Disposable Probe Research Articles

Hygiène en échographie endocavitaire gynécologique et obstétricale en 2008

Hygiene of ultrasound probes is a hot topic in obstetric and gynecologic ultrasound. The issue concerns mainly the risk of contamination and the need for specific procedures to ensure a high degree of protection against infectious diseases, even if a disposable barrier cover is used. As there are no referenced quality criteria for these disposable probe covers, it is crucial to verify that they are CE marked. The use of condoms as probe covers is not recommended even though they present a lower rate of disruption compared to commercial probe covers. The global rate of probe cover perforation is of 1 to 9%. To date, there are no case reports of contamination by ultrasound examination, be it vaginal or abdominal. Nevertheless, every patient must be regarded as a potential source of infection. The French recommendations consider endovaginal ultrasound probes as semi-critical instruments and thus require intermediate-level disinfection. Because of the risk of disruption, American as well as Canadian and Australian recommendations insist on high-level disinfection of the probe. Every operator should follow reasonable hygiene rules and appropriate precautions should be taken in order to reassure the patients about the risks of contamination during any ultrasound examination.

A Disposable Optical Fiber-Based Capillary Probe for Sensing Lead Ions

<para xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> A disposable capillary-based probe using optical fiber technology to create a compact and portable configuration has been designed for sensing lead ions. It is based around a glass capillary tube pretreated with a fluorophore with high sensitivity and selectivity towards lead ions. The capillary tube makes use of capillary action to uptake the same sample volume for each single-shot measurement. The probe response to lead has been shown to be in the 20–150 <formula formulatype="inline"><tex>$\mu {\hbox {M}}$</tex></formula> concentration range with a dynamic range of 20–80 <formula formulatype="inline"><tex>$\mu {\hbox {M}}$</tex></formula>. A relative standard deviation of <formula formulatype="inline"> <tex>${\sim {\hbox {6}}}\%$</tex></formula> was obtained from a series of results on different probes. This preliminary work is essentially a proof-of-principle for a probe design in which chemical indicators that cannot be immobilized onto a solid support can still be adapted for optical fiber sensing without any chemical modification. The disposable capillary probe provides a mechanical support and protection to the fluorophore without the use of membranes, thus avoiding problems with leaching. As far as the authors are aware, this is the first time that an optical fiber sensor using a fluorescent indicator for optical lead sensing in an organic solution has been produced. </para>

Standard Values of Maximum Tongue Pressure Taken Using Newly Developed Disposable Tongue Pressure Measurement Device

It is clinically important to evaluate tongue function in terms of rehabilitation of swallowing and eating ability. We have developed a disposable tongue pressure measurement device designed for clinical use. In this study we used this device to determine standard values of maximum tongue pressure in adult Japanese. Eight hundred fifty-three subjects (408 male, 445 female; 20-79 years) were selected for this study. All participants had no history of dysphagia and maintained occlusal contact in the premolar and molar regions with their own teeth. A balloon-type disposable oral probe was used to measure tongue pressure by asking subjects to compress it onto the palate for 7 s with maximum voluntary effort. Values were recorded three times for each subject, and the mean values were defined as maximum tongue pressure. Although maximum tongue pressure was higher for males than for females in the 20-49-year age groups, there was no significant difference between males and females in the 50-79-year age groups. The maximum tongue pressure of the seventies age group was significantly lower than that of the twenties to fifties age groups. It may be concluded that maximum tongue pressures were reduced with primary aging. Males may become weaker with age at a faster rate than females; however, further decreases in strength were in parallel for male and female subjects.

