Biomechanical Modeling and Inverse Problem Based Elasticity Imaging for Prostate Cancer Diagnosis

Early detection of prostate cancer plays an important role in successful prostate cancer treatment. This requires screening the prostate periodically after the age of 50. If screening tests lead to prostate cancer suspicion, prostate needle biopsy is administered which is still considered as the clinical gold standard for prostate cancer diagnosis. Given that needle biopsy is invasive and is associated with issues including discomfort and infection, it is desirable to develop a prostate cancer diagnosis system that has high sensitivity and specificity for early detection with a potential to improve needle biopsy outcome. Given the complexity and variability of prostate cancer pathologies, many research groups have been pursuing multi-parametric imaging approach as no single modality imaging technique has proven to be adequate. While imaging additional tissue properties increases the chance of reliable prostate cancer detection and diagnosis, selecting an additional property needs to be done carefully by considering clinical acceptability and cost. Clinical acceptability entails ease with respect to both operating by the radiologist and patient comfort. In this work, effective tissue biomechanics based diagnostic techniques are proposed for prostate cancer assessment with the aim of early detection and minimizing the numbers of prostate biopsies. The techniques take advantage of the low cost, widely available and well established TRUS imaging method. The proposed techniques include novel elastography methods which were formulated based on an inverse finite element frame work. Conventional finite element analysis is known to have high computational complexity, hence computation time demanding. This renders the proposed elastography methods not suitable for real-time applications. To address this issue, an accelerated finite element method was proposed which proved to be suitable for prostate elasticity reconstruction. In this method, accurate finite element analysis of a large number of prostates undergoing TRUS probe loadings was performed. Geometry input and displacement and stress fields output obtained from the analysis were used to train a neural network mapping function to be used for elastopgraphy imaging of prostate cancer patients. The last part of the research presented in this thesis tackles an issue with the current 3D TRUS prostate needle biopsy. Current 3D TRUS prostate needle biopsy systems require registering preoperative 3D TRUS to intra-operative 2D TRUS images. Such image registration is time-consuming while its real-time implementation is yet to be developed. To bypass this registration step, concept of a robotic system was proposed which can reliably determine the preoperative TRUS probe position relative to the prostate to place at the same position relative to the prostate intra-operatively. For this purpose, a contact pressure feedback system is proposed to ensure similar prostate deformation during 3D and 2D image acquisition in order to bypass the registration step

Effect of different parameters on sonochemical synthesized nanocrystalline TiO2 particles

An ultrasonic-assisted method to directly prepare nanocrystalline TiO2 has been used. TiO2 was synthesized by the hydrolysis of Tetraisopropyl titanate (TIPT) in the presence of de-ionized water and ethanol under high-intensity ultrasonic irradiation (24 KHz, 300 W/cm2) at different conditions. The effect of water content, water-to-TIPT ratio, water-to-ethanol ratio and sonication time on the particle size of TiO2 has been investigated by using design of experiment (DOE). The water content, water-to-TIPT ratio, water-to-ethanol ratio and sonication time were varied in the range 100-150 ml, 50-75 v/v, 20-30 v/v and 3-4 hr, respectively. Particle size of TiO2 was characterized using particle size analyzer. The results of DOE show that water content has the greatest effect on the particle size of TiO2

Surgeon and Anesthesiologist Responsibilities for Operating Room Law: The Dilemma of Ethics

Law, ethics and concern for patient safety in the operating room are important considerations of the operating team, i.e., nurses, surgeons, and anesthesiologists. Meaningless rituals observed in the operating room (OR) must be replaced by practices and procedures based on sound principles of medical ethics. Modern technology and medical advances relieve the surgeon and anesthesiologist of many of the manual tasks, but have not completely solved the problems of ethics in the operating suite. Apathy, carelessness and indifference may be a more formidable dilemma unless curbed by moral, ethical and legal constraints. Operating room policies and procedures need constant review and reexamination. To maintain good medical ethics, enforcement of these policies and rules requires the cooperation of all who enter the OR suite. Recommendations are suggested to guide ethical behavior as it relates to the disclosure of the patient’s information in the operating room

The effect of berberine nanomicells on hepatic cirrhosis in bile duct ligated rats

The present study was designed to investigate the possible hepatoprotective effect of berberine (BBR) nano micelles on liver cirrhosis induced by bile duct ligation model (BDL) in male rats. Introduction: The anti-fibrotic effect of chronic berberine (BBR) had previously demonstrated in a rat model of bile duct ligation (BDL) - induced liver fibrosis. As a result, the aim of present study was to investigate the possible hepatoprotective effect of BBR nanomicelles on liver cirrhosis induced by Bile duct ligation model (BDL) in male rats. Methods and Results: Male Wistar rats were divided into 7 groups (n= 6) including sham-operated, BDL + saline, BDL + nanoBBR (50 mg/kg, p.o.), BDL + nanomicelles, BDL + BBR (50 and 100 mg/kg, p.o.), BDL + silymarin (100 mg/kg, p.o.). After 21 days of drugs' treatments following bile duct ligateation, the serum and tissue levels of some hepatic markers were measured and pathologic evaluations performed.BDL could markedly increase aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBIL) serum levels and tissue tumor necrosis factor-alpha (TNF-α), level along with reductions in tissue levels of glutathione (GSH), superoxide dismutase (SOD) and total protein levels. On the other hand, BBR nanomicelles (50 mg/kg, p.o.) and silymarin (100 mg/kg, p.o.) markedly decreased the serum levels of AST and ALT while enhanced GSH level. In addition, BBR nanomicelles (50 mg/kg, p.o.), silymarin (100 mg/kg, p.o.) and BBR (100 mg/kg, p.o.) groups showed a considerable increase in SOD levels. BBR nanomicelles (50 mg/kg, p.o.) significantly lowered TNF-α level. In addition, nanoBBR group prevented liver cirrhosis in histopathologic analysis.  Conclusions:Therefore, formulation of BBR nanomicelles may represent a good approach to enhance the effect of BBR in liver injuries

Ethics of Palliative Surgery in Esophageal Cancer

Abstract Background: Surgery is one of the important palliative methods for patients with esophageal cancer. In addition to concerns related to clinical decision making, various moral challenges are encountered in palliative surgery. Some of them are related to patients and their illness, others to surgeons, their attitudes, skills and knowledge base

Results of abdominoplasty by electrodissection and short- term complications

Objective: To describe abdominoplasty by electrodissection technique for improving short-term complications.Design: A prospective controlled study consisting of 100 consecutive female candidates for abdominoplasty by electrodissection employing spray-coagulation was conducted . The technique and electrical current used are described in detail.Results: Intraoperative bleeding ranged from 25 to 160 ml, (median 85 ml). The short-term specific and general complication rates were very low, not exceeding the rates observed using cold scalpel. The frequency of seroma was 24% and the occurrence of seroma, total seroma volume, and total suction tube discharge were correlated to the area of dissection or depth of electrical tissue injury. Conclusion: Despite the relatively high frequency of seroma, we recommend the use of spray-coagulation for abdominoplasty because bleeding is minimized, visibility during dissection is highly increased and the rate of short-term complications is very low