Effects Of Ablation Research Articles

Hif-1α ablation reduces the efficiency of NeuroD1 gene-based therapy and aggravates the brain damage following ischemic stroke

ABSTRACT Introduction Hypoxia-inducible factor 1α [HIF1α] regulates gene expression, allowing the organism to respond to low oxygen levels. Meanwhile, astrocytes participate in inflammatory processes and are associated with neurotoxic chemicals that can increase stroke volume, contributing considerably to the devastating effects of a stroke. Objective To evaluate whether Hif-1α ablation from the central nervous system is implicated in motor dysfunction and ischemic brain damage following stroke. Furthermore, to explore if Hif-1α ablation affects the therapeutic impact of NeuroD1 gene-based therapy. Methods Endothelin-1 [ET-1] was injected to induce ischemic stroke in mice. Both wild-type and Hypoxia-inducible factor 1α conditional knockout [Hif-1α CKO] mice were used. The effect of Hif-1α ablation was assessed by the neuron numbers, astrocyte activity, vascular endothelial growth factor [VEGF] expression, and behavioral tests. Moreover, western blot, ELISA, and RNA sequencing were used. Then, we used pAAV2/9-GfaABC1D-NeuroD1-P2A-EGFP-WPRE injection to examine the impact of NeuroD1 in Hif-1α CKO mice following ischemic stroke. Results We found that following stroke, motor dysfunction significantly increased in Hif-1α CKO mice. Furthermore, elevation of apoptosis and activation in both microglia and astrocytes were observed, consequently up-regulating neuroinflammation. Meanwhile, Hif-1α ablation significantly decreased the efficiency of NeuroD1 gene-based therapy. Conclusion Our findings demonstrate that Hif-1α ablation from the nervous system is implicated in ischemic stroke pathogenesis mainly by increasing neuron cell death and inducing astrocytes as well as decreasing the efficiency of NeuroD1. These data support the idea that manipulating HIF-1α is a viable therapeutic for ischemic stroke.

A SiC Photo-Conductive Switch-Based Pulse Generator with Nanoseconds and High Voltage for Liver Cancer Cells Ablation Therapy

Electroporation ablation, as an innovative cancer treatment, not only preserves the structure and function of affected organs but also significantly reduces surgical risks, offers patients a safer and more effective therapeutic option, and demonstrates immense potential in the field of oncology. This paper presents the innovative design of a high-voltage nanosecond pulse generator triggered by a silicon carbide (SiC) photoconductive switch. The generator is capable of stably outputting adjustable voltages ranging from 10 kV to 15 kV, with pulse widths precisely controlled between 10 and 15 nanoseconds, and an operating frequency adjustable from 1 Hz to 10 Hz. This device enables instant activation and deactivation of the pulse generator during ablation, enhancing the efficiency of strong electric field applications and preventing overtreatment due to delayed shutdown. This paper introduces the structure and basic principles of this novel SiC photoconductive switch-triggered pulse device and reports on the impact of device-related pulse parameters on the ablation effect of hepatocellular carcinoma cells through cell experiments. Under optimal ablation parameters, the CCK8 results show that the number of viable cells is only 0.7% of that in the untreated control group after 12 h of subculture following ablation. These findings hold significant importance for expanding the application areas of SiC devices.

Gr-1 blockade remodels the immunosuppressive microenvironment induced by incomplete microwave ablation of hepatocellular carcinoma