Editorial Comment

The authors investigate whether the use of a disposable needle guide results in a decreased incidence of infectious complications after transrectal prostate biopsy. Previous studies have focused on different antibiotic prophylaxis regimens and the use of enemas to reduce infectious complications. This appears to be the first study reporting the use of a disposable needle guide. One hundred ninety-eight patients were randomly assigned into 2 groups. Group 1 underwent a biopsy with a reusable needle guide that was disinfected with 3.2% glutaraldehyde solution between patients and group 2 underwent a biopsy with a disposable transrectal ultrasound probe needle guide. All patients had a negative urine and blood culture 2 days before the procedure. The patients also received ciprofloxacin 500 mg twice a day beginning the day before the biopsy and continued for 1 week after. The infectious complication rates were recorded as asymptomatic bacteriuria, high fever, and acute urinary infection. All 3 complication rates were found to be significantly lower in group 2.

Laparoscopic Doppler Technology: Applications in Laparoscopic Pyeloplasty and Radical and Partial Nephrectomy

The identification and isolation of vascular structures are crucial and technically demanding aspects of laparoscopic renal surgery. Doppler technology has been used for this purpose in laparoscopic varicocele repair, renal cryoablation, and adrenalectomy. However, it has not been formally described for use in laparoscopic radical nephrectomy, partial nephrectomy, or pyeloplasty. We report our initial experience with Doppler technology in 20 patients undergoing these procedures. A laparoscopic Doppler probe was used in laparoscopic radical nephrectomy (n = 6), partial nephrectomy (n = 8), nephroureterectomy (n = 3), and robotic-assisted pyeloplasty (n = 3). The Doppler system consisted of a disposable 8-MHz probe passed through a 5-mm port and a battery-powered transceiver. The probe was used to guide dissection/isolation of the renal hilum and aberrant vasculature in radical and partial nephrectomy, confirm parenchymal ischemia before resection in partial nephrectomy, and identify crossing vessels during pyeloplasty. Nine accessory vessels were detected in 6 (35%) of 17 patients undergoing radical/partial nephrectomy or nephroureterectomy. In 1 case of partial nephrectomy, persistent parenchymal flow despite renal artery clamping required clamp repositioning. In 1 case of pyeloplasty, the Doppler probe detected a crossing vessel despite negative preoperative imaging findings. Use of the probe altered management in 7 (35%) and saved time in 15 (75%) of 20 cases. No complications were associated with the use of the probe. Doppler ultrasound technology might have extended applications in laparoscopic renal surgery by facilitating the dissection and evaluation of vasculature. A prospective study with objective endpoints would be helpful in confirming the utility of this technology in these settings.

The science of disinfection in ARTS (assisted reproductive technology services)

ISSUE: Vaginal probes are used in our assisted reproductive technology services (ARTS) during transvaginal sonagraphy. Disposable single-use condom probe covers are used to cover the transvaginal ultrasound transducer head to reduce transmission of bloodborne pathogens. After each use, the probe requires cleaning and high-level disinfection to avoid pathogenic spread from one patient to another. The use of disinfectant wipes and alcohol pads are not adequate to provide high-level disinfection. Because of concerns regarding the potentially harmful effects of the disinfectant used on developing embryos, we began a search for a safer high-level disinfectant. PROJECT: The infection control staff worked closely with the ARTS staff and the probe manufacturer to review available disinfectant products to ensure high-level disinfection for transvaginal probes that was safe for embryos. RESULTS: We found a disinfectant that provided adequate high-level disinfection and was embryo safe for use in ARTS. LESSONS LEARNED: Using a multidisciplinary team approach, close scrutiny, and meticulous examination of our current disinfection process revealed opportunities to improve embryo safety in our choice of disinfectant. We identified a disinfectant that provided embryo-safe high-level disinfection. Working with the probe manufacturer, we received their written permission to use the selected disinfectant on the probe. This was necessary because the disinfectant chosen was not on the list of disinfectants approved for use by the manufacturer for high-level probe disinfection. The use of a disinfectant that has not been approved by the probe manufacturer can void the probe warranty. The identified improvements also included updating policies and procedures, designing a staff competency checklist, and creating quality-control forms for recording the testing of new boxes of test vials and for solution use. We improved our high-level disinfection of transvaginal probes using an embryo safe high-level disinfectant that was approved for use by the probe manufacturer and improved patient safety and quality of care.

