129 research outputs found

    Magnetic Resonance Imaging-Guided Focused Ultrasound Treatment of Symptomatic Uterine Fibroids Impact of Technology Advancement on Ablation Volumes in 115 Patients

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    Objectives: The aim of this study was to assess the impact of the advanced technology of the new ExAblate 2100 system (Insightec Ltd, Haifa, Israel) for magnetic resonance imaging (MRI)-guided focused ultrasound surgery on treatment outcomes in patients with symptomatic uterine fibroids, as measured by the nonperfused volume ratio. Materials and Methods: This is a retrospective analysis of 115 women (mean age, 42 years; range, 27-54 years) with symptomatic fibroids who consecutively underwent MRI-guided focused ultrasound treatment in a single center with the new generation ExAblate 2100 system from November 2010 to June 2011. Mean +/- SD total volume and number of treated fibroids (per patient) were 89 +/- 94 cm(3) and 2.2 +/- 1.7, respectively. Patient baseline characteristics were analyzed regarding their impact on the resulting nonperfused volume ratio. Results: Magnetic resonance imaging-guided focused ultrasound treatment was technically successful in 115 of 123 patients (93.5%). In 8 patients, treatment was not possible because of bowel loops in the beam pathway that could not be mitigated (n = 6), patient movement (n = 1), and system malfunction (n = 1). Mean nonperfused volume ratio was 88% +/- 15% (range, 38%-100%). Mean applied energy level was 5400 +/- 1200 J, and mean number of sonications was 74 +/- 27. No major complications occurred. Two cases of first-degree skin burn resolved within 1 week after the intervention. Of the baseline characteristics analyzed, only the planned treatment volume had a statistically significant impact on nonperfused volume ratio. Conclusions: With technological advancement, the outcome of MRI-guided focused ultrasound treatment in terms of the nonperfused volume ratio can be enhanced with a high safety profile, markedly exceeding results reported in previous clinical trials

    An Unusual Transmission Spectrum for the Sub-Saturn KELT-11b Suggestive of a Sub-Solar Water Abundance

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    We present an optical-to-infrared transmission spectrum of the inflated sub-Saturn KELT-11b measured with the Transiting Exoplanet Survey Satellite (TESS), the Hubble Space Telescope (HST) Wide Field Camera 3 G141 spectroscopic grism, and the Spitzer Space Telescope (Spitzer) at 3.6 μ\mum, in addition to a Spitzer 4.5 μ\mum secondary eclipse. The precise HST transmission spectrum notably reveals a low-amplitude water feature with an unusual shape. Based on free retrieval analyses with varying molecular abundances, we find strong evidence for water absorption. Depending on model assumptions, we also find tentative evidence for other absorbers (HCN, TiO, and AlO). The retrieved water abundance is generally ≲0.1×\lesssim 0.1\times solar (0.001--0.7×\times solar over a range of model assumptions), several orders of magnitude lower than expected from planet formation models based on the solar system metallicity trend. We also consider chemical equilibrium and self-consistent 1D radiative-convective equilibrium model fits and find they too prefer low metallicities ([M/H]≲−2[M/H] \lesssim -2, consistent with the free retrieval results). However, all the retrievals should be interpreted with some caution since they either require additional absorbers that are far out of chemical equilibrium to explain the shape of the spectrum or are simply poor fits to the data. Finally, we find the Spitzer secondary eclipse is indicative of full heat redistribution from KELT-11b's dayside to nightside, assuming a clear dayside. These potentially unusual results for KELT-11b's composition are suggestive of new challenges on the horizon for atmosphere and formation models in the face of increasingly precise measurements of exoplanet spectra.Comment: Accepted to The Astronomical Journal. 31 pages, 20 figures, 7 table

    Nuclear Activity in the Low Metallicity Dwarf Galaxy SDSS J0944-0038: A Glimpse into the Primordial Universe