BackgroundAblation is one of the main methods for local treatment of hepatocellular carcinoma (HCC). Different from radiofrequency ablation (RFA), microwave ablation (MWA) is not limited by tissue conductivity, and can use multiple electrodes at the same time to improve ablation efficiency. In addition, MWA can form a larger ablation area, which makes it possible to completely ablate large HCC. However, MWA may be incomplete due to factors such as larger tumors or tumors in high-risk areas. The mechanism by which the cellular and tumor immune microenvironment (TIME) is involved in the in vitro effects of incomplete microwave ablation (iMWA) needs to be further elucidated.MethodsH22 tumor-bearing C57BL/6 mice were treated with iMWA with several combinations of ablation power and time duration. The effects of iMWA on the genes of HCC cancer cells and the TIME were investigated by RNA sequencing, mass cytometry, immunohistochemistry, and immunofluorescence. The effect of iMWA in combination with anti-Gr-1 on HCC tumor growth was also evaluated.ResultsThermal stress generated by iMWA induced coagulative necrosis and apoptosis in the region of the ablation center of HCC. RNA sequencing analysis showed that iMWA can boost chemokine CXCL5, which was further confirmed by quantitative real time polymerase chain reaction (qRT-PCR). Mass cytometry results showed that relative to Ctrl group, iMWA-treated led to decreased CD4+ T, CD8+ T, Natural killer (NK), macrophages including both M1 and M2 types but increased monocytes and bone marrow-derived suppressor cells (MDSC). Therefore, inhibiting MDSC is the main target in the later stage of iMWA. In vivo results showed that the tumor volume and weight of iMWA+ anti-Gr-1 group were significantly reduced compared with iMWA+ anti-IgG group. In addition, the merged expressions of CD11b and Gr-1 proteins were found reduced in the iMWA+ anti-Gr-1 group compared with the iMWA+ anti-IgG group by immunofluorescence staining. Immunohistochemistry suggested that CD8 was enriched in the iMWA+ anti-Gr-1 group but not in the iMWA+ anti-IgG group.ConclusionOur data suggests that iMWA and Gr-1 blocking combined therapy can further inhibit HCC growth and significantly improve the CD8+ T cells in the mouse subcutaneous tumor model, which brings good news to HCC patients.

Long-term Outcomes of Catheter Ablation Compared to Medical Therapy in Atrial Fibrillation.

The long-term effects of catheter ablation (CA) compared to medical therapy on cardiovascular outcomes for atrial fibrillation (AF) remain undetermined. Using a population-based cohort, we sought to determine what the association between CA as compared to medical therapy was on these outcomes. Using Alberta administrative data, patients with AF as the primary diagnosis during hospitalization, emergency department, or a physician visit were included between October 1, 2008 and March 31, 2018. Based on therapy received, patients were categorized into CA, rate control, or rhythm control with medication. The association of treatment with the primary composite outcome of all-cause death, hospitalization for heart failure or stroke was examined after adjusting for age, sex, comorbidities and baseline medications. Among 39,966 treated AF patients, 2,077 (5.2%), 29,467 (73.7%), 8,422 (21.1%) were treated with CA, rate control, and rhythm control with medication, respectively. Patients in the CA group had a lower incidence of the primary outcome compared (4.0/100 person-years) with rate (8.7/100 person-years) or rhythm control with medication (6.8/100 person-years) group over a median follow-up 6.3 years. In multivariable analysis, compared to CA, both rate (HR: 1.28; 95% CI: 1.09-1.50) and rhythm control with medication (HR: 1.21; 95% CI: 1.03-1.43) were associated with a higher risk of the primary outcome. In this cohort study, patients who received CA demonstrated a reduction in the risk of long-term adverse cardiovascular outcomes compared to medical therapy in patients with AF, providing some data to indicate the effects of CA over the long-term.

Comparative Study of Arctic Front Advance Pro and POLARx Cryoballoons for Linear Ablation of the Left Atrial Roof.

The effectiveness of cryoballoon ablation (CBA) of the left atrial (LA) roof in addition to pulmonary vein isolation (PVI) using a novel cryoballoon catheter, POLARx, remains unclear. This study compared the efficacy of LA roof line ablation and PVI using POLARx (Boston Scientific) or AFA-Pro (Medtronic) in 100 patients with persistent atrial fibrillation. The right superior pulmonary vein (PV) anchoring and raise-up techniques were consistently used for LA roof line ablation, and rapid right ventricular pacing was applied if the cryoballoon temperature did not reach -40°C. Complete conduction block at the LA roof could be obtained in all patients with POLARx and in 98.0% of patients with AFA-Pro. Rapid right ventricular pacing was needed in 64.0% of patients with AFA-Pro and in no patients with POLARx. During LA roof line ablation, the nadir cryoballoon temperature was significantly lower with POLARx than with AFA-Pro (right: -54.2°C±4.4°C vs. -46.0°C±5.4°C; central: -56.8°C±4.4°C vs. -45.7°C±4.8°C; left: -56.1°C±4.3°C vs. -46.1°C±5.7°C), and the cryoballoon temperature reached -40°C earlier with POLARx than with AFA-Pro (right: 30.8±7.4 s vs. 74.1±37.7 s; central: 28.2±5.2 s vs. 62.9±30.9 s; left: 29.8±5.8 s vs. 69.6±40.7 s). The nadir cryoballoon temperature with POLARx was approximately 10°C lower than with AFA-Pro, consistently dropping below -40°C during LA roof line CBA. Thus, a complete conduction block of the LA roof line can be easily accomplished using right superior PV anchoring and the raise-up techniques without the need for rapid right ventricular pacing with POLARx.