Process Monitoring of a Thermosetting Resin Using Optical-Fiber Sensors in a Microwave Environment

Conventional means of curing thermosetting resins used in advanced fiber-reinforced composites involves heating the sample in an oven or autoclave where heat is transferred to the sample through conduction and convection. In general, the cure schedules that are used can be time consuming and expensive. Hence, significant attempts are being made to improve the processing efficiency and productivity of this class of material. Microwave-based processing has been claimed to offer the advantage of a significantly faster processing time. In this study, two remote (noncontact) sensor systems were designed and developed to facilitate spectral-based quantitative process monitoring inside a custom-modified commercial microwave oven. The two fiber-optic sensor systems were 1) a noncontact optical-fiber reflectance probe and 2) a reusable transmission probe assembly. Spectroscopic data were obtained using the fiber-optic probes at specified microwave power levels. Since conventional metal-based temperature monitoring devices cannot be used in the microwave oven, a low-cost disposable fiber-optic probe was developed. This design was based on an optical fiber-based extrinsic Fabry-Perot interferometer (FPI). The extrinsic FPI temperature sensor demonstrated an accuracy of /spl plusmn/0.5/spl deg/C over the range from ambient to 300/spl deg/C. The temperature of the resin system was also measured simultaneously, along with the spectral data, to monitor the progress of the chemical reaction (curing).

Endoscopic Treatment of Anorectal Condylamata Acuminata Using Argon Plasma Coagulation

Background: Human papillomaviruses (HPV) comprise a large family of double-stranded DNA viruses. At least 82 different HPV types have been identified; many remain yet uncharacterized. HPV infection is among the most common sexually transmitted diseases in industrialized countries. Anogenital warts (condylomata acuminata) are a common phenotypic expression of HPV, affecting 1% of the population (15% of sexually active adults in the USA have a subclinical infection); anal and perianal condylomata are an increasing problem that the gastroenterologist might be required to treat. These warts lead to itching, discomfort and bleeding in the anal region and may also be associated with anal canal neoplasia. Treatment options include chemical caustic agents, surgical ablative methods, and immunotherapy; however, a high rate of recurrence is encountered despite best of efforts. Aim: The purpose of this study was to evaluate the efficacy of Argon Plasma Coagulation (APC) in the ablation of anorectal condylomata acuminata in a series of consecutive patients. Patients and Methods: Between September 2001 and August 2002, 5 patients were referred to our Department for endoscopic treatment of anorectal condylomata acuminata. Three patients were female and the other 2 male, their mean age was 32.1 (ranging between 17 and 45 years of age) and all cases demonstrated condylomata acuminata in the anal and perianal region, as well as the rectum. All patients were scheduled to undergo APC to achieve the lesions' ablation in a maximum of three sessions; intervals between the sessions would range from 20-30 days. Local anesthesia was performed for the anal and perianal warts. We used an APC disposable probe for each patient. APC settings were: power 60 Watts and gas flow 0.8 L/min, while the application time was 0.5-1 sec (APC 300, ERBE GmbH, Germany). Results: Ablation of the lesions was obtained in 3 of the patients in 3 sessions; in 1 patient 2 sessions were adequate, whereas in 1 patient a fourth session was necessary to achieve ablation. Patients remain under endoscopic follow-up (2 months after the last APC application and afterwards every six months). The mean follow-up period in our patients has been 1 year. No hemorrhage has been noticed and in none of our patients has anal incontinence been observed; moreover the lesions have not recurred in any of the patients, once ablation was achieved. Conclusions: APC seems to be an easy-to-perform and effective method of treating anorectal condylomata acuminata.

The effect of a disposable probe cover on pulse oximetry.