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    Local low metallicity dwarf galaxies are relics of the early universe and hold clues into the origins of supermassive black holes (SMBHs). In recent work, coronal lines have been used to unveil a population of candidate accreting black holes in dwarf galaxies with gas phase metallicities and stellar masses well below the host galaxies of any previously known AGNs. Using MUSE/VLT observations, we report the detection of [Fe X] λ\lambda6374 coronal line emission and a broad Hα\alpha line in the nucleus of SDSS J094401.87−-003832.1, a nearby (z=0.0049z=0.0049) metal poor dwarf galaxy at least fifty times less massive than the LMC. The [Fe X] λ\lambda6374 emission is compact and centered on the brightest nuclear source, with a spatial extent of ≈\approx100 pc. The [Fe X] luminosity is ≈1037\approx 10^{37} erg s−1^{-1}, within the range seen in previously identified AGNs in the dwarf galaxy population. This line has never been observed in gas ionized by hot stars. While it can be produced in supernova ejecta, the [Fe X] flux from SDSS J094401.87−-003832.1 has persisted over the ~19 year time period between the SDSS and MUSE observations, ruling out supernovae as the origin for the emission. The FWHM of the broad component of the Hα\alpha line is 446±17446 \pm 17 km s−1^{-1} and its luminosity is ≈1.5×1038\approx 1.5\times10^{38} erg s−1^{-1}, lower than the broad line luminosities of previously identified low mass broad line AGNs. These observations, together with previously reported multi-wavelength observations, can most plausibly be explained by the presence of an accreting intermediate mass black hole in a primordial galaxy analog. However, we cannot rule out the possibility that current stellar population models of metal poor stars significantly under-predict the stellar ionizing photon flux, and that metal poor stars can produce an extreme ionizing spectrum similar to that produced by AGNs.Comment: 12 pages, 5 figures, 1 table, submitted to ApJL. Comments welcom

    Relics of Supermassive Black Hole Seeds: The Discovery of an Accreting Black Hole in an Optically Normal, Low Metallicity Dwarf Galaxy

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    The detection and characterization of supermassive black holes (SMBHs) in local low mass galaxies is crucial to our understanding of the origins of SMBHs. This statement assumes that low mass galaxies have had a relatively quiet cosmic history, so that their black holes have not undergone significant growth and therefore can be treated as relics of the original SMBH seeds. While recent studies have found optical signatures of active galactic nuclei (AGNs) in a growing population of dwarf galaxies, these studies are biased against low metallicity and relatively merger-free galaxies, thus missing precisely the demographic in which to search for the relics of SMBH seeds. Here, we report the detection of the [\ion{Si}{6}]1.963~μ\mum coronal line (CL), a robust indicator of an AGN in the galaxy SDSS~J160135.95+311353.7, a nearby (z=0.031z=0.031) low metallicity galaxy with a stellar mass approximately an order of magnitude lower than the LMC (M∗≈108.56M_*\approx10^{8.56}~M⊙_\odot) and no optical evidence for an AGN. The AGN bolometric luminosity implied by the CL detection is ≈1042\approx10^{42}~erg~s−1^{-1}, precisely what is predicted from its near-infrared continuum emission based on well-studied AGNs. Our results are consistent with a black hole of mass ≈ 105\approx~10^5~M⊙_\odot, in line with expectations based on its stellar mass. This is the first time a near-infrared CL has been detected in a low mass, low metallicity galaxy with no optical evidence for AGN activity, providing confirmation of the utility of infrared CLs in finding AGNs in low mass galaxies when optical diagnostics fail. These observations highlight a powerful avenue of investigation to hunt for low mass black holes in the JWST era.Comment: 11 pages, 3 figures, accepted to ApJ

    Case-oriented computer-based-training in radiology: concept, implementation and evaluation

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    BACKGROUND: Providing high-quality clinical cases is important for teaching radiology. We developed, implemented and evaluated a program for a university hospital to support this task. METHODS: The system was built with Intranet technology and connected to the Picture Archiving and Communications System (PACS). It contains cases for every user group from students to attendants and is structured according to the ACR-code (American College of Radiology) [2]. Each department member was given an individual account, could gather his teaching cases and put the completed cases into the common database. RESULTS: During 18 months 583 cases containing 4136 images involving all radiological techniques were compiled and 350 cases put into the common case repository. Workflow integration as well as individual interest influenced the personal efforts to participate but an increasing number of cases and minor modifications of the program improved user acceptance continuously. 101 students went through an evaluation which showed a high level of acceptance and a special interest in elaborate documentation. CONCLUSION: Electronic access to reference cases for all department members anytime anywhere is feasible. Critical success factors are workflow integration, reliability, efficient retrieval strategies and incentives for case authoring
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