Catheter ablation for atrial tachycardia in pediatric patients: a single-center experience.

Atrial tachycardia is an uncommon supraventricular tachycardia in children. It is often drug-resistant and likely to occur concomitantly with tachycardia-induced cardiomyopathy, making radiofrequency catheter ablation the preferred treatment. The aim of this study was to assess the feasibility, safety, and effectiveness of radiofrequency catheter ablation for the treatment of different types of atrial tachycardia in children, particularly in those with drug-resistant and tachycardia-induced cardiomyopathy. A total of 28 children with atrial tachycardia (including focal atrial tachycardia and atrial flutter) who underwent atrial radiofrequency ablation at the Children's Hospital Affiliated to Chongqing Medical University from May 2018 to December 2023 were included. The baseline characteristics, preoperative medication, surgical information, and postoperative follow-up data of these children were analyzed statistically. The mean age patients at ablation was 10.24 ± 3.40 years. A total of 78.6% of the patients (22/28) who received preoperative pharmacological treatment had intermittent or persistent atrial tachycardia. Of the 28 children who underwent radiofrequency ablation, 24 (85.7%) were diagnosed with focal atrial tachycardia, three (10.7%) with atrial flutter, and one (3.6%) with both. No postoperative complications occurred in any patient. The immediate ablation success rate in the 25 patients with focal atrial tachycardia was 96.0% (24/25). After 26.89 ± 18.17 months of follow-up, only three patients had recurrence. The ablation difficulty of focal atrial tachycardia originating in the appendage was higher than that originating in the non-atrial appendage (44.4% vs. 6.3%, p = 0.01). The success rate of ablation for atrial flutter was 100%, except in one child with underlying cardiomyopathy who experienced recurrence. Final success was achieved in 25 of the 28 patients (89.2%) at the end of the follow-up period. In addition, eight children (28.6%) in this study were diagnosed with tachycardia-induced cardiomyopathy, with significantly increased ejection fraction and shortening rate after radiofrequency ablation (p < 0.01), whereas the left ventricular end-systolic diameter were not significantly reduced during the follow-up period (p > 0.05). Radiofrequency catheter ablation is safe and effective for the treatment of atrial tachycardia in children in the short- and long-term.It can be used as the first treatment option for children with medically refractory atrial tachycardia and tachycardia-induced cardiomyopathy.

Tumor-derived extracellular vesicles disrupt the blood–brain barrier endothelium following high-frequency irreversible electroporation

High-frequency irreversible electroporation (H-FIRE), a nonthermal brain tumor ablation therapeutic, generates a central tumor ablation zone while transiently disrupting the peritumoral blood–brain barrier (BBB). We hypothesized that bystander effects of H-FIRE tumor cell ablation, mediated by small tumor-derived extracellular vesicles (sTDEV), disrupt the BBB endothelium. Monolayers of bEnd.3 cerebral endothelial cells were exposed to supernatants of H-FIRE or radiation (RT)-treated LL/2 and F98 cancer cells. Endothelial cell response was evaluated microscopically and via flow cytometry for apoptosis. sTDEV were isolated following H-FIRE and RT, characterized via nanoparticle tracking analysis (NTA) and transmission electron microscopy, and applied to a Transwell BBB endothelium model to quantify permeability changes. Supernatants of H-FIRE-treated tumor cells, but not supernatants of sham- or RT-treated cells, disrupted endothelial cell monolayer integrity while maintaining viability. sTDEV released by glioma cells treated with 3000 V/cm H-FIRE increased permeability of the BBB endothelium model compared to sTDEV released after lower H-FIRE doses and RT. NTA revealed significantly decreased sTDEV release after the 3000 V/cm H-FIRE dose. Our results demonstrate that sTDEV increase permeability of the BBB endothelium after H-FIRE ablation in vitro. sTDEV-mediated mechanisms of BBB disruption may be exploited for drug delivery to infiltrative margins following H-FIRE ablation.

