillation (AF). The ablation methods reviewed were catheter ablation and surgical ablation. Clinical Need Atrial fibrillation is characterized by an irregular, usually rapid, heart rate that limits the ability of the atria to pump blood effectively to the ventricles. Atrial fibrillation can be a primary diagnosis or it may be associated with other diseases, such as high blood pressure, abnormal heart muscle function, chronic lung diseases, and coronary heart disease. The most common symptom of AF is palpitations. Symptoms caused by decreased blood flow include dizziness, fatigue, and shortness of breath. Some patients with AF do not experience any symptoms. According to United States data, the incidence of AF increases with age, with a prevalence of 1 per 200 people aged between 50 and 60 years, and 1 per 10 people aged over 80 years. In 2004, the Institute for Clinical Evaluative Sciences (ICES) estimated that the rate of hospitalization for AF in Canada was 582.7 per 100,000 population. They also reported that of the patients discharged alive, 2.7% were readmitted within 1 year for stroke. One United States prevalence study of AF indicated that the overall prevalence of AF was 0.95%. When the results of this study were extrapolated to the population of Ontario, the prevalence of AF in Ontario is 98,758 for residents aged over 20 years. Currently, the first-line therapy for AF is medical therapy with antiarrhythmic drugs (AADs). There are several AADs available, because there is no one AAD that is effective for all patients. The AADs have critical adverse effects that can aggravate existing arrhythmias. The drug selection process frequently involves trial and error until the patient’s symptoms subside. The Technology Ablation has been frequently described as a “cure” for AF, compared with drug therapy, which controls AF but does not cure it. Ablation involves directing an energy source at cardiac tissue. For instance, radiofrequency energy uses heat to burn tissue near the source of the arrhythmia. The purpose is to create a series of scar tissue, so that the aberrant electrical pathways can no longer exist. Because the pulmonary veins are the predominant source of AF initiation, the primary goal of ablation is to isolate the pulmonary veins from the left atria through the creation of a conduction block. There are 2 methods of ablation: catheter ablation and surgical (operative) ablation. Radiofrequency energy is most commonly used for ablation. Catheter ablation involves inserting a catheter through the femoral vein to access the heart and burn abnormal foci of electrical activity by direct contact or by isolating them from the rest of the atrium. The surgical ablation is performed minimally invasively via direct visualization or with the assistance of a special scope for patients with lone AF. Review Strategy In March 2006, the following databases were searched: Cochrane Library International Agency for Health Technology Assessment (first quarter 2006), Cochrane Database of Systematic Reviews (first quarter 2006), Cochrane Central Register of Controlled Trials (first quarter 2006), MEDLINE (1966 to February 2006), MEDLINE In-Process and Other Non-indexed Citations (1966 to March 1, 2006), and EMBASE (1980 to 2006 week 9). The Medical Advisory Secretariat also searched Medscape on the Internet for recent reports on trials that were unpublished but that were presented at international conferences. In addition, the Web site Current Controlled Trials (www.controlled-trials.com) was searched for ongoing trials investigating ablation for atrial fibrillation. Search terms included: radiofrequency ablation, catheter ablation and atrial fibrillation. Summary of Findings Sixteen RCTs were identified that compared ablation methods in patients with AF. Two studies were identified that investigated first-line therapy for AF or atrial flutter. Seven other studies examined patients with drug-refractory, lone AF; and the remaining 7 RCTs compared ablation plus heart surgery to heart surgery alone in patients with drug-refractory AF and concomitant heart conditions. First-line Catheter Ablation for Atrial Fibrillation or Atrial Flutter Both studies concluded that catheter ablation was associated with significantly improved long-term freedom from arrhythmias and quality of life compared with medical therapy. These studies included different patient populations (those with AF in one pilot study, and those with atrial flutter in the other). Catheter ablation as first-line treatment is considered experimental at this time. Catheter Ablation Versus Medical Therapy in Patients With Drug-Refractory, Lone Atrial Fibrillation In this review, catheter ablation had success rates (freedom from arrhythmia) that ranged from 42% to 90% (median, 74%) in patients with drug-refractory, lone AF. All 3 of the RCTs comparing catheter ablation to medical therapy in patients with drug-refractory, lone AF found a significant improvement in terms of freedom from arrhythmia over a minimum of 12 months follow-up (P<.05). Ablation Plus Heart Surgery Versus Heart Surgery Alone in Patients With Atrial Fibrillation It is clear that patients with drug-refractory AF who are undergoing concomitant heart surgery (usually mitral valve repair or replacement) benefit significantly from surgical ablation, in terms of long-term freedom from AF, without substantial additional risk compared to open heart surgery alone. This group of patients represents about 1% of the patients with atrial fibrillation, thus the majority of the burden of AF lies within the patients with lone AF (i.e. those not requiring additional heart surgery). Conclusion Catheter ablation appears to be an effective treatment for patients with drug-refractory AF whose treatment alternatives are limited. Ablation technology is continually evolving with increasing success rates associated with the ablation procedure. PMID:23074498

Morphologies of femtosecond laser ablation of ITO thin films using gaussian or quasi-flat top beams for OLED repair

NASA Astrophysics Data System (ADS)

Kim, Hoon-Young; Choi, Won-Suk; Ji, Suk-Young; Shin, Young-Gwan; Jeon, Jin-Woo; Ahn, Sanghoon; Cho, Sung-Hak

2018-02-01

This study compares the ablation morphologies obtained with a femtosecond laser of both Gaussian and quasi-flat top beam profiles when applied to indium tin oxide (ITO) thin films for the purpose of OLED repair. A femtosecond laser system with a wavelength of 1030 nm and pulse duration of 190 fs is used to pattern an ITO thin film. The laser fluence is optimized for patterning at 1.38 J/cm2. The patterned ITO thin film is then evaluated through both optical microscope and atomic force microscope. Ablations with a square quasi-flat top beam are demonstrated using slits with varying x- y axes. With the Gaussian beam, the pattern width of the ablated area is shown to range from 9.17 to 9.99 μm when the number of irradiation pulse increases from one to six. In contrast, when slit control is used to obtain a quasi-flat top beam, the ablated pattern width remains constant at 10 μm, despite the increase in the number of pulse. The improved surface roughness is correlated with the quasi-flat top beam through measured Ra values. Furthermore, when using the Gaussian beam, the minimum resolution of the controllable ablation depth on the ITO thin film is found to be 60 nm. In contrast, when the quasi-flat top beam is used, the minimum ablation depth decreases to 40 nm.

Brain Emboli After Left Ventricular Endocardial Ablation.

PubMed

Whitman, Isaac R; Gladstone, Rachel A; Badhwar, Nitish; Hsia, Henry H; Lee, Byron K; Josephson, S Andrew; Meisel, Karl M; Dillon, William P; Hess, Christopher P; Gerstenfeld, Edward P; Marcus, Gregory M

2017-02-28

Catheter ablation for ventricular tachycardia and premature ventricular complexes (PVCs) is common. Catheter ablation of atrial fibrillation is associated with a risk of cerebral emboli attributed to cardioversions and numerous ablation lesions in the low-flow left atrium, but cerebral embolic risk in ventricular ablation has not been evaluated. We enrolled 18 consecutive patients meeting study criteria scheduled for ventricular tachycardia or PVC ablation over a 9-month period. Patients undergoing left ventricular (LV) ablation were compared with a control group of those undergoing right ventricular ablation only. Patients were excluded if they had implantable cardioverter defibrillators or permanent pacemakers. Radiofrequency energy was used for ablation in all cases and heparin was administered with goal-activated clotting times of 300 to 400 seconds for all LV procedures. Pre- and postprocedural brain MRI was performed on each patient within a week of the ablation procedure. Embolic infarcts were defined as new foci of reduced diffusion and high signal intensity on fluid-attenuated inversion recovery brain MRI within a vascular distribution. The mean age was 58 years, half of the patients were men, half had a history of hypertension, and the majority had no known vascular disease or heart failure. LV ablation was performed in 12 patients (ventricular tachycardia, n=2; PVC, n=10) and right ventricular ablation was performed exclusively in 6 patients (ventricular tachycardia, n=1; PVC, n=5). Seven patients (58%) undergoing LV ablation experienced a total of 16 cerebral emboli, in comparison with zero patients undergoing right ventricular ablation ( P =0.04). Seven of 11 patients (63%) undergoing a retrograde approach to the LV developed at least 1 new brain lesion. More than half of patients undergoing routine LV ablation procedures (predominately PVC ablations) experienced new brain emboli after the procedure. Future research is critical to understanding the long-term consequences of these lesions and to determining optimal strategies to avoid them. © 2017 American Heart Association, Inc.

Depth measurements of drilled holes in bone by laser triangulation for the field of oral implantology

NASA Astrophysics Data System (ADS)

Quest, D.; Gayer, C.; Hering, P.

2012-01-01

Laser osteotomy is one possible method of preparing beds for dental implants in the human jaw. A major problem in using this contactless treatment modality is the lack of haptic feedback to control the depth while drilling the implant bed. A contactless measurement system called laser triangulation is presented as a new procedure to overcome this problem. Together with a tomographic picture the actual position of the laser ablation in the bone can be calculated. Furthermore, the laser response is sufficiently fast as to pose little risk to surrounding sensitive areas such as nerves and blood vessels. In the jaw two different bone structures exist, namely the cancellous bone and the compact bone. Samples of both bone structures were examined with test drillings performed either by laser osteotomy or by a conventional rotating drilling tool. The depth of these holes was measured using laser triangulation. The results and the setup are reported in this study.

Feasibility of MRI-guided Focused Ultrasound as Organ-Sparing Treatment for Testicular Cancer

NASA Astrophysics Data System (ADS)

Staruch, Robert; Curiel, Laura; Chopra, Rajiv; Hynynen, Kullervo

2009-04-01

High cure rates for testicular cancer have prompted interest in organ-sparing surgery for patients with bilateral disease or single testis. Focused ultrasound (FUS) ablation could offer a noninvasive approach to organ-sparing surgery. The objective of this study was to determine the feasibility of using MR thermometry to guide organ-sparing focused ultrasound surgery in the testis. The testes of anesthetized rabbits were sonicated in several discrete locations using a single-element focused transducer operating at 2.787MHz. Focal heating was visualized with MR thermometry, using a measured PRF thermal coefficient of -0.0089±0.0003 ppm/° C. Sonications at 3.5-14 acoustic watts applied for 30 seconds produced maximum temperature elevations of 10-80° C, with coagulation verified by histology. Coagulation of precise volumes in the testicle is feasible with MRI-guided focused ultrasound. Variability in peak temperature for given sonication parameters suggests the need for online temperature feedback control.

Percutaneous microwave ablation with artificial ascites for symptomatic uterine adenomyosis: initial experience.

PubMed

Hai, Ning; Zhang, Jing; Xu, Ruifang; Han, Zhi-Yu; Liu, Fang Yi

2017-09-01

To evaluate the feasibility, safety and technical efficacy of ultrasound-guided percutaneous microwave ablation with artificial ascites for adenomyosis. Between May 2015 and May 2016, a total of 25 patients with symptomatic adenomyosis who underwent ultrasound-guided percutaneous microwave ablation with artificial ascites were included in this retrospective study. A matching cohort of 50 patients underwent ultrasound-guided percutaneous microwave ablation without artificial ascites as controls. The technical efficacy, complications and short-term treatment effectiveness were assessed and compared with the controls. Artificial ascites was successfully achieved in all of the 25 patients with the administration of a median of 550 mL (range, 250-1200 mL) of solution. There was substantial improvement in achieving a better antenna path in 100% (20/20) of the cases with a poor antenna path. The complete separation was achieved in 23 of 25 patients. The mean ablation time was 26.5 ± 7.3 min and the median non-perfusion volume ratio was 76% which was similar to the control group (p > .05). No serious complications were observed. Patient pain scores for dysmenorrhoea showed a statistically significant decline from the baseline of 6.71 ± 0.96 to 2.92 ± 0.79 and the symptom severity score declined statistically significantly from 21.8 ± 5.5 to 16.4 ± 4.8 at 3 months follow-up. Percutaneous microwave ablation with artificial ascites is feasible, safe and can be effective in improving access for treatment of adenomyosis.

Efficacy of Antiarrhythmic Drugs Short-Term Use After Catheter Ablation for Atrial Fibrillation (EAST-AF) trial.

PubMed

Kaitani, Kazuaki; Inoue, Koichi; Kobori, Atsushi; Nakazawa, Yuko; Ozawa, Tomoya; Kurotobi, Toshiya; Morishima, Itsuro; Miura, Fumiharu; Watanabe, Tetsuya; Masuda, Masaharu; Naito, Masaki; Fujimoto, Hajime; Nishida, Taku; Furukawa, Yoshio; Shirayama, Takeshi; Tanaka, Mariko; Okajima, Katsunori; Yao, Takenori; Egami, Yasuyuki; Satomi, Kazuhiro; Noda, Takashi; Miyamoto, Koji; Haruna, Tetsuya; Kawaji, Tetsuma; Yoshizawa, Takashi; Toyota, Toshiaki; Yahata, Mitsuhiko; Nakai, Kentaro; Sugiyama, Hiroaki; Higashi, Yukei; Ito, Makoto; Horie, Minoru; Kusano, Kengo F; Shimizu, Wataru; Kamakura, Shiro; Morimoto, Takeshi; Kimura, Takeshi; Shizuta, Satoshi

2016-02-14

Substantial portion of early arrhythmia recurrence after catheter ablation for atrial fibrillation (AF) is considered to be due to irritability in left atrium (LA) from the ablation procedure. We sought to evaluate whether 90-day use of antiarrhythmic drug (AAD) following AF ablation could reduce the incidence of early arrhythmia recurrence and thereby promote reverse remodelling of LA, leading to improved long-term clinical outcomes. A total of 2038 patients who had undergone radiofrequency catheter ablation for paroxysmal, persistent, or long-lasting AF were randomly assigned to either 90-day use of Vaughan Williams class I or III AAD (1016 patients) or control (1022 patients) group. The primary endpoint was recurrent atrial tachyarrhythmias lasting for >30 s or those requiring repeat ablation, hospital admission, or usage of class I or III AAD at 1 year, following the treatment period of 90 days post ablation. Patients assigned to AAD were associated with significantly higher event-free rate from recurrent atrial tachyarrhythmias when compared with the control group during the treatment period of 90 days [59.0 and 52.1%, respectively; adjusted hazard ratio (HR) 0.84; 95% confidence interval (CI) 0.73-0.96; P = 0.01]. However, there was no significant difference in the 1-year event-free rates from the primary endpoint between the groups (69.5 and 67.8%, respectively; adjusted HR 0.93; 95% CI 0.79-1.09; P = 0.38). Short-term use of AAD for 90 days following AF ablation reduced the incidence of recurrent atrial tachyarrhythmias during the treatment period, but it did not lead to improved clinical outcomes at the later phase. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Risk Factors for Bile Duct Injury After Percutaneous Thermal Ablation of Malignant Liver Tumors: A Retrospective Case-Control Study.

PubMed

Lin, Man-Xia; Ye, Jie-Yi; Tian, Wen-Shuo; Xu, Ming; Zhuang, Bo-Wen; Lu, Ming-De; Xie, Xiao-Yan; Kuang, Ming

2017-04-01

Bile duct injury after ablation of malignant liver tumors (MLTs) was not unusual and should be avoided. However, few studies have focused on evaluating the risk factors for intrahepatic bile duct injury. To evaluate the risk factors for intrahepatic bile duct injury after ablation of MLTs and to evaluate the minimum safe distance for ablating tumors abutting bile ducts. Sixty-five patients with intrahepatic bile duct injury after ablation of MLTs, and 65 controls were recruited. Risk factors for intrahepatic bile duct injury were analyzed. Tumor location was recorded as ≤5 mm (group A), 5-10 mm (group B), and >10 mm (group C) from the right/left main duct or segmental bile duct. Ascites history (P < 0.001), TACE treatment history (P = 0.025), intrahepatic bile duct dilatation before ablation (P < 0.001), and tumor location (P = 0.000) were identified as significant risk factors for intrahepatic bile duct injury. Significant differences in the risk of intrahepatic bile duct injury were found between groups B and C (P = 0.000), but not between groups A and B (P = 0.751). Ascites history (P = 0.002) and tumor location (P < 0.001) were independent predictors with the OR (95 % confidence interval) of 39.31(3.95-391.69) and 16.56 (5.87-46.71), respectively. Bile duct injury after ablation of MLTs was the result of local treatment-related factors combined with the patients' general condition. The minimum safe distance for ablation of tumor abutting a bile duct was 10 mm.

Percutaneous Radiofrequency Lung Ablation Combined with Transbronchial Saline Injection: An Experimental Study in Swine

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

Kawai, T., E-mail: t-kawai@hosp.yoka.hyogo.jp; Kaminou, T., E-mail: kaminout@grape.med.tottori-u.ac.jp; Sugiura, K.

2010-02-15

To evaluate the efficacy of radiofrequency lung ablation with transbronchial saline injection. The bilateral lungs of eight living swine were used. A 13-gauge bone biopsy needle was inserted percutaneously into the lung, and 1 ml of muscle paste was injected to create a tumor mimic. In total, 21 nodules were ablated. In the saline injection group (group A), radiofrequency ablation (RFA) was performed for 11 nodules after transbronchial saline injection under balloon occlusion with a 2-cm active single internally cooled electrode. In the control group (group B), conventional RFA was performed for 10 nodules as a control. The infused salinemore » liquid showed a wedge-shaped and homogeneous distribution surrounding a tumor mimic. All 21 RFAs were successfully completed. The total ablation time was significantly longer (13.4 {+-} 2.8 min vs. 8.9 {+-} 3.5 min; P = 0.0061) and the tissue impedance was significantly lower in group A compared with group B (73.1 {+-} 8.8 {Omega} vs. 100.6 {+-} 16.6 {Omega}; P = 0.0002). The temperature of the ablated area was not significantly different (69.4 {+-} 9.1{sup o}C vs. 66.0 {+-} 7.9{sup o}C; P = 0.4038). There was no significant difference of tumor mimic volume (769 {+-} 343 mm{sup 3} vs. 625 {+-} 191 mm{sup 3}; P = 0.2783). The volume of the coagulated area was significantly larger in group A than in group B (3886 {+-} 1247 mm{sup 3} vs. 2375 {+-} 1395 mm{sup 3}; P = 0.0221). Percutaneous radiofrequency lung ablation combined with transbronchial saline injection can create an extended area of ablation.« less

Effect of laser absorption on picosecond laser ablation of Cr12MoV mold steel, 9Cr18 stainless steel and H13A cemented carbide

NASA Astrophysics Data System (ADS)

Wu, Baoye; Liu, Peng; Wang, Xizhao; Zhang, Fei; Deng, Leimin; Duan, Jun; Zeng, Xiaoyan

2018-05-01

Due to excellent properties, Cr12MoV mold steel, 9Cr18 stainless steel and H13A cemented carbide are widely used in industry. In this paper, the effect of absorption of laser light on ablation efficiency and roughness have been studied using a picosecond pulse Nd:YVO4 laser. The experimental results reveal that laser wavelength, original surface roughness and chemical composition play an important role in controlling ablation efficiency and roughness. Firstly, higher ablation efficiency with lower surface roughness is achieved on the ablation of 9Cr18 at 532, comparing with 1064 nm. Secondly, the ablation efficiency increases while the Ra of the ablated region decreases with the decrease of original surface roughness on ablation of Cr12MoV mold steel at 532 nm. Thirdly, the ablation efficiency of H13A cemented carbide is much higher than 9Cr18 stainless steel and Cr12MoV mold steel at 1064 nm. Scanning electron microscopy images reveals the formation of pores on the surface of 9Cr18 stainless steel and Cr12MoV mold steel at 532 nm while no pores are formed at 1064 nm. As to H13A cemented carbide, worm-like structure is formed at 1064 nm. The synergetic effects of the heat accumulation, plasma shielding and ablation threshold on laser ablation efficiency and machining quality were analyzed and discussed systematically in this paper.

Laser-induced thermotherapy: an in-situ ablation technique for the local treatment of irresectable colorectal liver metastases

NASA Astrophysics Data System (ADS)

Ritz, Joerg-Peter; Isbert, Christoph M.; Roggan, Andre; Wacker, Frank; Buhr, Heinz-Johannes; Germer, Christoph-Thomas

2000-11-01

Laser-induced thermotherapy (LITT) is a so called in-situ- ablation technique which is used for the treatment of liver tumors. Coagulation necrosis is induced by transmitting the laser irradiation via quartz fibers directly into the tumor tissue. LITT represents similarly to surgical liver resection a local treatment form for liver metastases. The Nd-YAG laser (1064 nm) was used. The application system was placed percutaneously under open MRI control. On-line monitoring was done with MRI for evaluation of the postoperative follow-up we performed MRI-controls every 3 months. A total of 20 patients were treated. Due to the irradiation plan performed preoperatively, the treated tumors could be completely ablated by hyperthermia in all procedures. Complications were pleural effusion in 7 patients and a bile fistula and subcapsulary liver hematoma in one patient each. Local control of tumor growth can be achieved in tumors having undergone complete hyperthermic ablation. An assessment of the method regarding a prognostic benefit is not yet possible due to the short follow-up period and the small patient population.

Slow Pathway Radiofrequency Ablation Using Magnetic Navigation: A Description of Technique and Retrospective Case Analysis.

PubMed

Bhaskaran, Abhishek; Albarri, Maha; Ross, Neil; Al Raisi, Sara; Samanta, Rahul; Roode, Leonette; Nadri, Fazlur; Ng, Jeanette; Thomas, Stuart; Thiagalingam, Aravinda; Kovoor, Pramesh

2017-12-01

The Magnetic Navigation System (MNS) catheter was shown to be stable in the presence of significant cardiac wall motion and delivered more effective lesions compared to manual control. This stability could potentially make AV junctional re-entrant tachycardia (AVNRT) ablation safer. The aim of this study is to describe the method of mapping and ablation of AVNRT with MNS and 3-D electro-anatomical mapping system (CARTO, Biosense Webster, Diamond bar, CA, USA) anatomical mapping, with a view to improve the safety of ablation. The method of precise mapping and ablation with MNS is described. Consecutive AVNRT cases (n=30) from 2012 January to 2015 November, in which magnetic navigation was used, are analysed. Ablation was successful in 27 (90%) out of 30 patients. In three cases, ablation was abandoned due to the proximity of the three-dimensional His image to the potential ablation site. No complications, including AV nodal injury, occurred. The distance from the nearest His position to successful ablation site in both LAO and RAO projections of CARTO images was 26.4±8.8 and 27±7.7mm respectively. Only in two (9%) patients, ablation needed to be extended superior to the plane of coronary sinus ostium, towards the His bundle region, to achieve slow pathway modification. AVNRT ablation with MNS allows for accurate mapping of the AV node and stable ablation at a safe distance, which could help avoid AV nodal injury. We recommend this modality for younger patients with AVNRT. Copyright © 2017. Published by Elsevier B.V.

Measurement of intrahepatic pressure during radiofrequency ablation in porcine liver.

PubMed

Kawamoto, Chiaki; Yamauchi, Atsushi; Baba, Yoko; Kaneko, Keiko; Yakabi, Koji

2010-04-01

To identify the most effective procedures to avoid increased intrahepatic pressure during radiofrequency ablation, we evaluated different ablation methods. Laparotomy was performed in 19 pigs. Intrahepatic pressure was monitored using an invasive blood pressure monitor. Radiofrequency ablation was performed as follows: single-step standard ablation; single-step at 30 W; single-step at 70 W; 4-step at 30 W; 8-step at 30 W; 8-step at 70 W; and cooled-tip. The array was fully deployed in single-step methods. In the multi-step methods, the array was gradually deployed in four or eight steps. With the cooled-tip, ablation was performed by increasing output by 10 W/min, starting at 40 W. Intrahepatic pressure was as follows: single-step standard ablation, 154.5 +/- 30.9 mmHg; single-step at 30 W, 34.2 +/- 20.0 mmHg; single-step at 70 W, 46.7 +/- 24.3 mmHg; 4-step at 30 W, 42.3 +/- 17.9 mmHg; 8-step at 30 W, 24.1 +/- 18.2 mmHg; 8-step at 70 W, 47.5 +/- 31.5 mmHg; and cooled-tip, 114.5 +/- 16.6 mmHg. The radiofrequency ablation-induced area was spherical with single-step standard ablation, 4-step at 30 W, and 8-step at 30 W. Conversely, the ablated area was irregular with single-step at 30 W, single-step at 70 W, and 8-step at 70 W. The ablation time was significantly shorter for the multi-step method than for the single-step method. Increased intrahepatic pressure could be controlled using multi-step methods. From the shapes of the ablation area, 30-W 8-step expansions appear to be most suitable for radiofrequency ablation.

Radiofrequency multielectrode catheter ablation in the atrium.

PubMed

Panescu, D; Fleischman, S D; Whayne, J G; Swanson, D K; Mirotznik, M S; McRury, I; Haines, D E

1999-04-01

We developed a temperature-controlled radiofrequency (RF) system which can ablate by delivering energy to up to six 12.5 mm long coil electrodes simultaneously. Temperature feedback was obtained from temperature sensors placed at each end of coil electrodes, in diametrically opposite positions. The coil electrodes were connected in parallel, via a set of electronic switches, to a 150 W 500 kHz temperature-controlled RF generator. Temperatures measured at all user-selected coil electrodes were processed by a microcontroller which sent the maximum value to the temperature input of the generator. The generator adjusted the delivered power to regulate the temperature at its input within a 5 degrees C interval about a user-defined set point. The microcontroller also activated the corresponding electronic switches so that temperatures at all selected electrodes were controlled within a 5 degrees C interval with respect to each other. Physical aspects of tissue heating were first analysed using finite element models and current density measurements. Results from these analyses also constituted design input. The performance of this system was studied in vitro and in vivo. In vitro, at set temperatures of 70 degrees C, 85% of the lesions were contiguous. All lesions created at set temperatures of 80 and 90 degrees C were contiguous. The lesion length increased almost linearly with the number of electrodes. Power requirements to reach a set temperature were larger as more electrodes were driven by the generator. The system impedance decreased as more electrodes were connected in the ablation circuit and reached a low of 45.5 ohms with five coil electrodes in the circuit. In vivo, right atrial lesions were created in eight mongrel canines. The power needed to reach 70 degrees C set temperature varied between 15 and 114 W. The system impedance was 105+/-16 ohms, with one coil electrode in the circuit, and dropped to 75+/-12 ohms when two coil electrodes were simultaneously powered. The length and the width of the lesion set varied between 17.6+/-6.1 and 59.2+/-11.7 mm and 5.9+/-0.7 and 7.1+/-1.2 mm respectively. No sudden impedance rises occurred and 75% of the lesions were contiguous. From the set of contiguous lesions, 90% were potentially therapeutic as they were transmural and extended over the entire target region. The average total procedure and fluoroscopy times were 83.4 and 5.9 min respectively. We concluded that the system can safely perform long and contiguous lesions in canine right atria.

Percutaneous laser ablation of benign and malignant thyroid nodules.

PubMed

Papini, Enrico; Bizzarri, Giancarlo; Pacella, Claudio M

2008-10-01

Percutaneous image-guided procedures, largely based on thermal ablation, are at present under investigation for achieving a nonsurgical targeted cytoreduction in benign and malignant thyroid lesions. In several uncontrolled clinical trials and in two randomized clinical trials, laser ablation has demonstrated a good efficacy and safety for the shrinkage of benign cold thyroid nodules. In hyperfunctioning nodules, laser ablation induced a nearly 50% volume reduction with a variable frequency of normalization of thyroid-stimulating hormone levels. Laser ablation has been tested for the palliative treatment of poorly differentiated thyroid carcinomas, local recurrences or distant metastases. Laser ablation therapy is indicated for the shrinkage of benign cold nodules in patients with local pressure symptoms who are at high surgical risk. The treatment should be performed only by well trained operators and after a careful cytological evaluation. Laser ablation does not seem to be consistently effective in the long-term control of hyperfunctioning thyroid nodules and is not an alternative treatment to 131I therapy. Laser ablation may be considered for the cytoreduction of tumor tissue prior to external radiation therapy or chemotherapy of local or distant recurrences of thyroid malignancy that are not amenable to surgical or radioiodine treatment.

Robot-assisted, ultrasound-guided minimally invasive navigation tool for brachytherapy and ablation therapy: initial assessment

NASA Astrophysics Data System (ADS)

Bhattad, Srikanth; Escoto, Abelardo; Malthaner, Richard; Patel, Rajni

2015-03-01

Brachytherapy and thermal ablation are relatively new approaches in robot-assisted minimally invasive interventions for treating malignant tumors. Ultrasound remains the most favored choice for imaging feedback, the benefits being cost effectiveness, radiation free, and easy access in an OR. However it does not generally provide high contrast, noise free images. Distortion occurs when the sound waves pass through a medium that contains air and/or when the target organ is deep within the body. The distorted images make it quite difficult to recognize and localize tumors and surgical tools. Often tools, such as a bevel-tipped needle, deflect from its path during insertion, making it difficult to detect the needle tip using a single perspective view. The shifting of the target due to cardiac and/or respiratory motion can add further errors in reaching the target. This paper describes a comprehensive system that uses robot dexterity to capture 2D ultrasound images in various pre-determined modes for generating 3D ultrasound images and assists in maneuvering a surgical tool. An interactive 3D virtual reality environment is developed that visualizes various artifacts present in the surgical site in real-time. The system helps to avoid image distortion by grabbing images from multiple positions and orientation to provide a 3D view. Using the methods developed for this application, an accuracy of 1.3 mm was achieved in target attainment in an in-vivo experiment subjected to tissue motion. An accuracy of 1.36 mm and 0.93 mm respectively was achieved for the ex-vivo experiments with and without external induced motion. An ablation monitor widget that visualizes the changes during the complete ablation process and enables evaluation of the process in its entirety is integrated.

High-speed scanning ablation of dental hard tissues with a λ = 9.3 μm CO2 laser: adhesion, mechanical strength, heat accumulation, and peripheral thermal damage

PubMed Central

Nguyen, Daniel; Chang, Kwang; Hedayatollahnajafi, Saba; Staninec, Michal; Chan, Kenneth; Lee, Robert; Fried, Daniel

2011-01-01

CO2 lasers can be operated at high laser pulse repetition rates for the rapid and precise removal of dental decay. Excessive heat accumulation and peripheral thermal damage is a concern when using high pulse repetition rates. Peripheral thermal damage can adversely impact the mechanical strength of the irradiated tissue, particularly for dentin, and reduce the adhesion characteristics of the modified surfaces. The interpulpal temperature rise was recorded using microthermocouples situated at the roof of the pulp chamber on teeth that were occlusally ablated using a rapidly-scanned CO2 laser operating at 9.3 μm with a pulse duration of 10 to 15 μs and repetition rate of 300 Hz over a 2 min time course. The adhesion strength of laser treated enamel and dentin surfaces was measured for various laser scanning parameters with and without post-ablation acid etching using the single-plane shear test. The mechanical strength of laser-ablated dentin surfaces were determined via the four-point bend test and compared to control samples prepared with 320 grit wet sand paper to simulate conventional preparations. Thermocouple measurements indicated that the temperature remained below ambient temperature if water-cooling was used. There was no discoloration of either dentin or enamel laser treated surfaces, the surfaces were uniformly ablated, and there were no cracks visible. Four-point bend tests yielded mean mechanical strengths of 18.2 N (s.d. = 4.6) for ablated dentin and 18.1 N (s.d. = 2.7) for control (p > 0.05). Shear tests yielded mean bond strengths approaching 30 MPa for both enamel and dentin under certain irradiation conditions. These values were slightly lower than nonirradiated acid-etched control samples. Additional studies are needed to determine if the slightly lower bond strength than the acid-etched control samples is clinically significant. These measurements demonstrate that enamel and dentin surfaces can be rapidly ablated by CO2 lasers with minimal peripheral thermal and mechanical damage and without excessive heat accumulation. PMID:21806256

High-speed scanning ablation of dental hard tissues with a λ = 9.3 μm CO2 laser: adhesion, mechanical strength, heat accumulation, and peripheral thermal damage

NASA Astrophysics Data System (ADS)

Nguyen, Daniel; Chang, Kwang; Hedayatollahnajafi, Saba; Staninec, Michal; Chan, Kenneth; Lee, Robert; Fried, Daniel

2011-07-01

CO2 lasers can be operated at high laser pulse repetition rates for the rapid and precise removal of dental decay. Excessive heat accumulation and peripheral thermal damage is a concern when using high pulse repetition rates. Peripheral thermal damage can adversely impact the mechanical strength of the irradiated tissue, particularly for dentin, and reduce the adhesion characteristics of the modified surfaces. The interpulpal temperature rise was recorded using microthermocouples situated at the roof of the pulp chamber on teeth that were occlusally ablated using a rapidly-scanned CO2 laser operating at 9.3 μm with a pulse duration of 10 to 15 μs and repetition rate of 300 Hz over a 2 min time course. The adhesion strength of laser treated enamel and dentin surfaces was measured for various laser scanning parameters with and without post-ablation acid etching using the single-plane shear test. The mechanical strength of laser-ablated dentin surfaces were determined via the four-point bend test and compared to control samples prepared with 320 grit wet sand paper to simulate conventional preparations. Thermocouple measurements indicated that the temperature remained below ambient temperature if water-cooling was used. There was no discoloration of either dentin or enamel laser treated surfaces, the surfaces were uniformly ablated, and there were no cracks visible. Four-point bend tests yielded mean mechanical strengths of 18.2 N (s.d. = 4.6) for ablated dentin and 18.1 N (s.d. = 2.7) for control (p > 0.05). Shear tests yielded mean bond strengths approaching 30 MPa for both enamel and dentin under certain irradiation conditions. These values were slightly lower than nonirradiated acid-etched control samples. Additional studies are needed to determine if the slightly lower bond strength than the acid-etched control samples is clinically significant. These measurements demonstrate that enamel and dentin surfaces can be rapidly ablated by CO2 lasers with minimal peripheral thermal and mechanical damage and without excessive heat accumulation.

High-speed scanning ablation of dental hard tissues with a λ = 9.3 μm CO2 laser: adhesion, mechanical strength, heat accumulation, and peripheral thermal damage.

PubMed

Nguyen, Daniel; Chang, Kwang; Hedayatollahnajafi, Saba; Staninec, Michal; Chan, Kenneth; Lee, Robert; Fried, Daniel

2011-07-01

CO(2) lasers can be operated at high laser pulse repetition rates for the rapid and precise removal of dental decay. Excessive heat accumulation and peripheral thermal damage is a concern when using high pulse repetition rates. Peripheral thermal damage can adversely impact the mechanical strength of the irradiated tissue, particularly for dentin, and reduce the adhesion characteristics of the modified surfaces. The interpulpal temperature rise was recorded using microthermocouples situated at the roof of the pulp chamber on teeth that were occlusally ablated using a rapidly-scanned CO(2) laser operating at 9.3 μm with a pulse duration of 10 to 15 μs and repetition rate of 300 Hz over a 2 min time course. The adhesion strength of laser treated enamel and dentin surfaces was measured for various laser scanning parameters with and without post-ablation acid etching using the single-plane shear test. The mechanical strength of laser-ablated dentin surfaces were determined via the four-point bend test and compared to control samples prepared with 320 grit wet sand paper to simulate conventional preparations. Thermocouple measurements indicated that the temperature remained below ambient temperature if water-cooling was used. There was no discoloration of either dentin or enamel laser treated surfaces, the surfaces were uniformly ablated, and there were no cracks visible. Four-point bend tests yielded mean mechanical strengths of 18.2 N (s.d. = 4.6) for ablated dentin and 18.1 N (s.d. = 2.7) for control (p > 0.05). Shear tests yielded mean bond strengths approaching 30 MPa for both enamel and dentin under certain irradiation conditions. These values were slightly lower than nonirradiated acid-etched control samples. Additional studies are needed to determine if the slightly lower bond strength than the acid-etched control samples is clinically significant. These measurements demonstrate that enamel and dentin surfaces can be rapidly ablated by CO(2) lasers with minimal peripheral thermal and mechanical damage and without excessive heat accumulation.

Five seconds of 50-60 W radio frequency atrial ablations were transmural and safe: an in vitro mechanistic assessment and force-controlled in vivo validation.

PubMed

Bhaskaran, Abhishek; Chik, William; Pouliopoulos, Jim; Nalliah, Chrishan; Qian, Pierre; Barry, Tony; Nadri, Fazlur; Samanta, Rahul; Tran, Ying; Thomas, Stuart; Kovoor, Pramesh; Thiagalingam, Aravinda

2017-05-01

Longer procedural time is associated with complications in radiofrequency atrial fibrillation ablation. We sought to reduce ablation time and thereby potentially reduce complications. The aim was to compare the dimensions and complications of 40 W/30 s setting to that of high-power ablations (50-80 W) for 5 s in the in vitro and in vivo models. In vitro ablations-40 W/30 s were compared with 40-80 W powers for 5 s. In vivo ablations-40 W/30 s were compared with 50-80 W powers for 5 s. All in vivo ablations were performed with 10 g contact force and 30 mL/min irrigation rate. Steam pops and depth of lung lesions identified post-mortem were noted as complications. A total of 72 lesions on the non-trabeculated part of right atrium were performed in 10 Ovine. All in vitro ablations except for the 40 W/5 s setting achieved the critical lesion depth of 2 mm. For in vivo ablations, all lesions were transmural, and the lesion depths for the settings of 40 W/30 s, 50 W/5 s, 60 W/5 s, 70 W/5 s, and 80 W/5 s were 2.2 ± 0.5, 2.3 ± 0.5, 2.1 ± 0.4, 2.0 ± 0.3, and 2.3 ± 0.7 mm, respectively. The lesion depths of short-duration ablations were similar to that of the conventional ablation. Steam pops occurred in the ablation settings of 40 W/30 s and 80 W/5 s in 8 and 11% of ablations, respectively. Complications were absent in short-duration ablations of 50 and 60 W. High-power, short-duration atrial ablation was as safe and effective as the conventional ablation. Compared with the conventional 40 W/30 s setting, 50 and 60 W ablation for 5 s achieved transmurality and had fewer complications. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Bipolar radiofrequency ablation of liver metastases during laparotomy. First clinical experiences with a new multipolar ablation concept.

PubMed

Ritz, Joerg-Peter; Lehmann, Kai S; Reissfelder, Christoph; Albrecht, Thomas; Frericks, Bernd; Zurbuchen, Urte; Buhr, Heinz J

2006-01-01

Radiofrequency ablation (RFA) is a promising method for local treatment of liver malignancies. Currently available systems for radiofrequency ablation use monopolar current, which carries the risk of uncontrolled electrical current paths, collateral damages and limited effectiveness. To overcome this problem, we used a newly developed internally cooled bipolar application system in patients with irresectable liver metastases undergoing laparotomy. The aim of this study was to clinically evaluate the safety, feasibility and effectiveness of this new system with a novel multipolar application concept. Patients with a maximum of five liver metastases having a maximum diameter of 5 cm underwent laparotomy and abdominal exploration to control resectability. In cases of irresectability, RFA with the newly developed bipolar application system was performed. Treatment was carried out under ultrasound guidance. Depending on tumour size, shape and location, up to three applicators were simultaneously inserted in or closely around the tumour, never exceeding a maximum probe distance of 3 cm. In the multipolar ablation concept, the current runs alternating between all possible pairs of consecutively activated electrodes with up to 15 possible electrode combinations. Post-operative follow-up was evaluated by CT or MRI controls 24-48 h after RFA and every 3 months. In a total of six patients (four male, two female; 61-68 years), ten metastases (1.0-5.5 cm) were treated with a total of 14 RF applications. In four metastases three probes were used, and in another four and two metastases, two and one probes were used, respectively. During a mean ablation time of 18.8 min (10-31), a mean energy of 48.8 kJ (12-116) for each metastases was applied. No procedure-related complications occurred. The patients were released from the hospital between 7 and 12 days post-intervention (median 9 days). The post-interventional control showed complete tumour ablation in all cases. Bipolar radiofrequency using the novel multipolar ablation concept permits a safe and effective therapy for the induction of large volumes of coagulation in the local treatment of liver metastases.

Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review.

PubMed

Ho, Kwo Wei David; Przkora, Rene; Kumar, Sanjeev

2017-12-28

Sphenopalatine ganglion is the largest collection of neurons in the calvarium outside of the brain. Over the past century, it has been a target for interventional treatment of head and facial pain due to its ease of access. Block, radiofrequency ablation, and neurostimulation have all been applied to treat a myriad of painful syndromes. Despite the routine use of these interventions, the literature supporting their use has not been systematically summarized. This systematic review aims to collect and summarize the level of evidence supporting the use of sphenopalatine ganglion block, radiofrequency ablation and neurostimulation. Medline, Google Scholar, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were reviewed for studies on sphenopalatine ganglion block, radiofrequency ablation and neurostimulation. Studies included in this review were compiled and analyzed for their treated medical conditions, study design, outcomes and procedural details. Studies were graded using Oxford Center for Evidence-Based Medicine for level of evidence. Based on the level of evidence, grades of recommendations are provided for each intervention and its associated medical conditions. Eighty-three publications were included in this review, of which 60 were studies on sphenopalatine ganglion block, 15 were on radiofrequency ablation, and 8 were on neurostimulation. Of all the studies, 23 have evidence level above case series. Of the 23 studies, 19 were on sphenopalatine ganglion block, 1 study on radiofrequency ablation, and 3 studies on neurostimulation. The rest of the available literature was case reports and case series. The strongest evidence lies in using sphenopalatine ganglion block, radiofrequency ablation and neurostimulation for cluster headache. Sphenopalatine ganglion block also has evidence in treating trigeminal neuralgia, migraines, reducing the needs of analgesics after endoscopic sinus surgery and reducing pain associated with nasal packing removal after nasal operations. Overall, sphenopalatine ganglion is a promising target for treating cluster headache using blocks, radiofrequency ablation and neurostimulation. Sphenopalatine ganglion block also has some evidence supporting its use in a few other conditions. However, most of the controlled studies were small and without replications. Further controlled studies are warranted to replicate and expand on these previous findings.

Thermal fixation of swine liver tissue after magnetic resonance-guided high-intensity focused ultrasound ablation.

PubMed

Courivaud, Frédéric; Kazaryan, Airazat M; Lund, Alice; Orszagh, Vivian C; Svindland, Aud; Marangos, Irina Pavlik; Halvorsen, Per Steinar; Jebsen, Peter; Fosse, Erik; Hol, Per Kristian; Edwin, Bjørn

2014-07-01

The aim of this study was to investigate experimental conditions for efficient and controlled in vivo liver tissue ablation by magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) in a swine model, with the ultimate goal of improving clinical treatment outcome. Histological changes were examined both acutely (four animals) and 1 wk after treatment (five animals). Effects of acoustic power and multiple sonication cycles were investigated. There was good correlation between target size and observed ablation size by thermal dose calculation, post-procedural MR imaging and histopathology, when temperature at the focal point was kept below 90°C. Structural histopathology investigations revealed tissue thermal fixation in ablated regions. In the presence of cavitation, mechanical tissue destruction occurred, resulting in an ablation larger than the target. Complete extra-corporeal MR-guided HIFU ablation in the liver is feasible using high acoustic power. Nearby large vessels were preserved, which makes MR-guided HIFU promising for the ablation of liver tumors adjacent to large veins. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

A new catheter design for combined radiofrequency ablation and optoacoustic treatment monitoring using copper-coated light-guides

NASA Astrophysics Data System (ADS)

Rebling, Johannes; Oyaga Landa, Francisco Javier; Deán-Ben, Xosé Luis; Razansky, Daniel

2018-02-01

Electrosurgery, i.e. the application of radiofrequency current for tissue ablation, is a frequently used treatment for many cardiac arrhythmias. Electrophysiological and anatomic mapping, as well as careful radiofrequency power control typically guide the radiofrequency ablation procedure. Despite its widespread application, accurate monitoring of the lesion formation with sufficient spatio-temporal resolution remains challenging with the existing imaging techniques. We present a novel integrated catheter for simultaneous radiofrequency ablation and optoacoustic monitoring of the lesion formation in real time and 3D. The design combines the delivery of both electric current and optoacoustic excitation beam in a single catheter consisting of copper-coated multimode light-guides and its manufacturing is described in detail. The electrical current causes coagulation and desiccation while the excitation light is locally absorbed, generating OA responses from the entire treated volume. The combined ablation-monitoring capabilities were verified using ex-vivo bovine tissue. The formed ablation lesions showed a homogenous coagulation while the ablation was monitored in realtime with a volumetric frame rate of 10 Hz over 150 seconds.

Rapid control and feedback rates enhance neuroprosthetic control

PubMed Central

Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

2017-01-01

Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms. PMID:28059065

Rapid control and feedback rates enhance neuroprosthetic control

NASA Astrophysics Data System (ADS)

Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

2017-01-01

Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms.

Chemical ablation of the Purkinje system causes early termination and activation rate slowing of long-duration ventricular fibrillation in dogs.

PubMed

Dosdall, Derek J; Tabereaux, Paul B; Kim, Jong J; Walcott, Gregory P; Rogers, Jack M; Killingsworth, Cheryl R; Huang, Jian; Robertson, Peter G; Smith, William M; Ideker, Raymond E

2008-08-01

Endocardial mapping has suggested that Purkinje fibers may play a role in the maintenance of long-duration ventricular fibrillation (LDVF). To determine the influence of Purkinje fibers on LDVF, we chemically ablated the Purkinje system with Lugol solution and recorded endocardial and transmural activation during LDVF. Dog hearts were isolated and perfused, and the ventricular endocardium was exposed and treated with Lugol solution (n = 6) or normal Tyrode solution as a control (n = 6). The left anterior papillary muscle endocardium was mapped with a 504-electrode (21 x 24) plaque with electrodes spaced 1 mm apart. Transmural activation was recorded with a six-electrode plunge needle on each side of the plaque. Ventricular fibrillation (VF) was induced, and perfusion was halted. LDVF spontaneously terminated sooner in Lugol-ablated hearts than in control hearts (4.9 +/- 1.5 vs. 9.2 +/- 3.2 min, P = 0.01). After termination of VF, both the control and Lugol hearts were typically excitable, but only short episodes of VF could be reinduced. Endocardial activation rates were similar during the first 2 min of LDVF for Lugol-ablated and control hearts but were significantly slower in Lugol hearts by 3 min. In control hearts, the endocardium activated more rapidly than the epicardium after 4 min of LDVF with wave fronts propagating most often from the endocardium to epicardium. No difference in transmural activation rate or wave front direction was observed in Lugol hearts. Ablation of the subendocardium hastens VF spontaneous termination and alters VF activation sequences, suggesting that Purkinje fibers are important in the maintenance of LDVF.

Ice-atmosphere interactions in the Canadian High Arctic: Implications for the thermo-mechanical evolution of terrestrial ice masses

NASA Astrophysics Data System (ADS)

Wohlleben, Trudy M. H.

Canadian High Arctic terrestrial ice masses and the polar atmosphere evolve codependently, and interactions between the two systems can lead to feedbacks, positive and negative. The two primary positive cryosphere-atmosphere feedbacks are: (1) The snow/ice-albedo feedback (where area changes in snow and/or ice cause changes in surface albedo and surface air temperatures, leading to further area changes in snow/ice); and (2) The elevation - mass balance feedback (where thickness changes in terrestrial ice masses cause changes to atmospheric circulation and precipitation patterns, leading to further ice thickness changes). In this thesis, numerical experiments are performed to: (1) quantify the magnitudes of the two feedbacks for chosen Canadian High Arctic terrestrial ice masses; and (2) to examine the direct and indirect consequences of surface air temperature changes upon englacial temperatures with implications for ice flow, mass flux divergence, and topographic evolution. Model results show that: (a) for John Evans Glacier, Ellesmere Island, the magnitude of the terrestrial snow/ice-albedo feedback can locally exceed that of sea ice on less than decadal timescales, with implications for glacier response times to climate perturbations; (b) although historical air temperature changes might be the direct cause of measured englacial temperature anomalies in various glacier and ice cap accumulation zones, they can also be the indirect cause of their enhanced diffusive loss; (c) while the direct result of past air temperature changes has been to cool the interior of John Evans Glacier, and its bed, the indirect result has been to create and maintain warm (pressure melting point) basal temperatures in the ablation zone; and (d) for Devon Ice Cap, observed mass gains in the northwest sector of the ice cap would be smaller without orographic precipitation and the mass balance---elevation feedback, supporting the hypothesis that this feedback is playing a role in the evolution of the ice cap.

A dual-slot microwave antenna for more spherical ablation zones: ex vivo and in vivo validation.

PubMed

Chiang, Jason; Hynes, Kieran A; Bedoya, Mariajose; Brace, Christopher L

2013-08-01

To compare the performance of a microwave antenna design with two annular slots to that of a monopole antenna design in creating a more spherical ablation zone. Animal care and use committee approval was obtained before in vivo experiments were performed. Microwave ablation zones were created by using dual-slot and monopole control antennas for 2, 5, and 10 minutes at 50 and 100 W in ex vivo bovine livers. Dual-slot and monopole antennas were then used to create ablation zones at 100 W for 5 minutes in in vivo porcine livers, which also underwent intraprocedural imaging. Ablation diameter, length, and aspect ratio (diameter ÷ length) were measured at gross pathologic examination and compared at each combination of power and time by using the paired Student t test. A P value less than .05 was considered to indicate a significant difference. Aspect ratios closer to 1 reflected a more spherical ablation zone. The dual-slot antenna created ablation zones with a higher aspect ratio at 50 W for 2 minutes (0.75 vs 0.53, P = .003) and 5 minutes (0.82 vs 0.63, P = .053) than did the monopole antenna in ex vivo liver tissue, although the difference was only significant at 2 minutes. At 100 W, the dual-slot antenna had a significantly higher aspect ratio at 2 minutes (0.52 vs 0.42, P = .002). In vivo studies showed significantly higher aspect ratios at 100 W for 5 minutes (0.63 vs 0.53, respectively, P = .029). Intraprocedural imaging confirmed this characterization, showing higher rates of ablation zone growth and heating primarily at the early stages of the ablation procedure when the dual-slot antenna was used. The dual-slot microwave antenna created a more spherical ablation zone than did the monopole antenna both in vivo and ex vivo liver tissue. Greater control over power delivery can potentially extend the advantages of the dual-slot antenna design to higher power and longer treatment times.