The re-use of pulse oximeter probes presents the possibility of between-patient contamination. Use of a disposable polyethylene cover may reduce this risk. In a controlled, prospective study we examined the effect of such a cover on the accuracy of pulse oximetry. Each of ten volunteer subjects was monitored simultaneously by two identical Nellcor pulse oximeters, one with a plastic cover and the other, without a cover, used as a control. The pulse oximetry (SpO2) reading for each probe was recorded while subjects breathed 21% O2 and again while they breathed 10% O2. The probe cover was then swapped onto the other probe and the recordings were repeated. Ninety-five per cent limits of agreement in SpO2 (mean difference in SpO2 (1.95 x standard deviation of difference) between covered and non-covered probes were -0.6% to 0.6% while breathing 21% oxygen and -2.0% to 2.9% while breathing 10% oxygen. We conclude that a protective plastic sheath may induce a small error in pulse oximetry reading that is most marked during hypoxaemia. This error is unlikely to be of clinical significance.

A low-light-level sensor for medical diagnostic applications

A low-level light sensor and preprocessor for a disposable medical probe is described. A 10-Hz 4-/spl mu/A/cm/sup 2/ input optical signal in the visible spectrum is assumed in chemoluminant diagnostic applications. A single-bit first-order sigma-delta modulator has been employed for analog-to-digital conversion, thanks to its robustness, simplicity, inherent linearity, and high signal-to-noise ratio. A current buffer has been used to replicate the weak signal with sufficient bandwidth. Tests have shown the feasibility of this approach, and have also enabled improvements of the design.

Development of a disposable probe for the evaluation of acid-induced damage of the oesophageal mucosa

The development of a disposable probe to measure the acid burden over an extended period of time is reported. The probe consists of a screen-printed matrix that shows decomposition as a function of pH and exposure time. The concept development and realisation of the probe is discussed, and experimental results, both in vitro and under pre-clinical in vivo conditions, are presented. The in vitro experiments prove the validity of the concept and the feasibility of the approach. The in vivo experiments indicate that there is a good correlation between the probe response and the oesophageal epithelial cell damage produced by oesophageal acid perfusion of the feline oesophagus.

Effect of probe design on accuracy and reliability of pulse oximetry in pediatric patients

Study Objective: To determine if the traditional band-wrap disposable pulse oximeter probe is more accurate or reliable for oxygen monitoring in children than the reusable clip-type probe. Design: Prospective, observational clinical study. Setting: Operating room of a large university hospital. Patients: 18 children 11 years of age or younger, who were scheduled for general anesthesia with placement of an intraarterial catheter. Interventions: Pulse oximetry values were obtained using both band and clip probes of three pulse oximeters (Nellcor, Hayward CA; Novametrix, Wallingford, CT; Ohmeda, Boulder, CO) and compared with simultaneous hemoximetry values. Dropout rate (percent of down time) also was recorded for each probe-machine combination. Measurements and Main Results: Data were analyzed using bias and precision and t-test. p < 0.05 is considered significant. Bias (mean SpO 2 − SaO 2) is less than 2% for all probe-machine combinations. The range of error observed between SpO 2 and SaO 2for all data points was greatest using the Nellcor band (27.8%) and least using the Ohmeda band (11.4%). In cyanotic children, the greatest bias and precision were observed with Nellcor band (N = 11, −5.12 ± 9.74) and the best agreement with Novametrix band (N = 17, 0.08 ± 4.21). The difference in bias for any test units above or below the median weight of 13.75 kg did not vary by more than 1%. Dropout rate was minimal for all units in nonbypass situations. After cardiopulmonary bypass, no data dropout was observed with Ohmeda band; observed down time with the other units varied between 34% and 55%. Conclusions: The type of probe selected has little effect on accuracy of pulse oximetry in children. After cardiopulmonary bypass, using the Ohmeda band combination may improve the likelihood of obtaining consistent readings and decreasing down time.