Unexpected Anti-tumor Effect of Selective Internal Radiation Therapy and Radiofrequency Ablation Followed by Immune Checkpoint Inhibitors for Hepatocellular Carcinoma

Introduction: Hepatocellular carcinoma (HCC) has become an increasingly serious health problem worldwide. Combining immune checkpoint inhibitors (ICIs) for HCC with local treatments can produce synergistic effects. Although the abscopal effect was noted in 1953, most studies on this phenomenon have been conducted in the context of external beam radiotherapy (EBRT). The incidence of the abscopal effect induced by selective internal radiation therapy (SIRT) alone is lower. This research reports a case of a patient with multifocal HCC who received SIRT plus radiofrequency ablation (RFA) followed by ICI therapy. During the subsequent course of ICI therapy, an anti-tumor effect was detected in the left hepatic lobe, far from the site targeted by the local treatments. Case Presentation: The abscopal effect has recently attracted widespread attention because ICIs can enhance this phenomenon. However, little is known about the relationship between inducing the abscopal effect and local treatment against HCC. A 76-year-old male patient presented with multifocal HCC. During hepatic angiography, MRI showed multiple HCCs in both lobes of the liver. Selective internal radiation therapy was performed on a tumor with a diameter of approximately 80 millimeters in the right lobe. A month later, RFA was conducted on another tumor in the right lobe, approximately 30 mm in diameter, and ICI therapy was administered on the second day post-RFA. Hepatic arterial phase imaging of contrast-enhanced magnetic resonance performed 10 months after SIRT showed the disappearance of the tumor in the left liver lobe. Conclusions: This case highlights that the combination of multiple local treatment methods with ICI therapy can enhance the anti-tumor immune response and benefit patients with multifocal

An observational study on efficacy of atrioventricular nodal slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia and its influence on atrioventricular conduction function.

The study aimed to evaluate the effectiveness of atrioventricular nodal slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia (AVNRT) and examine its impact on the atrioventricular conduction function. A retrospective analysis was performed on the clinical data of 90 AVNRT patients who underwent radiofrequency ablation at our institution between August 2018 and February 2021. Based on the presence or absence of slow pathway conduction during the procedure, patients were classified into the slow pathway elimination group (SPE group) and the slow pathway improvement group (SPI group). Procedure-related parameters, His bundle electrogram, atrioventricular nodal effective refractory period (AVN-ERP), Wenckebach point of anterograde atrioventricular nodal conduction (AVN-WKB), Wenckebach point of retrograde atrioventricular nodal conduction (VAV-WKB), myocardial function were compared between the 2 groups. Additionally, the recurrence rates 1 and 2 years post-ablation were noted. Both groups reported a 100% success rate for the procedure. Post-ablation, 42 patients exhibited persisting atrioventricular nodal slow pathway, whereas 48 showed its disappearance, signifying the absence of the jump phenomenon and atrial echo. Post-ablation, the SPI group showed an increase in slow pathway AVN-ERP compared to pre-ablation values (P < .05), with no significant change in the fast pathway AVN-ERP (P > .05). The SPE group showed a reduction in both slow pathway and fast pathway AVN-ERP post-ablation (P < .05). Post-ablation, both slow pathway and fast pathway AVN-ERP in the SPI group were higher than in the SPE group (P < .05). AVN-WKB and VAV-WKB values increased in both groups after ablation (P < .05). There were no recurrences 1 or 2 years after ablation in the SPE group and 1 case of recurrence 2 years after ablation in the SPI group (2.38%). Different ablation endpoints during radiofrequency ablation had no apparent impact on atrioventricular conduction time, recurrence rate, and myocardial function in patients with AVNRT, but they advanced AVN-WKB and VAV-WKB. Slow pathway improvement led to an elongation of slow pathway AVN-ERP, while slow pathway elimination resulted in a reduction of both slow pathway and fast pathway AVN-ERP.

Equivalent Heat Source Model of Thermal Relay Contact Based on Surface Roughness of Silver-Magnesium-Nickel Contact.