Comparison of switching bipolar ablation with multiple cooled wet electrodes and switching monopolar ablation with separable clustered electrode in treatment of small hepatocellular carcinoma: A randomized controlled trial

PubMed Central

Chang, Won; Lee, Dong Ho; Yoon, Jeong Hee; Kim, Yoon Jun; Yoon, Jung Hwan; Han, Joon Koo

2018-01-01

Objective A randomized controlled trial was conducted to prospectively compare the therapeutic effectiveness of switching bipolar (SB) radiofrequency ablation (RFA) using cooled-wet electrodes and switching monopolar (SM) RFA using separable clustered (SC) electrodes in patients with hepatocellular carcinomas (HCCs). Materials and methods This prospective study was approved by our Institutional Review Board. Between April 2014 and January 2015, sixty-nine patients with 74 HCCs were randomly treated with RFA using either internally cooled-wet (ICW) electrodes in SB mode (SB-RFA, n = 36) or SC electrodes in SM mode (SM-RFA, n = 38). Technical parameters including the number of ablations, ablation time, volume, energy delivery, and complications were evaluated. Thereafter, 1-year and 2-year local tumor progression (LTP) free survival rates were compared between the two groups using the Kaplan-Meier method. Results In the SB-RFA group, less number of ablations were required (1.72±0.70 vs. 2.31±1.37, P = 0.039), the ablation time was shorter (10.9±3.9 vs.14.3±5.0 min, p = 0.004), and energy delivery was smaller (13.1±6.3 vs.23.4±12.8 kcal, p<0.001) compared to SM-RFA. Ablation volume was not significantly different between SB-RFA and SM-RFA groups (61.8±24.3 vs.54.9±23.7 cm3, p = 0.229). Technical failure occurred in one patient in the SM-RFA group, and major complications occurred in one patient in each group. The 1-year and 2-year LTP free survival rates were 93.9% and 84.3% in the SB-RFA group and 94.4% and 88.4% in the SM-RFA group (p = 0.687). Conclusion Both SB-RFA using ICW electrodes and SM-RFA using SC electrodes provided comparable LTP free survival rates although SB-RFA required less ablations and shorter ablation time. PMID:29420589

Overcoming difficulties with equipoise to enable recruitment to a randomised controlled trial of partial ablation versus radical prostatectomy for unilateral localised prostate cancer.

PubMed

Elliott, Daisy; Hamdy, Freddie C; Leslie, Tom A; Rosario, Derek; Dudderidge, Tim; Hindley, Richard; Emberton, Mark; Brewster, Simon; Sooriakumaran, Prasanna; Catto, James W F; Emara, Amr; Ahmed, Hashim; Whybrow, Paul; le Conte, Steffi; Donovan, Jenny L

2018-06-11

To describe how clinicians conceptualised equipoise in the PART (Partial prostate Ablation versus Radical prosTatectomy in intermediate risk, unilateral clinically localised prostate cancer) feasibility study and how this affected recruitment. PART included a QuinteT Recruitment Intervention (QRI) to optimise recruitment. Phase I aimed to understand recruitment, and included scrutinising recruitment data, interviewing the Trial Management Group and recruiters (n=13), and audio-recording recruitment consultations (n=64). Data were analysed using qualitative content and thematic analysis methods. In Phase II, strategies to improve recruitment were developed and delivered. Initially many recruiters found it difficult to maintain a position of equipoise and held preconceptions about which treatment was best for particular patients. They did not feel comfortable about approaching all eligible patients, and when the study was discussed, biases were conveyed through the use of terminology, poorly balanced information and direct treatment recommendations. Individual and group feedback led to presentations to patients becoming clearer and enabled recruiters to reconsider their sense of equipoise. Although the precise impact of the QRI alone cannot be determined, recruitment increased (from mean 1.4 (range=0-4) to 4.5 (range=0-12) patients per month) and the feasibility study reached its recruitment target. Although clinicians find it challenging to recruit participants to a trial comparing different contemporary treatments for prostate cancer, training and support can enable recruiters to become more comfortable with conveying equipoise and providing clearer information to patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Assessment of laser ablation techniques in a-si technologies for position-sensor development

NASA Astrophysics Data System (ADS)

Molpeceres, C.; Lauzurica, S.; Ocana, J. L.; Gandia, J. J.; Urbina, L.; Carabe, J.

2005-07-01

Laser micromachining of semiconductor and Transparent Conductive Oxides (TCO) materials is very important for the practical applications in photovoltaic industry. In particular, a problem of controlled ablation of those materials with minimum of debris and small heat affected zone is one of the most vital for the successful implementation of laser micromachining. In particular, selective ablation of thin films for the development of new photovoltaic panels and sensoring devices based on amorphous silicon (a-Si) is an emerging field, in which laser micromachining systems appear as appropriate tools for process development and device fabrication. In particular, a promising application is the development of purely photovoltaic position sensors. Standard p-i-n or Schottky configurations using Transparent Conductive Oxides (TCO), a-Si and metals are especially well suited for these applications, appearing selective laser ablation as an ideal process for controlled material patterning and isolation. In this work a detailed study of laser ablation of a widely used TCO, Indium-tin-oxide (ITO), and a-Si thin films of different thicknesses is presented, with special emphasis on the morphological analysis of the generated grooves. The profiles of ablated grooves have been studied in order to determine the best processing conditions, i.e. laser pulse energy and wavelength, and to asses this technology as potentially competitive to standard photolithographic processes. The encouraging results obtained, with well defined ablation grooves having thicknesses in the order of 10 μm both in ITO and a-Si, open up the possibility of developing a high-performance double Schottky photovoltaic matrix position sensor.

Radiofrequency ablation of hepatocellular carcinoma: pros and cons.

PubMed

Rhim, Hyunchul; Lim, Hyo K

2010-09-01

Among locoregional treatments for hepatocellular carcinoma (HCC), radiofrequency ablation (RFA) has been accepted as the most popular alternative to curative transplantation or resection, and it shows an excellent local tumor control rate and acceptable morbidity. The benefits of RFA have been universally validated by the practice guidelines of international societies of hepatology. The main advantages of RFA include 1) it is minimally invasive with acceptable morbidity, 2) it enables excellent local tumor control, 3) it has promising long-term survival, and 4) it is a multimodal approach. Based on these pros, RFA will play an important role in managing the patient with early HCC (smaller than 3 cm with fewer than four tumors). The main limitations of current RFA technology in hepatic ablation include 1) limitation of ablation volume, 2) technically infeasible in some tumors due to conspicuity and dangerous location, and 3) the heat-sink effect. Many technical approaches have been introduced to overcome those limitations, including a novel guiding modality, use of artificial fluid or air, and combined treatment strategies. RFA will continue to play a role as a representative ablative modality in the management of HCC, even in the era of targeted agents.

Radiofrequency Ablation of Hepatocellular Carcinoma: Pros and Cons

PubMed Central

Lim, Hyo K.

2010-01-01

Among locoregional treatments for hepatocellular carcinoma (HCC), radiofrequency ablation (RFA) has been accepted as the most popular alternative to curative transplantation or resection, and it shows an excellent local tumor control rate and acceptable morbidity. The benefits of RFA have been universally validated by the practice guidelines of international societies of hepatology. The main advantages of RFA include 1) it is minimally invasive with acceptable morbidity, 2) it enables excellent local tumor control, 3) it has promising long-term survival, and 4) it is a multimodal approach. Based on these pros, RFA will play an important role in managing the patient with early HCC (smaller than 3 cm with fewer than four tumors). The main limitations of current RFA technology in hepatic ablation include 1) limitation of ablation volume, 2) technically infeasible in some tumors due to conspicuity and dangerous location, and 3) the heat-sink effect. Many technical approaches have been introduced to overcome those limitations, including a novel guiding modality, use of artificial fluid or air, and combined treatment strategies. RFA will continue to play a role as a representative ablative modality in the management of HCC, even in the era of targeted agents. PMID:21103289

Impaired Feedforward Control and Enhanced Feedback Control of Speech in Patients with Cerebellar Degeneration

PubMed Central

Agnew, Zarinah; Nagarajan, Srikantan; Houde, John; Ivry, Richard B.

2017-01-01

The cerebellum has been hypothesized to form a crucial part of the speech motor control network. Evidence for this comes from patients with cerebellar damage, who exhibit a variety of speech deficits, as well as imaging studies showing cerebellar activation during speech production in healthy individuals. To date, the precise role of the cerebellum in speech motor control remains unclear, as it has been implicated in both anticipatory (feedforward) and reactive (feedback) control. Here, we assess both anticipatory and reactive aspects of speech motor control, comparing the performance of patients with cerebellar degeneration and matched controls. Experiment 1 tested feedforward control by examining speech adaptation across trials in response to a consistent perturbation of auditory feedback. Experiment 2 tested feedback control, examining online corrections in response to inconsistent perturbations of auditory feedback. Both male and female patients and controls were tested. The patients were impaired in adapting their feedforward control system relative to controls, exhibiting an attenuated anticipatory response to the perturbation. In contrast, the patients produced even larger compensatory responses than controls, suggesting an increased reliance on sensory feedback to guide speech articulation in this population. Together, these results suggest that the cerebellum is crucial for maintaining accurate feedforward control of speech, but relatively uninvolved in feedback control. SIGNIFICANCE STATEMENT Speech motor control is a complex activity that is thought to rely on both predictive, feedforward control as well as reactive, feedback control. While the cerebellum has been shown to be part of the speech motor control network, its functional contribution to feedback and feedforward control remains controversial. Here, we use real-time auditory perturbations of speech to show that patients with cerebellar degeneration are impaired in adapting feedforward control of speech but retain the ability to make online feedback corrections; indeed, the patients show an increased sensitivity to feedback. These results indicate that the cerebellum forms a crucial part of the feedforward control system for speech but is not essential for online, feedback control. PMID:28842410

An in-vitro animal experiment on metal implants’ thermal effect on radiofrequency ablation

PubMed Central

2013-01-01

Background To explore metal implants’ thermal effect on radiofrequency ablation (RFA) and ascertain distance-thermal relationship between the metal implants and radiofrequency (RF) electrode. Methods Metal implants models were established in seven in-vitro porcine livers using silver clips or 125I seeds. RFA were conducted centering the RF electrode axis1 cm away from them, with one side containing a metal implants model the test group and the other side the control group. The thermometric needles were used to measure multi-point temperatures in order to compare the time-distance-temperature difference between the two groups. The gross scopes of the ablation of the two groups were measured and the tissues were analyzed for microscopic histology. Results At the ablation times of 8, 12, and 15 min, the average multi-point temperatures of the test group and the control group were 48.2±18.07°C, 51.5±19.57°C, 54.6±19.75°C, and 48.6±17.69°C, 52.2±19.73°C, 54.9±19.24°C, respectively, and the differences were not statistically significant (n=126, P>0.05). At the ablation times of 12 and 15 min, the ablation scopes of the test group and the control group were (horizontal/longitudinal diameter) 1.55/3.48 cm, 1.89/3.72 cm, and 1.56/3.48 cm, 1.89/3.72 cm, respectively, and the differences were not statistically significant (n=14, P>0.05). The two groups had the same manifestations in microscopy. Conclusions Metal implants do not cause significant thermal effect on RFA. PMID:23799942

A Randomised Controlled Trial on the Effect of Nurse-Led Educational Intervention at the Time of Catheter Ablation for Atrial Fibrillation on Quality of Life, Symptom Severity and Rehospitalisation.

PubMed

Bowyer, John L; Tully, Phillip J; Ganesan, Anand N; Chahadi, Fahd K; Singleton, Cameron B; McGavigan, Andrew D

2017-01-01

Atrial Fibrillation (AF) is a common condition associated with impaired quality of life (QOL) and recurrent hospitalisation. Catheter ablation for AF is a well-established treatment for symptomatic patients despite medical therapy. We sought to examine the effect of point specific nurse-led education on QOL, AF symptomatology and readmission rate post AF ablation. Forty-one patients undergoing AF ablation were randomised to Nurse Intervention (NI) versus Control (C), n=22 vs. 19. Both groups were well matched with respect to age, sex and AF subtype. All patients completed SF36 and AF Symptom Checklist, Frequency and Severity Scale questionnaires at baseline and six months post ablation. The NI group underwent nurse education on admission, prior to discharge, and with telephone contact. Baseline SF-36 and AF Symptom Checklist, Frequency and Severity scores were similar. The NI group showed significant differences compared to Control with respect to higher QOL on the SF-36 score of Physical Functioning and Vitality at six months. There were significant improvements in seven components of the AF Symptom Checklist, Frequency and Severity at six months in the NI group with a trend in a further seven. There was no difference in AF related hospital readmissions at six months between C and NI groups (10.5% vs. 13.6%, p=ns). Nurse-led education at time of AF ablation is associated with improved QOL and reduced symptom frequency and severity compared to usual care. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Simulating a Dynamic Antarctic Ice Sheet in the Early to Middle Miocene

NASA Astrophysics Data System (ADS)

Gasson, E.; DeConto, R.; Pollard, D.; Levy, R. H.

2015-12-01

There are a variety of sources of geological data that suggest major variations in the volume and extent of the Antarctic ice sheet during the early to middle Miocene. Simulating such variability using coupled climate-ice sheet models is problematic due to a strong hysteresis effect caused by height-mass balance feedback and albedo feedback. This results in limited retreat of the ice sheet once it has reached the continental size, as likely occurred prior to the Miocene. Proxy records suggest a relatively narrow range of atmospheric CO2 during the early to middle Miocene, which exacerbates this problem. We use a new climate forcing which accounts for ice sheet-climate feedbacks through an asynchronous GCM-RCM coupling, which is able to better resolve the narrow Antarctic ablation zone in warm climate simulations. When combined with recently suggested mechanisms for retreat into subglacial basins due to ice shelf hydrofracture and ice cliff failure, we are able to simulate large-scale variability of the Antarctic ice sheet in the Miocene. This variability is equivalent to a seawater oxygen isotope signal of ~0.5 ‰, or a sea level equivalent change of ~35 m, for a range of atmospheric CO2 between 280 - 500 ppm.

Tracking Perfluorocarbon Nanoemulsion Delivery by 19F MRI for Precise High Intensity Focused Ultrasound Tumor Ablation

PubMed Central

Shin, Soo Hyun; Park, Eun-Joo; Min, Changki; Choi, Sun Il; Jeon, Soyeon; Kim, Yun-Hee; Kim, Daehong

2017-01-01

Perfluorocarbon nanoemulsions (PFCNEs) have recently been undergoing rigorous study to investigate their ability to improve the therapeutic efficacy of tumor ablation by high intensity focused ultrasound (HIFU). For precise control of PFCNE delivery and thermal ablation, their accumulation and distribution in a tumor should be quantitatively analyzed. Here, we used fluorine-19 (19F) magnetic resonance imaging (MRI) to quantitatively track PFCNE accumulation in a tumor, and analyzed how intra-tumoral PFCNE quantities affect the therapeutic efficacy of HIFU treatment. Ablation outcomes were assessed by intra-voxel incoherent motion analysis and bioluminescent imaging up to 14 days after the procedure. Assessment of PFCNE delivery and treatment outcomes showed that 2-3 mg/mL of PFCNE in a tumor produces the largest ablation volume under the same HIFU insonation conditions. Histology showed varying degrees of necrosis depending on the amount of PFCNE delivered. 19F MRI promises to be a valuable platform for precisely guiding PFCNE-enhanced HIFU ablation of tumors. PMID:28255351

Radiofrequency Ablation Followed by Percutaneous Ethanol Ablation Leading to Long-Term Remission of Hyperparathyroidism

PubMed Central

Menon, Arun S.; Nazar, P. K.; Moorthy, Srikanth; Kumar, Harish; Nair, Vasantha; Pavithran, Praveen Valiyaparambil; Bhavani, Nisha; Menon, Vadayath Usha; Abraham, Nithya; Jayakumar, R. Vasukutty

2017-01-01

A 30-year-old male with cerebral palsy and motor impairment presented with right femur fracture. He had gradually worsening mobility and contractures of all extremities for the preceding 5 years. Evaluation showed multiple vertebral and femoral fractures, severe osteoporosis, a large parathyroid adenoma, and parathormone (PTH) exceeding 2500 pg/mL. Because of poor general health and high anesthetic risk, parathyroidectomy was deemed impractical. Ultrasound-guided radiofrequency ablation (RFA) helped achieve 50% size reduction and PTH levels with better control of hypercalcemia. Later, as calcium and PTH remained elevated, percutaneous ethanol ablation was performed with resultant normalization of PTH and substantial symptomatic improvement. Two years later, he still remains normocalcaemic with normal PTH levels. We propose that RFA and percutaneous ethanol ablation be considered as effective short-term options for surgically difficult cases, which could even help achieve long-term remission. Although not previously reported, our case illustrates that both RFA and percutaneous ethanol ablation could be safely performed successively achieving long-term remission. PMID:29264521

Evaluation of a Novel Thermal Accelerant for Augmentation of Microwave Energy during Image-guided Tumor Ablation.

PubMed

Park, William Keun Chan; Maxwell, Aaron Wilhelm Palmer; Frank, Victoria Elizabeth; Primmer, Michael Patrick; Collins, Scott Andrew; Baird, Grayson Luderman; Dupuy, Damian Edward

2017-01-01

The primary challenge in thermal ablation of liver tumors (e.g. hepatocellular carcinoma and hepatic colorectal cancer) is the relatively high recurrence rate (~30%) for which incomplete ablation at the periphery of the tumor is the most common reason. In an attempt to overcome this, we have developed a novel thermal accelerant (TA) agent capable of augmenting microwave energy from a distance normally unattainable by a single microwave ablation antenna. This cesium-based block co-polymer compound transforms from a liquid to a gel at body temperature and is intrinsically visible by computed tomography. Using an agarose phantom model, herein we demonstrate that both the rate and magnitude of temperature increase during microwave ablation were significantly greater in the presence of TA when compared with controls. These results suggest robust augmentation of microwave energy, and may translate into larger ablation zone volumes within biologic tissues. Further work using in vivo techniques is necessary to confirm these findings.

Fetal programming: excess prenatal testosterone reduces postnatal luteinizing hormone, but not follicle-stimulating hormone responsiveness, to estradiol negative feedback in the female.

PubMed

Sarma, Hirendra N; Manikkam, Mohan; Herkimer, Carol; Dell'Orco, James; Welch, Kathleen B; Foster, Douglas L; Padmanabhan, Vasantha

2005-10-01

Exposure of female sheep fetuses to excess testosterone (T) during early to midgestation produces postnatal hypergonadotropism manifest as a selective increase in LH. This hypergonadotropism may result from reduced sensitivity to estradiol (E2) negative feedback and/or increased pituitary sensitivity to GnRH. We tested the hypothesis that excess T before birth reduces responsiveness of LH and FSH to E2 negative feedback after birth. Pregnant ewes were treated with T propionate (100 mg/kg in cotton seed oil) or vehicle twice weekly from d 30-90 gestation. Responsiveness to E2 negative feedback was assessed at 12 and 24 wk of age in the ovary-intact female offspring. Our experimental strategy was first to arrest follicular growth and reduce endogenous E2 by administering the GnRH antagonist (GnRH-A), Nal-Glu (50 microg/kg sc every 12 h for 72 h), and then provide a fixed amount of exogenous E2 via an implant. Blood samples were obtained every 20 min at 12 wk and every 10 min at 24 wk before treatment, during and after GnRH-A treatment both before and after E2 implant. GnRH-A ablated LH pulsatility, reduced FSH by approximately 25%, and E2 production diminished to near detection limit of assay at both ages in both groups. Prenatal T treatment produced a precocious and selective reduction in responsiveness of LH but not FSH to E2 negative feedback, which was manifest mainly at the level of LH/GnRH pulse frequency. Collectively, these findings support the hypothesis that prenatal exposure to excess T decreases postnatal responsiveness to E2 inhibitory feedback of LH/GnRH secretion to contribute to the development of hypergonadotropism.

Catheter Ablation of Atrial Fibrillation in Patients with Hardware in the Heart - Septal Closure Devices, Mechanical Valves and More.

PubMed

Bartoletti, Stefano; Santangeli, Pasquale; DI Biase, Luigi; Natale, Andrea

2013-01-01

Patients with mechanical "hardware" in the heart, such as those with mechanical cardiac valves or atrial septal closure devices, represent a population at high risk of developing AF. Catheter ablation of AF in these subjects might represent a challenge, due to the perceived higher risk of complications associated with the presence of intracardiac mechanical devices. Accordingly, such patients were excluded or poorly represented in major trials proving the benefit of catheter ablation for the rhythm-control of AF. However, recent evidence supports the concept that catheter ablation procedures might be equally effective in these patients, without a significant increase in the risk of procedural complications. This review will summarize the current state-of-the-art on catheter ablation of AF in patients with mechanical "hardware" in the heart.

Analysis of internal ablation for the thermal control of aerospace vehicles

NASA Technical Reports Server (NTRS)

Camberos, Jose A.; Roberts, Leonard

1989-01-01

A new method of thermal protection for transatmospheric vehicles is introduced. The method involves the combination of radiation, ablation and transpiration cooling. By placing an ablating material behind a fixed-shape, porous outer shield, the effectiveness of transpiration cooling is made possible while retaining the simplicity of a passive mechanism. A simplified one-dimensional approach is used to derive the governing equations. Reduction of these equations to non-dimensional form yields two parameters which characterize the thermal protection effectiveness of the shield and ablator combination for a given trajectory. The non-dimensional equations are solved numerically for a sample trajectory corresponding to glide re-entry. Four typical ablators are tested and compared with results obtained by using the thermal properties of water. For the present level of analysis, the numerical computations adequately support the analytical model.

Percutaneous Radiofrequency Ablation of Lung Tumors in Contact with the Aorta: Dangerous and Difficult but Efficient: A Report of Two Cases

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

Thanos, Loukas, E-mail: loutharad@yahoo.co; Mylona, Sofia; Giannoulakos, Nikolaos

Percutaneous imaging-guided tumor ablation is a widely accepted method for the treatment of primary and secondary lung tumors. Although it is generally feasible and effective for local tumor control, some conditions may affect its feasibility and effectiveness. Herein the authors report their experience with two patients with lung malignancies contiguous to the aorta who were successfully treated with radiofrequency ablation, even though it initially appeared highly risky due to the possible fatal complications.

Network control principles predict neuron function in the Caenorhabditis elegans connectome

PubMed Central

Chew, Yee Lian; Walker, Denise S.; Schafer, William R.; Barabási, Albert-László

2017-01-01

Recent studies on the controllability of complex systems offer a powerful mathematical framework to systematically explore the structure-function relationship in biological, social and technological networks1–3. Despite theoretical advances, we lack direct experimental proof of the validity of these widely used control principles. Here we fill this gap by applying a control framework to the connectome of the nematode C. elegans4–6, allowing us to predict the involvement of each C. elegans neuron in locomotor behaviours. We predict that control of the muscles or motor neurons requires twelve neuronal classes, which include neuronal groups previously implicated in locomotion by laser ablation7–13, as well as one previously uncharacterised neuron, PDB. We validate this prediction experimentally, finding that the ablation of PDB leads to a significant loss of dorsoventral polarity in large body bends. Importantly, control principles also allow us to investigate the involvement of individual neurons within each neuronal class. For example, we predict that, within the class of DD motor neurons, only three (DD04, DD05, or DD06) should affect locomotion when ablated individually. This prediction is also confirmed, with single-cell ablations of DD04 or DD05, but not DD02 or DD03, specifically affecting posterior body movements. Our predictions are robust to deletions of weak connections, missing connections, and rewired connections in the current connectome, indicating the potential applicability of this analytical framework to larger and less well-characterised connectomes. PMID:29045391

Controllable superhydrophobic aluminum surfaces with tunable adhesion fabricated by femtosecond laser

NASA Astrophysics Data System (ADS)

Song, Yuxin; Wang, Cong; Dong, Xinran; Yin, Kai; Zhang, Fan; Xie, Zheng; Chu, Dongkai; Duan, Ji'an

2018-06-01

In this study, a facile and detailed strategy to fabricate superhydrophobic aluminum surfaces with controllable adhesion by femtosecond laser ablation is presented. The influences of key femtosecond laser processing parameters including the scanning speed, laser power and interval on the wetting properties of the laser-ablated surfaces are investigated. It is demonstrated that the adhesion between water and superhydrophobic surface can be effectively tuned from extremely low adhesion to high adhesion by adjusting laser processing parameters. At the same time, the mechanism is discussed for the changes of the wetting behaviors of the laser-ablated surfaces. These superhydrophobic surfaces with tunable adhesion have many potential applications, such as self-cleaning surface, oil-water separation, anti-icing surface and liquid transportation.

Investigation of the efficacy of ultrafast laser in large bowel excision

NASA Astrophysics Data System (ADS)

Mohanan, Syam Mohan P. C.; Beck, Rainer J.; Góra, Wojciech S.; Perry, Sarah L.; Shires, Mike; Jayne, David; Hand, Duncan P.; Shephard, Jonathan D.

2017-02-01

Local resection of early stage tumors in the large bowel via colonoscopy has been a widely accepted surgical modality for colon neoplasm treatment. The conventional electrocautery techniques used for the resection of neoplasia in the mucosal or submucosal layer of colon tissue has been shown to create obvious thermal necrosis to adjacent healthy tissues and lacks accuracy in resection. Ultrafast picosecond (ps) laser ablation using a wavelength of 1030 or 515 nm is a promising surgical tool to overcome the limitations seen with conventional surgical techniques. The purpose of this initial study is to analyze the depth of ablation or the extent of coagulation deployed by the laser as a function of pulse energy and fluence in an ex-vivo porcine model. Precise control of the depth of tissue removal is of paramount importance for bowel surgery where bowel perforation can lead to morbidity or mortality. Thus we investigate the regimes that are optimal for tissue resection and coagulation through plasma mediated ablation of healthy colon tissue. The ablated tissue samples were analyzed by standard histologic methods and a three dimensional optical profilometer technique. We demonstrate that ultrafast laser resection of colonic tissue can minimize the region of collateral thermal damage (<50 μm) with a controlled ablation depth. This surgical modality allows potentially easier removal of early stage lesions and has the capability to provide more control to the surgeon in comparison with a mechanical or electrocautery device.

Engineering a light-activated caspase-3 for precise ablation of neurons in vivo.

PubMed

Smart, Ashley D; Pache, Roland A; Thomsen, Nathan D; Kortemme, Tanja; Davis, Graeme W; Wells, James A

2017-09-26

The circuitry of the brain is characterized by cell heterogeneity, sprawling cellular anatomy, and astonishingly complex patterns of connectivity. Determining how complex neural circuits control behavior is a major challenge that is often approached using surgical, chemical, or transgenic approaches to ablate neurons. However, all these approaches suffer from a lack of precise spatial and temporal control. This drawback would be overcome if cellular ablation could be controlled with light. Cells are naturally and cleanly ablated through apoptosis due to the terminal activation of caspases. Here, we describe the engineering of a light-activated human caspase-3 (Caspase-LOV) by exploiting its natural spring-loaded activation mechanism through rational insertion of the light-sensitive LOV2 domain that expands upon illumination. We apply the light-activated caspase (Caspase-LOV) to study neurodegeneration in larval and adult Drosophila Using the tissue-specific expression system (UAS)-GAL4, we express Caspase-LOV specifically in three neuronal cell types: retinal, sensory, and motor neurons. Illumination of whole flies or specific tissues containing Caspase-LOV-induced cell death and allowed us to follow the time course and sequence of neurodegenerative events. For example, we find that global synchronous activation of caspase-3 drives degeneration with a different time-course and extent in sensory versus motor neurons. We believe the Caspase-LOV tool we engineered will have many other uses for neurobiologists and others for specific temporal and spatial ablation of cells in complex organisms.

Thermodynamic properties and transport coefficients of a two-temperature polytetrafluoroethylene vapor plasma for ablation-controlled discharge applications

NASA Astrophysics Data System (ADS)

Wang, Haiyan; Wang, Weizong; Yan, Joseph D.; Qi, Haiyang; Geng, Jinyue; Wu, Yaowu

2017-10-01

Ablation-controlled plasmas have been used in a range of technical applications where local thermodynamic equilibrium (LTE) is often violated near the wall due to the strong cooling effect caused by the ablation of wall materials. The thermodynamic and transport properties of ablated polytetrafluoroethylene (PTFE) vapor, which determine the flowing plasma behavior in such applications, are calculated based on a two-temperature model at atmospheric pressure. To our knowledge, no data for PTFE have been reported in the literature. The species composition and thermodynamic properties are numerically determined using the two-temperature Saha equation and the Guldberg-Waage equation according to van de Sanden et al’s derivation. The transport coefficients, including viscosity, thermal conductivity and electrical conductivity, are calculated with the most recent collision interaction potentials using Devoto’s electron and heavy-particle decoupling approach but expanded to the third-order approximation (second-order for viscosity) in the frame of the Chapman-Enskog method. Results are computed for different degrees of thermal non-equilibrium, i.e. the ratio of electron to heavy-particle temperatures, from 1 to 10, with electron temperature ranging from 300 to 40 000 K. Plasma transport properties in the LTE state obtained from the present work are compared with existing published results and the causes for the discrepancy analyzed. The two-temperature plasma properties calculated in the present work enable the modeling of wall ablation-controlled plasma processes.

Engineering a light-activated caspase-3 for precise ablation of neurons in vivo

PubMed Central

Smart, Ashley D.; Pache, Roland A.; Thomsen, Nathan D.; Kortemme, Tanja; Davis, Graeme W.; Wells, James A.

2017-01-01

The circuitry of the brain is characterized by cell heterogeneity, sprawling cellular anatomy, and astonishingly complex patterns of connectivity. Determining how complex neural circuits control behavior is a major challenge that is often approached using surgical, chemical, or transgenic approaches to ablate neurons. However, all these approaches suffer from a lack of precise spatial and temporal control. This drawback would be overcome if cellular ablation could be controlled with light. Cells are naturally and cleanly ablated through apoptosis due to the terminal activation of caspases. Here, we describe the engineering of a light-activated human caspase-3 (Caspase-LOV) by exploiting its natural spring-loaded activation mechanism through rational insertion of the light-sensitive LOV2 domain that expands upon illumination. We apply the light-activated caspase (Caspase-LOV) to study neurodegeneration in larval and adult Drosophila. Using the tissue-specific expression system (UAS)-GAL4, we express Caspase-LOV specifically in three neuronal cell types: retinal, sensory, and motor neurons. Illumination of whole flies or specific tissues containing Caspase-LOV–induced cell death and allowed us to follow the time course and sequence of neurodegenerative events. For example, we find that global synchronous activation of caspase-3 drives degeneration with a different time-course and extent in sensory versus motor neurons. We believe the Caspase-LOV tool we engineered will have many other uses for neurobiologists and others for specific temporal and spatial ablation of cells in complex organisms. PMID:28893998

Significant skin-tightening by closure of fractional ablative laser holes.

PubMed

Russe, Elisabeth; Purschke, Martin; Limpiangkanan, Wikunda; Farinelli, William A; Wang, Ying; Doukas, Apostolos G; Sakamoto, Fernanda H; Wechselberger, Gottfried; Anderson, Richard Rox

2018-01-01

Ablative fractional laser treatment uses thousands of very small laser beam wounds to damage a fraction of the skin, which stimulates tissue remodeling. Each open micro-wound heals without scarring, but the amount of skin tightening achieved is limited. This animal study was performed to test the hypothesis that immediate temporary closure of fractional laser wounds could increase skin tightening after fractional ablative laser treatment. Four adult swine were used for the study; 98 square test sites (3 × 3 cm) were tattooed on the abdomen and flanks of each pig. An ablative fractional Erbium:YAG laser (Sciton Profile, Sciton Inc, Palo Alto, CA) was used to treat the test areas. A laser micro-spot fluence of 375 J/cm 2 was delivered in 150-250 microseconds pulses, resulting in an array of ablation channels extending 1.5 mm deep into the skin, with a spot size of 250 µm, with 10% treatment density. Immediately following laser exposure the resulting holes were closed using a stretched elastic adhesive dressing, which, when applied, recoiled and compressed the diameter of the ablation holes. The compressive dressings were removed after 7 days. This procedure was compared to removing the same amount of skin (10%) mechanically by specially designed 19 gauge coring needles, as well as to the same laser and coring methods without compression closure. Area and shape of test sites were measured by digital photography before and 28 days after treatment. Data analysis included compensation for animal growth, as measured by increase in the area of the untreated control sites. All treated and control sites healed within a week, without scarring evident at 28 days. Laser treatment combined with compressive wound closure caused significant shrinkage at 28 days compared with untreated control sites. The treated skin area was reduced by 11.5% (P = 0.0001). Needle coring with wound closure produced similar, significant shrinkage (8%, P < 0.0021), whereas laser and needle coring treatment without closure did not result in significant area reduction (P = 0.1289) compared with untreated control sites. Significant skin tightening can be achieved by immediate temporary non-invasive wound closure after short pulse Er:YAG fractional ablative laser treatment, as well as after mechanically removing skin with a coring needle. This approach may improve skin tightening after ablative laser treatments. Further clinical studies are necessary to confirm successful application in humans. Lasers Surg. Med. 50:64-69, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Measurement and Control of Electroosmotic Flow in Plastic Microchannels

NASA Astrophysics Data System (ADS)

Ross, David; Barker, Susan; Waddell, Emanuel; Johnson, Tim; Locascio, Laurie

2000-11-01

We have measured electroosmotic flow profiles in microchannels fabricated in a variety of commercially available plastics by imprinting using a silicon template and by UV laser ablation. It is possible to achieve nearly ideal plug flow profiles in straight imprinted channels made entirely of one material. In contrast, electroosmotic flow in imprinted channels constructed from two different materials and in channels fabricated using laser ablation show deviations from ideal plug flow resulting from non-uniformity of the surface charge density on the walls of the channels. We have also explored strategies for controlling electroosmotic flow through modification of the surface charge density. The techniques used to alter surface charge include the deposition of polyelectrolyte multilayers on channel surfaces and the use of combinations of imprinting and laser ablation in the fabrication of the channels. We will discuss the effectiveness of these strategies for controlling flow, sample dispersion, and mixing.

Impaired Feedforward Control and Enhanced Feedback Control of Speech in Patients with Cerebellar Degeneration.

PubMed

Parrell, Benjamin; Agnew, Zarinah; Nagarajan, Srikantan; Houde, John; Ivry, Richard B

2017-09-20

The cerebellum has been hypothesized to form a crucial part of the speech motor control network. Evidence for this comes from patients with cerebellar damage, who exhibit a variety of speech deficits, as well as imaging studies showing cerebellar activation during speech production in healthy individuals. To date, the precise role of the cerebellum in speech motor control remains unclear, as it has been implicated in both anticipatory (feedforward) and reactive (feedback) control. Here, we assess both anticipatory and reactive aspects of speech motor control, comparing the performance of patients with cerebellar degeneration and matched controls. Experiment 1 tested feedforward control by examining speech adaptation across trials in response to a consistent perturbation of auditory feedback. Experiment 2 tested feedback control, examining online corrections in response to inconsistent perturbations of auditory feedback. Both male and female patients and controls were tested. The patients were impaired in adapting their feedforward control system relative to controls, exhibiting an attenuated anticipatory response to the perturbation. In contrast, the patients produced even larger compensatory responses than controls, suggesting an increased reliance on sensory feedback to guide speech articulation in this population. Together, these results suggest that the cerebellum is crucial for maintaining accurate feedforward control of speech, but relatively uninvolved in feedback control. SIGNIFICANCE STATEMENT Speech motor control is a complex activity that is thought to rely on both predictive, feedforward control as well as reactive, feedback control. While the cerebellum has been shown to be part of the speech motor control network, its functional contribution to feedback and feedforward control remains controversial. Here, we use real-time auditory perturbations of speech to show that patients with cerebellar degeneration are impaired in adapting feedforward control of speech but retain the ability to make online feedback corrections; indeed, the patients show an increased sensitivity to feedback. These results indicate that the cerebellum forms a crucial part of the feedforward control system for speech but is not essential for online, feedback control. Copyright © 2017 the authors 0270-6474/17/379249-10$15.00/0.

Benefits of Moderate-Z Ablators for Direct-Drive Inertial Confinement Fusion

NASA Astrophysics Data System (ADS)

Lafon, M.; Betti, R.; Anderson, K. S.; Collins, T. J. B.; Skupsky, S.; McKenty, P. W.

2014-10-01

Control of hydrodynamic instabilities and DT-fuel preheating by hot electrons produced by laser-plasma interaction is crucial in inertial confinement fusion. Moderate- Z ablators have been shown to reduce the laser imprinting on target and suppress the generation of hot electrons from the two-plasmon-decay instability. These results have motivated the use of ablators of higher- Z than pure plastic in direct-drive-ignition target designs for the National Ignition Facility (NIF). Two-dimensional radiation-hydrodynamic simulations assess the robustness of these ignition designs to laser imprint and capsule nonuniformities. The complex behavior of the hydrodynamic stability of mid- Z ablators is investigated through single and multimode simulations. A polar-drive configuration is developed within the NIF Laser System specifications for each ablator material. The use of multilayer ablators is also investigated to enhance the hydrodynamic stability. Results indicate that ignition target designs using mid- Z ablators exhibit good hydrodynamic properties, leading to high target gain for direct-drive implosions on the NIF. This material is based upon work supported by the Department of Energy National Nuclear Security Administration under Award Number DE-NA0001944 and the Office of Fusion Energy Sciences Number DE-FG02-04ER54786.

Interstitial ablation and imaging of soft tissue using miniaturized ultrasound arrays

NASA Astrophysics Data System (ADS)

Makin, Inder R. S.; Gallagher, Laura A.; Mast, T. Douglas; Runk, Megan M.; Faidi, Waseem; Barthe, Peter G.; Slayton, Michael H.

2004-05-01

A potential alternative to extracorporeal, noninvasive HIFU therapy is minimally invasive, interstitial ultrasound ablation that can be performed laparoscopically or percutaneously. Research in this area at Guided Therapy Systems and Ethicon Endo-Surgery has included development of miniaturized (~3 mm diameter) linear ultrasound arrays capable of high power for bulk tissue ablation as well as broad bandwidth for imaging. An integrated control system allows therapy planning and automated treatment guided by real-time interstitial B-scan imaging. Image quality, challenging because of limited probe dimensions and channel count, is aided by signal processing techniques that improve image definition and contrast. Simulations of ultrasonic heat deposition, bio-heat transfer, and tissue modification provide understanding and guidance for development of treatment strategies. Results from in vitro and in vivo ablation experiments, together with corresponding simulations, will be described. Using methods of rotational scanning, this approach is shown to be capable of clinically relevant ablation rates and volumes.

Non-Intrusive Sensor for In-Situ Measurement of Recession Rate of Ablative and Eroding Materials

NASA Technical Reports Server (NTRS)

Papadopoulos, George (Inventor); Tiliakos, Nicholas (Inventor); Thomson, Clint (Inventor); Benel, Gabriel (Inventor)

2014-01-01

A non-intrusive sensor for in-situ measurement of recession rate of heat shield ablatives. An ultrasonic wave source is carried in the housing. A microphone is also carried in the housing, for collecting the reflected ultrasonic waves from an interface surface of the ablative material. A time phasing control circuit is also included for time-phasing the ultrasonic wave source so that the waves reflected from the interface surface of the ablative material focus on the microphone, to maximize the acoustic pressure detected by the microphone and to mitigate acoustic velocity variation effects through the material through a de-coupling process that involves a software algorithm. A software circuit for computing the location off of which the ultrasonic waves scattered to focus back at the microphone is also included, so that the recession rate of the heat shield ablative may be monitored in real-time through the scan-focus approach.

Optimization of gas-filled quartz capillary discharge waveguide for high-energy laser wakefield acceleration

NASA Astrophysics Data System (ADS)

Qin, Zhiyong; Li, Wentao; Liu, Jiansheng; Liu, Jiaqi; Yu, Changhai; Wang, Wentao; Qi, Rong; Zhang, Zhijun; Fang, Ming; Feng, Ke; Wu, Ying; Ke, Lintong; Chen, Yu; Wang, Cheng; Li, Ruxin; Xu, Zhizhan

2018-04-01

A hydrogen-filled capillary discharge waveguide made of quartz is presented for high-energy laser wakefield acceleration (LWFA). The experimental parameters (discharge current and gas pressure) were optimized to mitigate ablation by a quantitative analysis of the ablation plasma density inside the hydrogen-filled quartz capillary. The ablation plasma density was obtained by combining a spectroscopic measurement method with a calibrated gas transducer. In order to obtain a controllable plasma density and mitigate the ablation as much as possible, the range of suitable parameters was investigated. The experimental results demonstrated that the ablation in the quartz capillary could be mitigated by increasing the gas pressure to ˜7.5-14.7 Torr and decreasing the discharge current to ˜70-100 A. These optimized parameters are promising for future high-energy LWFA experiments based on the quartz capillary discharge waveguide.

Effects of oxytocin on high intensity focused ultrasound (HIFU) ablation of adenomysis: a prospective study.

PubMed

Zhang, Xin; Zou, Min; Zhang, Cai; He, Jia; Mao, Shihua; Wu, Qingrong; He, Min; Wang, Jian; Zhang, Ruitao; Zhang, Lian

2014-09-01

To investigate the effects of oxytocin on high-intensity focused ultrasound (HIFU) ablation for the treatment of adenomyosis. Eighty-six patients with adenomyosis from three hospitals were randomly assigned to the oxytocin group or control group for HIFU treatment. During HIFU treatment, 80 units of oxytocin was added in 500ml of 0.9% normal saline running at the rate of 2ml/min (0.32U/min) in the oxytocin group, while 0.9% normal saline was used in the control group. Both patients and HIFU operators were blinded to oxytocin or saline application. Treatment results, adverse effects were compared. When using oxytocin, the non-perfused volume (NPV) ratio was 80.7±11.6%, the energy-efficiency factor (EEF) was 8.1±9.9J/mm(3), and the sonication time required to ablate 1cm(3) was 30.0±36.0s/cm(3). When not using oxytocin, the non-perfused volume ratio was 70.8±16.7%, the EEF was 15.8±19.6J/mm(3), and the sonication time required to ablate 1cm(3) was 58.2±72.7S/cm(3). Significant difference in the NPV ratio, EEF, and the sonication time required to ablate 1cm(3) between the two groups was observed. No oxytocin related adverse effects occurred. Oxytocin could significantly decrease the energy for ablating adenomyosis with HIFU, safely enhance the treatment efficiency. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The impact of frequency on the performance of microwave ablation.

PubMed

Sawicki, James F; Shea, Jacob D; Behdad, Nader; Hagness, Susan C

2017-02-01

The use of higher frequencies in percutaneous microwave ablation (MWA) may offer compelling interstitial antenna design advantages over the 915 MHz and 2.45 GHz frequencies typically employed in current systems. To evaluate the impact of higher frequencies on ablation performance, we conducted a comprehensive computational and experimental study of microwave absorption and tissue heating as a function of frequency. We performed electromagnetic and thermal simulations of MWA in ex vivo and in vivo porcine muscle at discrete frequencies in the 1.9-26 GHz range. Ex vivo ablation experiments were performed in the 1.9-18 GHz range. We tracked the size of the ablation zone across frequency for constant input power and ablation duration. Further, we conducted simulations to investigate antenna feed line heating as a function of frequency, input power, and cable diameter. As the frequency was increased from 1.9 to 26 GHz the resulting ablation zone dimensions decreased in the longitudinal direction while remaining relatively constant in the radial direction; thus at higher frequencies the overall ablation zone was more spherical. However, cable heating at higher frequencies became more problematic for smaller diameter cables at constant input power. Comparably sized ablation zones are achievable well above 1.9 GHz, despite increasingly localised power absorption. Specific absorption rate alone does not accurately predict ablation performance, particularly at higher frequencies where thermal diffusion plays an important role. Cable heating due to ohmic losses at higher frequencies may be controlled through judicious choices of input power and cable diameter.

Histopomorphic Evaluation of Radiofrequency Mediated Débridement Chondroplasty

PubMed Central

Ganguly, Kumkum; McRury, Ian D; Goodwin, Peter M; Morgan, Roy E; Augé II, Wayne K

2010-01-01

The use of radiofrequency devices has become widespread for surgical ablation procedures. When ablation devices have been deployed in treatment settings requiring tissue preservation like débridement chondroplasty, adoption has been limited due to the collateral damage caused by these devices in healthy tissue surrounding the treatment site. Ex vivo radiofrequency mediated débridement chondroplasty was performed on osteochondral specimens demonstrating surface fibrillation obtained from patients undergoing knee total joint replacement. Three radiofrequency systems designed to perform débridement chondroplasty were tested each demonstrating different energy delivery methods: monopolar ablation, bipolar ablation, and non-ablation energy. Treatment outcomes were compared with control specimens as to clinical endpoint and histopomorphic characteristics. Fibrillated cartilage was removed in all specimens; however, the residual tissue remaining at the treatment site displayed significantly different characteristics attributable to radiofrequency energy delivery method. Systems that delivered ablation-based energies caused tissue necrosis and collateral damage at the treatment site including corruption of cartilage Superficial and Transitional Zones; whereas, the non-ablation system created a smooth articular surface with Superficial Zone maintenance and without chondrocyte death or tissue necrosis. The mechanism of radiofrequency energy deposition upon tissues is particularly important in treatment settings requiring tissue preservation. Ablation-based device systems can cause a worsened state of articular cartilage from that of pre-treatment. Non-ablation energy can be successful in modifying/preconditioning tissue during débridement chondroplasty without causing collateral damage. Utilizing a non-ablation radiofrequency system provides the ability to perform successful débridement chondroplasty without causing additional articular cartilage tissue damage and may allow for other cartilage intervention success. PMID:20721322

Static measurement of the thickness of the ablative coating of the solid rocket boosters

NASA Technical Reports Server (NTRS)

Harrison, Harry C.

1996-01-01

The Solid Rocket Boosters (SRB's) used to launch the Space Shuttle are coated with a layer of ablative material to prevent thermal damage when they reenter the earth's atmosphere. The coating consists of a mixture of cork, glass, and resin. A new coating (Marshall Convergent Coating, MCC-2) was recently developed that is environmentally complaint. The coating must meet certain minimum thickness standards in order to protect the SRB. The coating is applied by a robot controlled nozzle that moves from the bottom to top, as the rocket part rotates on a table. Several coats are applied, building up to the desired thickness. Inspectors do a limited amount of destructive 'wet' testing. This involves an inspector inserting a rod in the wet coating and removing the rod. This results in a hole that, of course, must be patched later. The material is cured and the thickness is measured. There is no real-time feedback as the coating is being applied. Although this might seem like the best way to control thickness, the problems with 'blowback' (reflected material covering the sensor) are formidable, and have not been solved. After the thermal coating is applied, a protective top coat is applied. The SRB part is then placed in a oven and baked to harden the surface. The operations personnel then measure the thickness of the layer using the Kaman 7200 Displacement Measuring System. The probe is placed on the surface. One person (the inspector) reads the instrument, while another(the technician) records the thickness. Measurements are taken at one foot intervals. After the measurements are taken, the number of low readings is tabulated. If more than 10 percent of the points fall below the minimum value, there is a design review, and the part may be stripped of coating, and a new coating is applied. There is no other analysis.

Results of the NeuroBlate System first-in-humans Phase I clinical trial for recurrent glioblastoma: clinical article.

PubMed

Sloan, Andrew E; Ahluwalia, Manmeet S; Valerio-Pascua, Jose; Manjila, Sunil; Torchia, Mark G; Jones, Stephen E; Sunshine, Jeffrey L; Phillips, Michael; Griswold, Mark A; Clampitt, Mark; Brewer, Cathy; Jochum, Jennifer; McGraw, Mary V; Diorio, Dawn; Ditz, Gail; Barnett, Gene H

2013-06-01

Laser interstitial thermal therapy has been used as an ablative treatment for glioma; however, its development was limited due to technical issues. The NeuroBlate System incorporates several technological advances to overcome these drawbacks. The authors report a Phase I, thermal dose-escalation trial assessing the safety and efficacy of NeuroBlate in recurrent glioblastoma multiforme (rGBM). Adults with suspected supratentorial rGBM of 15- to 40-mm dimension and a Karnofsky Performance Status score of ≥ 60 were eligible. After confirmatory biopsy, treatment was delivered using a rigid, gas-cooled, side-firing laser probe. Treatment was monitored using real-time MRI thermometry, and proprietary software providing predictive thermal damage feedback was used by the surgeon, along with control of probe rotation and depth, to tailor tissue coagulation. An external data safety monitoring board determined if toxicity at lower levels justified dose escalation. Ten patients were treated at the Case Comprehensive Cancer Center (Cleveland Clinic and University Hospitals-Case Medical Center). Their average age was 55 years (range 34-69 years) and the median preoperative Karnofsky Performance Status score was 80 (range 70-90). The mean tumor volume was 6.8 ± 5 cm(3) (range 2.6-19 cm(3)), the percentage of tumor treated was 78% ± 12% (range 57%-90%), and the conformality index was 1.21 ± 0.33 (range 1.00-2.04). Treatment-related necrosis was evident on MRI studies at 24 and 48 hours. The median survival was 316 days (range 62-767 days). Three patients improved neurologically, 6 remained stable, and 1 worsened. Steroid-responsive treatment-related edema occurred in all patients but one. Three had Grade 3 adverse events at the highest dose. NeuroBlate represents new technology for delivering laser interstitial thermal therapy, allowing controlled thermal ablation of deep hemispheric rGBM. CLINICAL TRIAL REGISTRATION NO.: NCT00747253 ( ClinicalTrials.gov ).

Left Atrial Appendage Electrical Isolation and Concomitant Device Occlusion to Treat Persistent Atrial Fibrillation: A First-in-Human Safety, Feasibility, and Efficacy Study.

