Acoustic particle palpation for measuring tissue elasticity

We propose acoustic particle palpation – the use of sound to press a population of acoustic particles against an interface – as a method for measuring the qualitative and quantitative mechanical properties of materials. We tested the feasibility of this method by emitting ultrasound pulses across a tunnel of an elastic material filled with microbubbles. Ultrasound stimulated the microbubble cloud to move in the direction of wave propagation, press against the distal surface, and cause deformations relevant for elasticity measurements. Shear waves propagated away from the palpation site with a velocity that was used to estimate the material’s Young’s modulus

Superharmonic microbubble Doppler effect in ultrasound therapy

The introduction of microbubbles in focused ultrasound therapies has enabled a diverse range of non-invasive technologies: sonoporation to deliver drugs into cells, sonothrombolysis to dissolve blood clots, and blood-brain barrier opening to deliver drugs into the brain. Current methods for passively monitoring the microbubble dynamics responsible for these therapeutic effects can identify the cavitation position by passive acoustic mapping and cavitation mode by spectral analysis. Here, we introduce a new feature that can be monitored: microbubble effective velocity. Previous studies have shown that echoes from short imaging pulses had a Doppler shift that was produced by the movement of microbubbles. Therapeutic pulses are longer (>1,000 cycles) and thus produce a larger alteration of microbubble distribution due to primary and secondary acoustic radiation force effects which cannot be monitored using pulse-echo techniques. In our experiments, we captured and analysed the Doppler shift during long therapeutic pulses using a passive cavitation detector. A population of microbubbles (5×104-5×107 microbubbles ml-1) was embedded in a vessel (inner diameter: 4mm) and sonicated using a 0.5 megahertz focused ultrasound transducer (peak-rarefactional pressure: 75-366 kPa, pulse length: 50,000 cycles or 100 milliseconds) within a water tank. Microbubble acoustic emissions were captured with a coaxially aligned 7.5 megahertz passive cavitation detector and spectrally analysed to measure the Doppler shift for multiple harmonics above the 10th harmonic (i.e., superharmonics). A Doppler shift was observed on the order of tens of kilohertz with respect to the primary superharmonic peak and is due to the axial movement of the microbubbles. The position, amplitude and width of the Doppler peaks depended on the acoustic pressure and the microbubble concentration. Higher pressures increased the effective velocity of the microbubbles up to 3m/s, prior to the onset of broadband emission, which is an indicator for high magnitude inertial cavitation. Although the microbubble redistribution was shown to persist for the entire sonication period in dense populations, it was constrained to the first few milliseconds in lower concentrations. In conclusion, superharmonic microbubble Doppler effects can provide a quantitative measure of effective velocities of a sonicated microbubble population and could be used for monitoring ultrasound therapy in real-time

Comparison of new-generation renal artery denervation systems: assessing lesion size and thermodynamics using a thermochromic liquid crystal phantom model

Aims: The aim of this study was to evaluate and compare lesion dimensions and thermodynamics of the new-generation multi-electrode Symplicity Spyral and the new-generation multi-electrode EnligHTN renal artery denervation systems, using a thermochromic liquid crystal phantom model. Methods and results: A previously described renal artery phantom model was used as a platform for radiofrequency ablation. A total of 32 radiofrequency ablations were performed using the multi-electrode Symplicity Spyral (n=16) and the new-generation EnligHTN systems (n=16). Both systems were used as clinically recommended by their respective manufacturer. Lesion borders were defined by the 51°C isotherm. Lesion size (depth and width) was measured and compared between the two systems. Mean lesion depth was 2.15±0.02 mm for the Symplicity Spyral and 2.32±0.02 mm for the new-generation EnligHTN (p-value <0.001). Mean lesion width was 3.64±0.08 mm and 3.59±0.05 mm (p-value=0.61) for the Symplicity Spyral and the new-generation EnligHTN, respectively. Conclusions: The new-generation EnligHTN system produced lesions of greater depth compared to the Symplicity Spyral under the same experimental conditions. Lesion width was similar between both systems. Achieving greater lesion depth by use of the new-generation EnligHTN may result in better efficacy of renal artery denervation

Comparison of two different radiofrequency ablation systems for renal artery denervation: Evaluation of short-term and long-term follow up

Objectives: To assess the clinical efficacy of renal artery denervation (RAD) in our center and to compare the efficacy of two different radiofrequency (RF) systems. Background: Several systems are available for RF renal denervation. Whether there is a difference in clinical efficacy among various systems remains unknown. Methods: Renal artery denervation was performed on 43 patients with resistant hypertension using either the single electrode Symplicity Flex (n = 20) or the multi-electrode EnligHTN system (n = 23). Median post-procedural follow-up was 32.93 months. The primary outcome was post-procedural change in office blood pressure (BP) within 1 year (short-term follow-up). Secondary outcomes were change in office BP between 1 and 4 years (long-term follow-up) and the difference in office BP reduction between the two systems at each follow-up period. Results: For the total cohort, mean baseline office BP (systolic/diastolic) was 174/94 mmHg. At follow-up, mean changes in office BP from baseline were −19.70/−11.86 mmHg (P < 0.001) and −21.90/−13.94 mmHg (P < 0.001) for short-term and long-term follow-up, respectively. The differences in office BP reduction between Symplicity and EnligHTN groups were 8.96/1.23 mmHg (P = 0.42 for systolic BP, P = 0.83 for diastolic BP) and 9.56/7.68 mmHg (P = 0.14 for systolic BP, P = 0.07 for diastolic BP) for short-term and long-term follow-up, respectively. Conclusions: In our cohort, there was a clinically significant office BP reduction after RAD, which persisted up to 4 years. No significant difference in office BP reduction between the two systems was found