In a sealed electromagnetic relay, the change in the surface roughness mainly depends on the collision wear between the contact and the moving reed and the ablation effect of the arc on the contact surface based on the strong correlation between the contact resistance and the surface roughness of the Ag-Mg-Ni contact. With a change in contact resistance, the contact temperature increase in a hermetically sealed electromagnetic relay (HSER) is greatly affected. Under extreme overload conditions, the contact surface is severely ablated by the arc, and the roughness increases rapidly with the number of cycles, which greatly affects the contact resistance of the contact surface and the reliability of the relay. A thermal model of a relay contact system based on the surface roughness of Ag-Mg-Ni contacts was established in this paper by analyzing the effect of an arc on the surface roughness of Ag-Mg-Ni contacts under heavy overload conditions. The arc image of the Ag-Mg-Ni contact was recorded using a double-axis arc photographing platform, and the moving track of the arc center under overload conditions was drawn. This paper explored the patterns of arc center movement on the contact surface and the effects of the arc on the surface roughness of the contacts by analyzing the probabilities of the arc center appearing in various locations. A mathematical model correlating the number of contact cycles with contact resistance was established. Subsequently, a finite element simulation model for the equivalent heat source of the contact was developed. The theoretical model error was less than 10%. The accuracy of the equivalent heat source model was verified by comparing the measured data with the simulation results.

Comparative study of the therapeutic effects of radiofrequency ablation of ganglionated plexi guided by high-frequency stimulation and anatomical localization methods in the treatment of vagal syncope in young people.

To investigate the differences in safety and efficacy between high-frequency stimulation (HFS) and anatomically guided endocardial catheter ablation (AA) of the ganglionated plexi (GPs) for treating vasovagal syncope (VVS) in individuals engaged in high-intensity physical training. Forty-five patients (age 22.5 ± 4.4 years) undergoing high-intensity physical training were included from January 2020 to January 2023 at our hospital. Patients underwent GP ablation for recurrent syncope. Comprehensive evaluations, including head MRI, cardiac ultrasound, electrocardiogram (ECG), ambulatory ECG (Holter), ambulatory blood pressure monitoring, plate motion tests, and head-up tilt tests (HUT), were conducted to exclude other systemic disorders causing syncope. HFS and AA-guided GP ablation were performed on 10 and 35 patients, respectively, all of whom tested positive for HUT. Differences between the two groups were compared regarding ablation sites, ablation time, safety, and effectiveness. The ablation time was significantly shorter in the AA group compared to the HFS group (P < 0.001). The number of GPs selected for ablation using the AA method was reduced (P < 0.001). All patients in the HFS group experienced palpitations and discomfort, whereas only 31.43% of patients in the AA group reported these symptoms (P = 0.001). Fentanyl analgesia was administered in both groups, and no significant complications arose from the ablation. The longest follow-up duration was 52 months, while the shortest was 15 months. One case of pre-syncope occurred in the HFS group 8 months post-ablation, and one case of pre-syncope and two cases of syncope occurred in the AA group at 1 and 3 months post-ablation, respectively. There were no statistically significant differences in heart rate variability (HRV) and cardiac deceleration capacity (DC) between the two groups after ablation (P > 0.05). Two cases in the AA group still exhibited type II second-degree atrioventricular block during sleep. Both groups of patients were able to complete high-intensity physical training and showed significant symptom improvement post-ablation. Young individuals with VVS engaged in high-intensity physical training can benefit from GP ablation using both HFS and AA methods. The AA method requires relatively simple equipment, shorter procedure time, and results in less discomfort during the ablation.

Abstract 4116281: Improvement in Valvular Regurgitation Severity with Atrioventricular Junction Ablation: Conduction System and Biventricular Devices

Background: Ablate-and-pace strategies for permanent atrial fibrillation (AF) have shown mortality benefit with biventricular pacemakers (BiV). The mechanism of benefit is not well understood, but may involve cardiac remodeling. We sought to characterize the effects of AV junction ablation (AVJA) in patients receiving BiV or conduction system pacing (CSP) devices on valvular regurgitation. Objective: To evaluate the effects of AVJA in permanent AF on valvular regurgitation as measured by standard 2D echocardiography. Methods: Consecutive patients undergoing BiV/CSP after AVJA for permanent AF with tricuspid regurgitation (TR) and/or mitral regurgitation (MR) between January 2018 and January 2023 at our institution were analyzed. Ejection fraction (EF), TR severity, and MR severity were compared pre-AVJA and post-AVJA. Results: A total of 102 patients met the above criteria. Median clinical follow up time was 902 days (IQR 578-1537 days) from AVJA. In patients with at least 1+ MR at baseline (N=65), there was significant improvement in MR severity post-AVJA (p=0.003). At baseline, 51% of patients had 1+ MR, 36% of patients had 2+ MR, 10% of patients had 3+, and 3% of patients had 4+ MR. Post AVJA, 45% (29 patients) had improvement in MR severity, 40% (26 patients) had no change, and 15% (10 patients) worsened. The greatest improvement was seen in patients with reduced baseline EF(defined as EF&lt;50%). All 3+ and 4+ MR improved to at least 2+ MR post-AVJA in this subset. In patients with at least 2+ TR at baseline (N=28), there was also significant improvement in TR severity (p=0.029). Conclusion: AVJA with physiologic pacing in patients with permanent AF is associated with improvement in MR and TR severity.