PubMed

Panikker, Sandeep; Jarman, Julian W E; Virmani, Renu; Kutys, Robert; Haldar, Shouvik; Lim, Eric; Butcher, Charles; Khan, Habib; Mantziari, Lilian; Nicol, Edward; Foran, John P; Markides, Vias; Wong, Tom

2016-07-01

Left atrial appendage (LAA) electric isolation is reported to improve persistent atrial fibrillation (AF) ablation outcomes. However, loss of LAA mechanical function may increase thromboembolic risk. Concomitant LAA electric isolation and occlusion as part of conventional AF ablation has never been tested in humans. We therefore evaluated the feasibility, safety, and efficacy of LAA electric isolation and occlusion in patients undergoing long-standing persistent AF ablation. Patients with long-standing persistent AF (age, 68±7 years; left atrium diameter, 46±3 mm; and AF duration, 25±15 months) underwent AF ablation, LAA electric isolation, and occlusion. Outcomes were compared with a balanced (1:2 ratio) control group who had AF ablation alone. Among 22 patients who underwent ablation, LAA electric isolation was possible in 20. Intraprocedural LAA reconnection occurred in 17 of 20 (85%) patients, predominantly at anterior and superior locations. All were reisolated. LAA occlusion was successful in all 20 patients. There were no major periprocedural complications. Imaging at 45 days and 9 months confirmed satisfactory device position and excluded pericardial effusion. One of twenty (5%) patients had a gap of ≥5 mm requiring anticoagulation. Nineteen of twenty (95%) patients stopped warfarin at 3 months. Without antiarrhythmic drugs, freedom from AF at 12 months after a single procedure was significantly higher in the study group (19/20, 95%) than in the control group (25/40, 63%), P=0.036. Freedom from atrial arrhythmias was demonstrated in 12 of 20 (60%) and 18 of 20 (90%) patients after 1 and ≤2 procedures (mean, 1.3), respectively. Persistent AF ablation, LAA electric isolation, and mechanical occlusion can be performed concomitantly. This technique may improve the success of persistent AF ablation while obviating the need for chronic anticoagulation. URL: https://clinicaltrials.gov. Unique identifier: NCT02028130. © 2016 American Heart Association, Inc.

Venous hemostasis postcatheter ablation of atrial fibrillation while under therapeutic levels of oral and intravenous anticoagulation.

PubMed

Issa, Ziad F; Amr, Bashar S

2015-11-01

Catheter ablation of atrial fibrillation (AF) requires utilizing multiple venous femoral sheaths in conjunction with aggressive periprocedural anticoagulation, which can lead to increased risk of vascular access complications. The objective of this study is to evaluate the safety and efficacy of the "figure-of-eight" ("F-8") suture technique for femoral venous hemostasis while on therapeutic doses of intravenous anticoagulation at the time of sheath removal. In this case-control analysis, 376 consecutive patients underwent AF ablation while on uninterrupted oral anticoagulation and received intraprocedural heparin. In the first 253 patients (the control group), manual pressure was used for femoral venous hemostasis after reversal of heparin effects. The subsequent 123 patients (the F-8 group) had femoral venous hemostasis using the F-8 suture technique and while under therapeutic heparin effects. The F-8 subcutaneous suture technique achieved adequate venous hemostasis in 98.4% of patients. As compared to the control group, there was significantly less frequent utilization of the FemoStop compression assist device (1.2 vs. 16.8%, p < 0.0001) and in a significantly shorter interval (6.8 ± 5.7 vs. 50.7 ± 12.2 min, p < 0.0001). Vascular access complications and thromboembolic events occurred in 9.8% in the F-8 group vs. 13.0% in the control group (p = 0.678). Immediate hemostasis of the femoral venous access sites after insertion of multiple sheaths for AF ablation in the presence of anticoagulation can be safely and effectively achieved using the F-8 suture technique. This technique helps minimize the period of inadequate anticoagulation immediately following ablation and shortens the time required to achieve adequate hemostasis.

Wall ablation of heated compound-materials into non-equilibrium discharge plasmas

NASA Astrophysics Data System (ADS)

Wang, Weizong; Kong, Linghan; Geng, Jinyue; Wei, Fuzhi; Xia, Guangqing

2017-02-01

The discharge properties of the plasma bulk flow near the surface of heated compound-materials strongly affects the kinetic layer parameters modeled and manifested in the Knudsen layer. This paper extends the widely used two-layer kinetic ablation model to the ablation controlled non-equilibrium discharge due to the fact that the local thermodynamic equilibrium (LTE) approximation is often violated as a result of the interaction between the plasma and solid walls. Modifications to the governing set of equations, to account for this effect, are derived and presented by assuming that the temperature of the electrons deviates from that of the heavy particles. The ablation characteristics of one typical material, polytetrafluoroethylene (PTFE) are calculated with this improved model. The internal degrees of freedom as well as the average particle mass and specific heat ratio of the polyatomic vapor, which strongly depends on the temperature, pressure and plasma non-equilibrium degree and plays a crucial role in the accurate determination of the ablation behavior by this model, are also taken into account. Our assessment showed the significance of including such modifications related to the non-equilibrium effect in the study of vaporization of heated compound materials in ablation controlled arcs. Additionally, a two-temperature magneto-hydrodynamic (MHD) model accounting for the thermal non-equilibrium occurring near the wall surface is developed and applied into an ablation-dominated discharge for an electro-thermal chemical launch device. Special attention is paid to the interaction between the non-equilibrium plasma and the solid propellant surface. Both the mass exchange process caused by the wall ablation and plasma species deposition as well as the associated momentum and energy exchange processes are taken into account. A detailed comparison of the results of the non-equilibrium model with those of an equilibrium model is presented. The non-equilibrium results show a non-equilibrium region near the plasma-wall interaction region and this indicates the need for the consideration of the influence of the possible departure from LTE in the plasma bulk on the determination of ablation rate.

Remote magnetic navigation for catheter ablation of atrioventricular nodal reentrant tachycardia: a systematic review and meta-analysis.

PubMed

Shurrab, Mohammed; Danon, Asaf; Crystal, Alexander; Arouny, Banafsheh; Tiong, Irving; Lashevsky, Ilan; Newman, David; Crystal, Eugene

2013-07-01

Catheter ablation has become a well-established, first-line therapy for atrioventricular nodal reentrant tachycardia (AVNRT), the most common reentry supraventricular tachycardia in humans. Robotic systems are becoming increasingly common in both complex and simple ablation procedures with presumed potential improvements in procedural efficacy and safety. The authors of this article conducted a systematic review and meta-analysis on the effectiveness and safety of the magnetic navigation system (MNS) in comparison with conventional catheter navigation for AVNRT ablation. An electronic search was performed using Cochrane Central database, Medline, Embase and Web of Knowledge between 2002 and 2012. References were searched manually. Outcomes of interest were: acute and long-term success, complications, total procedure, ablation and fluoroscopic times. Continuous variables were reported as standardized difference in means (SDM); odds ratios (OR) were reported for dichotomous variables. Thirteen studies (seven of which were nonrandomized controlled, four were case series and two were randomized controlled studies) involving 679 adult patients were identified. Twelve studies were based on a single center and one study was multicentral. MNS was deployed in 339 patients. The follow-up period ranged between 75 and 180 days. Acute success and long-term freedom from arrhythmia were not significantly different between MNS and control groups (98 vs 98%, OR: 0.94 [95% CI: 0.21-4.1] and 97 vs 96%, OR: 1.18 [95% CI: 0.35-4.0], respectively). A shorter fluoroscopic time was achieved with MNS; however, this did not reach statistical significance (15 vs 19 min, SDM: -0.26 [95% CI: -0.64-0.12]). Longer total procedure but similar ablation times were noted with MNS (160 vs 148 min, SDM: 3.48 [95% CI: 0.75-6.21] and 4 vs 6 min, SDM: -0.83 [95% CI: -2.19-0.53], respectively). The overall complication rate was similar between both groups (2.7 vs 1.0%, OR: 1.28 [95% CI: 0.33-4.96]). Our data suggest that the usage of MNS results in similar rates of success and complications when compared with conventional manual catheter ablation for AVNRT. MNS had a trend for reduced fluoroscopic time. Longer total procedure time was observed with MNS while the actual ablation time remained similar. Prospective randomized trials will be needed to better evaluate the relative role of MNS for catheter ablation of AVNRT.

Self-controlled video feedback on tactical skills for soccer teams results in more active involvement of players.

PubMed

van Maarseveen, Mariëtte J J; Oudejans, Raôul R D; Savelsbergh, Geert J P

2018-02-01

Many studies have shown that self-controlled feedback is beneficial for learning motor tasks, and that learners prefer to receive feedback after supposedly good trials. However, to date all studies conducted on self-controlled learning have used individual tasks and mainly relatively simple skills. Therefore, the aim of this study was to examine self-controlled feedback on tactical skills in small-sided soccer games. Highly talented youth soccer players were assigned to a self-control or yoked group and received video feedback on their offensive performance in 3 vs. 2 small-sided games. The results showed that the self-control group requested feedback mostly after good trials, that is, after they scored a goal. In addition, the perceived performance of the self-control group was higher on feedback than on no-feedback trials. Analyses of the conversations around the video feedback revealed that the players and coach discussed good and poor elements of performance and how to improve it. Although the coach had a major role in these conversations, the players of the self-control group spoke more and showed more initiative compared to the yoked group. The results revealed no significant beneficial effect of self-controlled feedback on performance as judged by the coach. Overall, the findings suggest that in such a complex situation as small-sided soccer games, self-controlled feedback is used both to confirm correct performance elements and to determine and correct errors, and that self-controlled learning stimulates the involvement of the learner in the learning process. Copyright © 2017 Elsevier B.V. All rights reserved.

Rationale and design of the NO-PARTY trial: near-zero fluoroscopic exposure during catheter ablation of supraventricular arrhythmias in young patients.

PubMed

Casella, Michela; Dello Russo, Antonio; Pelargonio, Gemma; Bongiorni, Maria Grazia; Del Greco, Maurizio; Piacenti, Marcello; Andreassi, Maria Grazia; Santangeli, Pasquale; Bartoletti, Stefano; Moltrasio, Massimo; Fassini, Gaetano; Marini, Massimiliano; Di Cori, Andrea; Di Biase, Luigi; Fiorentini, Cesare; Zecchi, Paolo; Natale, Andrea; Picano, Eugenio; Tondo, Claudio

2012-10-01

Radiofrequency catheter ablation is the mainstay of therapy for supraventricular tachyarrhythmias. Conventional radiofrequency catheter ablation requires the use of fluoroscopy, thus exposing patients to ionising radiation. The feasibility and safety of non-fluoroscopic radiofrequency catheter ablation has been recently reported in a wide range of supraventricular tachyarrhythmias using the EnSite NavX™ mapping system. The NO-PARTY is a multi-centre, randomised controlled trial designed to test the hypothesis that catheter ablation of supraventricular tachyarrhythmias guided by the EnSite NavX™ mapping system results in a clinically significant reduction in exposure to ionising radiation compared with conventional catheter ablation. The study will randomise 210 patients undergoing catheter ablation of supraventricular tachyarrhythmias to either a conventional ablation technique or one guided by the EnSite NavX™ mapping system. The primary end-point is the reduction of the radiation dose to the patient. Secondary end-points include procedural success, reduction of the radiation dose to the operator, and a cost-effectiveness analysis. In a subgroup of patients, we will also evaluate the radiobiological effectiveness of dose reduction by assessing acute chromosomal DNA damage in peripheral blood lymphocytes. NO-PARTY will determine whether radiofrequency catheter ablation of supraventricular tachyarrhythmias guided by the EnSite NavX™ mapping system is a suitable and cost-effective approach to achieve a clinically significant reduction in ionising radiation exposure for both patient and operator.

Meta-analysis of bipolar radiofrequency endometrial ablation versus thermal balloon endometrial ablation for the treatment of heavy menstrual bleeding.

PubMed

Zhai, Yan; Zhang, Zihan; Wang, Wei; Zheng, Tingping; Zhang, Huili

2018-01-01

Heavy menstrual bleeding is a common problem that can severely affect quality of life. To compare bipolar radiofrequency endometrial ablation and thermal balloon ablation for heavy menstrual bleeding in terms of efficacy and health-related quality of life (HRQoL). Online registries were systematically searched using relevant terms without language restriction from inception to November 24, 2016. Randomized control trials or cohort studies of women with heavy menstrual bleeding comparing the efficacy of two treatments were eligible. Data were extracted. Results were expressed as risk ratios (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs). Six studies involving 901 patients were included. Amenorrhea rate at 12 months was significantly higher after bipolar radiofrequency endometrial ablation than after thermal balloon ablation (RR 2.73, 95% CI 2.00-3.73). However, no difference at 12 months was noted for dysmenorrhea (RR 1.04, 95% CI 0.68-1.58) or treatment failure (RR 0.78, 95% CI 0.38-1.60). The only significant difference for HRQoL outcomes was for change in SAQ pleasure score (12 months: WMD -3.51, 95% CI -5.42 to -1.60). Bipolar radiofrequency endometrial ablation and thermal balloon ablation reduce menstrual loss and improve quality of life. However, bipolar radiofrequency endometrial ablation is more effective in terms of amenorrhea rate and SAQ pleasure. © 2017 International Federation of Gynecology and Obstetrics.

Accessory atrioventricular pathways refractory to catheter ablation: role of percutaneous epicardial approach.

PubMed

Scanavacca, Maurício Ibrahim; Sternick, Eduardo Back; Pisani, Cristiano; Lara, Sissy; Hardy, Carina; d'Ávila, André; Correa, Frederico Soares; Darrieux, Francisco; Hachul, Denise; Marcial, Miguel Barbero; Sosa, Eduardo A

2015-02-01

Epicardial mapping and ablation of accessory pathways through a subxiphoid approach can be an alternative when endocardial or epicardial transvenous mapping has failed. We reviewed acute and long-term follow-up of 21 patients (14 males) referred for percutaneous epicardial accessory pathway ablation. There was a median of 2 previous failed procedures. All patients were highly symptomatic, 8 had atrial fibrillation (3 with cardiac arrest) and 13 had frequent symptomatic episodes of atrioventricular reentrant tachycardia. Six patients (28.5%) had a successful epicardial ablation. Five patients (23.8%) underwent a successful repeated endocardial mapping, and ablation after epicardial mapping yielded no early activation site. Epicardial mapping was helpful in guiding endocardial ablation in 2 patients (9.5%), showing that the earliest activation was simultaneous at the epicardium and endocardium. Four patients (19%) underwent successful open-chest surgery after failing epicardial/endocardial ablation. Two patients (9.5%) remained controlled under antiarrhythmic drugs after unsuccessful endocardial/epicardial ablation. Two patients had a coronary sinus diverticulum and one a right atrium to right ventricle diverticulum. Three patients acquired postablation coronary sinus stenosis. There was no major complication related to pericardial access. Percutaneous epicardial approach is an alternative when conventional endocardial or transvenous epicardial ablation fails in the elimination of the accessory pathway. A new attempt by endocardial approach was successful in a significant number of patients. Open-chest surgery may be required in symptomatic cases refractory to endocardial-epicardial approach. © 2014 American Heart Association, Inc.

Evaluation of Finite-Rate Gas/Surface Interaction Models for a Carbon Based Ablator

NASA Technical Reports Server (NTRS)

Chen, Yih-Kanq; Goekcen, Tahir

2015-01-01

Two sets of finite-rate gas-surface interaction model between air and the carbon surface are studied. The first set is an engineering model with one-way chemical reactions, and the second set is a more detailed model with two-way chemical reactions. These two proposed models intend to cover the carbon surface ablation conditions including the low temperature rate-controlled oxidation, the mid-temperature diffusion-controlled oxidation, and the high temperature sublimation. The prediction of carbon surface recession is achieved by coupling a material thermal response code and a Navier-Stokes flow code. The material thermal response code used in this study is the Two-dimensional Implicit Thermal-response and Ablation Program, which predicts charring material thermal response and shape change on hypersonic space vehicles. The flow code solves the reacting full Navier-Stokes equations using Data Parallel Line Relaxation method. Recession analyses of stagnation tests conducted in NASA Ames Research Center arc-jet facilities with heat fluxes ranging from 45 to 1100 wcm2 are performed and compared with data for model validation. The ablating material used in these arc-jet tests is Phenolic Impregnated Carbon Ablator. Additionally, computational predictions of surface recession and shape change are in good agreement with measurement for arc-jet conditions of Small Probe Reentry Investigation for Thermal Protection System Engineering.

[Voice acoustic study of plasma radiofrequency ablation for the treatment of laryngeal premalignant lesions].

PubMed

Zang, Y Z; Wan, B L; Jia, X D; Wang, G K

2016-11-01

Objective: To study the voice function effect of low temperature plasma radiofrequency ablation in the treatment of patients with laryngeal premalignant lesions. Method: Fifty cases of laryngeal premalignant lesions were treated with low temperature plasma radiofrequency ablation. All of the patients were examined by electronic laryngoscopy and acoustic analysis(F0，Jitter，Shimmer，NNE，HNR) in 2 weeks,1 month,3 months after surgery. Voice acoustic results were compared with a control group of 50 normal adults for the further analysis. Result: Fifty patients with laryngeal premalignant lesions were treated by low temperature plasma radiofrequency ablation.The result showed that 47 patients(94%)were successfully decannulated without serious complications, such as dyspnea, aphonia and anterior glottic stenosis. Acoustic analysis showed that F0,Jitter,Shimmer and NNE were significantly different from normal 2 weeks after surgery（ P <0.01）.Voice function recovered weakly 1 month after operation（ P <0.05）.There were no significant differences in the vocal parameters between plasma radiofrequency ablation group and control group 3 months after surgery( P >0.05). Conclusion: Radiofrequency coblation was a safe,minimally invasive and effective surgical method and can be widely used to treat laryngeal premalignant lesions．. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Characterization and evaluation of femtosecond laser-induced sub-micron periodic structures generated on titanium to improve osseointegration of implants

NASA Astrophysics Data System (ADS)

Lee, Bryan E. J.; Exir, Hourieh; Weck, Arnaud; Grandfield, Kathryn

2018-05-01

Reproducible and controllable methods of modifying titanium surfaces for dental and orthopaedic applications are of interest to prevent poor implant outcomes by improving osseointegration. This study made use of a femtosecond laser to generate laser-induced periodic surface structures with periodicities of 300, 620 and 760 nm on titanium substrates. The reproducible rippled patterns showed consistent submicron scale roughness and relatively hydrophobic surfaces as measured by atomic force microscopy and contact angle, respectively. Transmission electron microscopy and Auger electron spectroscopy identified a thicker oxide layer on ablated surfaces compared to controls. In vitro testing was conducted using osteosarcoma Saos-2 cells. Cell metabolism on the laser-ablated surfaces was comparable to controls and alkaline phosphatase activity was notably increased at late time points for the 620 and 760 nm surfaces compared to controls. Cells showed a more elongated shape on laser-ablated surfaces compared to controls and showed perpendicular alignment to the periodic structures. This work has demonstrated the feasibility of generating submicron features on an implant material with the ability to influence cell response and improve implant outcomes.

Relationship of area postrema to three putative measures of motion sickness

NASA Technical Reports Server (NTRS)

Sutton, R.; Fox, Robert A.; Daunton, Nancy G.

1991-01-01

Although the rat has an incomplete emetic reflex, several species-specific responses to motion were proposed as measures of 'motion sickness' in rats. The purpose was to determine the dependence of these responses on one of several neural structures known to be essential to motion-induced vomiting in species with a complete emetic reflex. The Area Postrema (AP) was shown to play an important role in the production of motion sickness in vomiting species. The effects of thermo-cautery ablations of the AP on three different responses supposedly reflecting motion sickness in the rat were compared: conditioned taste aversion (CTA); drinking suppression; and fecal boli. Efficacy of the ablations was determined by subjecting ablated, sham-operated, and unoperated control animals to a CTA test which is known to require a functional AP. Animals with AP ablations failed to form CTA when 0.15 M LiCl was paired with a 10 percent sucrose solution, while sham-operated control subjects conditioned as well as the unoperated control subjects. The extent of the ablations was evaluated histologically at the end of the experiment. To determine the effects of the ablations on the measures of motion sickness, all animals were subjected to rotation for 30 min or 90 min on a platform displaced 20 deg from earth horizontal. Results indicate that ablation of AP in the rat has no effect on the formation of CTA to a 4 percent solution of cider paired with motion, on the suppression of drinking immediately after exposure to motion, or on the frequency of fecal boli during exposure to motion. This failure of AP ablations to eliminate the effects of motion on any of these responses discourages their use as equivalents of motion-induced vomiting. The appropriateness of other suggested measures, e.g., pica, remains untested but the dependence of such measures on stimulation more severe than commonly used in motion sickness research and the absence of a demonstration of their dependence on neural structures essential to motion sickness in vomiting species, suggest caution in the use of such responses. Further, until more is known about the neural structures underlying these putative measures, the rat will remain a questionable subject in which to study motion sickness.

Feedback-Equivalence of Nonlinear Systems with Applications to Power System Equations.

NASA Astrophysics Data System (ADS)

Marino, Riccardo

The key concept of the dissertation is feedback equivalence among systems affine in control. Feedback equivalence to linear systems in Brunovsky canonical form and the construction of the corresponding feedback transformation are used to: (i) design a nonlinear regulator for a detailed nonlinear model of a synchronous generator connected to an infinite bus; (ii) establish which power system network structures enjoy the feedback linearizability property and design a stabilizing control law for these networks with a constraint on the control space which comes from the use of d.c. lines. It is also shown that the feedback linearizability property allows the use of state feedback to contruct a linear controllable system with a positive definite linear Hamiltonian structure for the uncontrolled part if the state space is even; a stabilizing control law is derived for such systems. Feedback linearizability property is characterized by the involutivity of certain nested distributions for strongly accessible analytic systems; if the system is defined on a manifold M diffeomorphic to the Euclidean space, it is established that the set where the property holds is a submanifold open and dense in M. If an analytic output map is defined, a set of nested involutive distributions can be always defined and that allows the introduction of an observability property which is the dual concept, in some sense, to feedback linearizability: the goal is to investigate when a nonlinear system affine in control with an analytic output map is feedback equivalent to a linear controllable and observable system. Finally a nested involutive structure of distributions is shown to guarantee the existence of a state feedback that takes a nonlinear system affine in control to a single input one, both feedback equivalent to linear controllable systems, preserving one controlled vector field.

Radiofrequency ablation of osteoid osteoma with cooled probes and impedance-control energy delivery.

PubMed

Cantwell, Colin P; O'Byrne, John; Eustace, Stephen

2006-05-01

Our objective was to evaluate the efficacy of percutaneous radiofrequency ablation of osteoid osteoma with cooled radiofrequency probes and impedance control energy delivery from a 200-W generator. We also compared the outcome to published data for therapy with a 5-mm noncooled probe and temperature-controlled short-duration therapy protocols. Radiofrequency ablation was performed on 11 patients with a clinical and radiologic diagnosis of osteoid osteoma. A cooled radiofrequency probe was introduced into the lesion under CT guidance. Twelve minutes of radiofrequency energy was delivered from a 200-W generator under impedance control. Postprocedural pain, function, and satisfaction were evaluated by means of an interview and questionnaire. All procedures were technically successful. No serious complication occurred. Postoperative pain was scored at a mean of 6.9 +/- 3.06 (95% confidence interval) on a numeric rating scale. Postoperative pain was rated as similar to night pain. By 1 week after therapy, all patients had resolution of pain and returned to normal activity. There was no recurrence during the follow-up period (range, 6-27 months; mean, 14.4 months). Patients rated their satisfaction as high. Radiofrequency ablation of osteoid osteoma with a high-energy delivery technique is safe and has a high success rate. When compared with patients in a published series using 5-mm probes and manual energy control from lower-output generators, our cohort showed increased postoperative pain scores and an increased interval to symptom resolution.

Control theory for scanning probe microscopy revisited.

PubMed

Stirling, Julian

2014-01-01

We derive a theoretical model for studying SPM feedback in the context of control theory. Previous models presented in the literature that apply standard models for proportional-integral-derivative controllers predict a highly unstable feedback environment. This model uses features specific to the SPM implementation of the proportional-integral controller to give realistic feedback behaviour. As such the stability of SPM feedback for a wide range of feedback gains can be understood. Further consideration of mechanical responses of the SPM system gives insight into the causes of exciting mechanical resonances of the scanner during feedback operation.

Lesion size estimator of cardiac radiofrequency ablation at different common locations with different tip temperatures.

PubMed

Lai, Yu-Chi; Choy, Young Bin; Haemmerich, Dieter; Vorperian, Vicken R; Webster, John G

2004-10-01

Finite element method (FEM) analysis has become a common method to analyze the lesion formation during temperature-controlled radiofrequency (RF) cardiac ablation. We present a process of FEM modeling a system including blood, myocardium, and an ablation catheter with a thermistor embedded at the tip. The simulation used a simple proportional-integral (PI) controller to control the entire process operated in temperature-controlled mode. Several factors affect the lesion size such as target temperature, blood flow rate, and application time. We simulated the time response of RF ablation at different locations by using different target temperatures. The applied sites were divided into two groups each with a different convective heat transfer coefficient. The first group was high-flow such as the atrioventricular (AV) node and the atrial aspect of the AV annulus, and the other was low-flow such as beneath the valve or inside the coronary sinus. Results showed the change of lesion depth and lesion width with time, under different conditions. We collected data for all conditions and used it to create a database. We implemented a user-interface, the lesion size estimator, where the user enters set temperature and location. Based on the database, the software estimated lesion dimensions during different applied durations. This software could be used as a first-step predictor to help the electrophysiologist choose treatment parameters.

Comparison of light absorption levels with different skin phantoms and the Monte Carlo simulation using Fourier-domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Jo, Hang Chan; Kim, Jae Hun; Kim, Dae Yu

2018-02-01

Dermatologic patients have various skin characteristics such as skin tone and pigmentation color. However most studies on laser ablation and treatment only considered laser operating conditions like wavelength, output power and pulse duration. The laser ablation arises from photothermal effect by photon energy absorption. Chromophores like melanin exist as the absorber in the skin. In this study, we painted color to mimic chromophores on in-vivo and in-vitro skin models to demonstrate influence on the laser ablation by skin color. Water-based pens were used to paint color. Cross sectional images of the laser ablation were acquired by Fourier-domain optical coherence tomography (Fd-OCT). Light source to make ablation was a Q-switch diode-pumped Nd:YVO4 nanosecond laser (532nm central wavelength). Irradiated light energy dose of the laser could not make ablation craters in the control group. However experimental groups showed craters with same irradiation light energy dose. These results show painting on skin increased tissue damage by absorption in painted color without dyeing cells or tissues.

Microwave ablation with multiple simultaneously powered small-gauge triaxial antennas: results from an in vivo swine liver model.

PubMed

Brace, Christopher L; Laeseke, Paul F; Sampson, Lisa A; Frey, Tina M; van der Weide, Daniel W; Lee, Fred T

2007-07-01

To prospectively investigate the ability of a single generator to power multiple small-diameter antennas and create large zones of ablation in an in vivo swine liver model. Thirteen female domestic swine (mean weight, 70 kg) were used for the study as approved by the animal care and use committee. A single generator was used to simultaneously power three triaxial antennas at 55 W per antenna for 10 minutes in three groups: a control group where antennas were spaced to eliminate ablation zone overlap (n=6; 18 individual zones of ablation) and experimental groups where antennas were spaced 2.5 cm (n=7) or 3.0 cm (n=5) apart. Animals were euthanized after ablation, and ablation zones were sectioned and measured. A mixed linear model was used to test for differences in size and circularity among groups. Mean (+/-standard deviation) cross-sectional areas of multiple-antenna zones of ablation at 2.5- and 3.0-cm spacing (26.6 cm(2) +/- 9.7 and 32.2 cm(2) +/- 8.1, respectively) were significantly larger than individual ablation zones created with single antennas (6.76 cm(2) +/- 2.8, P<.001) and were 31% (2.5-cm spacing group: multiple antenna mean area, 26.6 cm(2); 3 x single antenna mean area, 20.28 cm(2)) to 59% (3.0-cm spacing group: multiple antenna mean area, 32.2 cm(2); 3 x single antenna mean area, 20.28 cm(2)) larger than 3 times the mean area of the single-antenna zones. Zones of ablation were found to be very circular, and vessels as large as 1.1 cm were completely coagulated with multiple antennas. A single generator may effectively deliver microwave power to multiple antennas. Large volumes of tissue may be ablated and large vessels coagulated with multiple-antenna ablation in the same time as single-antenna ablation. (c) RSNA, 2007.

Development of moldable carbonaceous materials for ablative rocket nozzles.

NASA Technical Reports Server (NTRS)

Lockhart, R. J.; Bortz, S. A.; Schwartz, M. A.

1972-01-01

Description of a materials system developed for use as low-cost ablative nozzles for NASA's 260-in. solid rocket motor. Petroleum coke and carbon black fillers were employed; high density was achieved by controlling particle size distribution. An alumina catalyzed furfuryl ester resin which produced high carbon residues after pyrolysis was employed as the binder. Staple carbon fibers improved the strength and crack resistance of molded bodies. In static firing tests of two subscale nozzles, this material compared favorably in erosion rate with several other ablative systems.

Frozen cultured sheets of epidermal keratinocytes in reepithelialization and repair of the cornea after photorefractive keratectomy.

PubMed

Castro-Muñozledo, Federico; Ozorno-Zarate, Jorge; Naranjo-Tackman, Ramon; Kuri-Harcuch, Walid

2002-09-01

To determine whether frozen cultured sheets of human allogeneic epidermal keratinocytes (CEAK) improved wound repair after experimental corneal ablation by photorefractive keratectomy (PRK). Hospital "Luis Sanchez Bulnes" de la Asociación para Evitar la Ceguera en Mexico, I.A.P, and Department of Cell Biology, CINVESTAV-IPN, Mexico City, Mexico. Transepithelial PRK was performed in the right eye of male albino rabbits to obtain a 112 microm deep and 6.0 mm diameter ablation zone. In 17 eyes, the ablations were covered with frozen CEAK; in 11 eyes, the ablations were covered with a disposable contact lens without the cultured sheets; and in the control group (13 eyes), the ablations were not covered. Subepithelial fibrosis and reepithelialization of the ablated zone were evaluated in serial paraffin-embedded tissue sections from all wounds. Treatment with CEAK reduced fibroblast proliferation and the inflammatory response beneath the ablated zone and produced better organization of the newly formed epithelium by eliminating significant hyperplasia or discontinuities in the periodic acid Shiff-stained basement membrane. It also led to accelerated reepithelialization. The use of frozen CEAK as a biologically active wound dressing improved tissue repair at 1 month in corneas ablated by transepithelial PRK in the male albino rabbit model. Treatment with CEAK could improve the outcome of PRK in humans.

Temperature-feedback upconversion nanocomposite for accurate photothermal therapy at facile temperature

PubMed Central

Zhu, Xingjun; Feng, Wei; Chang, Jian; Tan, Yan-Wen; Li, Jiachang; Chen, Min; Sun, Yun; Li, Fuyou

2016-01-01

Photothermal therapy (PTT) at present, following the temperature definition for conventional thermal therapy, usually keeps the temperature of lesions at 42–45 °C or even higher. Such high temperature kills cancer cells but also increases the damage of normal tissues near lesions through heat conduction and thus brings about more side effects and inhibits therapeutic accuracy. Here we use temperature-feedback upconversion nanoparticle combined with photothermal material for real-time monitoring of microscopic temperature in PTT. We observe that microscopic temperature of photothermal material upon illumination is high enough to kill cancer cells when the temperature of lesions is still low enough to prevent damage to normal tissue. On the basis of the above phenomenon, we further realize high spatial resolution photothermal ablation of labelled tumour with minimal damage to normal tissues in vivo. Our work points to a method for investigating photothermal properties at nanoscale, and for the development of new generation of PTT strategy. PMID:26842674

Toward continuous-wave operation of organic semiconductor lasers

PubMed Central

Sandanayaka, Atula S. D.; Matsushima, Toshinori; Bencheikh, Fatima; Yoshida, Kou; Inoue, Munetomo; Fujihara, Takashi; Goushi, Kenichi; Ribierre, Jean-Charles; Adachi, Chihaya

2017-01-01

The demonstration of continuous-wave lasing from organic semiconductor films is highly desirable for practical applications in the areas of spectroscopy, data communication, and sensing, but it still remains a challenging objective. We report low-threshold surface-emitting organic distributed feedback lasers operating in the quasi–continuous-wave regime at 80 MHz as well as under long-pulse photoexcitation of 30 ms. This outstanding performance was achieved using an organic semiconductor thin film with high optical gain, high photoluminescence quantum yield, and no triplet absorption losses at the lasing wavelength combined with a mixed-order distributed feedback grating to achieve a low lasing threshold. A simple encapsulation technique greatly reduced the laser-induced thermal degradation and suppressed the ablation of the gain medium otherwise taking place under intense continuous-wave photoexcitation. Overall, this study provides evidence that the development of a continuous-wave organic semiconductor laser technology is possible via the engineering of the gain medium and the device architecture. PMID:28508042

Temperature-feedback upconversion nanocomposite for accurate photothermal therapy at facile temperature.

PubMed

Zhu, Xingjun; Feng, Wei; Chang, Jian; Tan, Yan-Wen; Li, Jiachang; Chen, Min; Sun, Yun; Li, Fuyou

2016-02-04

Photothermal therapy (PTT) at present, following the temperature definition for conventional thermal therapy, usually keeps the temperature of lesions at 42-45 °C or even higher. Such high temperature kills cancer cells but also increases the damage of normal tissues near lesions through heat conduction and thus brings about more side effects and inhibits therapeutic accuracy. Here we use temperature-feedback upconversion nanoparticle combined with photothermal material for real-time monitoring of microscopic temperature in PTT. We observe that microscopic temperature of photothermal material upon illumination is high enough to kill cancer cells when the temperature of lesions is still low enough to prevent damage to normal tissue. On the basis of the above phenomenon, we further realize high spatial resolution photothermal ablation of labelled tumour with minimal damage to normal tissues in vivo. Our work points to a method for investigating photothermal properties at nanoscale, and for the development of new generation of PTT strategy.

Toward continuous-wave operation of organic semiconductor lasers.

PubMed

Sandanayaka, Atula S D; Matsushima, Toshinori; Bencheikh, Fatima; Yoshida, Kou; Inoue, Munetomo; Fujihara, Takashi; Goushi, Kenichi; Ribierre, Jean-Charles; Adachi, Chihaya

2017-04-01

The demonstration of continuous-wave lasing from organic semiconductor films is highly desirable for practical applications in the areas of spectroscopy, data communication, and sensing, but it still remains a challenging objective. We report low-threshold surface-emitting organic distributed feedback lasers operating in the quasi-continuous-wave regime at 80 MHz as well as under long-pulse photoexcitation of 30 ms. This outstanding performance was achieved using an organic semiconductor thin film with high optical gain, high photoluminescence quantum yield, and no triplet absorption losses at the lasing wavelength combined with a mixed-order distributed feedback grating to achieve a low lasing threshold. A simple encapsulation technique greatly reduced the laser-induced thermal degradation and suppressed the ablation of the gain medium otherwise taking place under intense continuous-wave photoexcitation. Overall, this study provides evidence that the development of a continuous-wave organic semiconductor laser technology is possible via the engineering of the gain medium and the device architecture.

Realizing actual feedback control of complex network

NASA Astrophysics Data System (ADS)

Tu, Chengyi; Cheng, Yuhua

2014-06-01

In this paper, we present the concept of feedbackability and how to identify the Minimum Feedbackability Set of an arbitrary complex directed network. Furthermore, we design an estimator and a feedback controller accessing one MFS to realize actual feedback control, i.e. control the system to our desired state according to the estimated system internal state from the output of estimator. Last but not least, we perform numerical simulations of a small linear time-invariant dynamics network and a real simple food network to verify the theoretical results. The framework presented here could make an arbitrary complex directed network realize actual feedback control and deepen our understanding of complex systems.

Learning feedback and feedforward control in a mirror-reversed visual environment.

PubMed

Kasuga, Shoko; Telgen, Sebastian; Ushiba, Junichi; Nozaki, Daichi; Diedrichsen, Jörn

2015-10-01

When we learn a novel task, the motor system needs to acquire both feedforward and feedback control. Currently, little is known about how the learning of these two mechanisms relate to each other. In the present study, we tested whether feedforward and feedback control need to be learned separately, or whether they are learned as common mechanism when a new control policy is acquired. Participants were trained to reach to two lateral and one central target in an environment with mirror (left-right)-reversed visual feedback. One group was allowed to make online movement corrections, whereas the other group only received visual information after the end of the movement. Learning of feedforward control was assessed by measuring the accuracy of the initial movement direction to lateral targets. Feedback control was measured in the responses to sudden visual perturbations of the cursor when reaching to the central target. Although feedforward control improved in both groups, it was significantly better when online corrections were not allowed. In contrast, feedback control only adaptively changed in participants who received online feedback and remained unchanged in the group without online corrections. Our findings suggest that when a new control policy is acquired, feedforward and feedback control are learned separately, and that there may be a trade-off in learning between feedback and feedforward controllers. Copyright © 2015 the American Physiological Society.

Learning feedback and feedforward control in a mirror-reversed visual environment

PubMed Central

Kasuga, Shoko; Telgen, Sebastian; Ushiba, Junichi; Nozaki, Daichi

2015-01-01

When we learn a novel task, the motor system needs to acquire both feedforward and feedback control. Currently, little is known about how the learning of these two mechanisms relate to each other. In the present study, we tested whether feedforward and feedback control need to be learned separately, or whether they are learned as common mechanism when a new control policy is acquired. Participants were trained to reach to two lateral and one central target in an environment with mirror (left-right)-reversed visual feedback. One group was allowed to make online movement corrections, whereas the other group only received visual information after the end of the movement. Learning of feedforward control was assessed by measuring the accuracy of the initial movement direction to lateral targets. Feedback control was measured in the responses to sudden visual perturbations of the cursor when reaching to the central target. Although feedforward control improved in both groups, it was significantly better when online corrections were not allowed. In contrast, feedback control only adaptively changed in participants who received online feedback and remained unchanged in the group without online corrections. Our findings suggest that when a new control policy is acquired, feedforward and feedback control are learned separately, and that there may be a trade-off in learning between feedback and feedforward controllers. PMID:26245313

Effect of vibrotactile feedback on an EMG-based proportional cursor control system.

PubMed

Li, Shunchong; Chen, Xingyu; Zhang, Dingguo; Sheng, Xinjun; Zhu, Xiangyang

2013-01-01

Surface electromyography (sEMG) has been introduced into the bio-mechatronics systems, however, most of them are lack of the sensory feedback. In this paper, the effect of vibrotactile feedback for a myoelectric cursor control system is investigated quantitatively. Simultaneous and proportional control signals are extracted from EMG using a muscle synergy model. Different types of feedback including vibrotactile feedback and visual feedback are added, assessed and compared with each other. The results show that vibrotactile feedback is capable of improving the performance of EMG-based human machine interface.

Antiviral therapy after non-surgical tumor ablation in patients with hepatocellular carcinoma associated with hepatitis C virus.

PubMed

Hung, Chao-Hung; Lee, Chuan-Mo; Wang, Jing-Houng; Tung, Hung-Da; Chen, Chien-Hung; Lu, Sheng-Nan

2005-10-01

Antiviral therapy for chronic hepatitis C virus (HCV) infection has led to a reduction in the incidence of hepatocellular carcinoma (HCC). The purpose of the present paper was to assess whether antiviral therapy might suppress tumor recurrence and influence overall survival in patients with HCV-related HCC who had complete ablation of nodules by non-surgical treatments. Twenty patients with three or fewer nodules of HCV-related HCC who were treated with percutaneous tumor ablation and/or transcatheter arterial embolization received combined interferon (IFN; 3 or 5 million units of IFN alpha-2b thrice weekly) plus ribavirin (1000-1200 mg per day) therapy for 24-48 weeks after complete ablation of lesions. During the same period, an additional 40 age- and sex-matched control patients with similar characteristics of tumors (sizes, numbers and treatment modalities) and severity of liver disease were recruited from the HCC database. Both recurrence-free survival and actuarial survival were evaluated. Of the 20 patients, 16 completed therapy and 10 showed a sustained response with normalization of alanine aminotransferase and negative HCV-RNA at 6 months after therapy completion. Due to severe side-effects experienced by Child B patients, who mostly discontinued antiviral therapy, clinical outcome was analyzed in the Child A treated (n = 16) and control (n = 33) patients. There was no significant difference in the incidence of local recurrence in sustained responders compared with non-responders or control patients (P = 0.174, 0.1284, respectively); but the second recurrence-free interval in the sustained responders was significantly longer than that of non-responders and the control group (P = 0.0141, 0.0243, respectively). Survival in sustained responders was better than in non-responders and control patients (P = 0.0691, 0.0554, respectively). These results indicate that successful antiviral therapy after non-surgical tumor ablation for HCV-related HCC may lower tumor recurrence rate and prolong survival.

Microwaves create larger ablations than radiofrequency when controlled for power in ex vivo tissue.

PubMed

Andreano, A; Huang, Yu; Meloni, M Franca; Lee, Fred T; Brace, Christopher

2010-06-01

To compare ablation zones created with equal amounts of 2.45 GHz microwave and 480 kHz radiofrequency (RF) energy in ex vivo liver and lung. A total of 38 ablations were performed in ex vivo liver and lung for 10 min each. Nineteen RF ablations (nine liver, ten lung) were performed with a 480 kHz system (200 W max, impedance-based pulsing) and cooled electrode while measuring the average RF power applied. Nineteen microwave ablations (nine liver, ten lung) were then created using a cooled triaxial antenna to deliver 2.45 GHz at the same power level as in RF experiments. Ablation zones were then sectioned and measured for minimum, maximum and mean diameters, and circularity. Measurements were compared using t-tests, with P < 0.05 indicating statistical significance. Mean diameters of microwave ablations were greater than RF ablations in both liver and lung (4.4 +/- 0.3 vs 3.3 +/- 0.2 cm in liver; 2.45 +/- 0.3 vs 1.6 +/- 0.5 cm in lungs; P < 0.0005 all comparisons). There was no significant difference in the mean power applied during microwave or RF ablations in either organ (54.44 +/- 1.71 W vs 56.4 +/- 6.7 W in liver, P > 0.05; 40 +/- 0.95 W vs 44.9 +/- 7.1 W in lung, P > 0.05). Using a single cooled applicator, microwave energy at 2.45 GHz produces larger ablations than an equivalent amount of 480 kHz RF energy in normal liver and lung. This was more apparent in lung, likely due to the high baseline impedance which limits RF, but not microwave power delivery.

How to diagnose and treat focal therapy failure and recurrence?

PubMed

Barret, Eric; Harvey-Bryan, Kadi-Ann; Sanchez-Salas, Rafael; Rozet, Francois; Galiano, Marc; Cathelineau, Xavier

2014-05-01

Focal therapy presents an alternative option for disease-targeted therapy while preserving erectile and urinary function without compromising oncological outcome. Such treatment, which preserves normal prostate parenchyma, presents a clinical challenge to the urologist, as typical disease surveillance parameters are not as reliable in post-ablation follow-up. We propose an integrated approach to post-ablation surveillance to identify treatment failure as well as recurrence. Post-ablation prostate-specific antigen kinetics, imaging based on multiparametric MRI and control biopsies are the tools currently used to follow patients after focal therapy. Good treatment response is indicated by a negative control biopsy, absence of persistent lesion on post-treatment imaging and a reduction in prostate-specific antigen of at least 50%. When histological evidence of therapeutic failure or recurrence is present, different options of management may be proposed to the patient including active surveillance, focal salvage therapy or radical salvage treatment, depending on the characteristics of the lesion found. A recommended post-ablation surveillance protocol is presented as well as a discussion of management strategies based on the data currently available.

Simulation and design of feedback control on resistive wall modes in Keda Torus eXperiment

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

Li, Chenguang; Liu, Wandong; Li, Hong

2014-12-15

The feedback control of resistive wall modes (RWMs) in Keda Torus eXperiment (KTX) (Liu et al., Plasma Phys. Controlled Fusion 56, 094009 (2014)) is investigated by simulation. A linear model is built to describe the growth of the unstable modes in the absence of feedback and the resulting mode suppression due to feedback, given the typical reversed field pinch plasma equilibrium. The layout of KTX with two shell structures (the vacuum vessel and the stabilizing shell) is taken into account. The feedback performance is explored both in the scheme of “clean mode control” (Zanca et al., Nucl. Fusion 47, 1425more » (2007)) and “raw mode control.” The discrete time control model with specific characteristic times will mimic the real feedback control action and lead to the favored control cycle. Moreover, the conceptual design of feedback control system is also presented, targeting on both RWMs and tearing modes.« less

Renal denervation using catheter-based radiofrequency ablation with temperature control: renovascular safety profile and underlying mechanisms in a hypertensive canine model.

PubMed

Li, Huijie; Yu, Hang; Zeng, Chunyu; Fang, Yuqiang; He, Duofen; Zhang, Xiaoqun; Wen, Chunlan; Yang, Chengming

2015-01-01

Renal denervation is a novel method for hypertension treatment. In this study, we aimed to investigate the safety and efficacy of radiofrequency ablation (RFA) at ablation temperatures of 45 °C or 50 °C and its possible mechanisms. A hypertensive canine model was established by abdominal aortic constriction in 20 healthy hybrid dogs. These dogs were then randomly assigned to the treatment and the control groups, with dogs in the treatment group further randomly assigned to receive RFA at ablation temperatures of 45 °C or 50 °C. In the treatment group, RFA was performed at 1 month after modeling; renal angiography was performed at 2 months after ablation. The arterial vessels of the dogs were examined histologically with hematoxylin and eosin staining. Changes in blood pressure in the foreleg and whole-body norepinephrine spillover rate were also assessed. No arterial stenosis, dissection, thrombosis or other abnormalities were detected in the treated vessels by renal angiography, yet histology results showed minimal to mild renal arterial injury. Renal denervation resulted in a marked decrease in the whole-body norepinephrine spillover rate (p < 0.05) in addition to significantly reducing blood pressure (p < 0.05), with no significant differences detected between the 45 °C and 50 °C subgroups for both (p > 0.05). Renal denervation can be performed without acute major adverse events, using catheter-based RFA with temperature control. The procedure was feasible in reducing blood pressure by at least partially inhibiting sympathetic drive and systemic sympathetic outflow.

Microjet-assisted dye-enhanced diode laser ablation of cartilaginous tissue

NASA Astrophysics Data System (ADS)

Pohl, John; Bell, Brent A.; Motamedi, Massoud; Frederickson, Chris J.; Wallace, David B.; Hayes, Donald J.; Cowan, Daniel

1994-08-01

Recent studies have established clinical application of laser ablation of cartilaginous tissue. The goal of this study was to investigate removal of cartilaginous tissue using diode laser. To enhance the interaction of laser light with tissue, improve the ablation efficiency and localize the extent of laser-induced thermal damage in surrounding tissue, we studied the use of a novel delivery system developed by MicroFab Technologies to dispense a known amount of Indocyanine Green (ICG) with a high spatial resolution to alter the optical properties of the tissue in a controlled fashion. Canine intervertebral disks were harvested and used within eight hours after collection. One hundred forty nL of ICG was topically applied to both annulus and nucleus at the desired location with the MicroJet prior to each irradiation. Fiber catheters (600 micrometers ) were used and positioned to irradiate the tissue with a 0.8 mm spot size. Laser powers of 3 - 10 W (Diomed, 810 nm) were used to irradiate the tissue with ten pulses (200 - 500 msec). Discs not stained with ICG were irradiated as control samples. Efficient tissue ablation (80 - 300 micrometers /pulse) was observed using ICG to enhance light absorption and confine thermal damage while there was no observable ablation in control studied. The extent of tissue damage observed microscopically was limited to 50 - 100 micrometers . The diode laser/Microjet combination showed promise for applications involving removal of cartilaginous tissue. This procedure can be performed using a low power compact diode laser, is efficient, and potentially more economical compared to procedures using conventional lasers.

Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

PubMed

Celis-Aguilar, Erika; Hinojosa-González, Ramon; Vales-Hidalgo, Olivia; Coutinho-Toledo, Heloisa

Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients. To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment. Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8mL of gentamicin intratympanic application at a 30mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients. Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30dB. Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials). Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Mathematical 3D modelling and sensitivity analysis of multipolar radiofrequency ablation in the spine.

PubMed

Matschek, Janine; Bullinger, Eric; von Haeseler, Friedrich; Skalej, Martin; Findeisen, Rolf

2017-02-01

Radiofrequency ablation is a valuable tool in the treatment of many diseases, especially cancer. However, controlled heating up to apoptosis of the desired target tissue in complex situations, e.g. in the spine, is challenging and requires experienced interventionalists. For such challenging situations a mathematical model of radiofrequency ablation allows to understand, improve and optimise the outcome of the medical therapy. The main contribution of this work is the derivation of a tailored, yet expandable mathematical model, for the simulation, analysis, planning and control of radiofrequency ablation in complex situations. The dynamic model consists of partial differential equations that describe the potential and temperature distribution during intervention. To account for multipolar operation, time-dependent boundary conditions are introduced. Spatially distributed parameters, like tissue conductivity and blood perfusion, allow to describe the complex 3D environment representing diverse involved tissue types in the spine. To identify the key parameters affecting the prediction quality of the model, the influence of the parameters on the temperature distribution is investigated via a sensitivity analysis. Simulations underpin the quality of the derived model and the analysis approach. The proposed modelling and analysis schemes set the basis for intervention planning, state- and parameter estimation, and control. Copyright © 2016. Published by Elsevier Inc.

Translational medicine in the field of ablative fractional laser (AFXL)-assisted drug delivery: A critical review from basics to current clinical status.

PubMed

Haedersdal, Merete; Erlendsson, Andrés M; Paasch, Uwe; Anderson, R Rox

2016-05-01

Ablative fractional lasers enhance uptake of topical therapeutics and the concept of fractional laser-assisted drug delivery has now been taken into clinical practice. We systematically reviewed preclinical data and clinical evidence for fractional lasers to enhance drug uptake and improve clinical efficacy. We searched PubMed and Embase databases; 34 articles met the inclusion criteria. Studies were categorized into experimental preclinical studies and clinical trials, the latter graded according to level of evidence. All preclinical trials (n = 16) documented enhanced topical drug uptake into skin after ablative fractional laser treatment. Clinical evidence encompassed 18 studies, of which 9 were randomized controlled trials and 2 were controlled trials, examining neoplastic lesions, photodamaged skin, scars, onychomycosis, and topical anesthetics. The highest level of evidence was reached for actinic keratoses treated with methylaminolevulinate for photodynamic therapy (level IB, 5 randomized controlled trials), substantiating superior and long-lasting efficacy versus conventional photodynamic therapy. No adverse events were reported, but ablative fractional laser-assisted drug delivery implies risks of systemic drug absorption, especially when performed over large skin areas. Fractional laser-assisted drug delivery is beneficial in enhancing preclinical and clinical outcomes for certain skin conditions. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

CO laser angioplasty system: efficacy of manipulatable laser angioscope catheter

NASA Astrophysics Data System (ADS)

Arai, Tsunenori; Kikuchi, Makoto; Mizuno, Kyoichi; Sakurada, Masami; Miyamoto, Akira; Arakawa, Koh; Kurita, Akira; Nakamura, Haruo; Takeuchi, Kiyoshi; Utsumi, Atsushi; Akai, Yoshiro

1992-08-01

A percutaneous transluminal coronary angioplasty system using a unique combination of CO laser (5 micrometers ) and As-S infrared glass fiber under the guidance of a manipulatable laser angioscope catheter is described. The ablation and guidance functions of this system are evaluated. The angioplasty treatment procedure under angioscope guidance was studied by in vitro model experiment and in vivo animal experiment. The whole angioplasty system is newly developed. That is, a transportable compact medical CO laser device which can emit up to 10 W, a 5 F manipulatable laser angioscope catheter, a thin CO laser cable of which the diameter is 0.6 mm, an angioscope imaging system for laser ablation guidance, and a system controller were developed. Anesthetized adult mongrel dogs (n equals 5) with an artificial complete occlusion in the femoral artery and an artificial human vessel model including occluded or stenotic coronary artery were used. The manipulatability of the catheter was drastically improved (both rotation and bending), therefore, precise control of ablation to expand stenosis was obtained. A 90% artificial stenosis made of human yellow plaque in 4.0 mm diameter in the vessel was expanded to 70% stenosis by repetitive CO laser ablations of which total energy was 220 J. All procedures were performed and controlled under angioscope visualization.