Image guided breast biopsy--technical advances.

where appropriate, needle biopsy. Management examination is critical for some types of lesion. There decisions for non-palpable lesions are made on the remain, however, some types of mammographic basis of the imaging work-up and the results of abnormality, such as low or intermediate suspicion imaging guided needle biopsy. This non-operative microcalcifications and localized areas of architecapproach for confirming the diagnosis is of benefit tural distortion, where imaging guided CB may not both to patients and to the Health Service because give a definitive diagnosis or may demonstrate areas it reduces the number of diagnostic surgical excision of atypical ductal hyperplasia. In a proportion of biopsies for benign conditions and enables a definisuch cases, full histological examination of surgically tive diagnosis of malignancy to be made for patients excised tissue shows either non-invasive or invasive with breast cancer. Patients with breast cancer can carcinoma. One of the major advantages of CB over thus be offered effective pre-operative counselling FNAC is that unequivocal histological evidence of and definitive surgery can be planned, often avoiding invasive tumour may be demonstrated. In a prothe need for multiple operations. Quality targets for portion of cases, however, particularly where the sole both benign surgical biopsy rates and pre-operative mammographic abnormality is microcalcification, diagnosis rates for lesions detected in the National CB may fail to detect the presence of invasive tumour Health Service Breast Screening Programme within an area of ductal carcinoma in situ. This is (NHSBSP) are set in the published surgery and significant in clinical practice because treatment for radiology quality assurance guidelines. Although invasive cancer in most centres will involve axillary high benign surgical biopsy rates are not a feature surgery. Recent technical developments have made it of the NHSBSP, few programmes have been able to possible to carry out imaging guided diagnostic permeet the target standard of 70% for a positive precutaneous excision of larger tissue specimens for operative diagnosis of screening detected cancers. histological examination from non-palpable lesions. Image guided breast biopsy is currently based The Mammotome vacuum biopsy system conon the use of fine needle aspiration cytology sists of a disposable biopsy probe and a re-usable (FNAC) or core biopsy (CB). Both techniques can drive unit [4]. The Mammotome can be used with be used with either ultrasound or stereotactic either dedicated prone stereotactic equipment or guidance. Stereotaxis is generally used for microultrasound but cannot at present be used with calcifications and very small soft tissue masses or conventional upright add-on stereotactic units. The areas of architectural distortion which are invisible biopsy probe is available in either 14 G or 11 G or difficult to see on ultrasound. Although good sizes, but the best results have been obtained with FNAC results have been achieved by some centres, 11 G size. Within the biopsy probe is a vacuum particularly where there is a specialist breast cytochannel and a rotating cutting cylinder. The biopsy pathologist available, ‘‘equivocal’’ or ‘‘suspicious’’ probe is first advanced so that the tip of the probe results in 20–30% of cases, false negative rates of is just distal to the lesion. Just proximal to the up to 10% and inadequate sample rates of up to piercing tip of the probe is an aperture through 20% have led many centres in the UK to use CB which tissue is drawn by the vacuum. When the instead of or as well as FNAC [1, 2]. A further tissue has been drawn into the sample chamber,

Temporal Structure of Body Core Temperature in Twin Newborns

On the basis of our previous investigations on rectal temperature in newborns, we studied the rhythmic variations of body core temperature in twins immediately after birth. We studied 8 pairs of healthy full-term twins during the first two days of life. Continuous recording of body temperature was performed every 10 minutes for 24-48 hours by a solid memory recorder (Fiamarker) connected with a disposable rectal probe. Data were analysed by the single cosinor method and spectral analysis. All the newborns, except one, demonstrated a statistically significant circadian periodicity of body temperature (p<0,001). Acrophases were distributed along the 24 h immediately after birth since the synchronization to the new environment of life was not yet completed. The spectral analysis of data demonstrated ultradian fluctuations of temperature in 14 of the newborns. Temperature data in newborn twins should be collected over a time span long enough to allow discrimination between the adaptation phase and the beginning of the synchronized span.