Abstract 4137964: Electrical Gaps and Outcomes After Redo AF Ablation: Comparative Analysis from the EARNEST-PVI Trial

Introduction: The efficacy of extensive ablation strategies in addition to pulmonary vein (PV) isolation is still controversial in persistent atrial fibrillation (AF) ablation. Gaps in previously ablated lesions can induce arrhythmias, potentially decreasing the effectiveness of extensive ablation. Purpose: To evaluate the incidence of gaps, gap-related reentry, and subsequent recurrence following redo AF ablation in the EARNEST-PVI trial (NCT03514693). Methods: The analysis was performed using the extended data of the EARNEST-PVI trial (N=512), a randomized controlled trial evaluating ablation strategies for persistent AF. Patients were randomized 1:1 to either the PVI-plus or PVI-alone group. During a median follow-up of 47 months, 126 (25%) patients underwent redo AF ablation. Among them, we enrolled patients who underwent PVI-alone (N=69), or PVI-plus left atrial (LA) linear ablations (LA roof and mitral isthmus) (N=46) during the index ablation. Results: In the previous PVI-alone group, electrical PV gaps were observed in 38 (57%) patients. In the previous PVI-plus group, 19 (41%), 10 (22%), and 11 (24%) patients had electrical gaps in the PVs, LA linear lines, or both, respectively. During the redo session, 19 atrial tachycardias (ATs) were observed/induced in 15 patients. ATs were more frequently observed in the PVI-plus group than in the PVI-alone group (23.9% vs. 5.8%, p=0.005). While 7 ATs were not associated with gaps, 2 were related to PV gaps, and 10 were related to gaps in the linear lesions. In the redo AF ablation, PVI was re-completed in all patients, and any induced ATs were eliminated by additional ablation. During a median follow-up of 32 months post-redo, patients with gaps had a lower clinical recurrence rate than those without (44.3 vs. 47.2%, log-rank p=0.033). However, the Cox regression analysis revealed that AF recurrence post-redo was associated only with PV gaps, and not with linear ablation gaps (hazard ratio, 0.57; 95% confidence interval, 0.32–0.99; p = 0.049). Conclusions: In redo AF ablations, electrical gaps were more prevalent in patients who underwent extensive ablation during the index procedure. While all gaps during redo were potentially arrhythmogenic, PV gaps alone were associated with AF recurrence after redo AF ablation.

Safety and Effectiveness of Triple-Antenna Hepatic Microwave Ablation.

Microwave ablation is becoming a standard procedure for treating tumors based on heat generation, causing an elevation in the tissue temperature level from 50 to 60 °C, causing tissue death. Microwave ablation is associated with uniform cell killing within ablation zones, multiple-antenna capability, low complication rates, and long-term survival. Several reports have demonstrated that multiple-antenna microwave ablation is a promising strategy for safely, rapidly, and effectively treating large tumors. The key advantage of multi-antenna tumor microwave ablation is the creation of a large, well-defined ablation zone without excessively long treatment times or high power that can damage healthy tissue. The strategic positioning of multiple probes provides a fully ablated volume, even in regions where individual probe damage is incomplete. Accurate modeling of the complex thermal and electromagnetic behaviors of tissue is critical for optimizing microwave ablation because material parameters and tissue responses can change significantly during the procedure. In the case of multi-antenna microwave ablation, the calculation complexity increases significantly, requiring significant computational resources and time. This study aimed to evaluate the efficacy and safety of liver percutaneous microwave ablation using the simultaneous activation of three antennas for the treatment of lesions larger than 3 cm. Based on the known results from a single-probe setup, researchers can estimate and evaluate various spatial configurations of the three-probe array to identify the optimal arrangement. Due to the synergistic effects of the combined radiation from the three antennas, the resulting ablation zone can be significantly larger, leading to better outcomes in terms of treatment time and effectiveness. The obtained results revealed that volumetric damage and the amount of damaged healthy tissue are smaller for a three-antenna configuration than for microwave ablation using a single-antenna and two-antenna configurations.