MRI features after radiofrequency ablation of osteoid osteoma with cooled probes and impedance-control energy delivery.

PubMed

Cantwell, Colin P; Kerr, Jennifer; O'Byrne, John; Eustace, Stephen

2006-05-01

The purposes of our study were to determine the temporal changes in MR signal in bone after radiofrequency ablation of osteoid osteoma and the size of the zone of marrow signal change produced by the radiofrequency technique and to compare the size of the zone with published data for radiofrequency ablation with manual-control protocols. Radiofrequency ablation was performed in 10 patients with a clinical and radiologic diagnosis of osteoid osteoma. A cooled radiofrequency probe was inserted in the nidus. Twelve minutes of radiofrequency energy was applied from a 200-W radiofrequency generator in an impedance-control setting. MRI with multiplanar turbo spin-echo T1-weighted and STIR sequences was performed at 1, 7, and 28 days after the procedure in seven patients. The three remaining patients had follow-up imaging at 28 days only. The images were reviewed by two radiologists who categorized the imaging features and measured the marrow zone of signal alteration when visible. The size of the zone of marrow signal change produced by the radiofrequency technique was compared with published data for radiofrequency ablation with manual-control protocols. A 1-mm band of homogeneous altered marrow signal distributed symmetrically parallel to the entire probe tract was seen earliest, at 1 day, in the femoral neck lesion treated with the 2-cm probe. The band was low signal on the T1 sequence and high signal on the STIR sequence, and the diameter of the zone was 27 mm. By 7 days, five of the seven treated bones showed a band of marrow signal alteration. By 28 days, all 10 treated bones had a band of marrow signal alteration. The interband distance at 90 degrees to the probe measured on STIR images at 28 days was a mean of 20.9 mm (confidence interval, 16.1-25.7 mm [p < 0.05]; range +/- measurement error, 10.5-35 +/- 1.64 mm) with a 1-cm probe and 30.5 mm (measurement error, +/- 0.78 mm) on T1 images without contrast material when a 2-cm exposed-tip probe was used. Higher-output generators with impedance-control software and internally cooled radiofrequency probes with longer exposed tips produce larger zones of marrow signal change than expected with manual-control protocols. MRI allows detection of temporal marrow signal change after radiofrequency ablation. The marrow signal change with a high-energy delivery protocol is larger than manual-control protocols.

Non-coaxial-based microwave ablation antennas for creating symmetric and asymmetric coagulation zones

NASA Astrophysics Data System (ADS)

Mohtashami, Yahya; Luyen, Hung; Hagness, Susan C.; Behdad, Nader

2018-06-01

We present an investigation of a new class of microwave ablation (MWA) antennas capable of producing axially symmetric or asymmetric heating patterns. The antenna design is based on a dipole fed by a balanced parallel-wire transmission line. The angle and direction of the deployed dipole arms are used to control the heating pattern. We analyzed the specific absorption rate and temperature profiles using electromagnetic and thermal simulations. Two prototypes were fabricated and tested in ex vivo ablation experiments: one was designed to produce symmetric heating patterns and the other was designed to generate asymmetric heating patterns. Both fabricated prototypes exhibited good impedance matching and produced localized coagulation zones as predicted by the simulations. The prototype operating in porcine muscle created an ˜10 cm3 symmetric ablation zone after 10 min of ablation with a power level of 18 W. The prototype operating in egg white created an ˜4 cm3 asymmetric ablation zone with a directionality ratio of 40% after 5 min of ablation with a power level of 25 W. The proposed MWA antenna design shows promise for minimally invasive treatment of tumors in various clinical scenarios where, depending on the situation, a symmetric or an asymmetric heating pattern may be needed.

Magnetic Resonance Mediated Radiofrequency Ablation.

PubMed

Hue, Yik-Kiong; Guimaraes, Alexander R; Cohen, Ouri; Nevo, Erez; Roth, Abraham; Ackerman, Jerome L

2018-02-01

To introduce magnetic resonance mediated radiofrequency ablation (MR-RFA), in which the MRI scanner uniquely serves both diagnostic and therapeutic roles. In MR-RFA scanner-induced RF heating is channeled to the ablation site via a Larmor frequency RF pickup device and needle system, and controlled via the pulse sequence. MR-RFA was evaluated with simulation of electric and magnetic fields to predict the increase in local specific-absorption-rate (SAR). Temperature-time profiles were measured for different configurations of the device in agar phantoms and ex vivo bovine liver in a 1.5 T scanner. Temperature rise in MR-RFA was imaged using the proton resonance frequency method validated with fiber-optic thermometry. MR-RFA was performed on the livers of two healthy live pigs. Simulations indicated a near tenfold increase in SAR at the RFA needle tip. Temperature-time profiles depended significantly on the physical parameters of the device although both configurations tested yielded temperature increases sufficient for ablation. Resected livers from live ablations exhibited clear thermal lesions. MR-RFA holds potential for integrating RF ablation tumor therapy with MRI scanning. MR-RFA may add value to MRI with the addition of a potentially disposable ablation device, while retaining MRI's ability to provide real time procedure guidance and measurement of tissue temperature, perfusion, and coagulation.

Ablation of synovial pannus using microbubble-mediated ultrasonic cavitation in antigen-induced arthritis in rabbits.

PubMed

Qiu, Li; Jiang, Yong; Zhang, Lingyan; Wang, Lei; Luo, Yan

2012-12-01

To investigate the ablative effectiveness of microbubble-mediated ultrasonic cavitation for treating synovial pannus and to determine a potential mechanism using the antigen-induced arthritis model (AIA). Ultrasonic ablation was performed on the knee joints of AIA rabbits using optimal ultrasonic ablative parameters. Rabbits with antigen-induced arthritis were randomly assigned to 4 groups: (1) the ultrasound (US) + microbubble group; (2) the US only group; (3) the microbubble only group, and (4) the control group. At 1 h and 14 days after the first ablation, contrast-enhanced ultrasonography (CEUS) monitoring and pathology synovitis score were used to evaluate the therapeutic effects. Synovial necrosis and microvascular changes were also measured. After the ablation treatment, the thickness of synovium and parameters of time intensity curve including derived peak intensity and area under curve were measured using CEUS, and the pathology synovitis score in the ultrasound + microbubble group was significantly lower than that found in the remaining groups. No damage was observed in the surrounding normal tissues. The mechanism underlying the ultrasonic ablation was related to microthrombosis and microvascular rupture that resulted in synovial necrosis. The results suggest that microbubble-mediated ultrasonic cavitation should be applied as a non-invasive strategy for the treatment of synovial pannus in arthritis under optimal conditions.

New advances in focal therapy for early stage prostate cancer.

PubMed

Tay, Kae Jack; Schulman, Ariel A; Sze, Christina; Tsivian, Efrat; Polascik, Thomas J

2017-08-01

Prostate focal therapy offers men the opportunity to achieve oncological control while preserving sexual and urinary function. The prerequisites for successful focal therapy are to accurately identify, localize and completely ablate the clinically significant cancer(s) within the prostate. We aim to evaluate the evidence for current and upcoming technologies that could shape the future of prostate cancer focal therapy in the next five years. Areas covered: Current literature on advances in patient selection using imaging, biopsy and biomarkers, ablation techniques and adjuvant treatments for focal therapy are summarized. A literature search of major databases was performed using the search terms 'focal therapy', 'focal ablation', 'partial ablation', 'targeted ablation', 'image guided therapy' and 'prostate cancer'. Expert commentary: Advanced radiological tools such as multiparametric magnetic resonance imaging (mpMRI), multiparametric ultrasound (mpUS), prostate-specific-membrane-antigen positron emission tomography (PSMA-PET) represent a revolution in the ability to understand cancer function and biology. Advances in ablative technologies now provide a menu of modalities that can be rationalized based on lesion location, size and perhaps in the near future, pre-determined resistance to therapy. However, these need to be carefully studied to establish their safety and efficacy parameters. Adjuvant strategies to enhance focal ablation are under development.

Microwave endometrial ablation versus thermal balloon endometrial ablation (MEATBall): 5-year follow up of a randomised controlled trial.

PubMed

Sambrook, A M; Elders, A; Cooper, K G

2014-05-01

To compare long-term outcomes following microwave endometrial ablation (MEA™) and thermal balloon ablation (TBall). Follow up of a prospective, double-blind randomised controlled trial at 5 years. A teaching hospital in the UK. A total of 320 women eligible for and requesting endometrial ablation. Eligible women were randomised in a 1:1 ratio to undergo MEA or Tball. Postal questionnaires were sent to participants at a minimum of 5 years postoperatively to determine satisfaction with outcome, menstrual status, bleeding scores and quality of life measurement. Subsequent surgery was ascertained from the women and the hospital operative database. The primary outcome measure was overall satisfaction with treatment. Secondary outcomes included evaluation of menstrual loss, change in quality of life scores and subsequent surgery. Of the women originally randomised 217/314 (69.1%) returned questionnaires. Nonresponders were assumed to be treatment failures for data analysis. The primary outcome of satisfaction was similar in both groups (58% for MEA™ versus 53% for TBall, difference 5%; 95% CI -6 to 16%). Amenorrhoea rates were high following both techniques (51% versus 45%, difference 6%; 95% CI -5 to 17%). There was no significant difference in the hysterectomy rates between the two arms (9% versus 7%, difference 2%; 95% CI -5 to 9%). At 5 years post-treatment there were no significant clinical differences in patient satisfaction, menstrual status, quality of life scores or hysterectomy rates between MEA™ and Thermachoice 3, thermal balloon ablation. © 2014 Royal College of Obstetricians and Gynaecologists.

Laser-induced breakdown spectroscopy of dental lesions: diagnostic and therapeutic monitoring tool

NASA Astrophysics Data System (ADS)

Borisova, Ekaterina; Uzunov, Tzonko; Penev, Dimitar; Genova, Tsanislava; Avramov, Latchezar

2016-01-01

The carious decay develops a tiny area of demineralization on the enamel, which could be detected by element analytic techniques such as laser-induced breakdown spectroscopy (LIBS). That demineralization can quickly turn into a large lesion inside the tooth, it is often discovered too late to prevent the kind of decay that leads to cavities. The same optical LIBS detection approach could be used for monitoring of the caries removal using laser ablation or drilling techniques. For LIBS measurements we applied LIBS 2500Plus (Ocean Optics Inc., Dunedin, USA) system, which consists of seven spectrometric channels, covering spectral region from 200 to 980 nm, which optical resolution 0,05 nm, the spectrometers are connected with sample fiber bundle for 7-channels spectral system to the chamber for solid and liquid samples, Q-switched Nd:YAG laser, at 1 064 nm, with energy per pulse - 40 mJ, which is applied to induce plasma in the samples. LIBS spectra were obtained after single shot of the laser in the region of pathology. Samples investigated by LIBS are extracted teeth from patients, with periodontal problems on different stage of carious lesions, and their LIBS spectra are compared with the LIBS signals obtained from normal enamel and dentine tissues to receive complete picture of the carious lesion development. The major line of our investigations is related to the development of a methodology for real-time optical feedback control during selective ablation of tooth tissues using LIBS. Tooth structures, with and without pathological changes, are compared and their LIBS element analysis is used to differentiate major changes, which occur during tooth carious process and growth.

Feasibility of Real-Time Intraprocedural Temperature Control during Bone Metastasis Thermal Microwave Ablation: A Bicentric Retrospective Study.

PubMed

Kastler, Adrian; Krainik, Alexandre; Sakhri, Linda; Mousseau, Mireille; Kastler, Bruno

2017-03-01

To evaluate feasibility of using a thermocouple for temperature monitoring during microwave (MW) ablation of metastatic bone disease. This retrospective study comprised 16 patients (8 men with mean age 63 y and 8 women with mean age 59 y) with 18 bone metastases treated with MW ablation using a thermocouple between March 2012 and October 2015. The mean maximum tumor size was 29.5 mm. MW ablation power was set between 15 W and 40 W and applied for 1-6 minutes. Thermocouple placements were as follows: epidural space (n = 7 cases), nerve roots (n = 9 cases), pleura (n = 1), and pericardium (n = 1). The procedure was considered technically successful when the MW and the thermocouple probes were accurately placed and thermoablation was initiated. Clinical success was defined as a 50% visual analog scale score decrease at 1 month as assessed by the operators. Mean MW ablation time was 4.3 minutes with a mean energy of 30 W. Procedural success was 100%. In 16 cases with neural structure monitoring, temperature did not increase > 43°C. In 8 cases, MW ablation had to be discontinued because of temperature reaching 42°C. Efficacy of the procedure in regard to pain was achieved in 17 of 18 ablation sessions at 1 month. Use of a thermocouple during bone MW ablation is a feasible technique and may be a potentially useful tool to help avoid nontarget ablation surrounding tumors. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Stabilization of model-based networked control systems

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

Miranda, Francisco; Instituto Politécnico de Viana do Castelo, Viana do Castelo; Abreu, Carlos

2016-06-08

A class of networked control systems called Model-Based Networked Control Systems (MB-NCSs) is considered. Stabilization of MB-NCSs is studied using feedback controls and simulation of stabilization for different feedbacks is made with the purpose to reduce the network trafic. The feedback control input is applied in a compensated model of the plant that approximates the plant dynamics and stabilizes the plant even under slow network conditions. Conditions for global exponential stabilizability and for the choosing of a feedback control input for a given constant time between the information moments of the network are derived. An optimal control problem to obtainmore » an optimal feedback control is also presented.« less

Thermo-sensitive hydrogel for preventing bowel injury in percutaneous renal radiofrequency ablation.

PubMed

Wang, Xin; Zhao, Xiaozhi; Lin, Tingsheng; Guo, Hongqian

2016-10-01

Percutaneous radiofrequency ablation (PRFA) has been used to ablate renal neoplasms with good outcome. However, if bowel lies adjacent to a tumor, ablation increases the risk of thermal bowel injury, and the consequences could be fatal. We describe the technique, effectiveness and safety of using thermo-sensitive hydrogel as insulation to displace the bowel away during PRFA. The study was divided into two main parts: the in vitro and in vivo studies. In in vitro study, to explore the heat insulation of hydrogel, the rabbit kidney was entirely embedded in hydrogel, and then radiofrequency ablation was performed; the temperature on the gel-air and gel-kidney interfaces was measured. In in vivo study, hydrogel of poloxamer 407, 25 % concentration (w/v), was instilled into the perinephric space of 10 rabbits under CT guidance to separate the kidney from adjacent bowel before PRFA performed in the targeted parenchyma in the gel group. For the control group, PRFA was performed in similar portions of 10 rabbits without instillation of hydrogel. Some parameters were recorded such as kidney-to-bowel and electrode-to-bowel distance. Immediately after PRFA, distribution of hydrogel was evaluated and the dimension of radiofrequency ablation zone was measured; bowel thermal injury was compared between the gel and control groups by gross anatomy and histopathological examination. To assess safety, two additional follow-up groups with 10 rabbits in each were set; after PRFA, CT scan was performed every 2 days; gel absorption, thermal damage and some other complications were evaluated during the period. In in vitro study, temperature was significantly lower at the gel-air than gel-kidney interface (P < .05), and the temperature gradient was positively associated with gel thickness. In in vivo study, hydrogel was instilled successfully in all rabbits in the gel group. The kidney-to-bowel and electrode-to-bowel distances were larger in the gel than control group [(1.1 ± 0.6 cm vs 0.1 ± 0.0 cm, P < .01), (1.8 ± 0.4 cm vs 0.5 ± 0.1 cm, P < .01), respectively]. The gel and control groups did not differ in size of the ablation zones (0.80 ± 0.2 cm vs 0.75 ± 0.3 cm, P > .05). Thermal injury in adjacent bowel was more serious in the control than gel group (P < .01). As for the follow-up, rabbits with gel instillation showed good condition and gel was absorbed gradually within 5 days. Those rabbits with no bowel displacement by gel got significantly lower survival rate and high complication rate (P < .01). Hydrogel-dissection by means of thermo-sensitive hydrogel instillation is valuable for protecting the bowel adjacent to ablation area against thermal injury during PRFA.

Knockdown of cardiac Kir3.1 gene with siRNA can improve bradycardia in an experimental sinus bradycardia rat model.

PubMed

Li, Yang; Fu, Xiaodan; Zhang, Zhi; Yu, Bo

2017-05-01

The objective of this study was to explore whether the inhibition of potassium inwardly rectifying channel (Kir3.1) with short interfering RNA (siRNA) can improve bradycardia in an experimental sinus bradycardia rat model. 54 Sprague Dawley (SD) rats were randomly divided into three groups: experimental group, control group, and sham group. Sinus bradycardia model was established in SD rats through chemical ablation of sinoatrial (SA) node with 20% formaldehyde. Variations of Kir3.1 expression at mRNA and protein level were examined with qPCR and Western blotting. Electrocardiograms (ECG) of rats at 3 days and 1, 2, 3, and 4 weeks after chemical ablation and lentivirus injection were recorded and differences were compared among the three groups. The differences among multiple groups were analyzed by one-way analysis of variance (ANOVA). It was found through RT-PCR and Western blot that the mRNA and protein levels of Kir3.1 at sinoatrial node areas were decreased by 42 ± 7% and 31 ± 7% in comparison with control group, respectively (P < 0.05 in both comparisons) after 4 weeks of chemical ablation/injection. Whole-cell patch clamp data showed that the lentiviral construct could significantly inhibit the potassium current of a muscarinic acetylcholine-sensitive K + channel, I KACh . ECG data showed that the heart rate of experimental group increased after 3 days of chemical ablation/injection and lasted for at least 4 weeks after the chemical ablation/injection (heart rate increased 15.4 ± 3.8% in comparison with control group, P < 0.05). Inhibition of Kir3.1 could rescue sinus bradycardia induced by chemical ablation of SA node with 20% formaldehyde at least partly through inhibiting I KACh channel.

Evaluating Internal Model Strength and Performance of Myoelectric Prosthesis Control Strategies.

PubMed

Shehata, Ahmed W; Scheme, Erik J; Sensinger, Jonathon W

2018-05-01

On-going developments in myoelectric prosthesis control have provided prosthesis users with an assortment of control strategies that vary in reliability and performance. Many studies have focused on improving performance by providing feedback to the user but have overlooked the effect of this feedback on internal model development, which is key to improve long-term performance. In this paper, the strength of internal models developed for two commonly used myoelectric control strategies: raw control with raw feedback (using a regression-based approach) and filtered control with filtered feedback (using a classifier-based approach), were evaluated using two psychometric measures: trial-by-trial adaptation and just-noticeable difference. The performance of both strategies was also evaluated using Schmidt's style target acquisition task. Results obtained from 24 able-bodied subjects showed that although filtered control with filtered feedback had better short-term performance in path efficiency ( ), raw control with raw feedback resulted in stronger internal model development ( ), which may lead to better long-term performance. Despite inherent noise in the control signals of the regression controller, these findings suggest that rich feedback associated with regression control may be used to improve human understanding of the myoelectric control system.

A core outcome set for localised prostate cancer effectiveness trials: protocol for a systematic review of the literature and stakeholder involvement through interviews and a Delphi survey.

PubMed

MacLennan, Steven; Bekema, Hendrika J; Williamson, Paula R; Campbell, Marion K; Stewart, Fiona; MacLennan, Sara J; N'Dow, James M O; Lam, Thomas B L

2015-03-04

Prostate cancer is a growing health problem worldwide. The management of localised prostate cancer is controversial. It is unclear which of several surgical, radiotherapeutic, ablative, and surveillance treatments is the most effective. All have cost, process and recovery, and morbidity implications which add to treatment decision-making complexity for patients and healthcare professionals. Evidence from randomised controlled trials (RCTs) is not optimal because of uncertainty as to what constitutes important outcomes. Another issue hampering evidence synthesis is heterogeneity of outcome definition, measurement, and reporting. This project aims to determine which outcomes are the most important to patients and healthcare professionals, and use these findings to recommend a standardised core outcome set for comparative effectiveness trials of treatments for localised prostate cancer, to optimise decision-making. The range of potentially important outcomes and measures will be identified through systematic reviews of the literature and semi-structured interviews with patients. A consultation exercise involving representatives from two key stakeholder groups (patients and healthcare professionals) will ratify the list of outcomes to be entered into a three round Delphi study. The Delphi process will refine and prioritise the list of identified outcomes. A methodological substudy (nested RCT design) will also be undertaken. Participants will be randomised after round one of the Delphi study to one of three feedback groups, based on different feedback strategies, in order to explore the potential impact of feedback strategies on participant responses. This may assist the design of a future core outcome set and Delphi studies. Following the Delphi study, a final consensus meeting attended by representatives from both stakeholder groups will determine the final recommended core outcome set. This study will inform clinical practice and future trials of interventions of localised prostate cancer by standardising a core outcome set which should be considered in comparative effectiveness studies for localised prostate cancer.

Strategies in probabilistic feedback learning in Parkinson patients OFF medication.

PubMed

Bellebaum, C; Kobza, S; Ferrea, S; Schnitzler, A; Pollok, B; Südmeyer, M

2016-04-21

Studies on classification learning suggested that altered dopamine function in Parkinson's Disease (PD) specifically affects learning from feedback. In patients OFF medication, enhanced learning from negative feedback has been described. This learning bias was not seen in observational learning from feedback, indicating different neural mechanisms for this type of learning. The present study aimed to compare the acquisition of stimulus-response-outcome associations in PD patients OFF medication and healthy control subjects in active and observational learning. 16 PD patients OFF medication and 16 controls were examined with three parallel learning tasks each, two feedback-based (active and observational) and one non-feedback-based paired associates task. No acquisition deficit was seen in the patients for any of the tasks. More detailed analyses on the learning strategies did, however, reveal that the patients showed more lose-shift responses during active feedback learning than controls, and that lose-shift and win-stay responses more strongly determined performance accuracy in patients than controls. For observational feedback learning, the performance of both groups correlated similarly with the performance in non-feedback-based paired associates learning and with the accuracy of observed performance. Also, patients and controls showed comparable evidence of feedback processing in observational learning. In active feedback learning, PD patients use alternative learning strategies than healthy controls. Analyses on observational learning did not yield differences between patients and controls, adding to recent evidence of a differential role of the human striatum in active and observational learning from feedback. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Percutaneous thermal ablation of lung tumors - Radiofrequency, microwave and cryotherapy: Where are we going?

PubMed

Palussière, J; Catena, V; Buy, X

2017-09-01

Main indications of percutaneous pulmonary thermal ablation are early stage non-small cell lung carcinoma (NSCLC) for patients who are not amenable to surgery and slow-evolving localized metastatic disease, either spontaneous or following a general treatment. Radiofrequency ablation (RFA) is the most evaluated technique. This technique offers a local control rate ranging between 80 and 90% for tumors <3cm in diameter. Other more recently used ablation techniques such as microwaves and cryotherapy could overcome some limitations of RFA. One common characteristic of these techniques is an excellent tolerance with very few complications. This article reviews the differences between these techniques when applied to lung tumors, indications, results and complications. Future potential associations with immunotherapy will be discussed. Copyright © 2017. Published by Elsevier Masson SAS.

Patient and Partner Feedback Reports to Improve Statin Medication Adherence: A Randomized Control Trial.

PubMed

Reddy, Ashok; Huseman, Tiffany L; Canamucio, Anne; Marcus, Steven C; Asch, David A; Volpp, Kevin; Long, Judith A

2017-03-01

Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence. To test the impact of a pill bottle used to monitor adherence, deliver a daily alarm, and generate weekly medication adherence feedback reports on statin adherence. Three-month, three-arm randomized clinical trial (ClinicalTrials.gov identifier: NCT02480530). One hundred and twenty-six veterans with known coronary artery disease and poor adherence (medication possession ratio <80 %). Patients were randomized to one of three groups: (1) a control group (n = 36) that received a pill-monitoring device with no alarms or feedback; (2) an individual feedback group (n = 36) that received a daily alarm and a weekly medication adherence feedback report; and (3) a partner feedback group (n = 54) that received an alarm and a weekly feedback report that was shared with a friend, family member, or a peer. The intervention continued for 3 months, and participants were followed for an additional 3 months after the intervention period. Adherence as measured by pill bottle. Secondary outcomes included change in LDL (mg/dl), patient activation, and social support. During the 3-month intervention period, medication adherence was higher in both feedback arms than in the control arm (individual feedback group 89 %, partner feedback group 86 %, control group 67 %; p < 0.001 and = 0.001). At 6 months, there was no difference in medication adherence between either of the feedback groups and the control (individual feedback 60 %, partner feedback 52 %, control group 54 %; p = 0.75 and 0.97). Daily alarms combined with individual or partner feedback reports improved statin medication adherence. While neither an individual feedback nor partner feedback strategy created a sustainable medication adherence habit, the intervention itself is relatively easy to implement and low cost.

Robust design of feedback feed-forward iterative learning control based on 2D system theory for linear uncertain systems

NASA Astrophysics Data System (ADS)

Li, Zhifu; Hu, Yueming; Li, Di

2016-08-01

For a class of linear discrete-time uncertain systems, a feedback feed-forward iterative learning control (ILC) scheme is proposed, which is comprised of an iterative learning controller and two current iteration feedback controllers. The iterative learning controller is used to improve the performance along the iteration direction and the feedback controllers are used to improve the performance along the time direction. First of all, the uncertain feedback feed-forward ILC system is presented by an uncertain two-dimensional Roesser model system. Then, two robust control schemes are proposed. One can ensure that the feedback feed-forward ILC system is bounded-input bounded-output stable along time direction, and the other can ensure that the feedback feed-forward ILC system is asymptotically stable along time direction. Both schemes can guarantee the system is robust monotonically convergent along the iteration direction. Third, the robust convergent sufficient conditions are given, which contains a linear matrix inequality (LMI). Moreover, the LMI can be used to determine the gain matrix of the feedback feed-forward iterative learning controller. Finally, the simulation results are presented to demonstrate the effectiveness of the proposed schemes.

The Drosophila Duox maturation factor is a key component of a positive feedback loop that sustains regeneration signaling.

PubMed

Khan, Sumbul Jawed; Abidi, Syeda Nayab Fatima; Skinner, Andrea; Tian, Yuan; Smith-Bolton, Rachel K

2017-07-01

Regenerating tissue must initiate the signaling that drives regenerative growth, and sustain that signaling long enough for regeneration to complete. How these key signals are sustained is unclear. To gain a comprehensive view of the changes in gene expression that occur during regeneration, we performed whole-genome mRNAseq of actively regenerating tissue from damaged Drosophila wing imaginal discs. We used genetic tools to ablate the wing primordium to induce regeneration, and carried out transcriptional profiling of the regeneration blastema by fluorescently labeling and sorting the blastema cells, thus identifying differentially expressed genes. Importantly, by using genetic mutants of several of these differentially expressed genes we have confirmed that they have roles in regeneration. Using this approach, we show that high expression of the gene moladietz (mol), which encodes the Duox-maturation factor NIP, is required during regeneration to produce reactive oxygen species (ROS), which in turn sustain JNK signaling during regeneration. We also show that JNK signaling upregulates mol expression, thereby activating a positive feedback signal that ensures the prolonged JNK activation required for regenerative growth. Thus, by whole-genome transcriptional profiling of regenerating tissue we have identified a positive feedback loop that regulates the extent of regenerative growth.

The Drosophila Duox maturation factor is a key component of a positive feedback loop that sustains regeneration signaling

PubMed Central

Skinner, Andrea; Tian, Yuan

2017-01-01

Regenerating tissue must initiate the signaling that drives regenerative growth, and sustain that signaling long enough for regeneration to complete. How these key signals are sustained is unclear. To gain a comprehensive view of the changes in gene expression that occur during regeneration, we performed whole-genome mRNAseq of actively regenerating tissue from damaged Drosophila wing imaginal discs. We used genetic tools to ablate the wing primordium to induce regeneration, and carried out transcriptional profiling of the regeneration blastema by fluorescently labeling and sorting the blastema cells, thus identifying differentially expressed genes. Importantly, by using genetic mutants of several of these differentially expressed genes we have confirmed that they have roles in regeneration. Using this approach, we show that high expression of the gene moladietz (mol), which encodes the Duox-maturation factor NIP, is required during regeneration to produce reactive oxygen species (ROS), which in turn sustain JNK signaling during regeneration. We also show that JNK signaling upregulates mol expression, thereby activating a positive feedback signal that ensures the prolonged JNK activation required for regenerative growth. Thus, by whole-genome transcriptional profiling of regenerating tissue we have identified a positive feedback loop that regulates the extent of regenerative growth. PMID:28753614

Feedback is the breakfast of champions: the significance of self-controlled formal feedback for autonomous task engagement.

PubMed

Meng, Liang; Yang, Zijing

2018-01-03

With the aim of examining the positive effect of the formal feedback mechanism itself beyond its informational aspect, we engaged participants in the stopwatch task and recorded their electroencephalogram throughout the experiment. This task requires a button press to stop the watch within a given time interval, the completion of which is simultaneously accompanied by adequate information on task performance. In the self-controlled feedback mode, participants could freely choose whether to request formal feedback after completing the task. In another mode, additional feedback was not provided. The 'non-choice' cue was found to elicit a more negative cue-elicited feedback negativity compared with 'choice', suggesting that the opportunity to solicit formal feedback was perceived as more desirable. In addition, a more enhanced stimulus-preceding negativity was observed prior to the task initiation cue in the self-controlled feedback condition, indicating that participants paid more sustained anticipatory attention during task preparation. Taken together, these electrophysiological results suggested an inherent reward within the formal feedback mechanism itself and the significance of self-controlled formal feedback for autonomous task engagement.

Observer-Based Adaptive Neural Network Control for Nonlinear Systems in Nonstrict-Feedback Form.

PubMed

Chen, Bing; Zhang, Huaguang; Lin, Chong

2016-01-01

This paper focuses on the problem of adaptive neural network (NN) control for a class of nonlinear nonstrict-feedback systems via output feedback. A novel adaptive NN backstepping output-feedback control approach is first proposed for nonlinear nonstrict-feedback systems. The monotonicity of system bounding functions and the structure character of radial basis function (RBF) NNs are used to overcome the difficulties that arise from nonstrict-feedback structure. A state observer is constructed to estimate the immeasurable state variables. By combining adaptive backstepping technique with approximation capability of radial basis function NNs, an output-feedback adaptive NN controller is designed through backstepping approach. It is shown that the proposed controller guarantees semiglobal boundedness of all the signals in the closed-loop systems. Two examples are used to illustrate the effectiveness of the proposed approach.

Debris thickness patterns on debris-covered glaciers

NASA Astrophysics Data System (ADS)

Anderson, Leif S.; Anderson, Robert S.

2018-06-01

Many debris-covered glaciers have broadly similar debris thickness patterns: surface debris thickens and tends to transition from convex- to concave-up-down glacier. We explain this pattern using theory (analytical and numerical models) paired with empirical observations. Down glacier debris thickening results from the conveyor-belt-like nature of the glacier surface in the ablation zone (debris can typically only be added but not removed) and from the inevitable decline in ice surface velocity toward the terminus. Down-glacier thickening of debris leads to the reduction of sub-debris melt and debris emergence toward the terminus. Convex-up debris thickness patterns occur near the up-glacier end of debris covers where debris emergence dominates (ablation controlled). Concave-up debris thickness patterns occur toward glacier termini where declining surface velocities dominate (velocity controlled). A convex-concave debris thickness profile inevitably results from the transition between ablation-control and velocity-control down-glacier. Debris thickness patterns deviating from this longitudinal shape are most likely caused by changes in hillslope debris supply through time. By establishing this expected debris thickness pattern, the effects of climate change on debris cover can be better identified.

Low-to-Medium Power Single Chip Digital Controlled DC-DC Regulator for Point-of-Load Applications

NASA Technical Reports Server (NTRS)

Adell, Philippe C. (Inventor); Bakkaloglu, Bertan (Inventor); Vermeire, Bert (Inventor); Liu, Tao (Inventor)

2015-01-01

A DC-DC converter for generating a DC output voltage includes: a digitally controlled pulse width modulator (DPWM) for controlling a switching power stage to supply a varying voltage to an inductor; and a digital voltage feedback circuit for controlling the DPWM in accordance with a feedback voltage corresponding to the DC output voltage, the digital voltage feedback circuit including: a first voltage controlled oscillator for converting the feedback voltage into a first frequency signal and to supply the first frequency signal to a first frequency discriminator; a second voltage controlled oscillator for converting a reference voltage into a second frequency signal and to supply the second frequency signal to a second frequency discriminator; a digital comparator for comparing digital outputs of the first and second frequency discriminators and for outputting a digital feedback signal; and a controller for controlling the DPWM in accordance with the digital feedback signal.

Servo control booster system for minimizing following error

DOEpatents

Wise, William L.

1985-01-01

A closed-loop feedback-controlled servo system is disclosed which reduces command-to-response error to the system's position feedback resolution least increment, .DELTA.S.sub.R, on a continuous real-time basis for all operating speeds. The servo system employs a second position feedback control loop on a by exception basis, when the command-to-response error .gtoreq..DELTA.S.sub.R, to produce precise position correction signals. When the command-to-response error is less than .DELTA.S.sub.R, control automatically reverts to conventional control means as the second position feedback control loop is disconnected, becoming transparent to conventional servo control means. By operating the second unique position feedback control loop used herein at the appropriate clocking rate, command-to-response error may be reduced to the position feedback resolution least increment. The present system may be utilized in combination with a tachometer loop for increased stability.

Remote magnetic navigation for accurate, real-time catheter positioning and ablation in cardiac electrophysiology procedures.

PubMed

Filgueiras-Rama, David; Estrada, Alejandro; Shachar, Josh; Castrejón, Sergio; Doiny, David; Ortega, Marta; Gang, Eli; Merino, José L

2013-04-21

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac substrates such as left atrial flutter. This protocol describes all the clinical and invasive interventional steps performed during a human electrophysiological study and ablation to assess the accuracy, safety and real-time navigation of the Catheter Guidance, Control and Imaging (CGCI) system. Patients who underwent ablation of a right or left atrium flutter substrate were included. Specifically, data from three left atrial flutter and two counterclockwise right atrial flutter procedures are shown in this report. One representative left atrial flutter procedure is shown in the movie. This system is based on eight coil-core electromagnets, which generate a dynamic magnetic field focused on the heart. Remote navigation by rapid changes (msec) in the magnetic field magnitude and a very flexible magnetized catheter allow real-time closed-loop integration and accurate, stable positioning and ablation of the arrhythmogenic substrate.

Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

PubMed Central

Filgueiras-Rama, David; Estrada, Alejandro; Shachar, Josh; Castrejón, Sergio; Doiny, David; Ortega, Marta; Gang, Eli; Merino, José L.

2013-01-01

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac substrates such as left atrial flutter. This protocol describes all the clinical and invasive interventional steps performed during a human electrophysiological study and ablation to assess the accuracy, safety and real-time navigation of the Catheter Guidance, Control and Imaging (CGCI) system. Patients who underwent ablation of a right or left atrium flutter substrate were included. Specifically, data from three left atrial flutter and two counterclockwise right atrial flutter procedures are shown in this report. One representative left atrial flutter procedure is shown in the movie. This system is based on eight coil-core electromagnets, which generate a dynamic magnetic field focused on the heart. Remote navigation by rapid changes (msec) in the magnetic field magnitude and a very flexible magnetized catheter allow real-time closed-loop integration and accurate, stable positioning and ablation of the arrhythmogenic substrate. PMID:23628883

[Oligometastatic bone disease. Can limited metastatic bone disease be cured? Is there room for local ablative treatments?].

PubMed

Thariat, J; Leysalle, A; Vignot, S; Marcy, P-Y; Lacout, A; Bera, G; Lagrange, J-L; Clezardin, P; Chiras, J

2012-09-01

Solitary metastases have been reported in up to 30% of cases in imaging series. Local treatment aims at consolidating the injured bone and to prevent neurologic complications. Since the prognosis of bony metastatic disease is about 30 months and includes some long survivors, the multisdisciplinary committee in charge of the patient should ask the question and decide on the type of radical/ablative intervention in case of oligometastases. A literature search was performed using MESH terms (bone, metastases, radiotherapy, radiology, cement, radiofrequency ablation, chemoembolisation). Local ablative treatments can yield symptomatic relief and local control rates of about 90%. Stereotactic hypofractionated irradiation and cementoplasty are increasingly used. In conclusion, local ablative treatment of bony oligometastases is an efficient treatment. Its potential impact on survival remains to be demonstrated prospectively in clinical trials. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Role of measurement in feedback-controlled quantum engines

NASA Astrophysics Data System (ADS)

Yi, Juyeon; Kim, Yong Woon

2018-01-01

In feedback controls, measurement is an essential step in designing protocols according to outcomes. For quantum mechanical systems, measurement has another effect; to supply energy to the measured system. We verify that in feedback-controlled quantum engines, measurement plays a dual role; not only as an auxiliary to perform feedback control but also as an energy supply to drive the engines. We consider a specific engine cycle exploiting feedback control followed by projective measurement and show that the maximum bound of the extractable work is set by both the efficacy of the feedback control and the energy change caused by projective measurement. We take a concrete example of an engine using an immobile spin-1/2 particle as a working substance and suggest two possible scenarios for work extraction.

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

Schnapauff, Dirk, E-mail: dirk.schnapauff@charite.de; Denecke, Timm; Grieser, Christian

Purpose: This study was designed to investigate the clinical outcome of patients with irresectable, intrahepatic cholangiocarcinoma (IHC) treated with computed tomography (CT)-guided HDR-brachytherapy (CT-HDRBT) for local tumor ablation.MethodFifteen consecutive patients with histologically proven cholangiocarcinoma were selected for this retrospective study. Patients were treated by high-dose-rate internal brachytherapy (HDRBT) using an Iridium-192 source in afterloading technique through CT-guided percutaneous placed catheters. A total of 27 brachytherapy treatments were performed in these patients between 2006 and 2009. Median tumor enclosing target dose was 20 Gy, and mean target volume of the radiated tumors was 131 ({+-} 90) ml (range, 10-257 ml). Follow-upmore » consisted of clinical visits and magnetic resonance imaging of the liver every third month. Statistical evaluation included survival analysis using the Kaplan-Meier method. Results: After a median follow-up of 18 (range, 1-27) months after local ablation, 6 of the 15 patients are still alive; 4 of them did not get further chemotherapy and are regarded as disease-free. The reached median local tumor control was 10 months; median local tumor control, including repetitive local ablation, was 11 months. Median survival after local ablation was 14 months and after primary diagnosis 21 months. Conclusion: In view of current clinical data on the clinical outcome of cholangiocarcinoma, locally ablative treatment with CT-HDRBT represents a promising and safe technique for patients who are not eligible for tumor resection.« less

Composite Configuration Interventional Therapy Robot for the Microwave Ablation of Liver Tumors

NASA Astrophysics Data System (ADS)

Cao, Ying-Yu; Xue, Long; Qi, Bo-Jin; Jiang, Li-Pei; Deng, Shuang-Cheng; Liang, Ping; Liu, Jia

2017-11-01

The existing interventional therapy robots for the microwave ablation of liver tumors have a poor clinical applicability with a large volume, low positioning speed and complex automatic navigation control. To solve above problems, a composite configuration interventional therapy robot with passive and active joints is developed. The design of composite configuration reduces the size of the robot under the premise of a wide range of movement, and the robot with composite configuration can realizes rapid positioning with operation safety. The cumulative error of positioning is eliminated and the control complexity is reduced by decoupling active parts. The navigation algorithms for the robot are proposed based on solution of the inverse kinematics and geometric analysis. A simulation clinical test method is designed for the robot, and the functions of the robot and the navigation algorithms are verified by the test method. The mean error of navigation is 1.488 mm and the maximum error is 2.056 mm, and the positioning time for the ablation needle is in 10 s. The experimental results show that the designed robot can meet the clinical requirements for the microwave ablation of liver tumors. The composite configuration is proposed in development of the interventional therapy robot for the microwave ablation of liver tumors, which provides a new idea for the structural design of medical robots.

Radiofrequency Ablation versus Cryoablation in the Treatment of Paroxysmal Atrial Fibrillation: A Meta-Analysis

PubMed Central

Hachem, Ali H.; Marine, Joseph E.; Tahboub, Housam A.; Kamdar, Sana; Kanjwal, Shaffi; Soni, Ronak

2018-01-01

Background Pulmonary vein isolation is commonly performed using radiofrequency energy with cryoablation gaining acceptance. We performed a meta-analysis of randomized controlled trials which compared radiofrequency versus cryoablation for patients with atrial fibrillation. Methods A systematic search strategy identified both published and unpublished articles from inception to November 10, 2016, in multiple databases. The primary outcomes for this meta-analysis were long-term freedom from atrial fibrillation at 12-month follow-up and overall postoperative complication rates. For all included studies, the methodological quality was assessed through the Cochrane Collaboration's tool for risk of bias. Results A total of 247 articles were identified with eight being included in this review as they satisfied the prespecified inclusion criteria. Overall, there was no significant difference in freedom from atrial fibrillation at ≥12-month follow-up between those receiving cryoballoon and radiofrequency ablation, respectively (OR = 0.98, CI = 0.67–1.43, I2 = 56%, p=0.90). Additionally, the secondary outcomes of duration of ablation, fluoroscopy time, and ablation time failed to reach significance. Cryoballoon ablation had significantly greater odds of postoperative phrenic nerve injury at 12-month follow-up. Conclusions Our meta-analysis suggests that cryoballoon ablation provides comparable benefits with regard to freedom from atrial fibrillation at medium-term follow-up, fluoroscopy time, ablation time, operative duration, and overall complication rate in comparison to radiofrequency ablation. PMID:29805800

State feedback controller design for the synchronization of Boolean networks with time delays

NASA Astrophysics Data System (ADS)

Li, Fangfei; Li, Jianning; Shen, Lijuan

2018-01-01

State feedback control design to make the response Boolean network synchronize with the drive Boolean network is far from being solved in the literature. Motivated by this, this paper studies the feedback control design for the complete synchronization of two coupled Boolean networks with time delays. A necessary condition for the existence of a state feedback controller is derived first. Then the feedback control design procedure for the complete synchronization of two coupled Boolean networks is provided based on the necessary condition. Finally, an example is given to illustrate the proposed design procedure.

Investigation of factors affecting the synthesis of nano-cadmium sulfide by pulsed laser ablation in liquid environment

NASA Astrophysics Data System (ADS)

Darwish, Ayman M.; Eisa, Wael H.; Shabaka, Ali A.; Talaat, Mohamed H.

2016-01-01

Pulsed laser ablation in a liquid medium is a promising technique as compared to the other synthetic methods to synthesize different materials in nanoscale form. The laser parameters (e.g., wavelength, pulse width, fluence, and repetition frequency) and liquid medium (e.g., aqueous/nonaqueous liquid or solution with surfactant) were tightly controlled during and after the ablation process. By optimizing these parameters, the particle size and distribution of materials can be adjusted. The UV-vis absorption spectra and weight changes of targets were used for the characterization and comparison of products.

Delayed vertebral body collapse after stereotactic radiosurgery and radiofrequency ablation: Case report with histopathologic-MRI correlation.

PubMed

Wallace, Adam N; Vyhmeister, Ross; Hsi, Andy C; Robinson, Clifford G; Chang, Randy O; Jennings, Jack W

2015-12-01

Stereotactic radiosurgery and percutaneous radiofrequency ablation are emerging therapies for pain palliation and local control of spinal metastases. However, the post-treatment imaging findings are not well characterized and the risk of long-term complications is unknown. We present the case of a 46-year-old woman with delayed vertebral body collapse after stereotactic radiosurgery and radiofrequency ablation of a painful lumbar metastasis. Histopathologic-MRI correlation confirmed osteonecrosis as the underlying etiology and demonstrated that treatment-induced vascular fibrosis and tumor progression can have identical imaging appearances. © The Author(s) 2015.

An Analysis of Ablation-Shield Requirements for Manned Reentry Vehicles

NASA Technical Reports Server (NTRS)

Roberts, Leonard

1960-01-01

The problem of sublimation of material and accumulation of heat in an ablation shield is analyzed and the results are applied to the reentry of manned vehicles into the earth's atmosphere. The parameters which control the amount of sublimation and the temperature distribution within the ablation shield are determined and presented in a manner useful for engineering calculation. It is shown that the total mass loss from the shield during reentry and the insulation requirements may be given very simply in terms of the maximum deceleration of the vehicle or the total reentry time.

SwiftLase: a new technology for char-free ablation in rectal surgery

NASA Astrophysics Data System (ADS)

Arnold, David A.

1995-05-01

We describe layer-by-layer char-free ablation of hemorrhoids and other rectal lesions at very low CO2 laser power levels with a miniature `SwiftLaser' optomechanical flashscanner. Increased speed with excellent control, very shallow thermal damage, and less postoperative pain are the main advantages of the flashscan technology in rectal surgery.

Assessment of MR Thermometry During High Intensity Ultrasound Ablation of the Canine Prostate

NASA Astrophysics Data System (ADS)

Butts Pauly, Kim; Rieke, Viola; Pisani, Laura; Sommer, Graham; Bouley, Donna; Diederich, Chris; Ross, Anthony; Nau, Will; Kinsey, Adam; Dumoulin, Charles; Watkins, Ronald

2006-05-01

We are developing transurethral and interstitial ultrasound applicators for the local control of prostate cancer and BPH. The ultrasound energy will be delivered under magnetic resonance imaging guidance because it can provide exquisite temperature mapping capability. The purpose of this work was to evaluate MR thermometry during high intensity ultrasound ablation often canine prostates.

Servo control of an optical trap.

PubMed

Wulff, Kurt D; Cole, Daniel G; Clark, Robert L

2007-08-01

A versatile optical trap has been constructed to control the position of trapped objects and ultimately to apply specified forces using feedback control. While the design, development, and use of optical traps has been extensive and feedback control has played a critical role in pushing the state of the art, few comprehensive examinations of feedback control of optical traps have been undertaken. Furthermore, as the requirements are pushed to ever smaller distances and forces, the performance of optical traps reaches limits. It is well understood that feedback control can result in both positive and negative effects in controlled systems. We give an analysis of the trapping limits as well as introducing an optical trap with a feedback control scheme that dramatically improves an optical trap's sensitivity at low frequencies.

High Accuracy Attitude Control of a Spacecraft Using Feedback Linearization

DTIC Science & Technology

1992-05-01

High Accuracy Attitude Control of a Spacecraft Using Feedback Linearization A Thesis Presented by Louis Joseph PoehIman, Captain, USAF B.S., U.S. Air...High Accuracy Attitude Control of a Spacecraft Using Feedback Linearization by Louis Joseph Poehlman, Captain, USAF Submitted to the Department of...31 2-4 Attitude Determination and Control System Architecture ................. 33 3-1 Exact Linearization Using Nonlinear Feedback

Effect of Ablation of Area Postrema on Frequency and Latency of Motion Sickness-Induced Emesis in the Squirrel Monkey

NASA Technical Reports Server (NTRS)

Brizzee, K. R.; Ordy, J. M.; Mehler, W. R.

1980-01-01

Twelve young adult squirrel monkeys of the Bolivian subspecies were subjected to continuous counter-clockwise horizontal rotary motion at 25 rpm, together with a sinusoidal vertical excursion of 6 in. every 2 sec (0.5 Hz). Each animal was exposed to this motion regimen for a period of 60 min once each week for three consecutive weeks. Following the third weekly motion test bilateral ablation of the Area Postrema (AP) was performed in eight of the animals by thermal cautery. Two control animals were sham-operated after the third motion test while two additional controls were given the motion tests as noted above but were not operated. The four controls were considered as a single group for statistical analyses of results of the motion tests. After a recovery period of 30 to 40 days, and at a comparable interval in the non-operated controls, each animal was again tested for motion sensitivity for three consecutive weeks. The brains of all of the animals were then fixed by left ventriculal cardiac perfusion with Bouin's fluid and processed for histological evaluation of the bilateral AP ablation in comparison with the control brains. Five of the AP-ablated animals postoperatively were completely refractory to the motion stimuli, two exhibited a decreased number of emetic responses, and one exhibited the same number of responses before and after the AP lesions. The controls exhibited no significant difference in emetic sensitivity on the second series of three weekly tests than on the first series. The results of this investigation appear to be in agreement with the observations of Wang and Chinn in the dog indicating that the integrity of the AP (CTZ) is essential to the emetic response to motion.

Radiographic Local Tumor Control and Pain Palliation of Sarcoma Metastases within the Musculoskeletal System with Percutaneous Thermal Ablation.