Evaluation of the influence of movement on saturation readings from pulse oximeters

This study aimed to develop a protocol for assessing the influence of movement on oxyhaemoglobin saturation readings from pulse oximeters. Thirty-six volunteers took part in the study. In each volunteer, each hand was monitored by both a Nellcor N200 oximeter using a disposable probe and by a Datex Satlite DS103 oximeter using a clip-on finger probe. Volunteers made five standardised movements during which output was recorded from all four oximeters. All movements were associated with apparent decreases in oxyhaemoglobin saturation which were statistically significant for two movements with the Nellcor equipment and for four movements with the Datex equipment. Movement was associated with increases in the magnitude of pulse amplitude, but this was not quantitatively associated with magnitude of artefactual changes in saturation. Use of this standardised movement protocol allows quantification of movement artefact from pulse oximeters and should facilitate the development of equipment less affected by movement.

A disposable probe to measure the esophageal acid burden: [formula omitted](a) J. Janssens (a), G. Huyberechts (b), R. Van Overstraeten (B). (a) Center for Gastroenterological Research, KU Leuven; (b) Interuniversity Micro Electronics Center (IMEC), Leuven, Belgium

A disposable probe to measure the esophageal acid burden: [formula omitted](a) J. Janssens (a), G. Huyberechts (b), R. Van Overstraeten (B). (a) Center for Gastroenterological Research, KU Leuven; (b) Interuniversity Micro Electronics Center (IMEC), Leuven, Belgium

Malignant Hyperthermia During Sevoflurane Administration

Malignant Hyperthermia During Sevoflurane Administration

In situ real-time monitoring of reactive systems by remote fibre-optic near-infra-red spectroscopy

A remote fibre-optic near-infra-red (n.i.r.) spectroscopy set-up was recently assembled in our laboratory and successfully used for in situ real-time monitoring of various reactive systems. A disposable probe was designed and employed, enabling us to study processing of thermosetting polymers. A detailed description of our experimental set-up and several selected examples are presented in this communication.

Thermodynamics of Nickel Aluminate Formation in Molten Nickel

AbstractAs part of an ongoing program of the study of oxidation and deoxidation reactions in nickel alloy melts, experiments were performed to determine the oxygen solubility in molten nickel in equilibrium with alumina and nickel aluminate in the temperature range 1733–1873 K. Experiments were conducted at the University of Toronto with nickel of initial low oxygen content while those at the University of Kyoto were with initial high oxygen content. The results show very good agreement. Both sets of results were combined to show the effect of temperature on the reaction under investigation as follows:Ni(l)+O +Al2O3(s) = NiO. Al2O3(s);∆G0=(−188,840±16,700)+(82.8±9.3)T J mol−1.The oxygen potential of the melt corresponding to the three phase equilibrium was measured by means of a disposable oxygen probe and the results were utilized to redetermine the free energy of dissolution of oxygen gas in liquid nickel in the temperature range 1733–1873 K, which is given as:1/2 O2(g) = O(Ni)(1 wt%), ∆G0 = −102,420+19...

銅製錬転炉への酸素プローブの適用

Oxygen pressure measurements were carried out by immersing a disposable oxygen probe into converter slag, white metal or blister copper which had been poured into a ladle from a commercial PS copper converter after the completion of the slag or copper making stage. Measured oxygen pressures were all normalized at a constant temperature depending on the molten phase so as to investigate the reproducibility of the measurements, the oxidation degree of each phase and so on. The following results were obtained in this study.(1) A stable electromotive force of the oxygen probe was obtained in about 15 s after the immersion of the probe by shaking it in each molten phase.(2) The reproducibility of the measurements was good in each of the phases. However, the reproducibility for white metal was slightly inferior to those for converter slag and blister copper, probably because white metal is more easily oxidized by air than the others.(3) Each of the molten phases produced in the converter was completely poured into several ladles, and then the oxygen probe was applied to each of the ladles. Since there was no significant difference in oxygen pressure among the ladles, the oxidation degree of each phase can be deemed uniform in each phase.(4) However the oxygen pressure of converter slag was a little lower than that of white metal, and the converter slag was not in real equilibrium with the white metal even after the completion of the slag making stage.(5) Part of the blister copper near the tuyeres was excessively oxidized at the final blowing in the copper making stage to the extent that Cu2O (s) was formed.