Transcatheter non-contact microwave ablation may enable circumferential renal artery denervation while sparing the vessel intima and media

Aims: Trials of transcatheter renal artery denervation (RDN) have failed to show consistent antihypertensive efficacy. Procedural factors and limitations of radiofrequency ablation can lead to incomplete denervation. The aim of the study was to show that non-contact microwave catheter ablation could produce deep circumferential perivascular heating while avoiding injury to the renal artery intima and media. Methods and results: A novel microwave catheter was designed and tested in a renal artery model consisting of layers of phantom materials embedded with a thermochromic liquid crystal sheet, colour range 50-78°C. Ablations were performed at 140 W for 180 sec and 120 W for 210 sec, delivering 25,200 J with renal arterial flow at 0.5 L/min and 0.1 L/min. Transcatheter microwave ablations 100-160 W for 180 sec were then performed in the renal arteries of five sheep. In vitro, ablations at 140 W and 0.5 L/min flow produced circumferential lesions 5.9±0.2 mm deep and 19.2±1.5 mm long with subendothelial sparing depth of 1.0±0.1 mm. In vivo, transcatheter microwave ablation was feasible with no collateral visceral thermal injury. There was histological evidence of preferential outer media and adventitial ablation. Conclusions: Transcatheter microwave ablation for RDN appears feasible and provides a heating pattern that may enable more complete denervation while sparing the renal arterial intima and media

X-ray diffraction and extended X-ray absorption fine structure study of epitaxial mixed ternary bixbyite PrxY2-xO3 (x = 0-2) films on Si (111)

Ternary single crystalline bixbyite PrxY2−xO3 films over the full stoichiometry range (x = 0–2) have been epitaxially grown on Si (111) with tailored electronic and crystallographic structure. In this work, we present a detailed study of their local atomic environment by extended X-ray absorption fine structure at both Y K and Pr LIII edges, in combination with complementary high resolution x-ray diffraction measurements. The local structure exhibits systematic variations as a function of the film composition. The cation coordination in the second and third coordination shells changes with composition and is equal to the average concentration, implying that the PrxY2−xO3 films are indeed fully mixed and have a local bixbyite structure with random atomic-scale ordering. A clear deviation from the virtual crystal approximation for the cation-oxygen bond lengths is detected. This demonstrates that the observed Vegard's law for the lattice variation as a function of composition is based microscopically on a more complex scheme related to local structural distortions which accommodate the different cation–oxygen bond lengths

Simultaneous Ultrasound Therapy and Monitoring of Microbubble-Seeded Acoustic Cavitation Using a Single-Element Transducer

Ultrasound-driven microbubble (MB) activity is used in therapeutic applications such as blood clot dissolution and targeted drug delivery. The safety and performance of these technologies are linked to the type and distribution of MB activities produced within the targeted area, but controlling and monitoring these activities in vivo and in real time has proven to be difficult. As therapeutic pulses are often milliseconds long, MB monitoring currently requires a separate transducer used in a passive reception mode. Here, we present a simple, inexpensive, integrated setup, in which a focused single-element transducer can perform ultrasound therapy and monitoring simultaneously. MBs were made to flow through a vesselmimicking tube, placed within the transducer's focus, and were sonicated with therapeutic pulses (peak rarefactional pressure: 75-827 kPa, pulse lengths: 200 μs and 20 ms). The MB-seeded acoustic emissions were captured using the same transducer. The received signals were separated from the therapeutic signal with a hybrid coupler and a high-pass filter. We discriminated the MB-generated cavitation signal from the primary acoustic field and characterized MB behavior in real time. The simplicity and versatility of our circuit could make existing single-element therapeutic transducers also act as cavitation detectors, allowing the production of compact therapeutic systems with real time monitoring capabilities

The Effect of surgical immunomodulation on liver inflammation and clearance of DHBV infection

The key to developing a therapeutic vaccine for chronic hepadnavirus infection lies in the characteristics of the host-immune response which leads to clearance of acute infection. Groups of 28-day-old ducks which had been surgically bursectomized (n = 10) or thymectomized (n =  13) on the day of hatch or were untreated (n = 21) were inoculated with 10⁹ viral genome equivalents (vge) DHBV, then bled twice a week, and euthanased 40 days later. Serum and liver were tested for DHBV DNA and total leukocytes and peripheral blood mononuclear cells (PBMCs) counted. Liver and spleen sections were either stained with hematoxylin and eosin, and graded for inflammation or stained with peroxidase-labeled anti-human CD3 antibody and examined for T lymphocyte distribution. PBMC counts were similar in all groups. DHBV infection combined with bursectomy increased significantly, while thymectomy decreased significantly the total leukocyte count. The spleen and liver bursectomy increased T lymphocyte number while B cells were decreased. Converse changes were observed in thymectomized ducks. Histological evidence of hepatitis was present in infected control and bursectomized ducks but not in the uninfected control or infected thymectomized ducks. In control animals, DHBV challenge caused viremia in 17 and persistent infection in 11 (56%). Fewer thymectomized ducks (3/13, 23%) and significantly more (100%) bursectomized ducks remained persistently infected (P < 0.001). Unexpectedly, bursectomy led to persistence of infection while clearance of infection occurred normally in thymectomized ducks despite decreased T lymphocyte numbers. This suggests that clearance requires T and B lymphocyte collaboration.7 page(s