PubMed

Vaswani, Devin; Wallace, Adam N; Eiswirth, Preston S; Madaelil, Thomas P; Chang, Randy O; Tomasian, Anderanik; Jennings, Jack W

2018-03-14

To evaluate the effectiveness of percutaneous image-guided thermal ablation in achieving local tumor control and pain palliation of sarcoma metastases within the musculoskeletal system. Retrospective review of 64 sarcoma metastases within the musculoskeletal system in 26 women and 15 men (total = 41) treated with ablation between December 2011 and August 2016 was performed. Mean age of the cohort was 42.9 years ± 16.0 years. Two subgroups were treated: oligometastatic disease (n = 13) and widely metastatic disease (n = 51). A variety of sarcoma histologies were treated with average tumor volume of 42.5 cm 3 (range 0.1-484.7 cm 3 ). Pain scores were recorded before and 4 weeks after therapy for 59% (38/64) of treated lesions. Follow-up imaging was evaluated for local control and to monitor sites of untreated disease as an internal control. Fifty-eight percent (37/64) were lost to imaging follow-up at varying time points over a year. Complication rate was 5% (3/64; one minor and two major events). One-year local tumor control rates were 70% (19/27) in all patients, 67% (12/18) in the setting of progression of untreated metastases, and 100% (10/10) in the setting of oligometastatic disease. Median pain scores decreased from 8 (interquartile range 5.0-9.0) to 3 (interquartile range 0.1-4.0) 1 month after the procedure (P < 0.001). Image-guided percutaneous ablation is an effective option for local tumor control and pain palliation of metastatic sarcomas within the musculoskeletal system. Treatment in the setting of oligometastatic disease offers potential for remission. Level 4, Retrospective Review.

Cryoconite pans on Snowball Earth: supraglacial oases for Cryogenian eukaryotes?

PubMed

Hoffman, P F

2016-11-01

Geochemical, paleomagnetic, and geochronological data increasingly support the Snowball Earth hypothesis for Cryogenian glaciations. Yet, the fossil record reveals no clear-cut evolutionary bottleneck. Climate models and the modern cryobiosphere offer insights on this paradox. Recent modeling implies that Snowball continents never lacked ice-free areas. Wind-blown dust from these areas plus volcanic ash were trapped by snow on ice sheets and sea ice. At a Snowball onset, sea ice was too thin to flow and ablative ice was too cold for dust retention. After a few millenia, sea ice reached 100 s of meters in thickness and began to flow as a 'sea glacier' toward an equatorial ablation zone. At first, dust advected to the ablative surface was recycled by winds, but as the surface warmed with rising CO 2 , dust aka cryoconite began to accumulate. As a sea glacier has no terminus, cryoconite saturated the surface. It absorbed solar radiation, supported cyanobacterial growth, and sank to an equilibrium depth forming holes and decameter-scale pans of meltwater. As meltwater production rose, drainages developed, connecting pans to moulins, where meltwater was flushed into the subglacial ocean. Flushing cleansed the surface, creating a stabilizing feedback. If the dust flux rose, cryoconite was removed; if the dust flux waned, cryoconite accumulated. In addition to cyanobacteria, modern cryoconite holes are inhabited by green algae, fungi, protists, and certain metazoans. On Snowball Earth, cryoconite pans provided stable interconnected habitats for eukaryotes tolerant of fresh to brackish cold water on an ablation surface 60 million km 2 in area. Flushing and burial of organic matter was a potential source of atmospheric oxygen. Dominance of green algae among Ediacaran eukaryotic primary producers is a possible legacy of Cryogenian cryoconite pans, but a schizohaline ocean-supraglacial freshwater and subglacial brine-may have exerted selective stress on early metazoans, or impeded their evolution. © 2016 John Wiley & Sons Ltd.

Uncovering glacier dynamics beneath a debris mantle

NASA Astrophysics Data System (ADS)

Lefeuvre, P.-M.; Ng, F. S. L.

2012-04-01

Debris-covered glaciers (DCGs) have an extensive sediment mantle whose low albedo influences their surface energy balance to cause a buffering effect that could enhance or reduce ablation rates depending on the sediment thickness. The last effect suggests that some DCGs may be less sensitive to climate change and survive for longer than debris-free (or 'clean') glaciers under sustained climatic warming. However, the origin of DCGs is debated and the precise impact of the debris mantle on their flow dynamics and surface geometry has not been quantified. Here we investigate these issues with a numerical model that encapsulates ice-flow physics and surface debris evolution and transport along a glacier flow-line, as well as couples these with glacier mass balance. We model the impact of surface debris on ablation rates by a mathematical function based on published empirical data (including Ostrem's curve). A key interest is potential positive feedback of ablation on debris thickening and lowering of surface albedo. Model simulations show that when DCGs evolve to attain steady-state profiles, they reach lower elevations than clean glaciers do for the same initial and climatic conditions. Their mass-balance profile at steady state displays an inversion near the snout (where the debris cover is thickest) that is not observed in the clean-glacier simulations. In these cases, where the mantle causes complete buffering to inhibit ablation, the DCG does not reach a steady-state profile, and the sediment thickness evolves to a steady value that depends sensitively on the glacier surface velocities. Variation in the assumed englacial debris concentration in our simulations also determines glacier behaviour. With low englacial debris concentration, the DCG retreats initially while its mass-balance gradient steepens, but the glacier re-advances if it subsequently builds up a thick enough debris cover to cause complete buffering. We identify possible ways and challenges of testing this model with field observations of DCGs, given the inherent difficulty that such glaciers may not be in steady state.

Pulsed Dose Radiofrequency Before Ablation of Medial Branch of the Lumbar Dorsal Ramus for Zygapophyseal Joint Pain Reduces Post-procedural Pain.

PubMed

Arsanious, David; Gage, Emmanuel; Koning, Jonathon; Sarhan, Mazin; Chaiban, Gassan; Almualim, Mohammed; Atallah, Joseph

2016-01-01

One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease. This is a prospective, double-blinded, randomized, controlled trial. Patients who met all the inclusion criteria and were not subject to any of the exclusion criteria were required to have two positive diagnostic medial branch blocks prior to undergoing randomization, intervention, and analysis. University hospital. Eligible patients were randomized in a 1:1 ratio to either receive thermal radiofrequency ablation alone (standard group) or pulsed dose radiofrequency (PDRF) immediately followed by thermal radiofrequency ablation (investigational group), all of which were performed by a single Board Certified Pain Medicine physician. Post-procedural pain levels between the two groups were assessed using the numerical pain Scale (NPS), and patients were contacted by phone on post-procedural days 1 and 2 in the morning and afternoon regarding the amount of oral analgesic medications used in the first 48 hours following the procedure. Patients who received pulsed dose radiofrequency followed by continuous radiofrequency neurotomy reported statistically significantly lower post-procedural pain scores in the first 24 hours compared to patients who received thermal radiofrequency neurotomy alone. These patients also used less oral analgesic medication in the post-procedural period. These interventions were carried out by one board accredited pain physician at one center. The procedures were exclusively performed using one model of radiofrequency generator, at one setting for the PDRF and RFA. The difference in the number of levels of ablation was not considered in the analysis of the results. Treating patients with pulsed dose radiofrequency prior to continuous thermal radiofrequency ablation can provide patients with less post-procedural pain during the first 24 hours and also reduce analgesic requirements. Furthermore, the addition of PDRF to standard thermal RFA did not prolong the time of standard thermal radiofrequency ablation procedures, as it was performed during the typically allotted time for local anesthetic action. Low back pain, facet joint disease, medial branch block, Radiofrequency ablation, thermal radiofrequency, pulsed dose radiofrequency, PDRF, zygapophyseal joint.

On the interaction structure of linear multi-input feedback control systems. M.S. Thesis; [problem solving, lattices (mathematics)

NASA Technical Reports Server (NTRS)

Wong, P. K.

1975-01-01

The closely-related problems of designing reliable feedback stabilization strategy and coordinating decentralized feedbacks are considered. Two approaches are taken. A geometric characterization of the structure of control interaction (and its dual) was first attempted and a concept of structural homomorphism developed based on the idea of 'similarity' of interaction pattern. The idea of finding classes of individual feedback maps that do not 'interfere' with the stabilizing action of each other was developed by identifying the structural properties of nondestabilizing and LQ-optimal feedback maps. Some known stability properties of LQ-feedback were generalized and some partial solutions were provided to the reliable stabilization and decentralized feedback coordination problems. A concept of coordination parametrization was introduced, and a scheme for classifying different modes of decentralization (information, control law computation, on-line control implementation) in control systems was developed.

Temperature feedback control for long-term carrier-envelope phase locking

DOEpatents

Chang, Zenghu [Manhattan, KS; Yun, Chenxia [Manhattan, KS; Chen, Shouyuan [Manhattan, KS; Wang, He [Manhattan, KS; Chini, Michael [Manhattan, KS

2012-07-24

A feedback control module for stabilizing a carrier-envelope phase of an output of a laser oscillator system comprises a first photodetector, a second photodetector, a phase stabilizer, an optical modulator, and a thermal control element. The first photodetector may generate a first feedback signal corresponding to a first portion of a laser beam from an oscillator. The second photodetector may generate a second feedback signal corresponding to a second portion of the laser beam filtered by a low-pass filter. The phase stabilizer may divide the frequency of the first feedback signal by a factor and generate an error signal corresponding to the difference between the frequency-divided first feedback signal and the second feedback signal. The optical modulator may modulate the laser beam within the oscillator corresponding to the error signal. The thermal control unit may change the temperature of the oscillator corresponding to a signal operable to control the optical modulator.

Clinical predictors of challenging atrioventricular node ablation procedure for rate control in patients with atrial fibrillation.

PubMed

Polin, Baptiste; Behar, Nathalie; Galand, Vincent; Auffret, Vincent; Behaghel, Albin; Pavin, Dominique; Daubert, Jean-Claude; Mabo, Philippe; Leclercq, Christophe; Martins, Raphael P

2017-10-15

Atrioventricular node (AVN) ablation is usually a simple procedure but may sometimes be challenging. We aimed at identifying pre-procedural clinical predictors of challenging AVN ablation. Patients referred for AVN ablation from 2009 to 2015 were retrospectively included. Baseline clinical data, procedural variables and outcomes of AVN ablation were collected. A "challenging procedure" was defined 1) total radiofrequency delivery to get persistent AVN block≥400s, 2) need for left-sided arterial approach or 3) failure to obtain AVN ablation. 200 patients were included (71±10years). A total of 37 (18.5%) patients had "challenging" procedures (including 9 failures, 4.5%), while 163 (81.5%) had "non-challenging" ablations. In multivariable analysis, male sex (Odds ratio (OR)=4.66, 95% confidence interval (CI): 1.74-12.46), body mass index (BMI, OR=1.08 per 1kg/m 2 , 95%CI 1.01-1.16), operator experience (OR=0.40, 95%CI 0.17-0.94), and moderate-to-severe tricuspid regurgitation (TR, OR=3.65, 95%CI 1.63-8.15) were significant predictors of "challenging" ablations. The proportion as a function of number of predictors was analyzed (from 0 to 4, including male sex, operator inexperience, a BMI>23.5kg/m 2 and moderate-to-severe TR). There was a gradual increase in the risk of "challenging" procedure with the number of predictors by patient (No predictor: 0%; 1 predictor: 6.3%; 2 predictors: 16.5%; 3 predictors: 32.5%; 4 predictors: 77.8%). Operator experience, male sex, higher BMI and the degree of TR were independent predictors of "challenging" AVN ablation procedure. The risk increases with the number of predictors by patient. Copyright © 2017. Published by Elsevier B.V.

Treatment of Recurrent Nonparoxysmal Atrial Fibrillation Using Focal Impulse and Rotor Mapping (FIRM)-Guided Rotor Ablation: Early Recurrence and Long-Term Outcomes.

PubMed

Spitzer, Stefan Georg; Károlyi, László; Rämmler, Carola; Scharfe, Frank; Weinmann, Thomas; Zieschank, Mirko; Langbein, Anke

2017-01-01

A patient-tailored ablation approach focused on the elimination of both pulmonary vein triggers as well as substrate drivers may result in favorable outcomes in recurrent persistent AF patients. We evaluated the long-term outcomes of rotor ablation combined with conventional pulmonary vein isolation (PVI) in patients with recurrent nonparoxysmal AF. Fifty-eight consecutive patients underwent FIRM-guided rotor ablation followed by conventional PVI for the treatment of recurrent nonparoxysmal AF. A software algorithm was used to display rotational activity at rotor sites by creating propagation maps from unipolar electrograms recorded using a 64-electrode basket catheter. These rotor sites were targeted for ablation, followed by conventional PVI. All patients had nonparoxysmal AF (83% longstanding persistent) and a previously failed conventional ablation procedure. Stable rotors were identified in all patients (mean of 3.0 ± 1.6 per patient), with 55.2% having right atrial rotors and 96.6% left atrial rotors, respectively. Complications occurred in 5.2% of patients, none related to the FIRM procedure. The median follow-up was 12 months. At 6 and 12 months of follow-up, 73.2% and 76.9% of patients remained free from AF/AT, respectively. Excluding 2 patients who underwent a successful redo ablation procedure/electrical cardioversion, at 12 months of follow-up, 69.2% were free from any AF/AT and 73.1% were free from AF after a single FIRM-guided ablation procedure. A high degree of success was observed in this cohort of primarily longstanding persistent AF patients treated for recurrent AF with FIRM-guided rotor ablation. Prospective randomized controlled trials are needed. © 2016 Wiley Periodicals, Inc.

Flexible Ablators: Applications and Arcjet Testing

NASA Technical Reports Server (NTRS)

Arnold, James O.; Venkatapathy, Ethiraj; Beck, Robin A S.; Mcguire, Kathy; Prabhu, Dinesh K.; Gorbunov, Sergey

2011-01-01

Flexible ablators were conceived in 2009 to meet the technology pull for large, human Mars Exploration Class, 23 m diameter hypersonic inflatable aerodynamic decelerators. As described elsewhere, they have been recently undergoing initial technical readiness (TRL) advancement by NASA. The performance limits of flexible ablators in terms of maximum heat rates, pressure and shear remain to be defined. Further, it is hoped that this emerging technology will vastly expand the capability of future NASA missions involving atmospheric entry systems. This paper considers four topics of relevance to flexible ablators: (1) Their potential applications to near/far term human and robotic missions (2) Brief consideration of the balance between heat shield diameter, flexible ablator performance limits, entry vehicle controllability and aft-body shear layer impingement of interest to designers of very large entry vehicles, (3) The approach for developing bonding processes of flexible ablators for use on rigid entry bodies and (4) Design of large arcjet test articles that will enable the testing of flexible ablators in flight-like, combined environments (heat flux, pressure, shear and structural tensile loading). Based on a review of thermal protection system performance requirements for future entry vehicles, it is concluded that flexible ablators have broad applications to conventional, rigid entry body systems and are enabling to large deployable (both inflatable and mechanical) heat shields. Because of the game-changing nature of flexible ablators, it appears that NASA's Office of the Chief Technologist (OCT) will fund a focused, 3-year TRL advancement of the new materials capable of performance in heat fluxes in the range of 200-600 W/sq. cm. This support will enable the manufacture and use of the large-scale arcjet test designs that will be a key element of this OCT funded activity.

Value of microwave ablation in treatment of large lesions of hepatocellular carcinoma.

PubMed

Medhat, Eman; Abdel Aziz, Ashraf; Nabeel, Mohammed; Elbaz, Tamer; Zakaria, Zeinab; Shousha, Hend; Amer, Ayman; Fouad Fathalah, Waleed; Maher, Rabab; Musa, Shereif

2015-08-01

Thermal ablative therapies continue to be favored as a safe and effective treatment for patients with non-resectable hepatocellular carcinoma (HCC). Percutaneous microwave ablative therapy, which is a relatively new technique, has the advantage in providing faster ablation of large tumors. This study aimed to evaluate microwave ablation in the treatment of large HCC (5-7 cm) and to assess its effect on local tumor progression, prognostic outcome and patients' survival. In all, 26 patients with large HCC lesions (5-7 cm) were managed in the multidisciplinary clinic of Kasr Al Ainy University hospital using microwave ablation. The treatment was performed with the patient under conscious sedation and analgesia and ultrasonography-guided using an HS AMICA microwave machine operating at frequency of 2450 MHz and a power up to 100 W. Multiple needle insertions were made in one or two sessions according to the size of the lesion. The complete ablation rate, local tumor progression and patients' overall survival were analyzed, and the efficacy and safety of MWA was evaluated. Complete ablation was achieved in 19/26 (73.1%). Local tumor progression was recorded in five treated lesions (19.2%). Distant tumor progression within the liver was recorded in six patients (23.1%), with a mean survival of 21.5 months. No procedure-related major complications or deaths were observed. Percutaneous microwave ablation is safe and effective in the treatment of large HCC tumors. Patients' survival and local tumor control were acceptable. © 2015 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device: A pilot feasibility study

PubMed Central

Moris, Maria; Atar, Mustafa; Kadayifci, Abdurrahman; Krishna, Murli; Librero, Ariston; Richie, Eugene; Brugge, William; Wallace, Michael B.

2017-01-01

Background and Objectives: Pancreatic cysts are evaluated by endoscopic ultrasound and fine needle aspiration (EUS). The only accepted treatment is pancreatectomy, which is associated with morbidity and mortality. This study evaluated the optimal thermal dosimetry of a novel radiofrequency ablation device using a standard electrosurgical unit in ex vivo cyst models. Methods: A modified EUS 22-gauge monopolar needle prototype with a tip electrode connected to a standard electrosurgical unit (Erbe USA, Marietta, GA, USA) was used to induce a subboiling point temperature. A cyst model was created using 2-cm sections of porcine small intestine ligated and filled with saline. After ablation, the cyst models were prepared for pathological evaluation. The epithelial layers were measured in at least two different sites with a micrometer and compared with the corresponding control sample. Results: Thirty-two cyst models were ablated with maximum temperatures of 50°C, 60°C, 90°C, and 97°C in 8, 11, 11, and 2 cysts, respectively. Longer ablation times were required to induce higher temperatures. A trend in the reduction in thickness of the measured layers was observed after exposure to higher temperatures. A temperature over 50°C was required for the ablation of the muscularis, submucosa, and villi, and over 60°C was required to ablate the mucosal crypts. Conclusions: In a preclinical model, a novel radiofrequency EUS-capable needle connected to a standard electrosurgical unit using standard low-voltage coagulation provided ablation in a temperature-dependent fashion with a threshold of at least 60°C and a safe cyst margin below 97°C. This potentially will allow low-cost, convenient cyst ablation. PMID:28440238

Pulmonary Vein Antral Isolation and Nonpulmonary Vein Trigger Ablation Are Sufficient to Achieve Favorable Long-Term Outcomes Including Transformation to Paroxysmal Arrhythmias in Patients With Persistent and Long-Standing Persistent Atrial Fibrillation.

PubMed

Liang, Jackson J; Elafros, Melissa A; Muser, Daniele; Pathak, Rajeev K; Santangeli, Pasquale; Zado, Erica S; Frankel, David S; Supple, Gregory E; Schaller, Robert D; Deo, Rajat; Garcia, Fermin C; Lin, David; Hutchinson, Mathew D; Riley, Michael P; Callans, David J; Marchlinski, Francis E; Dixit, Sanjay

2016-11-01

Transformation from persistent to paroxysmal atrial fibrillation (AF) after ablation suggests modification of the underlying substrate. We examined the nature of initial arrhythmia recurrence in patients with nonparoxysmal AF undergoing antral pulmonary vein isolation and nonpulmonary vein trigger ablation and correlated recurrence type with long-term ablation efficacy after the last procedure. Three hundred and seventeen consecutive patients with persistent (n=200) and long-standing persistent (n=117) AF undergoing first ablation were included. AF recurrence was defined as early (≤6 weeks) or late (>6 weeks after ablation) and paroxysmal (either spontaneous conversion or treated with cardioversion ≤7 days) or persistent (lasting >7 days). During median follow-up of 29.8 (interquartile range: 14.8-49.9) months, 221 patients had ≥1 recurrence. Initial recurrence was paroxysmal in 169 patients (76%) and persistent in 52 patients (24%). Patients experiencing paroxysmal (versus persistent) initial recurrence were more likely to achieve long-term freedom off antiarrhythmic drugs (hazard ratio, 2.2; 95% confidence interval, 1.5-3.2; P<0.0001), freedom on/off antiarrhythmic drugs (hazard ratio, 2.5; 95% confidence interval, 1.6-3.8; P<0.0001), and arrhythmia control (hazard ratio, 5.2; 95% confidence interval, 2.9-9.2; P<0.0001) after last ablation. In patients with persistent and long-standing persistent AF, limited ablation targeting pulmonary veins and documented nonpulmonary vein triggers improves the maintenance of sinus rhythm and reverses disease progression. Transformation to paroxysmal AF after initial ablation may be a step toward long-term freedom from recurrent arrhythmia. © 2016 American Heart Association, Inc.

Thyroid remnant ablation success and disease outcome in stage III or IV differentiated thyroid carcinoma: recombinant human thyrotropin versus thyroid hormone withdrawal.

PubMed

Vallejo Casas, Juan A; Mena Bares, Luisa M; Gálvez Moreno, Maria A; Moreno Ortega, Estefanía; Marlowe, Robert J; Maza Muret, Francisco R; Albalá González, María D

2016-06-01

Most publications to date compare outcomes after post-surgical thyroid remnant ablation stimulated by recombinant human thyrotropin (rhTSH) versus thyroid hormone withholding/withdrawal (THW) in low-recurrence risk differentiated thyroid carcinoma (DTC) patients. We sought to perform this comparison in high-risk patients. We retrospectively analyzed ~9-year single-center experience in 70 consecutive adults with initial UICC (Union for International Cancer Control) stage III/IV, M0 DTC undergoing rhTSH-aided (N.=54) or THW-aided (N.=16) high-activity ablation. Endpoints included ablation success and DTC outcome. Assessed ≥1 year post-ablation, ablation success comprised a) no visible scintigraphic thyroid bed uptake or pathological extra-thyroidal uptake; b) undetectable stimulated serum thyroglobulin (Tg) without interfering autoantibodies; c) both criteria. DTC outcome, determined at the latest visit, comprised either 1) "no evidence of disease" (NED): undetectable Tg, negative Tg autoantibodies, negative most recent whole-body scan, no suspicious findings clinically, on neck ultrasonography, or on other imaging; 2) persistent disease: failure to attain NED; or 3) recurrence: loss of NED. After the first ablative activity, ablation success by scintigraphic plus biochemical criteria was 64.8% in rhTSH patients, 56.3% in THW patients (P=NS). After 3.5-year versus 6.2-year median follow-up (P<0.05), DTC outcomes were NED, 85.2%, persistent disease, 13.0%, recurrence, 1.9%, in the rhTSH group and NED, 87.5%, persistent or recurrent disease, 6.3% each, in the THW group (P=NS). In patients with initial stage III/IV, M0 DTC, rhTSH-aided and THW-assisted ablation were associated with comparable remnant eradication or DTC cure rates.

Carbon dioxide laser ablation of basal cell carcinoma with visual guidance by reflectance confocal microscopy: a proof-of-principle pilot study.

PubMed

Hibler, B P; Sierra, H; Cordova, M; Phillips, W; Rajadhyaksha, M; Nehal, K S; Rossi, A M

2016-06-01

Laser ablation is an alternative, nonsurgical treatment modality for low-risk basal cell carcinoma (BCC). However, lack of confirmative tumour destruction or residual tumour presence has been a limiting factor to its adoption. Reflectance confocal microscopy (RCM) provides noninvasive, cellular-level resolution imaging of the skin and is capable of identifying tumour. To evaluate the use of RCM to guide carbon dioxide (CO2 ) laser ablation of BCC, confirm destruction and correlate findings with histology. RCM was used preablation to evaluate for features of BCC. Ablation was performed with a CO2 laser, and the response rapidly assessed using handheld RCM to evaluate for residual tumour. Confirmative pathology was used to verify confocal imaging. Preablation RCM imaging identified tumour with features not identified on normal, surrounding skin. Postablation, RCM documented complete removal of tumour in six cases and residual tumour in two. Histological examination identified the ablated area and confirmed clearance of tumour in the six aforementioned cases and corroborated confocal findings for residual tumour in the other two cases. We report successful treatment of superficial and nodular BCC using CO2 laser ablation augmented by RCM imaging for preablation guidance and verification of tumour removal postablation. Akin to complete circumferential and deep margin control techniques, using RCM helps to map peripheral and deep BCC margins to hone in on areas exhibiting persistent tumour after ablation. CO2 laser ablation visually guided by RCM can help circumvent previously cited limiting factors of laser ablation for tumour destruction by providing cellular-level resolution imaging of tumour and margin assessment in between each laser pass and postablation. © 2016 British Association of Dermatologists.

A Feedback Loop between Dynamin and Actin Recruitment during Clathrin-Mediated Endocytosis

PubMed Central

Taylor, Marcus J.; Lampe, Marko; Merrifield, Christien J.

2012-01-01

Clathrin-mediated endocytosis proceeds by a sequential series of reactions catalyzed by discrete sets of protein machinery. The final reaction in clathrin-mediated endocytosis is membrane scission, which is mediated by the large guanosine triophosphate hydrolase (GTPase) dynamin and which may involve the actin-dependent recruitment of N-terminal containing BIN/Amphiphysin/RVS domain containing (N-BAR) proteins. Optical microscopy has revealed a detailed picture of when and where particular protein types are recruited in the ∼20–30 s preceding scission. Nevertheless, the regulatory mechanisms and functions that underpin protein recruitment are not well understood. Here we used an optical assay to investigate the coordination and interdependencies between the recruitment of dynamin, the actin cytoskeleton, and N-BAR proteins to individual clathrin-mediated endocytic scission events. These measurements revealed that a feedback loop exists between dynamin and actin at sites of membrane scission. The kinetics of dynamin, actin, and N-BAR protein recruitment were modulated by dynamin GTPase activity. Conversely, acute ablation of actin dynamics using latrunculin-B led to a ∼50% decrease in the incidence of scission, an ∼50% decrease in the amplitude of dynamin recruitment, and abolished actin and N-BAR recruitment to scission events. Collectively these data suggest that dynamin, actin, and N-BAR proteins work cooperatively to efficiently catalyze membrane scission. Dynamin controls its own recruitment to scission events by modulating the kinetics of actin and N-BAR recruitment to sites of scission. Conversely actin serves as a dynamic scaffold that concentrates dynamin and N-BAR proteins at sites of scission. PMID:22505844

Algorithms for output feedback, multiple-model, and decentralized control problems

NASA Technical Reports Server (NTRS)

Halyo, N.; Broussard, J. R.

1984-01-01

The optimal stochastic output feedback, multiple-model, and decentralized control problems with dynamic compensation are formulated and discussed. Algorithms for each problem are presented, and their relationship to a basic output feedback algorithm is discussed. An aircraft control design problem is posed as a combined decentralized, multiple-model, output feedback problem. A control design is obtained using the combined algorithm. An analysis of the design is presented.

High intensity focused ultrasound in the treatment of breast fibroadenomata: results of the HIFU-F trial.

PubMed

Peek, M C L; Ahmed, M; Scudder, J; Baker, R; Pinder, S E; Douek, M

2016-12-01

Breast fibroadenomata (FAD) are the most common breast lumps in women. High intensity focused ultrasound (HIFU) is a non-invasive ablative technique that can be used to treat FAD but is associated with prolonged treatment times. In the HIFU-F trial, we evaluated the change in volume over time with circumferential HIFU treatment of FAD and compared this to no treatment. Patients ≥18 years, diagnosed with symptomatic, palpable FAD, visible on ultrasound (US) were recruited. Twenty patients were treated using US-guided HIFU under local anaesthesia. Another 20 participants underwent an US 6 months after diagnosis. Outcome measures included: reduction in treatment time compared to whole lesion ablation; feasibility to achieve a 50% reduction in volume after 6 months; decrease in volume compared to a control group and reduction in symptoms. Circumferential ablation reduced the mean treatment time by 37.5% (SD 20.1%) compared to whole lesion ablation. US demonstrated a significant mean reduction in FAD volume of 43.5% (SD 38.8%; p = 0.016, paired t-test) in the HIFU group compared to 4.6% (SD 46.0%; p = 0.530) in the control group after 6 months. This mean reduction in FAD volume between the two groups was significant in favour of the HIFU group (p = 0.002, grouped t-test). Pre-treatment pain completely resolved in 6 out of 8 patients 6 months post-treatment. Circumferential HIFU ablation of FAD is feasible, with a significant reduction in pain and volume compared to control participants. It provides a simple, non-invasive, outpatient-based alternative to surgical excision for FAD.

Effects of Foveal Ablation on Emmetropization and Form-Deprivation Myopia

PubMed Central

Smith, Earl L.; Ramamirtham, Ramkumar; Qiao-Grider, Ying; Hung, Li-Fang; Huang, Juan; Kee, Chea-su; Coats, David; Paysse, Evelyn

2009-01-01

Purpose Because of the prominence of central vision in primates, it has generally been assumed that signals from the fovea dominate refractive development. To test this assumption, the authors determined whether an intact fovea was essential for either normal emmetropization or the vision-induced myopic errors produced by form deprivation. Methods In 13 rhesus monkeys at 3 weeks of age, the fovea and most of the perifovea in one eye were ablated by laser photocoagulation. Five of these animals were subsequently allowed unrestricted vision. For the other eight monkeys with foveal ablations, a diffuser lens was secured in front of the treated eyes to produce form deprivation. Refractive development was assessed along the pupillary axis by retinoscopy, keratometry, and A-scan ultrasonography. Control data were obtained from 21 normal monkeys and three infants reared with plano lenses in front of both eyes. Results Foveal ablations had no apparent effect on emmetropization. Refractive errors for both eyes of the treated infants allowed unrestricted vision were within the control range throughout the observation period, and there were no systematic interocular differences in refractive error or axial length. In addition, foveal ablation did not prevent form deprivation myopia; six of the eight infants that experienced monocular form deprivation developed myopic axial anisometropias outside the control range. Conclusions Visual signals from the fovea are not essential for normal refractive development or the vision-induced alterations in ocular growth produced by form deprivation. Conversely, the peripheral retina, in isolation, can regulate emmetropizing responses and produce anomalous refractive errors in response to abnormal visual experience. These results indicate that peripheral vision should be considered when assessing the effects of visual experience on refractive development. PMID:17724167

Autonomous benthic algal cultivator under feedback control of ecosystem metabolism

USDA-ARS?s Scientific Manuscript database

An autonomous and internally-controlled techno-ecological hybrid was developed that controls primary production of algae in a laboratory-scale cultivator. The technoecosystem is based on an algal turf scrubber (ATS) system that combines engineered feedback control programming with internal feedback...

The characterization of neural tissue ablation rate and corresponding heat affected zone of a 2 micron Tm3+ doped fiber laser(Conference Presentation)

NASA Astrophysics Data System (ADS)

Marques, Andrew J.; Jivraj, Jamil; Reyes, Robnier; Ramjist, Joel; Gu, Xijia J.; Yang, Victor X. D.

2017-02-01

Tissue removal using electrocautery is standard practice in neurosurgery since tissue can be cut and cauterized simultaneously. Thermally mediated tissue ablation using lasers can potentially possess the same benefits but with increased precision. However, given the critical nature of the spine, brain, and nerves, the effects of direct photo-thermal interaction on neural tissue needs to be known, yielding not only high precision of tissue removal but also increased control of peripheral heat damage. The proposed use of lasers as a neurosurgical tool requires that a common ground is found between ablation rates and resulting peripheral heat damage. Most surgical laser systems rely on the conversion of light energy into heat resulting in both desirable and undesirable thermal damage to the targeted tissue. Classifying the distribution of thermal energy in neural tissue, and thus characterizing the extent of undesirable thermal damage, can prove to be exceptionally challenging considering its highly inhomogenous composition when compared to other tissues such as muscle and bone. Here we present the characterization of neural tissue ablation rate and heat affected zone of a 1.94 micron thulium doped fiber laser for neural tissue ablation. In-Vivo ablation of porcine cerebral cortex is performed. Ablation volumes are studied in association with laser parameters. Histological samples are taken and examined to characterize the extent of peripheral heat damage.

Thermal Protection and Control

NASA Technical Reports Server (NTRS)

Greene, Effie E.

2013-01-01

During all phases of a spacecraft's mission, a Thermal Protection System (TPS) is needed to protect the vehicle and structure from extreme temperatures and heating. When designing TPS, low weight and cost while ensuring the protection of the vehicle is highly desired. There are two main types of TPS, ablative and reusable. The Apollo missions needed ablators due to the high heat loads from lunar reentry. However, when the desire for a reusable space vehicle emerged, the resultant_ Space Shuttle program propelled a push for the development of reusable TPS. With the growth of reqsable TPS, the need for ablators declined, triggering a drop off of the ablator industry. As a result, the expertise was not heavily maintained within NASA or the industry. When the Orion Program initiated a few years back, a need. for an ablator reemerged. Yet, due to of the lack of industry capability, redeveloping the ablator material took several years and came at a high cost. As NASA looks towards the future with both the Orion and Commercial Crew Programs, a need to preserve reusable, ablative, and other TPS technologies is essential. Research of the different TPS materials alongside their properties, capabilities, and manufacturing process was performed, and the benefits of the materials were analyzed alongside the future of TPS. Knowledge of the different technologies has the ability to help us know what expertise to maintain and ensure a lack in the industry does not occur again.

Movement goals and feedback and feedforward control mechanisms in speech production

PubMed Central

Perkell, Joseph S.

2010-01-01

Studies of speech motor control are described that support a theoretical framework in which fundamental control variables for phonemic movements are multi-dimensional regions in auditory and somatosensory spaces. Auditory feedback is used to acquire and maintain auditory goals and in the development and function of feedback and feedforward control mechanisms. Several lines of evidence support the idea that speakers with more acute sensory discrimination acquire more distinct goal regions and therefore produce speech sounds with greater contrast. Feedback modification findings indicate that fluently produced sound sequences are encoded as feedforward commands, and feedback control serves to correct mismatches between expected and produced sensory consequences. PMID:22661828

Movement goals and feedback and feedforward control mechanisms in speech production.

PubMed

Perkell, Joseph S

2012-09-01

Studies of speech motor control are described that support a theoretical framework in which fundamental control variables for phonemic movements are multi-dimensional regions in auditory and somatosensory spaces. Auditory feedback is used to acquire and maintain auditory goals and in the development and function of feedback and feedforward control mechanisms. Several lines of evidence support the idea that speakers with more acute sensory discrimination acquire more distinct goal regions and therefore produce speech sounds with greater contrast. Feedback modification findings indicate that fluently produced sound sequences are encoded as feedforward commands, and feedback control serves to correct mismatches between expected and produced sensory consequences.

Pulmonary Vein Isolation Alone Versus Additional Linear Ablation in Patients With Persistent Atrial Fibrillation Converted to Paroxysmal Type With Antiarrhythmic Drug Therapy: A Multicenter, Prospective, Randomized Study.

PubMed

Yu, Hee Tae; Shim, Jaemin; Park, Junbeom; Kim, In-Soo; Kim, Tae-Hoon; Uhm, Jae-Sun; Joung, Boyoung; Lee, Moon-Hyoung; Kim, Young-Hoon; Pak, Hui-Nam

2017-06-01

Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF. We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60.4±10.1 years old) who underwent catheter ablation for nonvalvular AF at 3 tertiary hospitals. The participants were randomly assigned to 2 groups: CPVI alone (n=59) or CPVI plus linear ablation (CPVI+Line; posterior box+anterior line, n=54). Compared with the CPVI+Line, CPVI alone required shorter procedure (187.2±58.0 versus 211.2±63.9 min; P =0.043) and ablation times (4922.1±1110.5 versus 6205.7±1425.2 s; P <0.001) without difference in procedure-related major complication (3% versus 2%; P =0.611). Antiarrhythmic drug utility rates after ablation were not different between the 2 groups (22% versus 30%; P =0.356). Overall, AF-free survival (log-rank; P =0.206) and AF and antiarrhythmic drug-free survival (log-rank; P =0.321) were not different between groups. CPVI alone is an effective rhythm control strategy with a shorter procedure time in persistent AF patients converted to paroxysmal AF compared with CPVI with linear ablation. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02176616. © 2017 American Heart Association, Inc.

Experimentally reducing clutch size reveals a fixed upper limit to egg size in snakes, evidence from the king ratsnake, Elaphe carinata.

PubMed

Ji, Xiang; Du, Wei-Guo; Li, Hong; Lin, Long-Hui

2006-08-01

Snakes are free of the pelvic girdle's constraint on maximum offspring size, and therefore present an opportunity to investigate the upper limit to offspring size without the limit imposed by the pelvic girdle dimension. We used the king ratsnake (Elaphe carinata) as a model animal to examine whether follicle ablation may result in enlargement of egg size in snakes and, if so, whether there is a fixed upper limit to egg size. Females with small sized yolking follicles were assigned to three manipulated, one sham-manipulated and one control treatments in mid-May, and two, four or six yolking follicles in the manipulated females were then ablated. Females undergoing follicle ablation produced fewer, but larger as well as more elongated, eggs than control females primarily by increasing egg length. This finding suggests that follicle ablation may result in enlargement of egg size in E. carinata. Mean values for egg width remained almost unchanged across the five treatments, suggesting that egg width is more likely to be shaped by the morphological feature of the oviduct. Clutch mass dropped dramatically in four- and six-follicle ablated females. The function describing the relationship between size and number of eggs reveals that egg size increases with decreasing clutch size at an ever-decreasing rate, with the tangent slope of the function for the six-follicle ablation treatment being -0.04. According to the function describing instantaneous variation in tangent slope, the maximum value of tangent slope should converge towards zero. This result provides evidence that there is a fixed upper limit to egg size in E. carinata.

Radiofrequency ablation of neuroendocrine liver metastases: the Middlesex experience.

PubMed

Gillams, A; Cassoni, A; Conway, G; Lees, W

2005-01-01

Current treatment options for neuroendocrine liver metastases are not widely applicable or not that effective. Image-guided thermal ablation offers the possibility of a minimally invasive, albeit palliative, treatment that decreases tumor volume, preserves most of the normal liver, and can be repeated several times. We report our experience with image-guided thermal ablation in 25 patients with unresectable liver metastases. Since 1990 we have treated 189 tumors at 66 treatment sessions in 25 patients (12 female, 13 male; median age, 56 years; age range, 26--78 years). Thirty treatments were performed with a solid-state laser, and 36 treatments were performed with radiofrequency ablation. All but one treatment was performed percutaneously under image guidance. Sixteen patients had metastases from carcinoid primaries, three from gastrinoma, two from insulinoma, and four from miscellaneous causes. Fourteen of 25 had symptoms from hormone secretion. Imaging follow-up was available in 19 patients at a median of 21 months (range, 4--75 months). There was a complete response in six patients, a partial response in seven, and stable disease in one; hence, tumor load was controlled in 14 of 19 patients (74%). Relief of hormone-related symptoms was achieved in nine of 14 patients (69%). The median survival period from the diagnosis of liver metastases was 53 months. One patient with end-stage cardiac disease died after a carcinoid crisis. There were eight (12%) complications: five local and three distant, four major and four minor. As a minimally invasive, readily repeatable procedure that can be used to ablate small tumors, preferably before patients become severely symptomatic, radiofrequency ablation can provide effective control of liver tumor volume in most patients over many years.

Atrial Fibrillation Ablation Guided by a Novel Nonfluoroscopic Navigation System.

PubMed

Ballesteros, Gabriel; Ramos, Pablo; Neglia, Renzo; Menéndez, Diego; García-Bolao, Ignacio

2017-09-01

Rhythmia is a new nonfluoroscopic navigation system that is able to create high-density electroanatomic maps. The aim of this study was to describe the acute outcomes of atrial fibrillation (AF) ablation guided by this system, to analyze the volume provided by its electroanatomic map, and to describe its ability to locate pulmonary vein (PV) reconnection gaps in redo procedures. This observational study included 62 patients who underwent AF ablation with Rhythmia compared with a retrospective cohort who underwent AF ablation with a conventional nonfluoroscopic navigation system (Ensite Velocity). The number of surface electrograms per map was significantly higher in Rhythmia procedures (12 125 ± 2826 vs 133 ± 21 with Velocity; P < .001), with no significant differences in the total procedure time. The Orion catheter was placed for mapping in 99.5% of PV (95.61% in the control group with a conventional circular mapping catheter; P = .04). There were no significant differences in the percentage of PV isolation between the 2 groups. In redo procedures, an ablation gap could be identified on the activation map in 67% of the reconnected PV (40% in the control group; P = .042). The measured left atrial volume was lower than that calculated by computed tomography (109.3 v 15.2 and 129.9 ± 13.2 mL, respectively; P < .001). There were no significant differences in the number of complications. The Rhythmia system is effective for AF ablation procedures, with procedure times and safety profiles similar to conventional nonfluoroscopic navigation systems. In redo procedures, it appears to be more effective in identifying reconnected PV conduction gaps. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Bipolar versus balloon endometrial ablation in the office: a randomized controlled trial.

PubMed

Penninx, Josien P M; Herman, Malou C; Kruitwagen, Roy F P M; Ter Haar, Annette J F; Mol, Ben W; Bongers, Marlies Y

2016-01-01

To compare the effectiveness of bipolar radiofrequency (Novasure®) ablation and balloon endometrial ablation (Thermablate®). We performed a multi-center double blind, randomized controlled trial in three hospitals in The Netherlands. Women with heavy menstrual bleeding were randomly allocated to bipolar or balloon endometrial ablation, performed in the office, using a paracervical block. The primary outcome was amenorrhea. Secondary outcome measures were pain, satisfaction, quality of life and reintervention. 104 women were randomized into the bipolar (52) and balloon (52) groups. After 12 months amenorrhea rates were 56% (29/52) in the bipolar group and 23% (12/52) in the balloon group (relative risk (RR) 0.6, 95% confidence interval (CI) 0.4-0.8). The mean visual analog pain score of the total procedure was 7.1 in the bipolar group and 7.4 in the balloon group (P<.577). 87% (45/52) of the patients in the bipolar group were satisfied with the result of the treatment versus 69% (36/52) in the balloon group (RR 0.44, 95% CI 0.2-0.97). The reintervention rates were 5/52 (10%) in the bipolar group and 6/52 (12%) in the balloon group (RR 1.02, 95% CI 0.9-1.2). Quality of life (Shaw score) improved over time (P<.001) and was significantly higher in the bipolar group at 12 months follow-up (P=.025). In the treatment of heavy menstrual bleeding, bipolar radiofrequency endometrial ablation is superior to balloon endometrial ablation as an office procedure in amenorrhea rate, patient satisfaction and quality of life. Copyright © 2015. Published by Elsevier Ireland Ltd.

Contact-force guided single-catheter approach for pulmonary vein isolation: Feasibility, outcomes, and cost-effectiveness.

PubMed

Pambrun, Thomas; Combes, Stéphane; Sousa, Pedro; Bloa, Mathieu Le; El Bouazzaoui, Rim; Grand-Larrieu, Delphine; Thompson, Nathaniel; Martin, Ruairidh; Combes, Nicolas; Boveda, Serge; Haïssaguerre, Michel; Albenque, Jean-Paul

2017-03-01

For conventional ablation of paroxysmal atrial fibrillation (AF), an ablation catheter in conjunction with a circular mapping catheter (CMC) is typically used for pulmonary vein isolation (PVI). The purpose of this study was to evaluate an approach for PVI with a single contact-force (CF) ablation catheter in terms of procedural reliability, outcomes, and cost-effectiveness. One hundred consecutive patients with paroxysmal AF were included in the study. Fifty patients (study group) underwent a CF-guided single-catheter approach, whereby PVI was demonstrated when sequential pacing at 9 equidistant points within the lesion set (carina included) failed to capture the left atrium. For confirmation, PVI was verified with a CMC. In comparison, 50 patients (control group) underwent a conventional PVI ablation guided by a CMC. Procedure time (101 ± 17 minutes vs 107 ± 15 minutes, P = .11), ablation time (24.2 ± 7.1 minutes vs 22.6 ± 8.8 minutes, P = .37), fluoroscopy time (5.6 ± 2.2 minutes vs 8.3 ± 3.4 minutes, P = .09), and applied CF (17.8 ± 2.6 g vs 18 ± 2.8 g, P = .72) did not reach statistical difference between the study and control groups. CF-guided single-catheter ablation achieved successful PVI in 98% of the study group and a 31% reduction in cost. At 1-year follow-up, sinus rhythm maintenance rate was similar in both groups (86% vs 84%, P = .78). In paroxysmal AF, a CF-guided single-catheter technique is an effective method for PVI, yielding substantial cost savings and clinical results similar to a conventional approach. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Excimer laser delivery system for astigmatic and hyperopic photorefractive surgery

NASA Astrophysics Data System (ADS)

Beck, Rasmus; Foerster, Werner

1994-06-01

Ablation of corneal tissue with excimer laser light is an effective way to correct refractive errors of the eye. For this purpose a beam-stop (iris diaphragm or interchangeable masks) is illuminated by the laser radiation. The beam-stop is imaged onto the cornea, and circular or elliptic ablations are produced. The computer-controlled process varies the diameter of the ablation area in a way that the inner portions of the treatment zone receive more laser energy than the outer portions, thus flattening the curvature of the refractive surface. For the treatment of hyperopia, the outer portions of the ablation area receive more laser energy to steepen the surface profile of the cornea. The beam delivery system employs several sets of circular, elliptic and ring shaped masks which are etched into a stainless-steel tape.

Effects of Radioactive Iodine Ablation Therapy on Voice Quality.

PubMed

Aydoğdu, İmran; Atar, Yavuz; Saltürk, Ziya; Sarı, Hüseyin; Ataç, Enes; Aydoğdu, Zeynep; İnan, Muzaffer; Mersinlioğlu, Gökhan; Uyar, Yavuz

2017-01-01

The goal of this study was to evaluate the effects of radioactive iodine ablation therapy on voice quality of patients diagnosed with well-differentiated thyroid carcinoma. We enrolled 36 patients who underwent total or subtotal thyroidectomy due to well-differentiated thyroid carcinoma. Voice recordings from patients were analyzed for acoustic and aerodynamic voice. The Voice Handicap Index-10 was used for subjective analysis. The control group consisted of 36 healthy participants. Results taken before and after therapy were compared statistically. There were no differences in the results taken before and after therapy for the radioactive iodine ablation group. The Voice Handicap Index-10 results did not differ between groups before and after therapy. Radioactive iodine ablation therapy has no effect on voice quality objectively or subjectively. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Focused US system for MR imaging-guided tumor ablation.

PubMed

Cline, H E; Hynynen, K; Watkins, R D; Adams, W J; Schenck, J F; Ettinger, R H; Freund, W R; Vetro, J P; Jolesz, F A

1995-03-01

To measure the performance characteristics of a focused ultrasound (US) system for magnetic resonance (MR) imaging-guided tumor ablation. The authors constructed a focused US system for MR imaging-guided tumor ablation. The location of the heated region and thermal dose were monitored with temperature-sensitive MR images obtained in phantoms and rabbit skeletal muscle after application of each sonic pulse. The region heated by the focused ultrasound beam was within 1 mm of that observed on temperature-sensitive fast gradient-echo MR images of in vivo rabbit skeletal muscle. Analysis of heat flow and the rate of coagulation necrosis provided an estimate of the size of the ablated region that was in agreement with experimental findings. MR imaging provides target definition and control for thermal therapy in regions of variable perfusion or in tissues that are not well characterized.

Coherent feedback control of a single qubit in diamond

NASA Astrophysics Data System (ADS)

Hirose, Masashi; Cappellaro, Paola

2016-04-01

Engineering desired operations on qubits subjected to the deleterious effects of their environment is a critical task in quantum information processing, quantum simulation and sensing. The most common approach relies on open-loop quantum control techniques, including optimal-control algorithms based on analytical or numerical solutions, Lyapunov design and Hamiltonian engineering. An alternative strategy, inspired by the success of classical control, is feedback control. Because of the complications introduced by quantum measurement, closed-loop control is less pervasive in the quantum setting and, with exceptions, its experimental implementations have been mainly limited to quantum optics experiments. Here we implement a feedback-control algorithm using a solid-state spin qubit system associated with the nitrogen vacancy centre in diamond, using coherent feedback to overcome the limitations of measurement-based feedback, and show that it can protect the qubit against intrinsic dephasing noise for milliseconds. In coherent feedback, the quantum system is connected to an auxiliary quantum controller (ancilla) that acquires information about the output state of the system (by an entangling operation) and performs an appropriate feedback action (by a conditional gate). In contrast to open-loop dynamical decoupling techniques, feedback control can protect the qubit even against Markovian noise and for an arbitrary period of time (limited only by the coherence time of the ancilla), while allowing gate operations. It is thus more closely related to quantum error-correction schemes, although these require larger and increasing qubit overheads. Increasing the number of fresh ancillas enables protection beyond their coherence time. We further evaluate the robustness of the feedback protocol, which could be applied to quantum computation and sensing, by exploring a trade-off between information gain and decoherence protection, as measurement of the ancilla-qubit correlation after the feedback algorithm voids the protection, even if the rest of the dynamics is unchanged.

Servo control booster system for minimizing following error

DOEpatents

Wise, W.L.

1979-07-26

A closed-loop feedback-controlled servo system is disclosed which reduces command-to-response error to the system's position feedback resolution least increment, ..delta..S/sub R/, on a continuous real-time basis, for all operational times of consequence and for all operating speeds. The servo system employs a second position feedback control loop on a by exception basis, when the command-to-response error greater than or equal to ..delta..S/sub R/, to produce precise position correction signals. When the command-to-response error is less than ..delta..S/sub R/, control automatically reverts to conventional control means as the second position feedback control loop is disconnected, becoming transparent to conventional servo control means. By operating the second unique position feedback control loop used herein at the appropriate clocking rate, command-to-response error may be reduced to the position feedback resolution least increment. The present system may be utilized in combination with a tachometer loop for increased stability.

The use of ablative lasers in the treatment of facial melasma.

PubMed

Morais, Orlando Oliveira de; Lemos, Érica Freitas Lima; Sousa, Márcia Carolline dos Santos; Gomes, Ciro Martins; Costa, Izelda Maria Carvalho; Paula, Carmen Déa Ribeiro de

2013-01-01

Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.

The use of ablative lasers in the treatment of facial melasma*

PubMed Central

de Morais, Orlando Oliveira; Lemos, Érica Freitas Lima; Sousa, Márcia Carolline dos Santos; Gomes, Ciro Martins; Costa, Izelda Maria Carvalho; de Paula, Carmen Déa Ribeiro

2013-01-01

Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens. PMID:23739704

Analysis of radiation parameters to control the effects of Nd:YAG laser surgery on gastric malignancies

NASA Astrophysics Data System (ADS)

Pelayo-Fernández, M. L.; Fanjul-Vélez, F.; Salas-García, I.; Hernández-González, A.; Arce-Diego, J. L.

