Dynamic intraesophageal imagining of the heart with ultrasound

Real-time images of the heart from within the esophagus are produced by a new intraesophageal ultrasonic sector scanner. Sixty images per second are displayed on a gray scale CRT in real-time and recorded on standard videotape for review. By interactive positioning of the esophageal probe, heart ventricles, atria, and valves can be visualized and their dynamics can be studied. The esophageal probe comprises four 5 MHz PZT-5 piezoelements of 6.35 mm diameter, mounted on a shaft that rotates at 900 rpm. The piezoelements are pulsed at a 5 kHz rate and the echoes are processed electronically

Dynamic Intraesophageal Imaging of the Heart with Ultrasound

Real-time images of the heart from within the esophagus are produced by a new intraesophageal ultrasonic sector scanner. Sixty images per second are displayed on a gray scale CRT in real-time and recorded on standard videotape for review. By interactive positioning of the esophageal probe, heart ventricles, atria, and valves can be visualized and their dynamics can be studied. The esophageal probe comprises four 5 MHz PZT-5 piezoelements of 6.35 mm diameter, mounted on a shaft that rotates at 900 rpm. The piezoelements are pulsed at a 5 kHz rate and the echoes are processed electronically

Superficial Femoral Artery Recanalization with Self-expanding Nitinol Stents: Long-term Follow-up Results

PurposeSince long-term patency and device integrity of nitinol stents in SFA lesions are not well studied, we examined clinical outcome, patency and device integrity after stenting long lesions using a standardized implantation technique.MethodsBetween 2001 and 2006, 59 patients (74 lesions) were treated with the same nitinol self-expandable stent (Zilver, Cook, USA) and technique for SFA recanalization. Clinical charts and imaging were retrospectively reviewed for patency (primary and assisted-primary), and device integrity.ResultsPatients were 74.5 (10.9) years old (range 49 to 93), 64% male, 42% diabetic, 62% hypertensive and 67% current or former smokers. Lesions were 23% TASC B, 16% TASC C, or 61% TASC D. Mean recanalization length was 19cm (range 3 to 53). Mean number of stents per patient was 2.8 (total 210). Mean follow-up time was 2.4 years (range 3 days to 4.8 years). Kaplan-Meier estimates for primary patency rates were 90%, 78%, 74%, 69%, and 69% at 1, 2, 3, 4 and 4.8 years, respectively. Ten restenoses at a mean of 500 (388) days (1–1251 days) were successfully recanalized. The assisted primary patency rates were 96%, 90%, 90%, 90% and 90% at 1, 2, 3, 4 and 5 years, respectively. Six complete occlusions could not be reverted by a second recanalization procedure, and were treated by surgical bypass (1 case), amputation (3 cases), or medical management (2 cases). One (1.04%) Class II stent fracture was noted.ConclusionsSFA recanalization with a standardized implantation technique and nitinol stents provides good long-term primary and assisted-primary patency

Accuracy and precision of computer-simulated tissue temperatures in individual human intracranial tumours treated with interstitial hyperthermia

Accurate knowledge of tissue temperature is necessary for effective delivery of clinical hyperthermia in the treatment of malignant tumours. This report compares computer-predicted versus measured intratumoral temperatures in 11 human subjects with intracranial tumours, treated with a conceptually simple \u27conductive\u27 interstitial hyperthermia system. Interstitial hyperthermia was achieved by the use of parallel arrays of implanted, electrically heated catheters. The tissue was warmed by thermal conduction and blood convection. Simulation of intratumoral temperatures was achieved by solving a modified bioheat transfer equation on a digital computer using a finite difference method. Comparison of intratumoral temperatures from simulations and measured values differed by about ± 0.75 oC. Further analysis of computed temperature distributions between catheters revealed a rapidly computable relationship between the local minimum tumour temperature and nearby catheter power and temperature that accounts for effects of varying blood flow. These findings suggest that \u27on-line\u27 prediction and control of local minimum tumour temperatures are feasible with the conductive interstitial technique

Clinical feasibility of umbilical cord tissue-derived mesenchymal stem cells in the treatment of multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a progressively debilitating neurological condition in which the immune system abnormally erodes the myelin sheath insulating the nerves. Mesenchymal stem cells (MSC) have been used in the last decade to safely treat certain immune and inflammatory conditions. METHODS: A safety and feasibility study was completed on the use of umbilical cord MSC (UCMSC) as a treatment for MS. In this 1-year study, consenting subjects received seven intravenous infusions of 20 × 10 RESULTS: Twenty subjects were enrolled in this study. No serious adverse events were reported. Of the mild AEs denoted as possibly related to treatment, most were headache or fatigue. Symptom improvements were most notable 1 month after treatment. Improvements were seen in EDSS scores (p \u3c 0.03), as well as in bladder, bowel, and sexual dysfunction (p \u3c 0.01), in non-dominant hand average scores (p \u3c 0.01), in walk times (p \u3c 0.02) and general perspective of a positive health change and improved quality of life. MRI scans of the brain and the cervical spinal cord showed inactive lesions in 15/18 (83.3%) subjects after 1 year. CONCLUSIONS: Treatment with UCMSC intravenous infusions for subjects with MS is safe, and potential therapeutic benefits should be further investigated. Trial registration ClinicalTrials.gov NCT02034188. Registered Jan 13, 2014. https://clinicaltrials.gov/ct2/show/NCT02034188

Design and evaluation of closed-loop feedback control of minimum temperatures in human intracranial tumors treated with interstitial hyperthermia

The dynamic nature of blood flow during hyperthermia therapy has made the control of minimum tumor temperature a difficult task. This paper presents initial studies of a novel approach to closed-loop control of local minimum tissue temperatures utilizing a newly developed estimation algorithm for use with conductive interstitial heating systems. The local minimum tumor temperature is explicitly estimated from the power required to maintain each member of an array of electrically heated catheters at a known temperature, in conjunction with a new bioheat equation-based algorithm to predict the ‘droop’ or fractional decline in tissue temperature between heated catheters. A closed loop controller utilizes the estimated minimum temperature near each catheter as a feedback parameter, which reflects variations in local blood flow. In response the controller alters delivered power to each catheter to compensate for changes in blood flow. The validity and stability of this estimation/control scheme were tested in computer simulations and in closed-loop control of nine patient treatments. The average estimation error from patient data analysis of 21 sites at which temperature was independently measured (three per patient) was 0.0 oC, with a standard deviation of 0.8 oC. These results suggest that estimation of local minimum temperature and feedback control of power delivery can be employed effectively during conductive interstitial heat therapy of intracranial tumors in man