2015-07-01

Endoscopic laser surgery provides an advantageous alternative to Argon Plasma Coagulation, endoscopic tweezers or electro-ablation in gastroenterology that facilitates a selective ablation of stomach tumors with an additional hemostatic effect in the surrounding tissue. This coagulation effect can also be employed for the treatment of gastric ulcers. It is mandatory to control the laser parameters regardless of the desired effect, either cancerous tissue ablation or coagulation to prevent ulcerous bleeding, in order to avoid stomach wall perforation or an insufficient therapeutic outcome. Dosimetric models constitute an attractive tool to determine the proper light dose in order to offer a customized therapy planning that optimizes the treatment results. In this work, a model for Nd:YAG laser surgery is applied to predict both the coagulation zone in gastric ulcers and the removal in adenocarcinomas under different laser setups. Results show clear differences in the effective zone of the gastric malignancy affected by both coagulation and ablation. Therefore the current model could be employed in the clinical practice to plan the optimal laser beam parameters to treat a certain type of pathologic stomach tissue with variable morphology and without risk of perforation or undertreated parts.

Fabrication of Multi-point Side-Firing Optical Fiber by Laser Micro-ablation

PubMed Central

Nguyen, Hoang; Arnob, Md Masud Parvez; Becker, Aaron T; Wolfe, John C; Hogan, Matthew K; Horner, Philip J; Shih, Wei-Chuan

2018-01-01

A multi-point, side-firing design enables an optical fiber to output light at multiple desired locations along the fiber body. This provides advantages over traditional end-to-end fibers, especially in applications requiring fiber bundles such as brain stimulation or remote sensing. This paper demonstrates that continuous wave (CW) laser micro-ablation can controllably create conical-shaped cavities, or side windows, for outputting light. The dimensions of these cavities determine the amount of firing light and their firing angle. Experimental data show that a single side window on a 730 μm fiber can deliver more than 8 % of the input light. This was increased to more than 19 % on a 65 μm fiber with side windows created using femtosecond (fs) laser ablation and chemical etching. Fine control of light distribution along an optical fiber is critical for various biomedical applications such as light activated drug-release and optogenetics studies. PMID:28454166

Fabrication of multipoint side-firing optical fiber by laser micro-ablation.

PubMed

Nguyen, Hoang; Parvez Arnob, Md Masud; Becker, Aaron T; Wolfe, John C; Hogan, Matthew K; Horner, Philip J; Shih, Wei-Chuan

2017-05-01

A multipoint, side-firing design enables an optical fiber to output light at multiple desired locations along the fiber body. This provides advantages over traditional end-to-end fibers, especially in applications requiring fiber bundles such as brain stimulation or remote sensing. This Letter demonstrates that continuous wave (CW) laser micro-ablation can controllably create conical-shaped cavities, or side windows, for outputting light. The dimensions of these cavities determine the amount of firing light and their firing angle. Experimental data show that a single side window on a 730 μm fiber can deliver more than 8% of the input light. This can be increased to more than 19% on a 65 μm fiber with side windows created using femtosecond laser ablation and chemical etching. Fine control of light distribution along an optical fiber is critical for various biomedical applications such as light-activated drug-release and optogenetics studies.

A combined stochastic feedforward and feedback control design methodology with application to autoland design

NASA Technical Reports Server (NTRS)

Halyo, Nesim

1987-01-01

A combined stochastic feedforward and feedback control design methodology was developed. The objective of the feedforward control law is to track the commanded trajectory, whereas the feedback control law tries to maintain the plant state near the desired trajectory in the presence of disturbances and uncertainties about the plant. The feedforward control law design is formulated as a stochastic optimization problem and is embedded into the stochastic output feedback problem where the plant contains unstable and uncontrollable modes. An algorithm to compute the optimal feedforward is developed. In this approach, the use of error integral feedback, dynamic compensation, control rate command structures are an integral part of the methodology. An incremental implementation is recommended. Results on the eigenvalues of the implemented versus designed control laws are presented. The stochastic feedforward/feedback control methodology is used to design a digital automatic landing system for the ATOPS Research Vehicle, a Boeing 737-100 aircraft. The system control modes include localizer and glideslope capture and track, and flare to touchdown. Results of a detailed nonlinear simulation of the digital control laws, actuator systems, and aircraft aerodynamics are presented.

A novel integration of spectral-domain optical-coherence-tomography and laser-ablation system for precision treatment.

PubMed

Fan, Yingwei; Zhang, Boyu; Chang, Wei; Zhang, Xinran; Liao, Hongen

2018-03-01

Complete resection of diseased lesions reduces the recurrence of cancer, making it critical for surgical treatment. However, precisely resecting residual tumors is a challenge during operation. A novel integrated spectral-domain optical-coherence-tomography (SD-OCT) and laser-ablation therapy system for soft-biological-tissue resection is proposed. This is a prototype optical integrated diagnosis and therapeutic system as well as an optical theranostics system. We develop an optical theranostics system, which integrates SD-OCT, a laser-ablation unit, and an automatic scanning platform. The SD-OCT image of biological tissue provides an intuitive and clear view for intraoperative diagnosis and monitoring in real time. The effect of laser ablation is analyzed using a quantitative mathematical model. The automatic endoscopic scanning platform combines an endoscopic probe and an SD-OCT sample arm to provide optical theranostic scanning motion. An optical fiber and a charge-coupled device camera are integrated into the endoscopic probe, allowing detection and coupling of the OCT-aiming beam and laser spots. The integrated diagnostic and therapeutic system combines SD-OCT imaging and laser-ablation modules with an automatic scanning platform. OCT imaging, laser-ablation treatment, and the integration and control of diagnostic and therapeutic procedures were evaluated by performing phantom experiments. Furthermore, SD-OCT-guided laser ablation provided precision laser ablation and resection for the malignant lesions in soft-biological-tissue-lesion surgery. The results demonstrated that the appropriate laser-radiation power and duration time were 10 W and 10 s, respectively. In the laser-ablation evaluation experiment, the error reached approximately 0.1 mm. Another validation experiment was performed to obtain OCT images of the pre- and post-ablated craters of ex vivo porcine brainstem. We propose an optical integrated diagnosis and therapeutic system. The primary experimental results show the high efficiency and feasibility of our theranostics system, which is promising for realizing accurate resection of tumors in vivo and in situ in the future.

Geometric foundations of the theory of feedback equivalence

NASA Technical Reports Server (NTRS)

Hermann, R.

1987-01-01

A description of feedback control is presented within the context of differential equations, differential geometry, and Lie theory. Work related to the integration of differential geometry with the control techniques of feedback linearization is summarized. Particular attention is given to the application of the theory of vector field systems. Feedback invariants for control systems in state space form are also addressed.

Cross-entropy optimization for neuromodulation.

PubMed

Brar, Harleen K; Yunpeng Pan; Mahmoudi, Babak; Theodorou, Evangelos A

2016-08-01

This study presents a reinforcement learning approach for the optimization of the proportional-integral gains of the feedback controller represented in a computational model of epilepsy. The chaotic oscillator model provides a feedback control systems view of the dynamics of an epileptic brain with an internal feedback controller representative of the natural seizure suppression mechanism within the brain circuitry. Normal and pathological brain activity is simulated in this model by adjusting the feedback gain values of the internal controller. With insufficient gains, the internal controller cannot provide enough feedback to the brain dynamics causing an increase in correlation between different brain sites. This increase in synchronization results in the destabilization of the brain dynamics, which is representative of an epileptic seizure. To provide compensation for an insufficient internal controller an external controller is designed using proportional-integral feedback control strategy. A cross-entropy optimization algorithm is applied to the chaotic oscillator network model to learn the optimal feedback gains for the external controller instead of hand-tuning the gains to provide sufficient control to the pathological brain and prevent seizure generation. The correlation between the dynamics of neural activity within different brain sites is calculated for experimental data to show similar dynamics of epileptic neural activity as simulated by the network of chaotic oscillators.

Saphenous Venous Ablation with Hot Contrast in a Canine Model

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

Prasad, Amit; Qian Zhong; Kirsch, David

2008-01-15

Purpose. To determine the feasibility, efficacy, and safety of thermal ablation of the saphenous vein with hot contrast medium. Methods. Twelve saphenous veins of 6 dogs were percutaneously ablated with hot contrast medium. In all animals, ablation was performed in the vein of one leg, followed by ablation in the contralateral side 1 month later. An occlusion balloon catheter was placed in the infragenicular segment of the saphenous vein via a jugular access to prevent unwanted thermal effects on the non-target segment of the saphenous vein. After inflation of the balloon, 10 ml of hot contrast medium was injected undermore » fluoroscopic control through a sheath placed in the saphenous vein above the ankle. A second 10 ml injection of hot contrast medium was made after 5 min in each vessel. Venographic follow-up of the ablated veins was performed at 1 month (n = 12) and 2 months (n = 6). Results. Follow-up venograms showed that all ablated venous segments were occluded at 1 month. In 6 veins which were followed up to 2 months, 4 (66%) remained occluded, 1 (16%) was partially patent, and the remaining vein (16%) was completely patent. In these latter 2 cases, an inadequate amount of hot contrast was delivered to the lumen due to a closed balloon catheter downstream which did not allow contrast to displace blood within the vessel. Discussion. Hot contrast medium thermal ablation of the saphenous vein appears feasible, safe, and effective in the canine model, provided an adequate amount of embolization agent is used.« less

Increased preference of surface ablation over laser in situ keratomileusis between 2008–2011 is correlated to risk of ecatasia

PubMed Central

Moisseiev, Elad; Sela, Tzahi; Minkev, Liza; Varssano, David

2013-01-01

Purpose To evaluate the trends in corneal refractive procedure selection for the correction of myopia, focusing on the relative proportions of laser in situ keratomileusis (LASIK) and surface ablation procedures. Methods Only eyes that underwent LASIK or surface ablation for the correction of myopia between 2008–2011 were included in this retrospective study. Additional recorded parameters included patient age, preoperative manifest refraction, corneal thickness, and calculated residual corneal bed thickness. A risk score was given to each eye, based on these parameters, according to the Ectasia Risk Factor Score System (ERFSS), without the preoperative corneal topography. Results This study included 16,163 eyes, of which 38.4% underwent LASIK and 61.6% underwent surface ablation. The risk score correlated with procedure selection, with LASIK being preferred in eyes with a score of 0 and surface ablation in eyes with a score of 2 or higher. When controlling for age, preoperative manifest refraction, corneal thickness, and all parameters, the relative proportion of surface ablation compared with LASIK was found to have grown significantly during the study period. Conclusions Our results indicate that with time, surface ablation tended to be performed more often than LASIK for the correction of myopia in our cohort. Increased awareness of risk factors and preoperative risk assessment tools, such as the ERFSS, have shifted the current practice of refractive surgery from LASIK towards surface ablation despite the former’s advantages, especially in cases in which the risk for ectasia is more than minimal (risk score 2 and higher). PMID:23345963

Hybrid Feedforward-Feedback Noise Control Using Virtual Sensors

NASA Technical Reports Server (NTRS)

Bean, Jacob; Fuller, Chris; Schiller, Noah

2016-01-01

Several approaches to active noise control using virtual sensors are evaluated for eventual use in an active headrest. Specifically, adaptive feedforward, feedback, and hybrid control structures are compared. Each controller incorporates the traditional filtered-x least mean squares algorithm. The feedback controller is arranged in an internal model configuration to draw comparisons with standard feedforward control theory results. Simulation and experimental results are presented that illustrate each controllers ability to minimize the pressure at both physical and virtual microphone locations. The remote microphone technique is used to obtain pressure estimates at the virtual locations. It is shown that a hybrid controller offers performance benefits over the traditional feedforward and feedback controllers. Stability issues associated with feedback and hybrid controllers are also addressed. Experimental results show that 15-20 dB reduction in broadband disturbances can be achieved by minimizing the measured pressure, whereas 10-15 dB reduction is obtained when minimizing the estimated pressure at a virtual location.

Delay-based virtual congestion control in multi-tenant datacenters

NASA Astrophysics Data System (ADS)

Liu, Yuxin; Zhu, Danhong; Zhang, Dong

2018-03-01

With the evolution of cloud computing and virtualization, the congestion control of virtual datacenters has become the basic issue for multi-tenant datacenters transmission. Regarding to the friendly conflict of heterogeneous congestion control among multi-tenant, this paper proposes a delay-based virtual congestion control, which translates the multi-tenant heterogeneous congestion control into delay-based feedback uniformly by setting the hypervisor translation layer, modifying three-way handshake of explicit feedback and packet loss feedback and throttling receive window. The simulation results show that the delay-based virtual congestion control can effectively solve the unfairness of heterogeneous feedback congestion control algorithms.

Comprehensive joint feedback control for standing by functional neuromuscular stimulation-a simulation study.

PubMed

Nataraj, Raviraj; Audu, Musa L; Kirsch, Robert F; Triolo, Ronald J

2010-12-01

Previous investigations of feedback control of standing after spinal cord injury (SCI) using functional neuromuscular stimulation (FNS) have primarily targeted individual joints. This study assesses the potential efficacy of comprehensive (trunk, hips, knees, and ankles) joint feedback control against postural disturbances using a bipedal, 3-D computer model of SCI stance. Proportional-derivative feedback drove an artificial neural network trained to produce muscle excitation patterns consistent with maximal joint stiffness values achievable about neutral stance given typical SCI muscle properties. Feedback gains were optimized to minimize upper extremity (UE) loading required to stabilize against disturbances. Compared to the baseline case of maximum constant muscle excitations used clinically, the controller reduced UE loading by 55% in resisting external force perturbations and by 84% during simulated one-arm functional tasks. Performance was most sensitive to inaccurate measurements of ankle plantar/dorsiflexion position and hip ab/adduction velocity feedback. In conclusion, comprehensive joint feedback demonstrates potential to markedly improve FNS standing function. However, alternative control structures capable of effective performance with fewer sensor-based feedback parameters may better facilitate clinical usage.

Comprehensive Joint Feedback Control for Standing by Functional Neuromuscular Stimulation – a Simulation Study

PubMed Central

Nataraj, Raviraj; Audu, Musa L.; Kirsch, Robert F.; Triolo, Ronald J.

2013-01-01

Previous investigations of feedback control of standing after spinal cord injury (SCI) using functional neuromuscular stimulation (FNS) have primarily targeted individual joints. This study assesses the potential efficacy of comprehensive (trunk, hips, knees, and ankles) joint-feedback control against postural disturbances using a bipedal, three-dimensional computer model of SCI stance. Proportional-derivative feedback drove an artificial neural network trained to produce muscle excitation patterns consistent with maximal joint stiffness values achievable about neutral stance given typical SCI muscle properties. Feedback gains were optimized to minimize upper extremity (UE) loading required to stabilize against disturbances. Compared to the baseline case of maximum constant muscle excitations used clinically, the controller reduced UE loading by 55% in resisting external force perturbations and by 84% during simulated one-arm functional tasks. Performance was most sensitive to inaccurate measurements of ankle plantar/dorsiflexion position and hip ab/adduction velocity feedback. In conclusion, comprehensive joint-feedback demonstrates potential to markedly improve FNS standing function. However, alternative control structures capable of effective performance with fewer sensor-based feedback parameters may better facilitate clinical usage. PMID:20923741

Mechanisms of ultrafast laser-induced deep-subwavelength gratings on graphite and diamond

NASA Astrophysics Data System (ADS)

Huang, Min; Zhao, Fuli; Cheng, Ya; Xu, Ningsheg; Xu, Zhizhan

2009-03-01

Deep-subwavelength gratings with periodicities of 170, 120, and 70 nm can be observed on highly oriented pyrolytic graphite irradiated by a femtosecond (fs) laser at 800 nm. Under picosecond laser irradiation, such gratings likewise can be produced. Interestingly, the 170-nm grating is also observed on single-crystal diamond irradiated by the 800-nm fs laser. In our opinion, the optical properties of the high-excited state of material surface play a key role for the formation of the deep-subwavelength gratings. The numerical simulations of the graphite deep-subwavelength grating at normal and high-excited states confirm that in the groove the light intensity can be extraordinarily enhanced via cavity-mode excitation in the condition of transverse-magnetic wave irradiation with near-ablation-threshold fluences. This field enhancement of polarization sensitiveness in deep-subwavelength apertures acts as an important feedback mechanism for the growth and polarization dependence of the deep-subwavelength gratings. In addition, we suggest that surface plasmons are responsible for the formation of seed deep-subwavelength apertures with a particular periodicity and the initial polarization dependence. Finally, we propose that the nanoscale Coulomb explosion occurring in the groove is responsible for the ultrafast nonthermal ablation mechanism.

Optimal feedback scheme and universal time scaling for Hamiltonian parameter estimation.

PubMed

Yuan, Haidong; Fung, Chi-Hang Fred

2015-09-11

Time is a valuable resource and it is expected that a longer time period should lead to better precision in Hamiltonian parameter estimation. However, recent studies in quantum metrology have shown that in certain cases more time may even lead to worse estimations, which puts this intuition into question. In this Letter we show that by including feedback controls this intuition can be restored. By deriving asymptotically optimal feedback controls we quantify the maximal improvement feedback controls can provide in Hamiltonian parameter estimation and show a universal time scaling for the precision limit under the optimal feedback scheme. Our study reveals an intriguing connection between noncommutativity in the dynamics and the gain of feedback controls in Hamiltonian parameter estimation.

[The role of the somatosensory cortex in the development of reflex analgesia].

PubMed

Kukushkin, M L; Reshetniak, V K; Durinian, R A

1986-06-01

The effects of reflex stimulation on the changes of nociception thresholds in animals before and after ablation of the somatosensory cortex were studied in behavioural experiments on adult cats. Electroacupuncture stimulation (EAP) was shown to increase nociception thresholds at all levels of the conventional scale. The ablation of both the first (S1) and the second (S2) somatosensory cortex led to EAP inefficiency at the side opposite to the ablation. Partial lesion of the lateral and suprasylvian gyri, used as control, did not affect the efficiency of reflex analgesia. It is concluded that somatosensory areas of the cortex, especially 2, are involved in reflex analgesia.

High-speed observation of ZnO microspherical crystals produced by laser ablation (Conference Presentation)

NASA Astrophysics Data System (ADS)

Nakamura, Daisuke; Tasaki, Ryohei; Fujiwara, Yuki; Nagasaki, Fumiaki; Higashihata, Mitsuhiro; Ikenoue, Hiroshi; Okada, Tatsuo

2017-03-01

ZnO nano/microstructures have attracted much attention as building blocks for optoelectronic devices because of their high crystalline quality and unique structures. We have succeeded in synthesizing ZnO microspherical crystals by a simple atmospheric laser ablation method, and demonstrated ultraviolet whispering-gallery-mode lasing from the spheres. In the microsphere synthesis process, molten droplets formed into spherical shapes by surface tension, and crystalized during ejection from the ablation spot. In this study, we observed the generation of ZnO microspheres by high-speed camera. Now we are trying to control and manipulate the microspheres using a vortex beam.

Prostate thermal therapy with catheter-based ultrasound devices and MR thermal monitoring

NASA Astrophysics Data System (ADS)

Diederich, Chris J.; Nau, Will H.; Kinsey, Adam; Ross, Tony; Wootton, Jeff; Juang, Titania; Butts-Pauly, Kim; Ricke, Viola; Liu, Erin H.; Chen, Jing; Bouley, Donna M.; Van den Bosch, Maurice; Sommer, Graham

2007-02-01

Four types of transurethral applicators were devised for thermal ablation of prostate combined with MR thermal monitoring: sectored tubular transducer devices with directional heating patterns; planar and curvilinear devices with narrow heating patterns; and multi-sectored tubular devices capable of dynamic angular control without applicator movement. These devices are integrated with a 4 mm delivery catheter, incorporate an inflatable cooling balloon (10 mm OD) for positioning within the prostate and capable of rotation via an MR-compatible motor. Interstitial devices (2.4 mm OD) have been developed for percutaneous implantation with directional or dynamic angular control. In vivo experiments in canine prostate under MR temperature imaging were used to evaluate the heating technology and develop treatment control strategies. MR thermal imaging in a 0.5 T interventional MRI was used to monitor temperature and thermal dose in multiple slices through the target volume. Sectored tubular, planar, and curvilinear transurethral devices produce directional coagulation zones, extending 15-20 mm radial distance to the outer prostate capsule. Sequential rotation and modulated dwell time can conform thermal ablation to selected regions. Multi-sectored transurethral applicators can dynamically control the angular heating profile and target large regions of the gland in short treatment times without applicator manipulation. Interstitial implants with directional devices can be used to effectively ablate the posterior peripheral zone of the gland while protecting the rectum. The MR derived 52 °C and lethal thermal dose contours (t 43=240 min) allowed for real-time control of the applicators and effectively defined the extent of thermal damage. Catheter-based ultrasound devices, combined with MR thermal monitoring, can produce relatively fast and precise thermal ablation of prostate, with potential for treatment of cancer or BPH.

Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis.

PubMed

Hilerowicz, Yuval; Koren, Amir; Mashiah, Jacob; Katz, Oren; Sprecher, Eli; Artzi, Ofir

2018-05-01

Leishmaniasis is a protozoan zoonotic parasitic infection with cutaneous, mucocutaneous, and visceral manifestations. Israel is endemic for cutaneous leishmaniasis, which is a self-limited disease but is associated with scarring, which is often a source of psychological and social burden for patients. Scars can be especially devastating for children and teenagers. A wide range of physical and medical approaches is used to treat cutaneous leishmaniasis, among which intralesional injections of sodium stibogluconate rank among the most frequently used. Unfortunately, despite being effective, this therapeutic modality can be very painful. Fractional ablative laser creates a controlled mesh-like pattern of tissue ablation in the skin that promotes dermal remodeling and collagen production while at the same time facilitating enhanced delivery of topically applied medications. Patients were treated with fractional ablative carbon dioxide laser followed by immediate topical application of sodium stibogluconate. All children were diagnosed with cutaneous leishmaniasis prior to treatment initiation.. Ten children were treated. One leishmania tropica-positive girl failed to respond. The other nine patients achieved clinical cure and demonstrated good to excellent final cosmesis. Self-rated patient satisfaction and tolerance were high No adverse effects were observed or reported during treatment. Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application appears to be a safe and promising treatment for cutaneous leishmaniasis infection in children. Future controlled studies are required to validate these findings and compare this technique with traditional approaches. © 2018 Wiley Periodicals, Inc.

Experimental and computational study of the effect of 1 atm background gas on nanoparticle generation in femtosecond laser ablation of metals

NASA Astrophysics Data System (ADS)

Wu, Han; Wu, Chengping; Zhang, Nan; Zhu, Xiaonong; Ma, Xiuquan; Zhigilei, Leonid V.

2018-03-01

Laser ablation of metal targets is actively used for generation of chemically clean nanoparticles for a broad range of practical applications. The processes involved in the nanoparticle formation at all relevant spatial and temporal scales are still not fully understood, making the precise control of the size and shape of the nanoparticles challenging. In this paper, a combination of molecular dynamics simulations and experiments is applied to investigate femtosecond laser ablation of aluminum targets in vacuum and in 1 atm argon background gas. The results of the simulations reveal a strong effect of the background gas environment on the initial plume expansion and evolution of the nanoparticle size distribution. The suppression of the generation of small/medium-size Al clusters and formation of a dense layer at the front of the expanding ablation plume, observed during the first nanosecond of the plume expansion in a simulation performed in the gas environment, have important implications on the characteristics of the nanoparticles deposited on a substrate and characterized in the experiments. The nanoparticles deposited in the gas environment are found to be more round-shaped and less flattened as compared to those deposited in vacuum. The nanoparticle size distributions exhibit power-law dependences with similar values of exponents obtained from fitting experimental and simulated data. Taken together, the results of this study suggest that the gas environment may be effectively used to control size and shape of nanoparticles generated by laser ablation.

Method for neural network control of motion using real-time environmental feedback

NASA Technical Reports Server (NTRS)

Buckley, Theresa M. (Inventor)

1997-01-01

A method of motion control for robotics and other automatically controlled machinery using a neural network controller with real-time environmental feedback. The method is illustrated with a two-finger robotic hand having proximity sensors and force sensors that provide environmental feedback signals. The neural network controller is taught to control the robotic hand through training sets using back- propagation methods. The training sets are created by recording the control signals and the feedback signal as the robotic hand or a simulation of the robotic hand is moved through a representative grasping motion. The data recorded is divided into discrete increments of time and the feedback data is shifted out of phase with the control signal data so that the feedback signal data lag one time increment behind the control signal data. The modified data is presented to the neural network controller as a training set. The time lag introduced into the data allows the neural network controller to account for the temporal component of the robotic motion. Thus trained, the neural network controlled robotic hand is able to grasp a wide variety of different objects by generalizing from the training sets.

Feedback control of flow vorticity at low Reynolds numbers.

PubMed

Zeitz, Maria; Gurevich, Pavel; Stark, Holger

2015-03-01

Our aim is to explore strategies of feedback control to design and stabilize novel dynamic flow patterns in model systems of complex fluids. To introduce the control strategies, we investigate the simple Newtonian fluid at low Reynolds number in a circular geometry. Then, the fluid vorticity satisfies a diffusion equation. We determine the mean vorticity in the sensing area and use two control strategies to feed it back into the system by controlling the angular velocity of the circular boundary. Hysteretic feedback control generates self-regulated stable oscillations in time, the frequency of which can be adjusted over several orders of magnitude by tuning the relevant feedback parameters. Time-delayed feedback control initiates unstable vorticity modes for sufficiently large feedback strength. For increasing delay time, we first observe oscillations with beats and then regular trains of narrow pulses. Close to the transition line between the resting fluid and the unstable modes, these patterns are relatively stable over long times.

Robust Frequency-Domain Constrained Feedback Design via a Two-Stage Heuristic Approach.

PubMed

Li, Xianwei; Gao, Huijun

2015-10-01

Based on a two-stage heuristic method, this paper is concerned with the design of robust feedback controllers with restricted frequency-domain specifications (RFDSs) for uncertain linear discrete-time systems. Polytopic uncertainties are assumed to enter all the system matrices, while RFDSs are motivated by the fact that practical design specifications are often described in restricted finite frequency ranges. Dilated multipliers are first introduced to relax the generalized Kalman-Yakubovich-Popov lemma for output feedback controller synthesis and robust performance analysis. Then a two-stage approach to output feedback controller synthesis is proposed: at the first stage, a robust full-information (FI) controller is designed, which is used to construct a required output feedback controller at the second stage. To improve the solvability of the synthesis method, heuristic iterative algorithms are further formulated for exploring the feedback gain and optimizing the initial FI controller at the individual stage. The effectiveness of the proposed design method is finally demonstrated by the application to active control of suspension systems.

Optimization of Closed Loop Eigenvalues: Maneuvering, Vibration Control, and Structure/Control Design Iteration for Flexible Spacecraft.

DTIC Science & Technology

1986-05-31

Nonlinear Feedback Control 8-16 for Spacecraft Attitude Maneuvers" 2. " Spacecraft Attitude Control Using 17-35... nonlinear state feedback control laws are developed for space- craft attitude control using the Euler parameters and conjugate angular momenta. Time... Nonlinear Feedback Control for Spacecraft Attitude Maneuvers," to appear in AIAA J. of Guidance, Control, and Dynamics, (AIAA Paper No. 83-2230-CP,

The best of two worlds? Pulmonary vein isolation using a novel radiofrequency ablation catheter incorporating contact force sensing technology and 56-hole porous tip irrigation.

PubMed

Maurer, Tilman; Rottner, Laura; Makimoto, Hisaki; Reissmann, Bruno; Heeger, Christian-H; Lemes, Christine; Fink, Thomas; Riedl, Johannes; Santoro, Francesco; Wohlmuth, Peter; Volkmer, Marius; Mathew, Shibu; Metzner, Andreas; Ouyang, Feifan; Kuck, Karl-Heinz; Sohns, Christian

2018-05-08

This study aimed to evaluate feasibility and safety as well as 1-year clinical outcome of pulmonary vein isolation (PVI) using a unique radiofrequency ablation catheter ("Thermocool SmartTouch SurroundFlow"; STSF) incorporating both, contact force (CF) sensing technology and enhanced tip irrigation with 56 holes, in one device. A total of 110 patients suffering from drug-refractory atrial fibrillation underwent wide area circumferential PVI using either the STSF ablation catheter (75 consecutive patients, study group) or a CF catheter with conventional tip irrigation ("Thermocool SmartTouch", 35 consecutive patients, control group). For each ablation lesion, a target CF of ≥ 10-39 g and a force time integral (FTI) of > 400 g s was targeted. Acute PVI was achieved in all patients with target CF obtained in > 85% of ablation points when using either device. Mean procedure time (131.3 ± 33.7 min in the study group vs. 133.0 ± 42.0 min in the control group; p = 0.99), mean fluoroscopy time (14.0 ± 6 vs. 13.5 ± 6.6 min; p = 0.56) and total ablation time were not significantly different (1751.0 ± 394.0 vs. 1604.6 ± 287.8 s; p = 0.2). However, there was a marked reduction in total irrigation fluid delivery by 51.7% (265.52 ± 64.4 vs. 539.6 ± 118.2 ml; p < 0.01). The Kaplan-Meier estimate 12-month arrhythmia-free survival after the index procedure following a 3-month blanking period was 79.9% (95% CI 70.4%, 90.4%) for the study group and 66.7% for the control group (95% CI 50.2%, 88.5%). This finding did not reach statistical significance (p = 0.18). Major complications occurred in 2/75 patients (2.7%; one pericardial tamponade and one transient ischemic attack) in the study group and no patient in the control group (p = 18). PVI using the STSF catheter is safe and effective and results in beneficial 1-year clinical outcome. The improved tip irrigation leads to a significant reduction in procedural fluid burden.

Why self-controlled feedback enhances motor learning: Answers from electroencephalography and indices of motivation.

PubMed

Grand, Kirk F; Bruzi, Alessandro T; Dyke, Ford B; Godwin, Maurice M; Leiker, Amber M; Thompson, Andrew G; Buchanan, Taylor L; Miller, Matthew W

2015-10-01

It was tested whether learners who choose when to receive augmented feedback while practicing a motor skill exhibit enhanced augmented feedback processing and intrinsic motivation, along with superior learning, relative to learners who do not control their feedback. Accordingly, participants were assigned to either self-control (Self) or yoked groups and asked to practice a non-dominant arm beanbag toss. Self participants received augmented feedback at their discretion, whereas Yoked participants were given feedback schedules matched to Self counterparts. Participants' visual feedback was occluded, and when they received augmented feedback, their processing of it was indexed with the electroencephalography-derived feedback-related negativity (FRN). Participants self-reported intrinsic motivation via the Intrinsic Motivation Inventory (IMI) after practice, and completed a retention and transfer test the next day to index learning. Results partially support the hypothesis. Specifically, Self participants reported higher IMI scores, exhibited larger FRNs, and demonstrated better accuracy on the transfer test, but not on the retention test, nor did they exhibit greater consistency on the retention or transfer tests. Additionally, post-hoc multiple regression analysis indicated FRN amplitude predicted transfer test accuracy (accounting for IMI score). Results suggest self-controlled feedback schedules enhance feedback processing, which enhances the transfer of a newly acquired motor skill. Copyright © 2015 Elsevier B.V. All rights reserved.

Laser dosimetry planning tool for colonoscopic tumor resection

NASA Astrophysics Data System (ADS)

Pelayo-Fernández, M. L.; Fanjul-Vélez, F.; Salas-García, I.; Zverev, M.; Arce-Diego, J. L.

2016-03-01

Gastrointestinal tumoral pathologies are quite common nowadays. Diseases such as gastric antral vascular ectasia (GAVE) or actinic proctitis may require endoscopic surgery. Argon Plasma Coagulated (APC) or radiofrequency are usually employed. However, they present disadvantages, such as the reduced treated area, magnetic resonance incompatibility, or an uncontrolled ablation depth. Optical surgery could avoid these problems and contribute to a better and controlled treatment result, either ablative or coagulative, in a minimally invasive, non-contact and non-ionizing way. The treatment area could also be increased by adequate optical fiber probe design. In this work laser surgery is analyzed for resection of colonic tumors. A Monte Carlo model is employed to study optical propagation, and an optical ablation approach allows the estimation of the resected volume. The ablation approach is based on plasma-induced ablation, particularly taking into account the freeelectron density generated in the tissue by the pulsed optical source. Several wavelengths, radii and malignant tissue types are considered, either healthy, adenomatous or even coagulated tissues. Optimum source parameters as a function of tumor geometry can be estimated for treatment planning.

Radiofrequency ablation of liver tumors (I): biological background.

PubMed

Vanagas, Tomas; Gulbinas, Antanas; Pundzius, Juozas; Barauskas, Giedrius

2010-01-01

Majority of patients suffering from liver tumors are not candidates for surgery. Currently, minimal invasive techniques have become available for local destruction of hepatic tumors. Radiofrequency ablation is based on biological response to tissue hyperthermia. The aim of this article is to review available biological data on tissue destruction mechanisms. Experimental evidence shows that tissue injury following thermal ablation occurs in two distinct phases. The initial phase is direct injury, which is determined by energy applied, tumor biology, and tumor microenvironment. The temperature varies along the ablation zone and this is reflected by different morphological changes in affected tissues. The local hyperthermia alters metabolism, exacerbates tissue hypoxia, and increases thermosensitivity. The second phase - indirect injury - is observed after the cessation of heat stimulus. This phase represents a balance of several promoting and inhibiting mechanisms, such as induction of apoptosis, heat shock proteins, Kupffer cell activation, stimulation of the immune response, release of cytokines, and ischemia-reperfusion injury. A deeper understanding of the underlying mechanisms may possibly lead to refinements in radiofrequency ablation technology, resulting in advanced local tumor control and prolonged overall survival.

Standardization of the carbon-phenolic materials and processes. Vol. 2: Test methods and specifications

NASA Technical Reports Server (NTRS)

Hall, William B.

1988-01-01

Carbon-phenolic composite materials are used in the ablation process in the nozzles of the Space Shuttle Main Engine. The nozzle is lined with carbon cloth-phenolic resin composites. The extreme heat and erosion of the burning propellant are controlled by the carbon-phenolic composite by means of ablation, a heat and mass transfer process in which a large amount of heat is dissipated by sacrificailly removing material from a surface. Phenolic materials ablate with the initial formation of a char. The depth of the char is a function of the heat conduction coefficient of the composite. The char layer is a poor conductor so it protects the underlying phenolic composite from the high heat of the burning propellant. The nozzle component ablative liners (carbon cloth-phenolic resin composites) are tape wrapped, hydroclave and/or autoclave cured, machined and assembled. The tape consists of prepreg broadcloth. The materials flow sheet for the nozzle ablative liners is given. The prepreg is a three component system: phenolic resin, carbon cloth, and carbon filler. This is Volume 2 of the report, Test Methods and Specifications.

Percutaneous thermal ablation for stage IA non-small cell lung cancer: long-term follow-up.

PubMed

Narsule, Chaitan K; Sridhar, Praveen; Nair, Divya; Gupta, Avneesh; Oommen, Roy G; Ebright, Michael I; Litle, Virginia R; Fernando, Hiran C

2017-10-01

Surgical resection is the most effective curative therapy for non-small cell lung cancer (NSCLC). However, many patients are unable to tolerate resection secondary to poor reserve or comorbid disease. Radiofrequency ablation (RFA) and microwave ablation (MWA) are methods of percutaneous thermal ablation that can be used to treat medically inoperable patients with NSCLC. We present long-term outcomes following thermal ablation of stage IA NSCLC from a single center. Patients with stage IA NSCLC and factors precluding resection who underwent RFA or MWA from July 2005 to September 2009 were studied. CT and PET-CT scans were performed at 3 and 6 month intervals, respectively, for first 24 months of follow-up. Factors associated with local progression (LP) and overall survival (OS) were analyzed. Twenty-one patients underwent 21 RFA and 4 MWA for a total of 25 ablations. Fifteen patients had T1a and six patients had T1b tumors. Mean follow-up was 42 months, median survival was 39 months, and OS at three years was 52%. There was no significant difference in median survival between T1a nodules and T1b nodules (36 vs . 39 months, P=0.29) or for RFA and MWA (36 vs . 50 months, P=0.80). Ten patients had LP (47.6%), at a median time of 35 months. There was no significant difference in LP between T1a and T1b tumors (22 vs . 35 months, P=0.94) or RFA and MWA (35 vs . 17 months, P=0.18). Median OS with LP was 32 months compared to 39 months without LP (P=0.68). Three patients underwent repeat ablations. Mean time to LP following repeat ablation was 14.75 months. One patient had two repeat ablations and was disease free at 40-month follow-up. Thermal ablation effectively treated or controlled stage IA NSCLC in medically inoperable patients. Three-year OS exceeded 50%, and LP did not affect OS. Therefore, thermal ablation is a viable option for medically inoperable patients with early stage NSCLC.

Impact of spatial variation in snow water equivalent and snow ablation on spring snowcover depletion over an alpine ridge

NASA Astrophysics Data System (ADS)

Schirmer, Michael; Harder, Phillip; Pomeroy, John

2016-04-01

The spatial and temporal dynamics of mountain snowmelt are controlled by the spatial distribution of snow accumulation and redistribution and the pattern of melt energy applied to this snowcover. In order to better quantify the spatial variations of accumulation and ablation, Structure-from-Motion techniques were applied to sequential aerial photographs of an alpine ridge in the Canadian Rocky Mountains taken from an Unmanned Aerial Vehicle (UAV). Seven spatial maps of snow depth and changes to depth during late melt (May-July) were generated at very high resolutions covering an area of 800 x 600 m. The accuracy was assessed with over 100 GPS measurements and RMSE were found to be less than 10 cm. Low resolution manual measurements of density permitted calculation of snow water equivalent (SWE) and change in SWE (ablation rate). The results indicate a highly variable initial SWE distribution, which was five times more variable than the spatial variation in ablation rate. Spatial variation in ablation rate was still substantial, with a factor of two difference between north and south aspects and small scale variations due to local dust deposition. However, the impact of spatial variations in ablation rate on the snowcover depletion curve could not be discerned. The reason for this is that only a weak spatial correlation developed between SWE and ablation rate. These findings suggest that despite substantial variations in ablation rate, snowcover depletion curve calculations should emphasize the spatial variation of initial SWE rather than the variation in ablation rate. While there is scientific evidence from other field studies that support this, there are also studies that suggest that spatial variations in ablation rate can influence snowcover depletion curves in complex terrain, particularly in early melt. The development of UAV photogrammetry has provided an opportunity for further detailed measurement of ablation rates, SWE and snowcover depletion over complex terrain and UAV field studies are recommended to clarify the relative importance of SWE and melt variability on snowcover depletion in various environmental conditions.

Motivation in vigilance - Effects of self-evaluation and experimenter-controlled feedback.

NASA Technical Reports Server (NTRS)

Warm, J. S.; Kanfer, F. H.; Kuwada, S.; Clark, J. L.

1972-01-01

Vigilance experiments have been performed to study the relative efficiency of feedback operations in enhancing vigilance performance. Two feedback operations were compared - i.e., experimenter-controlled feedback in the form of knowledge of results (KR) regarding response times to signal detections, and subject-controlled feedback in the form of self-evaluation (SE) of response times to signal detections. The subjects responded to the aperiodic offset of a visual signal during a 1-hr vigil. Both feedback operations were found to enhance performance efficiency: subjects in the KR and SE conditions had faster response times than controls receiving no evaluative feedback. Moreover, the data of the KR and SE groups did not differ significantly from each other. The results are discussed in terms of the hypothesis that self-evaluation is a critical factor underlying the incentive value of KR in vigilance tasks.

Effect of Concurrent Visual Feedback Frequency on Postural Control Learning in Adolescents.

PubMed

Marco-Ahulló, Adrià; Sánchez-Tormo, Alexis; García-Pérez, José A; Villarrasa-Sapiña, Israel; González, Luis M; García-Massó, Xavier

2018-04-13

The purpose was to find better augmented visual feedback frequency (100% or 67%) for learning a balance task in adolescents. Thirty subjects were divided randomly into a control group, and 100% and 67% feedback groups. The three groups performed pretest (3 trials), practice (12 trials), posttest (3 trials) and retention (3 trials, 24 hours later). The reduced feedback group showed lower RMS in the posttest than in the pretest (p = 0.04). The control and reduced feedback groups showed significant lower median frequency in the posttest than in the pretest (p < 0.05). Both feedback groups showed lower values in retention than in the pretest (p < 0.05). Even when the effect of feedback frequency could not be detected in motor learning, 67% of the feedback was recommended for motor adaptation.

Verbal communication improves laparoscopic team performance.

PubMed

Shiliang Chang; Waid, Erin; Martinec, Danny V; Bin Zheng; Swanstrom, Lee L

2008-06-01

The impact of verbal communication on laparoscopic team performance was examined. A total of 24 dyad teams, comprised of residents, medical students, and office staff, underwent 2 team tasks using a previously validated bench model. Twelve teams (feedback groups) received instant verbal instruction and feedback on their performance from an instructor which was compared with 12 teams (control groups) with minimal or no verbal feedback. Their performances were both video and audio taped for analysis. Surgical backgrounds were similar between feedback and control groups. Teams with more verbal feedback achieved significantly better task performance (P = .002) compared with the control group with less feedback. Impact of verbal feedback was more pronounced for tasks requiring team cooperation (aiming and navigation) than tasks depending on individual skills (knotting). Verbal communication, especially the instructions and feedback from an experienced instructor, improved team efficiency and performance.

Catheter ablation of junctional ectopic tachycardia in children, with preservation of atrioventricular conduction.

PubMed

Emmel, M; Sreeram, N; Brockmeier, K

2005-04-01

Idiopathic junctional ectopic tachycardia is a rare arrhythmia in children. Several studies have demonstrated that drug therapy is often ineffective and sometimes the only achieved effect is rate control. Early presentation and frequent recurrence are associated with adverse outcome. Three consecutive children, aged 9, 7 and 12 years respectively, underwent radiofrequency catheter ablation for junctional ectopic tachycardia, after having failed antiarrhythmic drug therapy. The entire His bundle was plotted out and marked, using the Localisa navigation system. The arrhythmia was readily and repeatedly inducible using intravenous isoprenaline infusion and the site of earliest retrograde conduction during tachycardia could be assessed. Ablations were performed in sinus rhythm, empirically targeting the site of earliest retrograde conduction during tachycardia. This approach was successful in abolishing tachyarrhythmia in the first two patients, in whom the successful ablation site was located superoparaseptally. In the third patient, junctional ectopic tachycardia was inducible, despite abolishing retrograde atrial activation, in a septal location on the tricuspid valve annulus. Further ablations in the superoparaseptal region, closer to the His bundle, were successful in rendering tachyarrhythmia noninducible. Over a median follow-up of 10 months, none of the patients has had recurrence of arrhythmia, despite discontinuing all antiarrhythmic medications. Radio frequency catheter ablation of junctional ectopic tachycardia is feasible with preservation of atrioventricular conduction.

Predictive analysis of optical ablation in several dermatological tumoral tissues

NASA Astrophysics Data System (ADS)

Fanjul-Vélez, F.; Blanco-Gutiérrez, A.; Salas-García, I.; Ortega-Quijano, N.; Arce-Diego, J. L.

2013-06-01

Optical techniques for treatment and characterization of biological tissues are revolutionizing several branches of medical praxis, for example in ophthalmology or dermatology. The non-invasive, non-contact and non-ionizing character of optical radiation makes it specially suitable for these applications. Optical radiation can be employed in medical ablation applications, either for tissue resection or surgery. Optical ablation may provide a controlled and clean cut on a biological tissue. This is particularly relevant in tumoral tissue resection, where a small amount of cancerous cells could make the tumor appear again. A very important aspect of tissue optical ablation is then the estimation of the affected volume. In this work we propose a complete predictive model of tissue ablation that provides an estimation of the resected volume. The model is based on a Monte Carlo approach for the optical propagation of radiation inside the tissue, and a blow-off model for tissue ablation. This model is applied to several types of dermatological tumoral tissues, specifically squamous cells, basocellular and infiltrative carcinomas. The parameters of the optical source are varied and the estimated resected volume is calculated. The results for the different tumor types are presented and compared. This model can be used for surgical planning, in order to assure the complete resection of the tumoral tissue.

Laser treatment of solar lentigines on dorsum of hands: QS Ruby laser versus ablative CO2 fractional laser - a randomized controlled trial.

PubMed

Schoenewolf, Nicola L; Hafner, Jürg; Dummer, Reinhard; Bogdan Allemann, Inja

2015-04-01

Lentigines solares (LS) on the dorsum of hands are often esthetically disturbing. Q-switched ruby laser treatment is highly effective in the treatment of these lesions. Ablative fractional photothermolysis may be a suitable alternative. We compared the Q-switched ruby laser with ablative CO2 fractional photothermolysis for the treatment of solar lentigines. To evaluate the efficacy and side-effects of 694nm Q-switched ruby laser (Sinon) with the ablative 10,600nm CO2 fractional laser (Quantel Excel O2) in an intra-individual side-to-side comparison in the treatment of LS on the dorsum of hands. Eleven patients were included in the study. The hands of each patient were randomized for treatment with the two laser systems. Three treatment sessions were scheduled at weeks 0, 4 and 8. Evaluations by patients, treating physician and blinded experts were scheduled at weeks 0, 4, 8, 16 and 24. The Q-switched ruby laser was significantly more efficacious than the ablative CO2 fractional laser for removing LS on the dorsum of hands (p = 0.01). In this first study on this topic, the Q-switched ruby laser was superior to the ablative CO2 fractional laser in the treatment of lentigines solares on the dorsum of hands.

Feedback power control strategies in wireless sensor networks with joint channel decoding.

PubMed

Abrardo, Andrea; Ferrari, Gianluigi; Martalò, Marco; Perna, Fabio

2009-01-01

In this paper, we derive feedback power control strategies for block-faded multiple access schemes with correlated sources and joint channel decoding (JCD). In particular, upon the derivation of the feasible signal-to-noise ratio (SNR) region for the considered multiple access schemes, i.e., the multidimensional SNR region where error-free communications are, in principle, possible, two feedback power control strategies are proposed: (i) a classical feedback power control strategy, which aims at equalizing all link SNRs at the access point (AP), and (ii) an innovative optimized feedback power control strategy, which tries to make the network operational point fall in the feasible SNR region at the lowest overall transmit energy consumption. These strategies will be referred to as "balanced SNR" and "unbalanced SNR," respectively. While they require, in principle, an unlimited power control range at the sources, we also propose practical versions with a limited power control range. We preliminary consider a scenario with orthogonal links and ideal feedback. Then, we analyze the robustness of the proposed power control strategies to possible non-idealities, in terms of residual multiple access interference and noisy feedback channels. Finally, we successfully apply the proposed feedback power control strategies to a limiting case of the class of considered multiple access schemes, namely a central estimating officer (CEO) scenario, where the sensors observe noisy versions of a common binary information sequence and the AP's goal is to estimate this sequence by properly fusing the soft-output information output by the JCD algorithm.

Comparing the Effects of Self-Controlled and Examiner-Controlled Feedback on Learning in Children With Developmental Coordination Disorder.

PubMed

Zamani, Mohamad Hosein; Fatemi, Rouholah; Soroushmoghadam, Keyvan

2015-12-01

Feedback can improve task learning in children with developmental coordination disorder (DCD). However, the frequency and type of feedback may play different role in learning and needs to more investigations. The aim of this study was to evaluate the acquisition and retention of new feedback skills in children with DCD under different frequency of self-control and control examiner feedback. In this quasi-experimental study with pretest-posttest design, participants based on their retention were divided into four feedback groups: self-controlled feedback groups with frequencies of 50% and75%, experimenter controls with frequencies of 50% and 75%. The study sample consisted of 24 boys with DCD aged between 9 to 11 years old in Ahvaz City, Iran. Then subjects practiced 30 throwing (6 blocks of 5 attempts) in eighth session. Acquisition test immediately after the last training session, and then the retention test were taken. Data were analyzed using the paired t-test, ANOVA and Tukey tests. The results showed no significant difference between groups in the acquisition phase (P > 0.05). However,in the retention session, group of self-control showed better performance than the control tester group (P < 0.05). Based on the current findings, self-control feedback with high frequency leads to more learning in DCD children. The results of this study can be used in rehabilitation programs to improve performance and learning in children with DCD.

Precision machining of pig intestine using ultrafast laser pulses

NASA Astrophysics Data System (ADS)

Beck, Rainer J.; Góra, Wojciech S.; Carter, Richard M.; Gunadi, Sonny; Jayne, David; Hand, Duncan P.; Shephard, Jonathan D.

2015-07-01

Endoluminal surgery for the treatment of early stage colorectal cancer is typically based on electrocautery tools which imply restrictions on precision and the risk of harm through collateral thermal damage to the healthy tissue. As a potential alternative to mitigate these drawbacks we present laser machining of pig intestine by means of picosecond laser pulses. The high intensities of an ultrafast laser enable nonlinear absorption processes and a predominantly nonthermal ablation regime. Laser ablation results of square cavities with comparable thickness to early stage colorectal cancers are presented for a wavelength of 1030 nm using an industrial picosecond laser. The corresponding histology sections exhibit only minimal collateral damage to the surrounding tissue. The depth of the ablation can be controlled precisely by means of the pulse energy. Overall, the application of ultrafast lasers to ablate pig intestine enables significantly improved precision and reduced thermal damage to the surrounding tissue compared to conventional techniques.

Excimer laser decontamination

NASA Astrophysics Data System (ADS)

Sentis, Marc L.; Delaporte, Philippe C.; Marine, Wladimir; Uteza, Olivier P.

2000-04-01

The application of excimer laser ablation process to the decontamination of radioactive surfaces is discussed. This technology is very attractive because it allows to efficiently remove the contaminated particles without secondary waste production. To demonstrate the capability of such technology to efficiently decontaminate large area, we studied and developed a prototype which include a XeCl laser, an optical fiber delivery system and an ablated particles collection cell. The main physical processes taking place during UV laser ablation will be explained. The influence of laser wavelength, pulse duration and absorption coefficient of material will be discussed. Special studies have been performed to understand the processes which limit the transmission of high average power excimer laser through optical fiber, and to determine the laser conditions to optimize the value of this transmission. An in-situ spectroscopic analysis of laser ablation plasma allows the real time control of the decontamination. The results obtained for painting or metallic oxides removal from stainless steel surfaces will be presented.

Numerical Modeling of Ablation Heat Transfer

NASA Technical Reports Server (NTRS)

Ewing, Mark E.; Laker, Travis S.; Walker, David T.

2013-01-01

A unique numerical method has been developed for solving one-dimensional ablation heat transfer problems. This paper provides a comprehensive description of the method, along with detailed derivations of the governing equations. This methodology supports solutions for traditional ablation modeling including such effects as heat transfer, material decomposition, pyrolysis gas permeation and heat exchange, and thermochemical surface erosion. The numerical scheme utilizes a control-volume approach with a variable grid to account for surface movement. This method directly supports implementation of nontraditional models such as material swelling and mechanical erosion, extending capabilities for modeling complex ablation phenomena. Verifications of the numerical implementation are provided using analytical solutions, code comparisons, and the method of manufactured solutions. These verifications are used to demonstrate solution accuracy and proper error convergence rates. A simple demonstration of a mechanical erosion (spallation) model is also provided to illustrate the unique capabilities of the method.

Review of the State of Renal Nerve Ablation for Patients with Severe and Resistant Hypertension

PubMed Central

Gulati, Vinay; White, William B.

2013-01-01

Through modulation of renin secretion, glomerular filtration rate and renal absorption of sodium, the sympathetic innervation of the kidneys plays an important role in the pathogenesis of hypertension. Renal nerve ablation technology is being developed for treatment of drug-treatment resistant hypertension worldwide. Preliminary research with the use of radiofrequency based renal denervation systems have demonstrated encouraging results with significant reduction of blood pressure in patients inadequately controlled despite nearly maximal drug therapy regimens. From work done thus far, the renal denervation procedure has not been associated with serious adverse effects. Long term efficacy and safety still needs to be established for renal nerve ablation. This review focuses on the impact of the renal sympathetic system on blood pressure regulation, the clinical rationale for renal nerve ablation in severe and drug-treatment resistant hypertension and current evidence from the more advanced renal denervation devices. PMID:23953998

Novel Approaches for the Treatment of the Patient with Resistant Hypertension: Renal Nerve Ablation

PubMed Central

Gulati, Vinay; White, William B.

2013-01-01

Sympathetic innervation of the kidneys plays a major role in the pathogenesis of hypertension through modulation of renin secretion, glomerular filtration rate and renal absorption of sodium. Targeted interventions for renal nerve ablation are being developed for treatment of drug resistant hypertension in the USA and rest of the world. Early studies with the use of radiofrequency based renal denervation systems have shown encouraging results with significant reduction of blood pressure in patients inadequately controlled despite nearly maximal drug therapy regimens. Thus far, the renal denervation procedure has been associated with minimal side effects. Long term efficacy and safety beyond 3 years needs to be determined for renal nerve ablation. This review focuses on the physiology of the renal sympathetic system, the rationale for renal nerve ablation and current evidence in support of the available therapeutic renal denervation systems. PMID:24244757

The effects of grooming on a copper ablative coating: a six year study.

PubMed

Tribou, Melissa; Swain, Geoffrey

2017-07-01

More than 90% of US Navy Ships are coated with copper ablative paint. These ships may spend long periods of time pier-side, which makes them vulnerable to fouling. Hull grooming has been proposed as a means of maintaining the coatings in an operational condition. This study investigated the effect of grooming on a copper ablative coating exposed statically for six years. Grooming was performed weekly or monthly with controls left ungroomed. The fouling community was visually assessed, dry film thickness measurements were taken to monitor coating loss, and the copper leaching rates were measured. It was found that weekly and monthly groomed surfaces reduced fouling, and the ungroomed surfaces became fully fouled. Coating loss was similar for weekly, monthly and ungroomed surfaces. The results suggest that grooming is a viable method for maintaining copper ablative coatings in a fouling-free condition without adverse increases in the total copper output.

Femtosecond laser induced tunable surface transformations on (111) Si aided by square grids diffraction

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

Han, Weina; Jiang, Lan; Li, Xiaowei, E-mail: lixiaowei@bit.edu.cn

We report an extra freedom to modulate the femtosecond laser energy distribution to control the surface ablated structures through a copper-grid mask. Due to the reduced deposited pulse energy by changing the scanning speed or the pulse fluence, a sequential evolution of three distinctly different surface patterns with periodic distributions is formed, namely, striped ripple lines, ripple microdots, and surface modification. By changing the scanning speed, the number of the multiple dots in a lattice can be modulated. Moreover, by exploring the ablation process through the copper grid mask, it shows an abnormal enhanced ablation effect with strong dependence ofmore » the diffraction-aided fs laser ablated surface structures on polarization direction. The sensitivity shows a quasi-cosinusoid-function with a periodicity of π/2. Particularly, the connection process of striped ripple lines manifests a preferential formation direction with the laser polarization.« less

Short- and Long-Term Learning of Feedforward Control of a Myoelectric Prosthesis with Sensory Feedback by Amputees.

PubMed

Strbac, Matija; Isakovic, Milica; Belic, Minja; Popovic, Igor; Simanic, Igor; Farina, Dario; Keller, Thierry; Dosen, Strahinja

2017-11-01

Human motor control relies on a combination of feedback and feedforward strategies. The aim of this study was to longitudinally investigate artificial somatosensory feedback and feedforward control in the context of grasping with myoelectric prosthesis. Nine amputee subjects performed routine grasping trials, with the aim to produce four levels of force during four blocks of 60 trials across five days. The electrotactile force feedback was provided in the second and third block using multipad electrode and spatial coding. The first baseline and last validation block (open-loop control) evaluated the effects of long- (across sessions) and short-term (within session) learning, respectively. The outcome measures were the absolute error between the generated and target force, and the number of force saturations. The results demonstrated that the electrotactile feedback improved the performance both within and across sessions. In the validation block, the performance did not significantly decrease and the quality of open-loop control (baseline) improved across days, converging to the performance characterizing closed-loop control. This paper provides important insights into the feedback and feedforward processes in prosthesis control, contributing to the better understanding of the role and design of feedback in prosthetic systems.

Robust high-performance control for robotic manipulators

NASA Technical Reports Server (NTRS)

Seraji, H.

1989-01-01

A robust control scheme to accomplish accurate trajectory tracking for an integrated system of manipulator-plus-actuators is proposed. The control scheme comprises a feedforward and a feedback controller. The feedforward controller contains any known part of the manipulator dynamics that can be used for online control. The feedback controller consists of adaptive position and velocity feedback gains and an auxiliary signal which is simply generated by a fixed-gain proportional/integral/derivative controller. The feedback controller is updated by very simple adaptation laws which contain both proportional and integral adaptation terms. By introduction of a simple sigma modification to the adaptation laws, robustness is guaranteed in the presence of unmodeled dynamics and disturbances.

Magnetic guidance versus manual control: comparison of radiofrequency lesion dimensions and evaluation of the effect of heart wall motion in a myocardial phantom.

PubMed

Bhaskaran, Abhishek; Barry, M A Tony; Al Raisi, Sara I; Chik, William; Nguyen, Doan Trang; Pouliopoulos, Jim; Nalliah, Chrishan; Hendricks, Roger; Thomas, Stuart; McEwan, Alistair L; Kovoor, Pramesh; Thiagalingam, Aravinda

2015-10-01

Magnetic navigation system (MNS) ablation was suspected to be less effective and unstable in highly mobile cardiac regions compared to radiofrequency (RF) ablations with manual control (MC). The aim of the study was to compare the (1) lesion size and (2) stability of MNS versus MC during irrigated RF ablation with and without simulated mechanical heart wall motion. In a previously validated myocardial phantom, the performance of Navistar RMT Thermocool catheter (Biosense Webster, CA, USA) guided with MNS was compared to manually controlled Navistar irrigated Thermocool catheter (Biosense Webster, CA, USA). The lesion dimensions were compared with the catheter in inferior and superior orientation, with and without 6-mm simulated wall motion. All ablations were performed with 40 W power and 30 ml/ min irrigation for 60 s. A total of 60 ablations were performed. The mean lesion volumes with MNS and MC were 57.5 ± 7.1 and 58.1 ± 7.1 mm(3), respectively, in the inferior catheter orientation (n = 23, p = 0.6), 62.8 ± 9.9 and 64.6 ± 7.6 mm(3), respectively, in the superior catheter orientation (n = 16, p = 0.9). With 6-mm simulated wall motion, the mean lesion volumes with MNS and MC were 60.2 ± 2.7 and 42.8 ± 8.4 mm(3), respectively, in the inferior catheter orientation (n = 11, p = <0.01*), 74.1 ± 5.8 and 54.2 ± 3.7 mm(3), respectively, in the superior catheter orientation (n = 10, p = <0.01*). During 6-mm simulated wall motion, the MC catheter and MNS catheter moved 5.2 ± 0.1 and 0 mm, respectively, in inferior orientation and 5.5 ± 0.1 and 0 mm, respectively, in the superior orientation on the ablation surface. The lesion dimensions were larger with MNS compared to MC in the presence of simulated wall motion, consistent with greater catheter stability. However, similar lesion dimensions were observed in the stationary model.

Improvement in quality of life after catheter ablation for paroxysmal versus long-standing persistent atrial fibrillation: a prospective study with 3-year follow-up.

PubMed

Bulková, Veronika; Fiala, Martin; Havránek, Stěpán; Simek, Jan; Skňouřil, Libor; Januška, Jaroslav; Spinar, Jindřich; Wichterle, Dan

2014-07-18

Changes in quality of life (QoL) after catheter ablation for long-standing persistent atrial fibrillation (LSPAF) are not well described. We sought to compare QoL improvement after catheter ablation of paroxysmal atrial fibrillation (PAF) versus that after LSPAF. A total of 261 PAF and 126 LSPAF ablation recipients were prospectively followed for arrhythmia recurrence, QoL, hospital stay, and sick leave. In PAF versus LSPAF groups, 1.3±0.6 versus 1.6±0.7 procedures were performed per patient (P<0.00001) during a 3-year follow-up. Good arrhythmia control was achieved in 86% versus 87% of patients (P=0.69) and in 69% versus 69% of patients not receiving antiarrhythmic drugs (P=0.99). The baseline QoL was better in the PAF than in the LSPAF group (European Quality of Life Group instrument self-report questionnaire visual analog scale: 66.4±14.2 versus 61.0±14.2, P=0.0005; European Quality of Life Group 3-level, 5-dimensional descriptive system: 71.4±9.2 versus 67.7±13.8, P=0.002). Postablation 3-year increase in QoL was significant in both groups (all P<0.00001) and significantly lower in PAF versus LSPAF patients (visual analog scale: +5.0±14.5 versus +10.2±12.8, P=0.001; descriptive system: +5.9±14.3 versus +9.3±13.9, P=0.03). In multivariate analysis, LSPAF, less advanced age, shorter history of AF and good arrhythmia control were consistently associated with postablation 3-year improvement in QoL. Days of hospital stay for cardiovascular reasons and days on sick leave per patient/year were significantly reduced in both groups. Patients with LSPAF had worse baseline QoL. The magnitude of QoL improvement after ablation of LSPAF was significantly greater compared with after ablation of PAF, particularly when good arrhythmia control was achieved without the use of antiarrhythmic drugs. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

V/STOL tilt rotor aircraft study. Volume 7: Tilt rotor flight control program feedback studies

NASA Technical Reports Server (NTRS)

Alexander, H. R.; Eason, W.; Gillmore, K.; Morris, J.; Spittle, R.

1973-01-01

An exploratory study has been made of the use of feedback control in tilt rotor aircraft. This has included the use of swashplate cyclic and collective controls and direct lift control. Various sensor and feedback systems are evaluated in relation to blade loads alleviation, improvement in flying qualities, and modal suppression. Recommendations are made regarding additional analytical and wind tunnel investigations and development of feedback systems in the full scale flight vehicle. Estimated costs and schedules are given.

Walking Flexibility after Hemispherectomy: Split-Belt Treadmill Adaptation and Feedback Control

ERIC Educational Resources Information Center

Choi, Julia T.; Vining, Eileen P. G.; Reisman, Darcy S.; Bastian, Amy J.

2009-01-01

Walking flexibility depends on use of feedback or reactive control to respond to unexpected changes in the environment, and the ability to adapt feedforward or predictive control for sustained alterations. Recent work has demonstrated that cerebellar damage impairs feedforward adaptation, but not feedback control, during human split-belt treadmill…

An Actomyosin-Arf-GEF Negative Feedback Loop for Tissue Elongation under Stress.

PubMed

West, Junior J; Zulueta-Coarasa, Teresa; Maier, Janna A; Lee, Donghoon M; Bruce, Ashley E E; Fernandez-Gonzalez, Rodrigo; Harris, Tony J C

2017-08-07

In response to a pulling force, a material can elongate, hold fast, or fracture. During animal development, multi-cellular contraction of one region often stretches neighboring tissue. Such local contraction occurs by induced actomyosin activity, but molecular mechanisms are unknown for regulating the physical properties of connected tissue for elongation under stress. We show that cytohesins, and their Arf small G protein guanine nucleotide exchange activity, are required for tissues to elongate under stress during both Drosophila dorsal closure (DC) and zebrafish epiboly. In Drosophila, protein localization, laser ablation, and genetic interaction studies indicate that the cytohesin Steppke reduces tissue tension by inhibiting actomyosin activity at adherens junctions. Without Steppke, embryogenesis fails, with epidermal distortions and tears resulting from myosin misregulation. Remarkably, actomyosin network assembly is necessary and sufficient for local Steppke accumulation, where live imaging shows Steppke recruitment within minutes. This rapid negative feedback loop provides a molecular mechanism for attenuating the main tension generator of animal tissues. Such attenuation relaxes tissues and allows orderly elongation under stress. Copyright © 2017 Elsevier Ltd. All rights reserved.

Augmented reality in surgical procedures

NASA Astrophysics Data System (ADS)

Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.

2008-02-01

Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

Dynamics of nonlinear feedback control.

PubMed

Snippe, H P; van Hateren, J H

2007-05-01

Feedback control in neural systems is ubiquitous. Here we study the mathematics of nonlinear feedback control. We compare models in which the input is multiplied by a dynamic gain (multiplicative control) with models in which the input is divided by a dynamic attenuation (divisive control). The gain signal (resp. the attenuation signal) is obtained through a concatenation of an instantaneous nonlinearity and a linear low-pass filter operating on the output of the feedback loop. For input steps, the dynamics of gain and attenuation can be very different, depending on the mathematical form of the nonlinearity and the ordering of the nonlinearity and the filtering in the feedback loop. Further, the dynamics of feedback control can be strongly asymmetrical for increment versus decrement steps of the input. Nevertheless, for each of the models studied, the nonlinearity in the feedback loop can be chosen such that immediately after an input step, the dynamics of feedback control is symmetric with respect to increments versus decrements. Finally, we study the dynamics of the output of the control loops and find conditions under which overshoots and undershoots of the output relative to the steady-state output occur when the models are stimulated with low-pass filtered steps. For small steps at the input, overshoots and undershoots of the output do not occur when the filtering in the control path is faster than the low-pass filtering at the input. For large steps at the input, however, results depend on the model, and for some of the models, multiple overshoots and undershoots can occur even with a fast control path.

Radiofrequency catheter ablation of Type 1 atrial flutter using a large-tip electrode catheter and high-power radiofrequency energy generator.

PubMed

Feld, Gregory K

2004-11-01

Recent studies have demonstrated a high degree of efficacy of 8 mm electrode-tipped or saline-irrigated-tip catheters for ablation of atrial flutter (AFL). These catheters have a theoretical advantage as they produce a large ablation lesion. However, large-tip ablation catheters have a larger surface area and require a higher power radiofrequency (RF) generator with up to 100 W capacity to produce adequate ablation temperatures (50-60 degrees C). The potential advantages of a large-tip ablation catheter and high-power RF generator include the need for fewer energy applications, shorter procedure and fluoroscopy times, and greater efficacy. Therefore, the safety and efficacy of AFL ablation using 8 or 10 mm electrode catheters and a 100-W RF generator was studied using the Boston Scientific, Inc., EPT-1000 XP cardiac ablation system. There were 169 patients, aged 61 +/- 12 years involved. Acute end points were bidirectional isthmus block and no inducible AFL. Following ablation, patients were seen at 1, 3 and 6 months, with event monitoring performed weekly and for any symptoms. Three quality of life surveys were completed during follow-up. Acute success was achieved in 158 patients (93%), with 12 +/- 11 RF energy applications. The efficacy of 8 and 10 mm electrodes did not differ significantly. The number of RF energy applications (10 +/- 8 vs. 14 +/- 8) and ablation time (0.5 +/- 0.4 vs. 0.8 +/- 0.6 h) were less with 10 mm compared with 8 mm electrodes (p < 0.01). Of 158 patients with acute success, 42 were not evaluated at 6 months due to study exclusions. Of the 116 patients evaluated at 6 months, 112 (97%) had no AFL recurrence. Of those without AFL recurrence at 6 months, 95 and 93% were free of symptoms at 12 and 24 months, respectively. Ablation of AFL improved quality of life scores (p < 0.05) and reduced anti-arrhythmic and rate control drug use (p < 0.05). Complications occurred in six out of 169 patients (3.6%) but there were no deaths. It was concluded that ablation of AFL with 8 or 10 mm electrode catheters and a high-power RF generator was safe, effective and improved quality of life. The number and duration of RF applications was lower with 10 mm compared with 8 mm electrode catheters.

Choosing Sensor Configuration for a Flexible Structure Using Full Control Synthesis

NASA Technical Reports Server (NTRS)

Lind, Rick; Nalbantoglu, Volkan; Balas, Gary

1997-01-01

Optimal locations and types for feedback sensors which meet design constraints and control requirements are difficult to determine. This paper introduces an approach to choosing a sensor configuration based on Full Control synthesis. A globally optimal Full Control compensator is computed for each member of a set of sensor configurations which are feasible for the plant. The sensor configuration associated with the Full Control system achieving the best closed-loop performance is chosen for feedback measurements to an output feedback controller. A flexible structure is used as an example to demonstrate this procedure. Experimental results show sensor configurations chosen to optimize the Full Control performance are effective for output feedback controllers.

Feedforward/feedback control synthesis for performance and robustness

NASA Technical Reports Server (NTRS)

Wie, Bong; Liu, Qiang

1990-01-01

Both feedforward and feedback control approaches for uncertain dynamical systems are investigated. The control design objective is to achieve a fast settling time (high performance) and robustness (insensitivity) to plant modeling uncertainty. Preshapong of an ideal, time-optimal control input using a 'tapped-delay' filter is shown to provide a rapid maneuver with robust performance. A robust, non-minimum-phase feedback controller is synthesized with particular emphasis on its proper implementation for a non-zero set-point control problem. The proposed feedforward/feedback control approach is robust for a certain class of uncertain dynamical systems, since the control input command computed for a given desired output does not depend on the plant parameters.

Inferential modeling and predictive feedback control in real-time motion compensation using the treatment couch during radiotherapy

NASA Astrophysics Data System (ADS)

Qiu, Peng; D'Souza, Warren D.; McAvoy, Thomas J.; Liu, K. J. Ray

2007-09-01

Tumor motion induced by respiration presents a challenge to the reliable delivery of conformal radiation treatments. Real-time motion compensation represents the technologically most challenging clinical solution but has the potential to overcome the limitations of existing methods. The performance of a real-time couch-based motion compensation system is mainly dependent on two aspects: the ability to infer the internal anatomical position and the performance of the feedback control system. In this paper, we propose two novel methods for the two aspects respectively, and then combine the proposed methods into one system. To accurately estimate the internal tumor position, we present partial-least squares (PLS) regression to predict the position of the diaphragm using skin-based motion surrogates. Four radio-opaque markers were placed on the abdomen of patients who underwent fluoroscopic imaging of the diaphragm. The coordinates of the markers served as input variables and the position of the diaphragm served as the output variable. PLS resulted in lower prediction errors compared with standard multiple linear regression (MLR). The performance of the feedback control system depends on the system dynamics and dead time (delay between the initiation and execution of the control action). While the dynamics of the system can be inverted in a feedback control system, the dead time cannot be inverted. To overcome the dead time of the system, we propose a predictive feedback control system by incorporating forward prediction using least-mean-square (LMS) and recursive least square (RLS) filtering into the couch-based control system. Motion data were obtained using a skin-based marker. The proposed predictive feedback control system was benchmarked against pure feedback control (no forward prediction) and resulted in a significant performance gain. Finally, we combined the PLS inference model and the predictive feedback control to evaluate the overall performance of the feedback control system. Our results show that, with the tumor motion unknown but inferred by skin-based markers through the PLS model, the predictive feedback control system was able to effectively compensate intra-fraction motion.

The clinical relevance of advanced artificial feedback in the control of a multi-functional myoelectric prosthesis.

PubMed

Markovic, Marko; Schweisfurth, Meike A; Engels, Leonard F; Bentz, Tashina; Wüstefeld, Daniela; Farina, Dario; Dosen, Strahinja

2018-03-27

To effectively replace the human hand, a prosthesis should seamlessly respond to user intentions but also convey sensory information back to the user. Restoration of sensory feedback is rated highly by the prosthesis users, and feedback is critical for grasping in able-bodied subjects. Nonetheless, the benefits of feedback in prosthetics are still debated. The lack of consensus is likely due to the complex nature of sensory feedback during prosthesis control, so that its effectiveness depends on multiple factors (e.g., task complexity, user learning). We evaluated the impact of these factors with a longitudinal assessment in six amputee subjects, using a clinical setup (socket, embedded control) and a range of tasks (box and blocks, block turn, clothespin and cups relocation). To provide feedback, we have proposed a novel vibrotactile stimulation scheme capable of transmitting multiple variables from a multifunction prosthesis. The subjects wore a bracelet with four by two uniformly placed vibro-tactors providing information on contact, prosthesis state (active function), and grasping force. The subjects also completed a questionnaire for the subjective evaluation of the feedback. The tests demonstrated that feedback was beneficial only in the complex tasks (block turn, clothespin and cups relocation), and that the training had an important, task-dependent impact. In the clothespin relocation and block turn tasks, training allowed the subjects to establish successful feedforward control, and therefore, the feedback became redundant. In the cups relocation task, however, the subjects needed some training to learn how to properly exploit the feedback. The subjective evaluation of the feedback was consistently positive, regardless of the objective benefits. These results underline the multifaceted nature of closed-loop prosthesis control as, depending on the context, the same feedback interface can have different impact on performance. Finally, even if the closed-loop control does not improve the performance, it could be beneficial as it seems to improve the subjective experience. Therefore, in this study we demonstrate, for the first time, the relevance of an advanced, multi-variable feedback interface for dexterous, multi-functional prosthesis control in a clinically relevant setting.

Comparing the effects of positive and negative feedback in information-integration category learning.

PubMed

Freedberg, Michael; Glass, Brian; Filoteo, J Vincent; Hazeltine, Eliot; Maddox, W Todd

2017-01-01

Categorical learning is dependent on feedback. Here, we compare how positive and negative feedback affect information-integration (II) category learning. Ashby and O'Brien (2007) demonstrated that both positive and negative feedback are required to solve II category problems when feedback was not guaranteed on each trial, and reported no differences between positive-only and negative-only feedback in terms of their effectiveness. We followed up on these findings and conducted 3 experiments in which participants completed 2,400 II categorization trials across three days under 1 of 3 conditions: positive feedback only (PFB), negative feedback only (NFB), or both types of feedback (CP; control partial). An adaptive algorithm controlled the amount of feedback given to each group so that feedback was nearly equated. Using different feedback control procedures, Experiments 1 and 2 demonstrated that participants in the NFB and CP group were able to engage II learning strategies, whereas the PFB group was not. Additionally, the NFB group was able to achieve significantly higher accuracy than the PFB group by Day 3. Experiment 3 revealed that these differences remained even when we equated the information received on feedback trials. Thus, negative feedback appears significantly more effective for learning II category structures. This suggests that the human implicit learning system may be capable of learning in the absence of positive feedback.

AGN Outflow Shocks on Bonnor–Ebert Spheres

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

Dugan, Zachary; Silk, Joseph; Rahman, Mubdi

Feedback from active galactic nuclei (AGNs) and subsequent jet cocoons and outflow bubbles can have a significant impact on star formation in the host galaxy. To investigate feedback physics on small scales, we perform hydrodynamic simulations of realistically fast AGN winds striking Bonnor–Ebert spheres and examine gravitational collapse and ablation. We test AGN wind velocities ranging from 300 to 3000 km s{sup −1} and wind densities ranging from 0.5 to 10 m {sub p} cm{sup −3}. We include heating and cooling of low- and high-temperature gas, self-gravity, and spatially correlated perturbations in the shock, with a maximum resolution of 0.01more » pc. We find that the ram pressure is the most important factor that determines the fate of the cloud. High ram pressure winds increase fragmentation and decrease the star formation rate, but they also cause star formation to occur on a much shorter timescale and with increased velocities of the newly formed stars. We find a threshold ram pressure of ∼2 × 10{sup −8} dyn cm{sup −2} above which stars are not formed because the resulting clumps have internal velocities large enough to prevent collapse. Our results indicate that simultaneous positive and negative feedback will be possible in a single galaxy, as AGN wind parameters will vary with location within a galaxy.« less

Use of CT Hounsfield unit density to identify ablated tumor after laparoscopic radiofrequency ablation of hepatic tumors.

PubMed

Berber, E; Foroutani, A; Garland, A M; Rogers, S J; Engle, K L; Ryan, T L; Siperstein, A E

2000-09-01

When attempting to interpret CT scans after radiofrequency thermal ablation (RFA) of liver tumors, it is sometimes difficult to distinguish ablated from viable tumor tissue. Identification of the two types of tissue is specially problematic for lesions that are hypodense before ablation. The aim of this study was to determine whether quantitative Hounsfield unit (HU) density measurements can be used to document the lack of tumor perfusion and thereby identify ablated tissue. Liver spiral CT scans of 13 patients with 51 lesions undergoing laparoscopic RFA for metastatic liver tumors within a 2-year time period were reviewed. HU density of the lesions as well as normal liver were measured pre- and postoperatively in each CT phase (noncontrast, arterial, portovenous). Statistical analyses were performed using Student's paired t-test and ANOVA. Normal liver parenchyma, which was used as a control, showed a similar increase with contrast injection in both pre- and postprocedure CT scans (56.4 +/- 2.4 vs 57.1 +/- 2.4 HU, respectively; p = 0.3). In contrast, ablated liver lesions showed a preablation increase of 45.7 +/- 3.4 HU but only a minimal postablation increase of 6.6 +/- 0.7 HU (p < 0.0001). This was true for highly vascular tumors (neuroendocrine) as well as hypovascular ones (adenocarcinoma). This is the first study to define quantitative radiological criteria using HU density for the evaluation of ablated tissues. A lack of increase in HU density with contrast injection indicates necrotic tissue, whereas perfused tissue shows an increase in HU density. This technique can be used in the evaluation of patients undergoing RFA.

Three potential mechanisms for failure of high intensity focused ultrasound ablation in cardiac tissue.

PubMed

Laughner, Jacob I; Sulkin, Matthew S; Wu, Ziqi; Deng, Cheri X; Efimov, Igor R

2012-04-01

High intensity focused ultrasound (HIFU) has been introduced for treatment of cardiac arrhythmias because it offers the ability to create rapid tissue modification in confined volumes without directly contacting the myocardium. In spite of the benefits of HIFU, a number of limitations have been reported, which hindered its clinical adoption. In this study, we used a multimodal approach to evaluate thermal and nonthermal effects of HIFU in cardiac ablation. We designed a computer controlled system capable of simultaneous fluorescence mapping and HIFU ablation. Using this system, linear lesions were created in isolated rabbit atria (n=6), and point lesions were created in the ventricles of whole-heart (n=6) preparations by applying HIFU at clinical doses (4-16 W). Additionally, we evaluate the gap size in ablation lines necessary for conduction in atrial preparations (n=4). The voltage sensitive dye di-4-ANEPPS was used to assess functional damage produced by HIFU. Optical coherence tomography and general histology were used to evaluate lesion extent. Conduction block was achieved in 1 (17%) of 6 atrial preparations with a single ablation line. Following 10 minutes of rest, 0 (0%) of 6 atrial preparations demonstrated sustained conduction block from a single ablation line. Tissue displacement of 1 to 3 mm was observed during HIFU application due to acoustic radiation force along the lesion line. Additionally, excessive acoustic pressure and high temperature from HIFU generated cavitation, causing macroscopic tissue damage. A minimum gap size of 1.5 mm was found to conduct electric activity. This study identified 3 potential mechanisms responsible for the failure of HIFU ablation in cardiac tissues. Both acoustic radiation force and acoustic cavitation, in conjunction with inconsistent thermal deposition, can increase the risk of lesion discontinuity and result in gap sizes that promote ablation failure.

Potassium titanyl phosphate laser tissue ablation: development and experimental validation of a new numerical model.

PubMed

Elkhalil, Hossam; Akkin, Taner; Pearce, John; Bischof, John

2012-10-01

The photoselective vaporization of prostate (PVP) green light (532 nm) laser is increasingly being used as an alternative to the transurethral resection of prostate (TURP) for treatment of benign prostatic hyperplasia (BPH) in older patients and those who are poor surgical candidates. In order to achieve the goals of increased tissue removal volume (i.e., "ablation" in the engineering sense) and reduced collateral thermal damage during the PVP green light treatment, a two dimensional computational model for laser tissue ablation based on available parameters in the literature has been developed and compared to experiments. The model is based on the control volume finite difference and the enthalpy method with a mechanistically defined energy necessary to ablate (i.e., physically remove) a volume of tissue (i.e., energy of ablation E(ab)). The model was able to capture the general trends experimentally observed in terms of ablation and coagulation areas, their ratio (therapeutic index (TI)), and the ablation rate (AR) (mm(3)/s). The model and experiment were in good agreement at a smaller working distance (WD) (distance from the tissue in mm) and a larger scanning speed (SS) (laser scan speed in mm/s). However, the model and experiment deviated somewhat with a larger WD and a smaller SS; this is most likely due to optical shielding and heat diffusion in the laser scanning direction, which are neglected in the model. This model is a useful first step in the mechanistic prediction of PVP based BPH laser tissue ablation. Future modeling efforts should focus on optical shielding, heat diffusion in the laser scanning direction (i.e., including 3D effects), convective heat losses at the tissue boundary, and the dynamic optical, thermal, and coagulation properties of BPH tissue.

Controllable underwater anisotropic oil-wetting

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

Yong, Jiale; Chen, Feng, E-mail: chenfeng@mail.xjtu.edu.cn; Yang, Qing

This Letter demonstrates a simple method to achieve underwater anisotropic oil-wetting using silicon surfaces with a microgroove array produced by femtosecond laser ablation. The oil contact angles along the direction perpendicular to the grooves are consistently larger than those parallel to the microgroove arrays in water because the oil droplet is restricted by the energy barrier that exists between the non-irradiated domain and the trapped water in the laser-ablated microgrooves. This underwater anisotropic oil-wetting is able to be controlled, and the anisotropy can be tuned from 0° to ∼20° by adjusting the period of the microgroove arrays.

Control Theory Perspective of Effects-Based Thinking and Operations: Modelling Operations as a Feedback Control System

DTIC Science & Technology

2007-11-01

Control Theory Perspective of Effects-Based Thinking and Operations Modelling “Operations” as a Feedback Control System Philip S. E... Theory Perspective of Effects-Based Thinking and Operations Modelling “Operations” as a Feedback Control System Philip S. E. Farrell...Abstract This paper explores operations that involve effects-based thinking (EBT) using Control Theory techniques in order to highlight the concept’s

Spatio-temporal control of gene expression and cancer treatment using magnetic resonance imaging-guided focused ultrasound.

PubMed

Moonen, Chrit T W

2007-06-15

Local temperature elevation may be used for tumor ablation, gene expression, drug activation, and gene and/or drug delivery. High-intensity focused ultrasound (HIFU) is the only clinically viable technology that can be used to achieve a local temperature increase deep inside the human body in a noninvasive way. Magnetic resonance imaging (MRI) guidance of the procedure allows in situ target definition and identification of nearby healthy tissue to be spared. In addition, MRI can be used to provide continuous temperature mapping during HIFU for spatial and temporal control of the heating procedure and prediction of the final lesion based on the received thermal dose. The primary purpose of the development of MRI-guided HIFU was to achieve safe noninvasive tissue ablation. The technique has been tested extensively in preclinical studies and is now accepted in the clinic for ablation of uterine fibroids. MRI-guided HIFU for ablation shows conceptual similarities with radiation therapy. However, thermal damage generally shows threshold-like behavior, with necrosis above the critical thermal dose and full recovery below. MRI-guided HIFU is being clinically evaluated in the cancer field. The technology also shows great promise for a variety of advanced therapeutic methods, such as gene therapy. MR-guided HIFU, together with the use of a temperature-sensitive promoter, provides local, physical, and spatio-temporal control of transgene expression. Specially designed contrast agents, together with the combined use of MRI and ultrasound, may be used for local gene and drug delivery.

Grip force control during virtual object interaction: effect of force feedback,accuracy demands, and training.

PubMed

Gibo, Tricia L; Bastian, Amy J; Okamura, Allison M

2014-03-01

When grasping and manipulating objects, people are able to efficiently modulate their grip force according to the experienced load force. Effective grip force control involves providing enough grip force to prevent the object from slipping, while avoiding excessive force to avoid damage and fatigue. During indirect object manipulation via teleoperation systems or in virtual environments, users often receive limited somatosensory feedback about objects with which they interact. This study examines the effects of force feedback, accuracy demands, and training on grip force control during object interaction in a virtual environment. The task required subjects to grasp and move a virtual object while tracking a target. When force feedback was not provided, subjects failed to couple grip and load force, a capability fundamental to direct object interaction. Subjects also exerted larger grip force without force feedback and when accuracy demands of the tracking task were high. In addition, the presence or absence of force feedback during training affected subsequent performance, even when the feedback condition was switched. Subjects' grip force control remained reminiscent of their employed grip during the initial training. These results motivate the use of force feedback during telemanipulation and highlight the effect of force feedback during training.

Combined Auditory and Vibrotactile Feedback for Human-Machine-Interface Control.

PubMed

Thorp, Elias B; Larson, Eric; Stepp, Cara E

2014-01-01

The purpose of this study was to determine the effect of the addition of binary vibrotactile stimulation to continuous auditory feedback (vowel synthesis) for human-machine interface (HMI) control. Sixteen healthy participants controlled facial surface electromyography to achieve 2-D targets (vowels). Eight participants used only real-time auditory feedback to locate targets whereas the other eight participants were additionally alerted to having achieved targets with confirmatory vibrotactile stimulation at the index finger. All participants trained using their assigned feedback modality (auditory alone or combined auditory and vibrotactile) over three sessions on three days and completed a fourth session on the third day using novel targets to assess generalization. Analyses of variance performed on the 1) percentage of targets reached and 2) percentage of trial time at the target revealed a main effect for feedback modality: participants using combined auditory and vibrotactile feedback performed significantly better than those using auditory feedback alone. No effect was found for session or the interaction of feedback modality and session, indicating a successful generalization to novel targets but lack of improvement over training sessions. Future research is necessary to determine the cognitive cost associated with combined auditory and vibrotactile feedback during HMI control.

Intermittent compared to continuous real-time fMRI neurofeedback boosts control over amygdala activation.

PubMed

Hellrung, Lydia; Dietrich, Anja; Hollmann, Maurice; Pleger, Burkhard; Kalberlah, Christian; Roggenhofer, Elisabeth; Villringer, Arno; Horstmann, Annette

2018-02-01

Real-time fMRI neurofeedback is a feasible tool to learn the volitional regulation of brain activity. So far, most studies provide continuous feedback information that is presented upon every volume acquisition. Although this maximizes the temporal resolution of feedback information, it may be accompanied by some disadvantages. Participants can be distracted from the regulation task due to (1) the intrinsic delay of the hemodynamic response and associated feedback and (2) limited cognitive resources available to simultaneously evaluate feedback information and stay engaged with the task. Here, we systematically investigate differences between groups presented with different variants of feedback (continuous vs. intermittent) and a control group receiving no feedback on their ability to regulate amygdala activity using positive memories and feelings. In contrast to the feedback groups, no learning effect was observed in the group without any feedback presentation. The group receiving intermittent feedback exhibited better amygdala regulation performance when compared with the group receiving continuous feedback. Behavioural measurements show that these effects were reflected in differences in task engagement. Overall, we not only demonstrate that the presentation of feedback is a prerequisite to learn volitional control of amygdala activity but also that intermittent feedback is superior to continuous feedback presentation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The Roles of Feedback and Feedforward as Humans Learn to Control Unknown Dynamic Systems.

PubMed

Zhang, Xingye; Wang, Shaoqian; Hoagg, Jesse B; Seigler, T Michael

2018-02-01

We present results from an experiment in which human subjects interact with an unknown dynamic system 40 times during a two-week period. During each interaction, subjects are asked to perform a command-following (i.e., pursuit tracking) task. Each subject's performance at that task improves from the first trial to the last trial. For each trial, we use subsystem identification to estimate each subject's feedforward (or anticipatory) control, feedback (or reactive) control, and feedback time delay. Over the 40 trials, the magnitudes of the identified feedback controllers and the identified feedback time delays do not change significantly. In contrast, the identified feedforward controllers do change significantly. By the last trial, the average identified feedforward controller approximates the inverse of the dynamic system. This observation provides evidence that a fundamental component of human learning is updating the anticipatory control until it models the inverse dynamics.

Design study of a feedback control system for the Multicyclic Flap System rotor (MFS)

NASA Technical Reports Server (NTRS)

Weisbrich, R.; Perley, R.; Howes, H.

1977-01-01

The feasibility of automatically providing higher harmonic control to a deflectable control flap at the tip of a helicopter rotor blade through feedback of selected independent parameter was investigated. Control parameters were selected for input to the feedback system. A preliminary circuit was designed to condition the selected parameters, weigh limiting factors, and provide a proper output signal to the multi-cyclic control actuators. Results indicate that feedback control for the higher harmonic is feasible; however, design for a flight system requires an extension of the present analysis which was done for one flight condition - 120 kts, 11,500 lbs gross weight and level flight.

Feedback linearization for control of air breathing engines

NASA Technical Reports Server (NTRS)

Phillips, Stephen; Mattern, Duane

1991-01-01

The method of feedback linearization for control of the nonlinear nozzle and compressor components of an air breathing engine is presented. This method overcomes the need for a large number of scheduling variables and operating points to accurately model highly nonlinear plants. Feedback linearization also results in linear closed loop system performance simplifying subsequent control design. Feedback linearization is used for the nonlinear partial engine model and performance is verified through simulation.

Indirect Identification of Linear Stochastic Systems with Known Feedback Dynamics

NASA Technical Reports Server (NTRS)

Huang, Jen-Kuang; Hsiao, Min-Hung; Cox, David E.

1996-01-01

An algorithm is presented for identifying a state-space model of linear stochastic systems operating under known feedback controller. In this algorithm, only the reference input and output of closed-loop data are required. No feedback signal needs to be recorded. The overall closed-loop system dynamics is first identified. Then a recursive formulation is derived to compute the open-loop plant dynamics from the identified closed-loop system dynamics and known feedback controller dynamics. The controller can be a dynamic or constant-gain full-state feedback controller. Numerical simulations and test data of a highly unstable large-gap magnetic suspension system are presented to demonstrate the feasibility of this indirect identification method.

Self-Controlled Feedback Facilitates Motor Learning in Both High and Low Activity Individuals

PubMed Central

Fairbrother, Jeffrey T.; Laughlin, David D.; Nguyen, Timothy V.

2012-01-01

The purpose of this study was to determine if high and low activity individuals differed in terms of the effects of self-controlled feedback on the performance and learning of a movement skill. The task consisted of a blindfolded beanbag toss using the non-preferred arm. Participants were pre-screened according to their physical activity level using the International Physical Activity Questionnaire. An equal number of high activity (HA) and low activity (LA) participants were assigned to self-control (SC) and yoked (YK) feedback conditions, creating four groups: Self-Control-High Activity; Self-Control-Low Activity; Yoked-High Activity; and Yoked-Low Activity. SC condition participants were provided feedback whenever they requested it, while YK condition participants received feedback according to a schedule created by their SC counterpart. Results indicated that the SC condition was more accurate than the YK condition during acquisition and transfer phases, and the HA condition was more accurate than the LA condition during all phases of the experiment. A post-training questionnaire indicated that participants in the SC condition asked for feedback mostly after what they perceived to be “good” trials; those in the YK condition indicated that they would have preferred to receive feedback after “good” trials. This study provided further support for the advantages of self-controlled feedback when learning motor skills, additionally showing benefits for both active and less active individuals. The results suggested that the provision of self-controlled feedback to less active learners may be a potential avenue to teaching motor skills necessary to engage in greater amounts of physical activity. PMID:22969745

Effectiveness of a smartphone app in increasing physical activity amongst male adults: a randomised controlled trial.

PubMed

Harries, Tim; Eslambolchilar, Parisa; Rettie, Ruth; Stride, Chris; Walton, Simon; van Woerden, Hugo C

2016-09-02

Smartphones are ideal for promoting physical activity in those with little intrinsic motivation for exercise. This study tested three hypotheses: H1 - receipt of social feedback generates higher step-counts than receipt of no feedback; H2 - receipt of social feedback generates higher step-counts than only receiving feedback on one's own walking; H3 - receipt of feedback on one's own walking generates higher step-counts than no feedback (H3). A parallel group randomised controlled trial measured the impact of feedback on steps-counts. Healthy male participants (n = 165) aged 18-40 were given phones pre-installed with an app that recorded steps continuously, without the need for user activation. Participants carried these with them as their main phones for a two-week run-in and six-week trial. Randomisation was to three groups: no feedback (control); personal feedback on step-counts; group feedback comparing step-counts against those taken by others in their group. The primary outcome measure, steps per day, was assessed using longitudinal multilevel regression analysis. Control variables included attitude to physical activity and perceived barriers to physical activity. Fifty-five participants were allocated to each group; 152 completed the study and were included in the analysis: n = 49, no feedback; n = 53, individual feedback; n = 50, individual and social feedback. The study provided support for H1 and H3 but not H2. Receipt of either form of feedback explained 7.7 % of between-subject variability in step-count (F = 6.626, p < 0.0005). Compared to the control, the expected step-count for the individual feedback group was 60 % higher (effect on log step-count = 0.474, 95 % CI = 0.166-0.782) and that for the social feedback group, 69 % higher (effect on log step-count = 0.526, 95 % CI = 0.212-0.840). The difference between the two feedback groups (individual vs social feedback) was not statistically significant. Always-on smartphone apps that provide step-counts can increase physical activity in young to early-middle-aged men but the provision of social feedback has no apparent incremental impact. This approach may be particularly suitable for inactive people with low levels of physical activity; it should now be tested with this population.

Microelectromechanical accelerometer with resonance-cancelling control circuit including an idle state

DOEpatents

Chu, Dahlon D.; Thelen, Jr., Donald C.; Campbell, David V.

2001-01-01

A digital feedback control circuit is disclosed for use in an accelerometer (e.g. a microelectromechanical accelerometer). The digital feedback control circuit, which periodically re-centers a proof mass in response to a sensed acceleration, is based on a sigma-delta (.SIGMA..DELTA.) configuration that includes a notch filter (e.g. a digital switched-capacitor filter) for rejecting signals due to mechanical resonances of the proof mass and further includes a comparator (e.g. a three-level comparator). The comparator generates one of three possible feedback states, with two of the feedback states acting to re-center the proof mass when that is needed, and with a third feedback state being an "idle" state which does not act to move the proof mass when no re-centering is needed. Additionally, the digital feedback control system includes an auto-zero trim capability for calibration of the accelerometer for accurate sensing of acceleration. The digital feedback control circuit can be fabricated using complementary metal-oxide semiconductor (CMOS) technology, bi-CMOS technology or bipolar technology and used in single- and dual-proof-mass accelerometers.

Elucidating the thermal, chemical, and mechanical mechanisms of ultraviolet ablation in poly(methyl methacrylate) via molecular dynamics simulations.

PubMed

Conforti, Patrick F; Prasad, Manish; Garrison, Barbara J

2008-08-01

[Figure: see text]. Laser ablation harnesses photon energy to remove material from a surface. Although applications such as laser-assisted in situ keratomileusis (LASIK) surgery, lithography, and nanoscale device fabrication take advantage of this process, a better understanding the underlying mechanism of ablation in polymeric materials remains much sought after. Molecular simulation is a particularly attractive technique to study the basic aspects of ablation because it allows control over specific process parameters and enables observation of microscopic mechanistic details. This Account describes a hybrid molecular dynamics-Monte Carlo technique to simulate laser ablation in poly(methyl methacrylate) (PMMA). It also discusses the impact of thermal and chemical excitation on the ensuing ejection processes. We used molecular dynamics simulation to study the molecular interactions in a coarse-grained PMMA substrate following photon absorption. To ascertain the role of chemistry in initiating ablation, we embedded a Monte Carlo protocol within the simulation framework. These calculations permit chemical reactions to occur probabilistically during the molecular dynamics calculation using predetermined reaction pathways and Arrhenius rates. With this hybrid scheme, we can examine thermal and chemical pathways of decomposition separately. In the simulations, we observed distinct mechanisms of ablation for each type of photoexcitation pathway. Ablation via thermal processes is governed by a critical number of bond breaks following the deposition of energy. For the case in which an absorbed photon directly causes a bond scission, ablation occurs following the rapid chemical decomposition of material. A detailed analysis of the processes shows that a critical energy for ablation can describe this complex series of events. The simulations show a decrease in the critical energy with a greater amount of photochemistry. Additionally, the simulations demonstrate the effects of the energy deposition rate on the ejection mechanism. When the energy is deposited rapidly, not allowing for mechanical relaxation of the sample, the formation of a pressure wave and subsequent tensile wave dominates the ejection process. This study provides insight into the influence of thermal, chemical, and mechanical processes in PMMA and facilitates greater understanding of the complex nature of polymer ablation. These simulations complement experiments that have used chemical design to harness the photochemical properties of materials to enhance laser ablation. We successfully fit the results of the simulations to established analytical models of both photothermal and photochemical ablation and demonstrate their relevance. Although the simulations are for PMMA, the mechanistic concepts are applicable to a large range of systems and provide a conceptual foundation for interpretation of experimental data.

Virtual grasping: closed-loop force control using electrotactile feedback.

PubMed

Jorgovanovic, Nikola; Dosen, Strahinja; Djozic, Damir J; Krajoski, Goran; Farina, Dario

2014-01-01

Closing the control loop by providing somatosensory feedback to the user of a prosthesis is a well-known, long standing challenge in the field of prosthetics. Various approaches have been investigated for feedback restoration, ranging from direct neural stimulation to noninvasive sensory substitution methods. Although there are many studies presenting closed-loop systems, only a few of them objectively evaluated the closed-loop performance, mostly using vibrotactile stimulation. Importantly, the conclusions about the utility of the feedback were partly contradictory. The goal of the current study was to systematically investigate the capability of human subjects to control grasping force in closed loop using electrotactile feedback. We have developed a realistic experimental setup for virtual grasping, which operated in real time, included a set of real life objects, as well as a graphical and dynamical model of the prosthesis. We have used the setup to test 10 healthy, able bodied subjects to investigate the role of training, feedback and feedforward control, robustness of the closed loop, and the ability of the human subjects to generalize the control to previously "unseen" objects. Overall, the outcomes of this study are very optimistic with regard to the benefits of feedback and reveal various, practically relevant, aspects of closed-loop control.

Improving Instruction Using Statistical Process Control.

ERIC Educational Resources Information Center

Higgins, Ronald C.; Messer, George H.

1990-01-01

Two applications of statistical process control to the process of education are described. Discussed are the use of prompt feedback to teachers and prompt feedback to students. A sample feedback form is provided. (CW)

Feedback Power Control Strategies in Wireless Sensor Networks with Joint Channel Decoding

PubMed Central

Abrardo, Andrea; Ferrari, Gianluigi; Martalò, Marco; Perna, Fabio

2009-01-01

In this paper, we derive feedback power control strategies for block-faded multiple access schemes with correlated sources and joint channel decoding (JCD). In particular, upon the derivation of the feasible signal-to-noise ratio (SNR) region for the considered multiple access schemes, i.e., the multidimensional SNR region where error-free communications are, in principle, possible, two feedback power control strategies are proposed: (i) a classical feedback power control strategy, which aims at equalizing all link SNRs at the access point (AP), and (ii) an innovative optimized feedback power control strategy, which tries to make the network operational point fall in the feasible SNR region at the lowest overall transmit energy consumption. These strategies will be referred to as “balanced SNR” and “unbalanced SNR,” respectively. While they require, in principle, an unlimited power control range at the sources, we also propose practical versions with a limited power control range. We preliminary consider a scenario with orthogonal links and ideal feedback. Then, we analyze the robustness of the proposed power control strategies to possible non-idealities, in terms of residual multiple access interference and noisy feedback channels. Finally, we successfully apply the proposed feedback power control strategies to a limiting case of the class of considered multiple access schemes, namely a central estimating officer (CEO) scenario, where the sensors observe noisy versions of a common binary information sequence and the AP's goal is to estimate this sequence by properly fusing the soft-output information output by the JCD algorithm. PMID:22291536

Method and apparatus for adaptive force and position control of manipulators

NASA Technical Reports Server (NTRS)

Seraji, Homayoun (Inventor)

1989-01-01

The present invention discloses systematic methods and apparatus for the design of real time controllers. Real-time control employs adaptive force/position by use of feedforward and feedback controllers, with the feedforward controller being the inverse of the linearized model of robot dynamics and containing only proportional-double-derivative terms is disclosed. The feedback controller, of the proportional-integral-derivative type, ensures that manipulator joints follow reference trajectories and the feedback controller achieves robust tracking of step-plus-exponential trajectories, all in real time. The adaptive controller includes adaptive force and position control within a hybrid control architecture. The adaptive controller, for force control, achieves tracking of desired force setpoints, and the adaptive position controller accomplishes tracking of desired position trajectories. Circuits in the adaptive feedback and feedforward controllers are varied by adaptation laws.

The role of auditory and kinaesthetic feedback mechanisms on phonatory stability in children.

PubMed

Rathna Kumar, S B; Azeem, Suhail; Choudhary, Abhishek Kumar; Prakash, S G R

2013-12-01

Auditory feedback plays an important role in phonatory control. When auditory feedback is disrupted, various changes are observed in vocal motor control. Vocal intensity and fundamental frequency (F0) levels tend to increase in response to auditory masking. Because of the close reflexive links between the auditory and phonatory systems, it is likely that phonatory stability may be disrupted when auditory feedback is disrupted or altered. However, studies on phonatory stability under auditory masking condition in adult subjects showed that most of the subjects maintained normal levels of phonatory stability. The authors in the earlier investigations suggested that auditory feedback is not the sole contributor to vocal motor control and phonatory stability, a complex neuromuscular reflex system known as kinaesthetic feedback may play a role in controlling phonatory stability when auditory feedback is disrupted or lacking. This proposes the need to further investigate this phenomenon as to whether children show similar patterns of phonatory stability under auditory masking since their neuromotor systems are still at developmental stage, less mature and are less resistant to altered auditory feedback than adults. A total of 40 normal hearing and speaking children (20 male and 20 female) between the age group of 6 and 8 years participated as subjects. The acoustic parameters such as shimmer, jitter and harmonic-to-noise ratio (HNR) were measures and compared between no masking condition (0 dB ML) and masking condition (90 dB ML). Despite the neuromotor systems being less mature in children and less resistant than adults to altered auditory feedback, most of the children in the study demonstrated increased phonatory stability which was reflected by reduced shimmer, jitter and increased HNR values. This study implicates that most of the children demonstrate well established patterns of kinaesthetic feedback, which might have allowed them to maintain normal levels of vocal motor control even in the presence of disturbed auditory feedback. Hence, it can be concluded that children also exhibit kinaesthetic feedback mechanism to control phonatory stability when auditory feedback is disrupted which in turn highlights the importance of kinaesthetic feedback to be included in the therapeutic/intervention approaches for children with hearing and neurogenic speech deficits.

Alternative approach for management of an electrical storm in Brugada syndrome:Importance of primary ablation within a narrow time window.

PubMed

Talib, Ahmed Karim; Yui, Yoshiaki; Kaneshiro, Takashi; Sekiguchi, Yukio; Nogami, Akihiko; Aonuma, Kazutaka

2016-06-01

Placement of an implantable cardioverter-defibrillator (ICD) is the only powerful treatment modality for Brugada syndrome in patients presenting with ventricular fibrillation (VF). For those whose first presentation is an electrical storm, pharmacologic therapy is typically used to control VF followed by ICD implantation. We report an alternative approach whereby, before ICD implantation, emergency catheter ablation of the VF-triggering premature ventricular contraction (PVC) resulted in long-term VF-free survival. The results suggest that, because VF triggers appear in a narrow time window, ablation of the culprit PVCs that initiate VF before the index PVCs subside is a reasonable alternative approach.

Vibrotactile Feedback Alters Dynamics Of Static Postural Control In Persons With Parkinson's Disease But Not Older Adults At High Fall Risk.

PubMed

High, Carleigh M; McHugh, Hannah F; Mills, Stephen C; Amano, Shinichi; Freund, Jane E; Vallabhajosula, Srikant

2018-06-01

Aging and Parkinson's disease are often associated with impaired postural control. Providing extrinsic feedback via vibrotactile sensation could supplement intrinsic feedback to maintain postural control. We investigated the postural control response to vibrotactile feedback provided at the trunk during challenging stance conditions in older adults at high fall risk and individuals with Parkinson's disease compared to healthy older adults. Nine older adults at high fall risk, 9 persons with Parkinson's disease and 10 healthy older adults performed 30s quiet standing on a force platform under five challenging stance conditions with eyes open/closed and standing on firm/foam surface with feet together, each with and without vibrotactile feedback. During vibrotactile feedback trials, feedback was provided when participants swayed >10% over the center of their base of support. Participants were instructed vibrations would be in response to their movement. Magnitude of postural sway was estimated using center of pressure path length, velocity, and sway area. Dynamics of individuals' postural control was evaluated using detrended fluctuation analysis. Results showed that vibrotactile feedback induced a change in postural control dynamics among persons with Parkinson's disease when standing with intact intrinsic visual input and altered intrinsic somatosensory input, but there was no change in sway magnitude. However, use of vibrotactile feedback did not significantly alter dynamics of postural control in older adults with high risk of falling or reduce the magnitude of sway. Considering the effects of vibrotactile feedback were dependent on the population and stance condition, designing an optimal therapeutic regimen for balance training should be carefully considered and be specific to a target population. Furthermore, our results suggest that explicit instructions on how to respond to the vibrotactile feedback could affect training outcome. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna--experimental and clinical studies.

PubMed

Kuang, Ming; Lu, Ming D; Xie, Xiao Y; Xu, Hui X; Mo, Li Q; Liu, Guang J; Xu, Zuo F; Zheng, Yan L; Liang, Jin Y

2007-03-01

To prospectively investigate whether the ablation zone induced with microwaves could be increased by delivering greater energy with a cooled-shaft antenna. All studies were animal care and ethics committee approved. Written informed consent was obtained from all patients. Microwave ablation was performed by using a cooled-shaft antenna in 48 ex vivo and 12 in vivo experiments with porcine livers. The coagulation diameters achieved in different microwave ablation parameter groups (60-90 W for 5-25 minutes) were compared. Ninety patients (78 men, 12 women; mean age, 53 years; age range, 20-82 years) with 133 0.8-8.0-cm (mean, 2.7 cm +/- 1.5 [standard deviation]) primary or metastatic liver cancers were treated with the same microwave ablation technique. Complete ablation (CA) and local tumor progression (LTP) rates were determined. Generalized estimating equations were used to compare differences in tumor size, ablation zone diameter, and CA and LTP rates between different patient subgroups. In the ex vivo livers, in vivo livers, and liver cancers, one application of microwave energy with 80 W for 25 minutes produced mean coagulation diameters of 5.6 x 7.4 cm, 3.5 x 5.9 cm, and 3.6 x 5.0 cm, respectively. Skin burn was not observed. CA rates in small (

Limited left atrial surgical ablation effectively treats atrial fibrillation but decreases left atrial function.

PubMed

Compier, Marieke G; Tops, Laurens F; Braun, Jerry; Zeppenfeld, Katja; Klautz, Robert J; Schalij, Martin J; Trines, Serge A

2017-04-01

Limited left atrial (LA) surgical ablation with bipolar radiofrequency is considered to be an effective procedure for treatment of atrial fibrillation (AF). We studied whether limited LA surgical ablation concomitant to cardiac surgery is able to maintain LA function. Thirty-six consecutive patients (age 66 ± 12 years, 53% male, 78% persistent AF) scheduled for valve surgery and/or coronary revascularization and concomitant LA surgical ablation were included. Epicardial pulmonary vein isolation (PVI) and additional endo-epicardial lines were performed using bipolar radiofrequency. An age- and gender-matched control group (n = 36, age 66 ± 9 years, 69% male, 81% paroxysmal AF) was selected from patients undergoing concomitant epicardial PVI only. Left atrial dimensions and function were assessed on two-dimensional echocardiography preoperatively and at 3- and 12-month follow-up. Sinus rhythm (SR) maintenance was 67% for limited LA ablation and 81% for PVI at 1-year follow-up (P = 0.18). Left atrial volume decreased from 72 ± 21 to 50 ± 14 mL (31%, P < 0.01) after limited LA ablation and from 65 ± 23 to 56 ± 20 mL (14%, P < 0.01) after PVI. Atrial transport function was restored in 54% of patients in SR after limited LA ablation compared with 100% of patients in SR after PVI. Atrial strain and contraction parameters (LA ejection fraction, A-wave velocity, reservoir function, and strain rate) significantly decreased after limited LA ablation. After PVI, strain and contraction parameters remained unchanged. Even limited LA ablation decreased LA volume, contraction, transport function, and compliance, indicating both reverse remodelling combined with significant functional deterioration. In contrast, surgical PVI decreased LA volume while function remained unchanged. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Cross-Layer Adaptive Feedback Scheduling of Wireless Control Systems

PubMed Central

Xia, Feng; Ma, Longhua; Peng, Chen; Sun, Youxian; Dong, Jinxiang

2008-01-01

There is a trend towards using wireless technologies in networked control systems. However, the adverse properties of the radio channels make it difficult to design and implement control systems in wireless environments. To attack the uncertainty in available communication resources in wireless control systems closed over WLAN, a cross-layer adaptive feedback scheduling (CLAFS) scheme is developed, which takes advantage of the co-design of control and wireless communications. By exploiting cross-layer design, CLAFS adjusts the sampling periods of control systems at the application layer based on information about deadline miss ratio and transmission rate from the physical layer. Within the framework of feedback scheduling, the control performance is maximized through controlling the deadline miss ratio. Key design parameters of the feedback scheduler are adapted to dynamic changes in the channel condition. An event-driven invocation mechanism for the feedback scheduler is also developed. Simulation results show that the proposed approach is efficient in dealing with channel capacity variations and noise interference, thus providing an enabling technology for control over WLAN. PMID:27879934

Effect of abdominal liposuction on sonographically guided high-intensity focused ultrasound ablation.

PubMed

Zhao, Wen-Peng; Chen, Jin-Yun; Chen, Wen-Zhi

2014-09-01

The aim of this study was to evaluate the effect of abdominal liposuction on sonographically guided high-intensity focused ultrasound (HIFU) ablation. A total of 10 women with uterine fibroids or adenomyosis who had received abdominal liposuction were analyzed after sonographically guided HIFU ablation. Of the 10 women, 6 had a diagnosis of uterine fibroids, and 4 had a diagnosis of uterine adenomyosis. All of them had a history of a horizontal-margin split-cesarean delivery. In addition, 26 women with a history of a single horizontal-margin split-cesarean delivery who had a diagnosis of uterine fibroids or adenomyosis but had not received liposuction were analyzed together as a control group. Of the 10 women, 1 woman with uterine fibroids developed local skin erythema after treatment; 1 women with uterine adenomyosis developed a skin burn after treatment; and the remaining women had obvious skin-burning pain during treatment. All women who had not received liposuction finished the treatment with no serious adverse events during or after treatment. The pain scores and incidence of skin-burning pain were significantly higher in the liposuction group than the control group (P= .021 and .038, respectively). Abdominal liposuction may increase the risk of skin burns during sonographically guided HIFU ablation. © 2014 by the American Institute of Ultrasound in Medicine.

Listening and Speaking: A Cybernetic Synthesis.

ERIC Educational Resources Information Center

Nord, James R.

1985-01-01

Cybernetic feedback theory sees the individual as a self-organizing feedback control system that generates its own activity to control its own perceptions. Applying the principle of feedback to language use, it appears that speaking as an overt public behavior is controlled by an internally private listening capacity. With that listening capacity,…

Collective synchronization of divisions in Drosophila development

NASA Astrophysics Data System (ADS)

Vergassola, Massimo

Mitoses in the early development of most metazoans are rapid and synchronized across the entire embryo. While diffusion is too slow, in vitro experiments have shown that waves of the cell-cycle regulator Cdk1 can transfer information rapidly across hundreds of microns. However, the signaling dynamics and the physical properties of chemical waves during embryonic development remain unclear. We develop FRET biosensors for the activity of Cdk1 and the checkpoint kinase Chk1 in Drosophila embryos and exploit them to measure waves in vivo. We demonstrate that Cdk1 chemical waves control mitotic waves and that their speed is regulated by the activity of Cdk1 during the S-phase (and not mitosis). We quantify the progressive slowdown of the waves with developmental cycles and identify its underlying control mechanism by the DNA replication checkpoint through the Chk1/Wee1 pathway. The global dynamics of the mitotic signaling network illustrates a novel control principle: the S-phase activity of Cdk1 regulates the speed of the mitotic wave, while the Cdk1 positive feedback ensures an invariantly rapid onset of mitosis. Mathematical modeling captures the speed of the waves and predicts a fundamental distinction between the S-phase Cdk1 trigger waves and the mitotic phase waves, which is illustrated by embryonic ablation experiments. In collaboration with Victoria Deneke1, Anna Melbinger2, and Stefano Di Talia1 1 Department of Cell Biology, Duke University Medical Center 2 Department of Physics, University of California San Diego.

Effects of feedback delay on learning from positive and negative feedback in patients with Parkinson's disease off medication.

PubMed

Weismüller, Benjamin; Ghio, Marta; Logmin, Kazimierz; Hartmann, Christian; Schnitzler, Alfons; Pollok, Bettina; Südmeyer, Martin; Bellebaum, Christian

2018-05-11

Phasic dopamine (DA) signals conveyed from the substantia nigra to the striatum and the prefrontal cortex crucially affect learning from feedback, with DA bursts facilitating learning from positive feedback and DA dips facilitating learning from negative feedback. Consequently, diminished nigro-striatal dopamine levels as in unmedicated patients suffering from Parkinson's Disease (PD) have been shown to lead to a negative learning bias. Recent studies suggested a diminished striatal contribution to feedback processing when the outcome of an action is temporally delayed. This study investigated whether the bias towards negative feedback learning induced by a lack of DA in PD patients OFF medication is modulated by feedback delay. To this end, PD patients OFF medication and healthy controls completed a probabilistic selection task, in which feedback was given immediately (after 800 ms) or delayed (after 6800 ms). PD patients were impaired in immediate but not delayed feedback learning. However, differences in the preference for positive/negative learning between patients and controls were seen for both learning from immediate and delayed feedback, with evidence of stronger negative learning in patients than controls. A Bayesian analysis of the data supports the conclusion that feedback timing did not affect the learning bias in the patients. These results hint at reduced, but still relevant nigro-striatal contribution to feedback learning, when feedback is delayed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Electrotactile Feedback Improves Performance and Facilitates Learning in the Routine Grasping Task.

PubMed

Isaković, Milica; Belić, Minja; Štrbac, Matija; Popović, Igor; Došen, Strahinja; Farina, Dario; Keller, Thierry

2016-06-13

Aim of this study was to investigate the feasibility of electrotactile feedback in closed loop training of force control during the routine grasping task. The feedback was provided using an array electrode and a simple six-level spatial coding, and the experiment was conducted in three amputee subjects. The psychometric tests confirmed that the subjects could perceive and interpret the electrotactile feedback with a high success rate. The subjects performed the routine grasping task comprising 4 blocks of 60 grasping trials. In each trial, the subjects employed feedforward control to close the hand and produce the desired grasping force (four levels). First (baseline) and the last (validation) session were performed in open loop, while the second and the third session (training) included electrotactile feedback. The obtained results confirmed that using the feedback improved the accuracy and precision of the force control. In addition, the subjects performed significantly better in the validation vs. baseline session, therefore suggesting that electrotactile feedback can be used for learning and training of myoelectric control.

Feedforward-feedback control of dissolved oxygen concentration in a predenitrification system.

PubMed

Yong, Ma; Yongzhen, Peng; Shuying, Wang

2005-07-01

As the largest single energy-consuming component in most biological wastewater treatment systems, aeration control is of great interest from the point of view of saving energy and improving wastewater treatment plant efficiency. In this paper, three different strategies, including conventional constant dissolved oxygen (DO) set-point control, cascade DO set-point control, and feedforward-feedback DO set-point control were evaluated using the denitrification layout of the IWA simulation benchmark. Simulation studies showed that the feedforward-feedback DO set-point control strategy was better than the other control strategies at meeting the effluent standards and reducing operational costs. The control strategy works primarily by feedforward control based on an ammonium sensor located at the head of the aerobic process. It has an important advantage over effluent measurements in that there is no (or only a very short) time delay for information; feedforward control was combined with slow feedback control to compensate for model approximations. The feedforward-feedback DO control was implemented in a lab-scale wastewater treatment plant for a period of 60 days. Compared to operation with constant DO concentration, the required airflow could be reduced by up to 8-15% by employing the feedforward-feedback DO-control strategy, and the effluent ammonia concentration could be reduced by up to 15-25%. This control strategy can be expected to be accepted by the operating personnel in wastewater treatment plants.

Percutaneous transhepatic cholangiography and intraductal radiofrequency ablation combined with biliary stent placement for malignant biliary obstruction.

PubMed

Li, Teng-Fei; Huang, Guo-Hao; Li, Zhen; Hao, Chang-Fu; Ren, Jian-Zhuang; Duan, Xu-Hua; Zhang, Kai; Chen, Chen; Han, Xin-Wei; Jiao, De-Chao; Zhang, Meng-Fan; Wang, Yan-Li

2015-05-01

To determine the safety and feasibility of percutaneous transhepatic cholangiography (PTC) and intraductal radiofrequency (RF) ablation combined with biliary stent placement for malignant biliary obstruction. Data from patients with unresectable malignant biliary obstruction who underwent PTC, intraductal RF ablation, and biliary stent placement (n = 12) or PTC and biliary stent placement only (control group; n = 14) were reviewed. Postoperative complications, jaundice remission, and stent patency were assessed. All procedures were successful. No severe complications (eg, biliary bleeding, perforation) occurred. Two experimental group patients developed cholangitis, which resolved with conservative treatment. The 1-week jaundice remission and 3-month stent patency rates were similar in both groups, but the 6-month stent patency rate was higher in the experimental group (P < .05). In the experimental group, one death occurred as a result of gastrointestinal hemorrhage (unrelated to stent placement) by 3 months, and there were two cases of recurrent jaundice by 6 months. The latter two patients underwent repeat PTC, ablation, and stent placement. In the control group, one death occurred as a result of hepatic failure caused by progressive jaundice at 3 months, and another death resulted from disseminated intravascular coagulation caused by jaundice recurrence at 138 days after stent placement. In addition, seven patients developed jaundice recurrence (50-151 d after stent placement). PTC and repeat stent placement were performed in these patients. Percutaneous transhepatic cholangiography and intraductal RF ablation combined with biliary stent placement for malignant biliary obstruction is safe and feasible and effectively prolongs stent patency time. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

MRI-guided prostate focal laser ablation therapy using a mechatronic needle guidance system

NASA Astrophysics Data System (ADS)

Cepek, Jeremy; Lindner, Uri; Ghai, Sangeet; Davidson, Sean R. H.; Trachtenberg, John; Fenster, Aaron

2014-03-01

Focal therapy of localized prostate cancer is receiving increased attention due to its potential for providing effective cancer control in select patients with minimal treatment-related side effects. Magnetic resonance imaging (MRI)-guided focal laser ablation (FLA) therapy is an attractive modality for such an approach. In FLA therapy, accurate placement of laser fibers is critical to ensuring that the full target volume is ablated. In practice, error in needle placement is invariably present due to pre- to intra-procedure image registration error, needle deflection, prostate motion, and variability in interventionalist skill. In addition, some of these sources of error are difficult to control, since the available workspace and patient positions are restricted within a clinical MRI bore. In an attempt to take full advantage of the utility of intraprocedure MRI, while minimizing error in needle placement, we developed an MRI-compatible mechatronic system for guiding needles to the prostate for FLA therapy. The system has been used to place interstitial catheters for MRI-guided FLA therapy in eight subjects in an ongoing Phase I/II clinical trial. Data from these cases has provided quantification of the level of uncertainty in needle placement error. To relate needle placement error to clinical outcome, we developed a model for predicting the probability of achieving complete focal target ablation for a family of parameterized treatment plans. Results from this work have enabled the specification of evidence-based selection criteria for the maximum target size that can be confidently ablated using this technique, and quantify the benefit that may be gained with improvements in needle placement accuracy.

The Preschool Classroom as a Context for Cognitive Development: Type of Teacher Feedback and Children's Metacognitive Control (El aula Preescolar como espacio de desarrollo cognitivo: tipo de feedback docente y control metacognitivo en los niños)

ERIC Educational Resources Information Center

Muñoz, Liz; Cruz, Josefina Santa

2016-01-01

Introduction: The aim of this work was to determine whether the type of feedback given by the preschool teacher during class impacts the children's metacognitive control. For this purpose, the children's behavior was analyzed while teachers provided feedback during collaborative learning sessions. Method: A quasi-experimental, cross-sectional…

A non-contact temperature measurement system for controlling photothermal medical laser treatments

NASA Astrophysics Data System (ADS)

Kaya, Ã.-zgür; Gülsoy, Murat

2016-03-01

Photothermal medical laser treatments are extremely dependent on the generated tissue temperature. It is necessary to reach a certain temperature threshold to achieve successful results, whereas preventing to exceed an upper temperature value is required to avoid thermal damage. One method to overcome this problem is to use previously conducted dosimetry studies as a reference. Nevertheless, these results are acquired in controlled environments using uniform subjects. In the clinical environment, the optical and thermal characteristics (tissue color, composition and hydration level) vary dramatically among different patients. Therefore, the most reliable solution is to use a closed-loop feedback system that monitors the target tissue temperature to control laser exposure. In this study, we present a compact, non-contact temperature measurement system for the control of photothermal medical laser applications that is cost-efficient and simple to use. The temperature measurement is achieved using a focused, commercially available MOEMS infrared thermocouple sensor embedded in an off-axis arrangement on the laser beam delivery hand probe. The spot size of the temperature sensor is ca. 2.5 mm, reasonably smaller than the laser spot sizes used in photothermal medical laser applications. The temperature readout and laser control is realized using a microcontroller for fast operation. The utilization of the developed system may enable the adaptation of several medical laser treatments that are currently conducted only in controlled laboratory environments into the clinic. Laser tissue welding and cartilage reshaping are two of the techniques that are limited to laboratory research at the moment. This system will also ensure the safety and success of laser treatments aiming hyperthermia, coagulation and ablation, as well as LLLT and PDT.

Optimal control of nonlinear continuous-time systems in strict-feedback form.

PubMed

Zargarzadeh, Hassan; Dierks, Travis; Jagannathan, Sarangapani

2015-10-01

This paper proposes a novel optimal tracking control scheme for nonlinear continuous-time systems in strict-feedback form with uncertain dynamics. The optimal tracking problem is transformed into an equivalent optimal regulation problem through a feedforward adaptive control input that is generated by modifying the standard backstepping technique. Subsequently, a neural network-based optimal control scheme is introduced to estimate the cost, or value function, over an infinite horizon for the resulting nonlinear continuous-time systems in affine form when the internal dynamics are unknown. The estimated cost function is then used to obtain the optimal feedback control input; therefore, the overall optimal control input for the nonlinear continuous-time system in strict-feedback form includes the feedforward plus the optimal feedback terms. It is shown that the estimated cost function minimizes the Hamilton-Jacobi-Bellman estimation error in a forward-in-time manner without using any value or policy iterations. Finally, optimal output feedback control is introduced through the design of a suitable observer. Lyapunov theory is utilized to show the overall stability of the proposed schemes without requiring an initial admissible controller. Simulation examples are provided to validate the theoretical results.

Does artificial ascites induce the heat-sink phenomenon during percutaneous radiofrequency ablation of the hepatic subcapsular area?: an in vivo experimental study using a rabbit model.

PubMed

Kim, Young Sun; Rhim, Hyunchul; Choi, Dongil; Lim, Hyo K

2009-01-01

To evaluate the effect of the heat-sink phenomenon induced by artificial ascites on the size of the ablation zone during percutaneous radiofrequency (RF) ablation of the hepatic subcapsular area in an in vivo rabbit model. A total of 21 percutaneous rabbit liver RF ablations were performed with and without artificial ascites (5% dextrose aqueous solution). The rabbits were divided into three groups: a) control group (C, n = 7); b) room temperature ascites group (R, n = 7); and c) warmed ascites group (W, n = 7). The tip of a 1 cm, internally cooled electrode was placed on the subcapsular region of the hepatic dome via ultrasound guidance, and ablation was continued for 6 min. Changes in temperature of the ascites were monitored during the ablation. The size of the ablation zones of the excised livers and immediate complications rates were compared statistically between the groups (Mann-Whitney U test, Kruskal-Wallis test, linear-by-linear association, p = 0.05). One rabbit from the "W" group expired during the procedure. In all groups, the ascites temperatures approached their respective body temperatures as the ablations continued; however, a significant difference in ascites temperature was found between groups "W" and "R" throughout the procedures (39.2+/-0.4 degrees C in group W and 33.4+/-4.3 degrees C in group R at 6 min, p = 0.003). No significant difference was found between the size of the ablation zones (782.4+/-237.3 mL in group C, 1,172.0+/-468.9 mL in group R, and 1,030.6+/-665.1 mL in group W, p = 0.170) for the excised liver specimens. Diaphragmatic injury was identified in three of seven cases (42.9%) upon visual inspection of group "C" rabbits (p = 0.030). Artificial ascites are not likely to cause a significant heat-sink phenomenon in the percutaneous RF ablation of the hepatic subcapsular region.

Effect of visuomotor-map uncertainty on visuomotor adaptation.

PubMed

Saijo, Naoki; Gomi, Hiroaki

2012-03-01

Vision and proprioception contribute to generating hand movement. If a conflict between the visual and proprioceptive feedback of hand position is given, reaching movement is disturbed initially but recovers after training. Although previous studies have predominantly investigated the adaptive change in the motor output, it is unclear whether the contributions of visual and proprioceptive feedback controls to the reaching movement are modified by visuomotor adaptation. To investigate this, we focused on the change in proprioceptive feedback control associated with visuomotor adaptation. After the adaptation to gradually introduce visuomotor rotation, the hand reached the shifted position of the visual target to move the cursor to the visual target correctly. When the cursor feedback was occasionally eliminated (probe trial), the end point of the hand movement was biased in the visual-target direction, while the movement was initiated in the adapted direction, suggesting the incomplete adaptation of proprioceptive feedback control. Moreover, after the learning of uncertain visuomotor rotation, in which the rotation angle was randomly fluctuated on a trial-by-trial basis, the end-point bias in the probe trial increased, but the initial movement direction was not affected, suggesting a reduction in the adaptation level of proprioceptive feedback control. These results suggest that the change in the relative contribution of visual and proprioceptive feedback controls to the reaching movement in response to the visuomotor-map uncertainty is involved in visuomotor adaptation, whereas feedforward control might adapt in a manner different from that of the feedback control.

Keratocyte density 3 months, 15 months, and 3 years after corneal surface ablation with mitomycin C.

PubMed

de Benito-Llopis, Laura; Cañadas, Pilar; Drake, Pilar; Hernández-Verdejo, José Luis; Teus, Miguel A

2012-01-01

To study the effects of surface ablation with mitomycin C (MMC) on keratocyte population. Prospective, nonrandomized, interventional, comparative case series. Thirty two eyes treated with surface ablation with 0.02% MMC were compared with nontreated eyes at Vissum Santa Hortensia, Madrid, Spain. Keratocyte density was measured with the Heidelberg Retina Tomograph II (Rostock Cornea Module) 3, 15, and 36 to 42 months after the surgery in the anterior, mid, and posterior stroma, and compared with control eyes. Three months postoperatively, we found a lower stromal bed density compared to controls (16 993 ± 8001 vs 29 660 ± 5904 cells/mm(3), P = .0001), while there was a significantly higher cell density in the mid (30 783 ± 9300 vs 18 505 ± 1996 cells/mm(3), P = .0001) and deep stroma (30 268 ± 8321 vs 18 438 ± 2139 cells/mm(3), P = .0001). Three years after the surgery, the cellularity in the stromal bed had not significantly changed from the 3-month follow-up, but the density in the mid (18 889 ± 3474 cells/mm(3)) and posterior stroma (18 992 ± 3402 cells/mm(3)) had decreased to show no difference from controls. The mean cell density between the anterior, mid, and posterior stroma was not significantly different from controls 15 months and 3 years after the surgery. Our study suggests that there is a reorganization of the stromal cell population soon after surface ablation with MMC, with a decrease in the stromal bed compensated initially with an increase in the mid and posterior stroma. Corneal cellularity tends to normalize over time, and 3 years postoperatively the mean cell density throughout the cornea seems to maintain normal values. Copyright © 2012 Elsevier Inc. All rights reserved.

Longterm effects of cardiac mediastinal nerve cryoablation on neural inducibility of atrial fibrillation in canines.

PubMed

Leiria, Tiago Luiz Luz; Glavinovic, Tamara; Armour, J Andrew; Cardinal, René; de Lima, Gustavo Glotz; Kus, Teresa

2011-04-26

In canines, excessive activation of select mediastinal nerve inputs to the intrinsic cardiac nervous system induces atrial fibrillation (AF). Since ablation of neural elements is proposed as an adjunct to circumferential pulmonary vein ablation for AF, we investigated the short and long-term effects of mediastinal nerve ablation on AF inducibility. Under general anesthesia, in 11 dogs several mediastinal nerve sites were identified on the superior vena cava that, when stimulated electrically during the atrial refractory period, reproducibly initiated AF. Cryoablation of one nerve site was then performed and inducibility retested early (1-2 months post Cryo; n=7) or late (4 months post Cryo; n=4). Four additional dogs that underwent a sham procedure were retested 1 to 2 months post-surgery. Stimulation induced AF at 91% of nerve sites tested in control versus 21% nerve sites early and 54% late post-ablation (both P<0.05). Fewer stimuli were required to induce AF in controls versus the Early Cryo group; this capacity returned to normal values in the Late Cryo group. AF episodes were longer in control versus the Early or Late Cryo groups. Heart rate responses to vagal or stellate ganglion stimulation, as well as to local nicotine infusion into the right coronary artery, were similar in all groups. In conclusion, focal damage to intrinsic cardiac neuronal inputs causes short-term stunning of neuronal inducibility of AF without major loss of overall adrenergic or cholinergic efferent neuronal control. That recovery of AF inducibility occurs rapidly post-surgery indicates the plasticity of intrathoracic neuronal elements to focal injury. Copyright © 2011 Elsevier B.V. All rights reserved.

Monitoring and control of amygdala neurofeedback involves distributed information processing in the human brain.

PubMed

Paret, Christian; Zähringer, Jenny; Ruf, Matthias; Gerchen, Martin Fungisai; Mall, Stephanie; Hendler, Talma; Schmahl, Christian; Ende, Gabriele

2018-03-30

Brain-computer interfaces provide conscious access to neural activity by means of brain-derived feedback ("neurofeedback"). An individual's abilities to monitor and control feedback are two necessary processes for effective neurofeedback therapy, yet their underlying functional neuroanatomy is still being debated. In this study, healthy subjects received visual feedback from their amygdala response to negative pictures. Activation and functional connectivity were analyzed to disentangle the role of brain regions in different processes. Feedback monitoring was mapped to the thalamus, ventromedial prefrontal cortex (vmPFC), ventral striatum (VS), and rostral PFC. The VS responded to feedback corresponding to instructions while rPFC activity differentiated between conditions and predicted amygdala regulation. Control involved the lateral PFC, anterior cingulate, and insula. Monitoring and control activity overlapped in the VS and thalamus. Extending current neural models of neurofeedback, this study introduces monitoring and control of feedback as anatomically dissociated processes, and suggests their important role in voluntary neuromodulation. © 2018 Wiley Periodicals, Inc.

Rapid feedback control and stabilization of an optical tweezers with a budget microcontroller

NASA Astrophysics Data System (ADS)

Nino, Daniel; Wang, Haowei; Milstein, Joshua N.

2014-09-01

Laboratories ranging the scientific disciplines employ feedback control to regulate variables within their experiments, from the flow of liquids within a microfluidic device to the temperature within a cell incubator. We have built an inexpensive, yet fast and rapidly deployed, feedback control system that is straightforward and flexible to implement from a commercially available Arduino Due microcontroller. This is in comparison with the complex, time-consuming and often expensive electronics that are commonly implemented. As an example of its utility, we apply our feedback controller to the task of stabilizing the main trapping laser of an optical tweezers. The feedback controller, which is inexpensive yet fast and rapidly deployed, was implemented from hacking an open source Arduino Due microcontroller. Our microcontroller based feedback system can stabilize the laser intensity to a few tenths of a per cent at 200 kHz, which is an order of magnitude better than the laser's base specifications, illustrating the utility of these devices.

The inhibitory microcircuit of the substantia nigra provides feedback gain control of the basal ganglia output

PubMed Central

Brown, Jennifer; Pan, Wei-Xing; Dudman, Joshua Tate

2014-01-01

Dysfunction of the basal ganglia produces severe deficits in the timing, initiation, and vigor of movement. These diverse impairments suggest a control system gone awry. In engineered systems, feedback is critical for control. By contrast, models of the basal ganglia highlight feedforward circuitry and ignore intrinsic feedback circuits. In this study, we show that feedback via axon collaterals of substantia nigra projection neurons control the gain of the basal ganglia output. Through a combination of physiology, optogenetics, anatomy, and circuit mapping, we elaborate a general circuit mechanism for gain control in a microcircuit lacking interneurons. Our data suggest that diverse tonic firing rates, weak unitary connections and a spatially diffuse collateral circuit with distinct topography and kinetics from feedforward input is sufficient to implement divisive feedback inhibition. The importance of feedback for engineered systems implies that the intranigral microcircuit, despite its absence from canonical models, could be essential to basal ganglia function. DOI: http://dx.doi.org/10.7554/eLife.02397.001 PMID:24849626

Structural and optical properties of novel surfactant-coated Yb@TiO2 nanoparticles

NASA Astrophysics Data System (ADS)

Calandra, P.; Lombardo, D.; Pistone, A.; Turco Liveri, V.; Trusso, S.

2011-11-01

In this paper a novel hybrid approach to synthesise composite nanoparticles is presented. It is based on the laser ablation of a bulk target (Yb) immersed in a reversed micellar solution which contains nanoparticles of a different host material (TiO2 nanoparticles) previously synthesised by chemical method. This approach thus exploits the advantages of the chemical synthesis through reversed micellar solution (size control, nanoparticle stabilisation), and of the laser ablation ("clean" synthesis, no side reactions). Central role is played by the microscopic processes controlling the deposition of the ablated Yb atoms onto the surface of TiO2 nanoparticles which actually behave as nucleation seeds. The structural features of the resulting Yb@TiO2 composite nanoparticles have been studied by Transmission Electron Microscopy, whereas their peculiar optical properties have been explored by UV-Vis spectroscopy and steady-state fluorescence. Results consistently show the formation of Yb and TiO2 glued nanodomains to form nearly spherical and non-interacting nanoparticles with enhanced photophysical properties.

Computer simulation of photorefractive keratectomy for the correction of myopia and hyperopia

NASA Astrophysics Data System (ADS)

Pinault, Pascal; 'Huillier, J. P.

1996-01-01

Photorefractive keratectomy (PRK) performed by means of the 193 nm excimer laser has stimulated considerable interest in the ophthalmic community because this new procedure has the potential to correct myopia, hyperopia, and astigmatism. The use of a laser beam to remove a controlled amount of tissue from the cornea implies that both the energy density of the laser beam and the target removed rate are accurately known. In addition, the required tissue ablation profile to achieve refractive correction must be predicted by optical calculations. This paper investigates: (1) Optical computations based on raytracing model to determine what anterior profile of cornea is needed postoperatively for ametropia. (2) Maximal depth of the removed corneal tissue against the ablation zone treated. And (3) the thickness of ablated corneal lenticule at any distance from the optical axis. Relationships between these data are well fitted by polynomial regressive curves in order to be useful as an algorithm in the computer-controlled delivery of the ArF laser beam.

Stability analysis of dynamic collaboration model with control signals on two lanes

NASA Astrophysics Data System (ADS)

Li, Zhipeng; Zhang, Run; Xu, Shangzhi; Qian, Yeqing; Xu, Juan

2014-12-01

In this paper, the influence of control signals on the stability of two-lane traffic flow is mainly studied by applying control theory with lane changing behaviors. We present the two-lane dynamic collaboration model with lateral friction and the expressions of feedback control signals. What is more, utilizing the delayed feedback control theory to the two-lane dynamic collaboration model with control signals, we investigate the stability of traffic flow theoretically and the stability conditions for both lanes are derived with finding that the forward and lateral feedback signals can improve the stability of traffic flow while the backward feedback signals cannot achieve it. Besides, direct simulations are conducted to verify the results of theoretical analysis, which shows that the feedback signals have a significant effect on the running state of two vehicle groups, and the results are same with the theoretical analysis.

Sedimentation Waves on the Martian North Polar Cap: Analogy with Megadunes in Antarctica

NASA Astrophysics Data System (ADS)

Herny, C.; Masse, M.; Bourgeois, O.; Carpy, S.; Le Mouelic, S.; Appéré, T.; Smith, I. B.; Spiga, A.; Perret, L.; Rodriguez, S.; Piquet, T.; Gaudin, D.; Le Menn, E.

2014-12-01

Complex feedbacks between katabatic winds and the cryosphere may lead to the development of sedimentation waves at the surface of ice sheets. These have been first described and named megadunes in Antarctica. Here we use topographic data, optical images, spectroscopic data and radar soundings, acquired by Mars orbiters, to show that the surface of the Martian North Polar Cap displays two superimposed sets of sedimentation waves with differing wavelengths. These sedimentation waves grow and migrate upwind in response to the development of periodic accumulation/ablation patterns controlled by katabatic winds. They have similarities with Antarctic megadunes regarding their surface morphology, texture, grain size, and internal stratigraphic architecture. Based on this analogy, we are currently developing a model of ice/wind interaction at the surface of ice sheets. In Antarctica the accumulation processes on megadunes fields is generally attributed to the wind-blown snow transport while on sedimentation waves of the North Polar Cap of Mars the accumulation seems to be dominated by sublimation/condensation processes at the surface. The model is designed to explore the implication of the water vapor mass transfer and heat transfer on the development of sedimentation waves both on Mars and Earth.

[Walking in Crustacea: motor program and peripheral regulation (author's transl)].

PubMed

Clarac, F; Ayers, J

1977-01-01

1. Rock lobsters can walk in all directions. In the present study, we report the organization of the motor output of the three muscles which control the mero-carpopodite joint (M-C): the extensor E, the flexor F and the accuracy flexor FA, during unrestrained locomotion (fig. 1). 2. During lateral walking, movements of the M-C joint provide most of the propulsive force, whereas during forward and backward walking this joint function more as a strut (fig. 2). Corresponding differences are observed in the motor discharge in the different walking modes. During lateral walking, discharge in the M-C extensor and M-C flexor alternates, whereas during forward and backward walking these antagonists are coactivated (fig. 3 and 4). 3. We have also examined the effects of alterations of proprioceptive feedback: the FA tendon has been cut to eliminate MCO afferents during walking. This ablation does not modify the burst period and the temporal structure of the output pattern is largely unaffected (fig. 5, 6 and 7). MCO may influence the motor output of a given muscle depending upon whether it participates in the return stroke or the power stroke.

Self-controlled concurrent feedback facilitates the learning of the final approach phase in a fixed-base flight simulator.

PubMed

Huet, Michaël; Jacobs, David M; Camachon, Cyril; Goulon, Cedric; Montagne, Gilles

2009-12-01

This study (a) compares the effectiveness of different types of feedback for novices who learn to land a virtual aircraft in a fixed-base flight simulator and (b) analyzes the informational variables that learners come to use after practice. An extensive body of research exists concerning the informational variables that allow successful landing. In contrast, few studies have examined how the attention of pilots can be directed toward these sources of information. In this study, 15 participants were asked to land a virtual Cessna 172 on 245 trials while trying to follow the glide-slope area as accurately as possible. Three groups of participants practiced under different feedback conditions: with self-controlled concurrent feedback (the self-controlled group), with imposed concurrent feedback (the yoked group), or without concurrent feedback (the control group). The self-controlled group outperformed the yoked group, which in turn outperformed the control group. Removing or manipulating specific sources of information during transfer tests had different effects for different individuals. However, removing the cockpit from the visual scene had a detrimental effect on the performance of the majority of the participants. Self-controlled concurrent feedback helps learners to more quickly attune to the informational variables that allow them to control the aircraft during the approach phase. Knowledge concerning feedback schedules can be used for the design of optimal practice methods for student pilots, and knowledge about the informational variables used by expert performers has implications for the design of cockpits and runways that facilitate the detection of these variables.

Effects of interactive visual feedback training on post-stroke pusher syndrome: a pilot randomized controlled study.

PubMed

Yang, Yea-Ru; Chen, Yi-Hua; Chang, Heng-Chih; Chan, Rai-Chi; Wei, Shun-Hwa; Wang, Ray-Yau

2015-10-01

We investigated the effects of a computer-generated interactive visual feedback training program on the recovery from pusher syndrome in stroke patients. Assessor-blinded, pilot randomized controlled study. A total of 12 stroke patients with pusher syndrome were randomly assigned to either the experimental group (N = 7, computer-generated interactive visual feedback training) or control group (N = 5, mirror visual feedback training). The scale for contraversive pushing for severity of pusher syndrome, the Berg Balance Scale for balance performance, and the Fugl-Meyer assessment scale for motor control were the outcome measures. Patients were assessed pre- and posttraining. A comparison of pre- and posttraining assessment results revealed that both training programs led to the following significant changes: decreased severity of pusher syndrome scores (decreases of 4.0 ± 1.1 and 1.4 ± 1.0 in the experimental and control groups, respectively); improved balance scores (increases of 14.7 ± 4.3 and 7.2 ± 1.6 in the experimental and control groups, respectively); and higher scores for lower extremity motor control (increases of 8.4 ± 2.2 and 5.6 ± 3.3 in the experimental and control groups, respectively). Furthermore, the computer-generated interactive visual feedback training program produced significantly better outcomes in the improvement of pusher syndrome (p < 0.01) and balance (p < 0.05) compared with the mirror visual feedback training program. Although both training programs were beneficial, the computer-generated interactive visual feedback training program more effectively aided recovery from pusher syndrome compared with mirror visual feedback training. © The Author(s) 2014.

Systematic review of surgical resection vs radiofrequency ablation for hepatocellular carcinoma

PubMed Central

Cucchetti, Alessandro; Piscaglia, Fabio; Cescon, Matteo; Ercolani, Giorgio; Pinna, Antonio Daniele

2013-01-01

Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation can not be offered or is not immediately accessible. Hepatic resection (HR) is currently considered the most curative strategy, but in the last decade local ablative therapies have started to obtain satisfactory results in term of efficacy and, of them, radiofrequency ablation (RFA) is considered the reference standard. An extensive literature review, from the year 2000, was performed, focusing on results coming from studies that directly compared HR and RFA. Qualities of the studies, characteristics of patients included, and patient survival and recurrence rates were analyzed. Except for three randomized controlled trials (RCT), most studies are affected by uncertain methodological approaches since surgical and ablated patients represent different populations as regards clinical and tumor features that are known to affect prognosis. Unfortunately, even the available RCTs report conflicting results. Until further evidences become available, it seems reasonable to offer RFA to very small HCC (< 2 cm) with no technical contraindications, since in this instance complete necrosis is most likely to be achieved. In larger nodules, namely > 2 cm and especially if > 3 cm, and/or in tumor locations in which ablation is not expected to be effective or safe, surgical removal is to be preferred. PMID:23864773

Comparison of Internal Energy Distributions of Ions Created by Electrospray Ionization and Laser Ablation-Liquid Vortex Capture-Electrospray Ionization

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

Cahill, John F.; Kertesz, Vilmos; Ovchinnikova, Olga S.

2015-06-27

Recently a number of techniques have combined laser ablation with liquid capture for mass spectrometry spot sampling and imaging applications. The newly developed non-contact liquid-vortex capture probe has been used to efficiently collect 355 nm UV laser ablated material in a continuous flow solvent stream in which the captured material dissolves and then undergoes electrospray ionization. This sampling and ionization approach has produced what appear to be classic electrospray ionization spectra; however, the softness of this sampling/ionization process versus simple electrospray ionization has not been definitely determined. A series of benzlypyridinium salts, known as thermometer ions, were used to comparemore » internal energy distributions between electrospray ionization and the UV laser ablation liquid-vortex capture probe electrospray combination. Measured internal energy distributions were identical between the two techniques, even with differences in laser fluence (0.7-3.1 J cm-2) and when using UV-absorbing or non-UV-absorbing sample substrates. This data indicates ions formed directly by UV laser ablation, if any, are likely an extremely small constituent of the total ion signal observed. Instead, neutral molecules, clusters or particulates ejected from the surface during laser ablation, subsequently captured and dissolved in the flowing solvent stream then electrosprayed are the predominant source of ion signal observed. The electrospray ionization process used controls the softness of the technique.« less

Coupled energy-balance/ice-sheet model simulations of the glacial cycle: A possible connection between terminations and terrigenous dust

NASA Astrophysics Data System (ADS)

Peltier, W. Richard; Marshall, Shawn

1995-07-01

We apply a coupled energy-balance/ice-sheet climate model in an investigation of northern hemisphere ice-sheet advance and retreat over the last glacial cycle. When driven only by orbital insolation variations, the model predicts ice-sheet advances over the continents of North America and Eurasia that are in good agreement with geological reconstructions in terms of the timescale of advance and the spatial positioning of the main ice masses. The orbital forcing alone, however, is unable to induce the observed rapid ice-sheet retreat, and we conclude that additional climatic feedbacks not explicitly included in the basic model must be acting. In the analyses presented here we have parameterized a number of potentially important effects in order to test their relative influence on the process of glacial termination. These include marine instability, thermohaline circulation effects, carbon dioxide variations, and snow albedo changes caused by dust loading during periods of high atmospheric aerosol concentration. For the purpose of these analyses the temporal changes in the latter two variables were inferred from ice core records. Of these various influences, our analyses suggest that the albedo variations in the ice-sheet ablation zone caused by dust loading may represent an extremely important ablation mechanism. Using our parameterization of "dirty" snow in the ablation zone we find glacial retreat to be strongly accelerated, such that complete collapse of the otherwise stable Laurentide ice sheet ensues. The last glacial maximum configurations of the Laurentide and Fennoscandian complexes are also brought into much closer accord with the ICE-3G reconstruction of Tushingham and Peltier (1991,1992) and the ICE-4G reconstruction of Peltier (1994) when this effect is reasonably introduced.

ON THE COAGULATION AND SIZE DISTRIBUTION OF PRESSURE CONFINED CORES

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

Huang Xu; Zhou Tingtao; Lin, D. N. C., E-mail: xuhuang@princeton.edu

2013-05-20

Observations of the Pipe Nebula have led to the discovery of dense starless cores. The mass of most cores is too small for their self-gravity to hold them together. Instead, they are thought to be pressure confined. The observed dense cores' mass function (CMF) matches well with the initial mass function of stars in young clusters. Similar CMFs are observed in other star forming regions such as the Aquila Nebula, albeit with some dispersion. The shape of these CMF provides important clues to the competing physical processes which lead to star formation and its feedback on the interstellar media. Inmore » this paper, we investigate the dynamical origin of the mass function of starless cores which are confined by a warm, less dense medium. In order to follow the evolution of the CMF, we construct a numerical method to consider the coagulation between the cold cores and their ablation due to Kelvin-Helmholtz instability induced by their relative motion through the warm medium. We are able to reproduce the observed CMF among the starless cores in the Pipe Nebula. Our results indicate that in environment similar to the Pipe Nebula: (1) before the onset of their gravitational collapse, the mass distribution of the progenitor cores is similar to that of the young stars, (2) the observed CMF is a robust consequence of dynamical equilibrium between the coagulation and ablation of cores, and (3) a break in the slope of the CMF is due to the enhancement of collisional cross section and suppression of ablation for cores with masses larger than the cores' Bonnor-Ebert mass.« less

Selective Removal of Natural Occlusal Caries by Coupling Near-infrared Imaging with a CO2 Laser

PubMed Central

Tao, You-Chen; Fried, Daniel

2011-01-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. Last year we successfully demonstrated that near-IR images can be used to guide a CO2 laser ablation system for the selective removal of artificial caries lesions on smooth surfaces. The objective of this study was to test the hypothesis that two-dimensional near-infrared images of natural occlusal caries can be used to guide a CO2 laser for selective removal. Two-dimensional NIR images were acquired at 1310-nm of extracted human molar teeth with occlusal caries. Polarization sensitive optical coherence tomography (PS-OCT) was also used to acquire depth-resolved images of the lesion areas. An imaging processing module was developed to analyze the NIR imaging output and generate optical maps that were used to guide a CO2 laser to selectively remove the lesions at a uniform depth. Post-ablation NIR images were acquired to verify caries removal. Based on the analysis of the NIR images, caries lesions were selectively removed with a CO2 laser while sound tissues were conserved. However, the removal rate varied markedly with the severity of decay and multiple passes were required for caries removal. These initial results are promising but indicate that the selective removal of natural caries is more challenging than the selective removal of artificial lesions due to varying tooth geometry, the highly variable organic/mineral ratio in natural lesions and more complicated lesion structure. PMID:21909225

Selective removal of natural occlusal caries by coupling near-infrared imaging with a CO II laser

NASA Astrophysics Data System (ADS)

Tao, You-Chen; Fried, Daniel

2008-02-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. Last year we successfully demonstrated that near-IR images can be used to guide a CO2 laser ablation system for the selective removal of artificial caries lesions on smooth surfaces. The objective of this study was to test the hypothesis that two-dimensional near-infrared images of natural occlusal caries can be used to guide a CO2 laser for selective removal. Two-dimensional NIR images were acquired at 1310-nm of extracted human molar teeth with occlusal caries. Polarization sensitive optical coherence tomography (PS-OCT) was also used to acquire depth-resolved images of the lesion areas. An imaging processing module was developed to analyze the NIR imaging output and generate optical maps that were used to guide a CO2 laser to selectively remove the lesions at a uniform depth. Post-ablation NIR images were acquired to verify caries removal. Based on the analysis of the NIR images, caries lesions were selectively removed with a CO2 laser while sound tissues were conserved. However, the removal rate varied markedly with the severity of decay and multiple passes were required for caries removal. These initial results are promising but indicate that the selective removal of natural caries is more challenging than the selective removal of artificial lesions due to varying tooth geometry, the highly variable organic/mineral ratio in natural lesions and more complicated lesion structure.

Selective Removal of Natural Occlusal Caries by Coupling Near-infrared Imaging with a CO(2) Laser.

PubMed

Tao, You-Chen; Fried, Daniel

2008-03-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. Last year we successfully demonstrated that near-IR images can be used to guide a CO(2) laser ablation system for the selective removal of artificial caries lesions on smooth surfaces. The objective of this study was to test the hypothesis that two-dimensional near-infrared images of natural occlusal caries can be used to guide a CO(2) laser for selective removal. Two-dimensional NIR images were acquired at 1310-nm of extracted human molar teeth with occlusal caries. Polarization sensitive optical coherence tomography (PS-OCT) was also used to acquire depth-resolved images of the lesion areas. An imaging processing module was developed to analyze the NIR imaging output and generate optical maps that were used to guide a CO(2) laser to selectively remove the lesions at a uniform depth. Post-ablation NIR images were acquired to verify caries removal. Based on the analysis of the NIR images, caries lesions were selectively removed with a CO(2) laser while sound tissues were conserved. However, the removal rate varied markedly with the severity of decay and multiple passes were required for caries removal. These initial results are promising but indicate that the selective removal of natural caries is more challenging than the selective removal of artificial lesions due to varying tooth geometry, the highly variable organic/mineral ratio in natural lesions and more complicated lesion structure.