Focused ultrasound for treatment of epilepsy: a systematic review and meta-analysis of preclinical and clinical studies.

Various preclinical and clinical studies have demonstrated the neuromodulatory and ablative effects of focused ultrasound (FUS). However, the safety and efficacy of FUS in clinical settings for treating epilepsy have not been well established. This study aims to provide a systematic review of all preclinical and clinical studies that have used FUS for the treatment of epilepsy. A systematic search was conducted using Scopus, Web of Science, PubMed, and Embase databases. All preclinical and clinical studies reporting outcomes of FUS in the treatment of epilepsy were included in the systematic review.Random-effect meta-analysis was performedtodetermine safety in clinical studies and seizure activity reduction in preclinical studies. A total of 24 articles were included in the study. Meta-analysis demonstrated that adverse events occurred in 13% (95% CI = 2-57%) of patients with epilepsy who underwent FUS. The frequency of adverse events was higher with the use of FUS for lesioning (36%, 95% CI = 4-88%) in comparison to neuromodulation (5%, 95% CI = 0-71%), although this difference was not significant (P = 0.31). Three-level meta-analysis in preclinical studies demonstrated a reduced spike rate in neuromodulating FUS compared to the control group (P = 0.02). According to this systematic review and meta-analysis, FUS can be considered a safe and feasible approach for treating epileptic seizures, especially in drug-resistant patients. While the efficacy of FUS has been demonstrated in several preclinical studies, further research is necessary to confirm its effectiveness in clinical practice and to determine the adverse events.

Acute depletion of complement C3 with cobra venom factor attenuates memory deficits induced by status epilepticus.

Status epilepticus (SE) significantly increases the risk for the development of unprovoked seizures, memory loss, and temporal lobe epilepsy. Our prior studies showed that SE increases complement C3 signaling in the hippocampus, which parallels memory deficits. Additionally, C3 knockout (KO) mice were protected against SE-induced memory impairments, suggesting a mechanistic role for C3 in this pathophysiology. In this study, we utilized cobra venom factor (CVF), a structural analog of C3 that results in its depletion, to investigate the protective effects of post-SE C3 ablation on memory deficits that develop during epileptogenesis. SE was induced in male rats using the chemoconvulsant pilocarpine. Two weeks later, control (C) and SE rats were treated with either vehicle (V) or CVF. Recognition memory was assessed using the novel object recognition (NOR) test in four groups (C + V, C + CVF, SE + V, and SE + CVF). Immunoblotting was used to measure hippocampal protein levels of C3 along with synaptic, astrocyte, and blood-brain barrier (BBB) stability markers, Psd95, GFAP, and albumin, respectively. In the NOR test, rats in the C + V and C + CVF groups spent more time exploring the novel object. SE + V rats explored both objects equally, while SE + CVF rats spent significantly more on the novel object, suggesting a rescue of cognitive performance by CVF. While CVF-mediated C3 depletion did not restore normal protein levels of Psd95 or GFAP in hippocampi of SE + CVF rats, CVF treatment attenuated SE-induced extravasation of albumin, suggesting potential rescue of BBB stability. Our findings indicate that acute C3 depletion with CVF can attenuate memory deficits that develop during SE-induced epileptogenesis. This finding further suggests that targeting C3 could hold promise in addressing cognitive comorbidities associated with SE and acquired epilepsy. A long-lasting seizure, known as status epilepticus (SE), can raise the chance of having more seizures in the future and can lead to memory problems. While the exact reasons for these issues are not completely known, it is believed that brain inflammation might be involved. In this study, we show that the activation of the body's immune response, especially a part called the C3 component, plays a role in the memory problems that occur after an episode of SE.

Luminescence Patterns on Multimillimeter Single-Crystal MAPbBr3 Microplatelets via Thermal Ablation Effects.

The single crystal distinguishes itself as the most outstanding representative of excellent optoelectronic performance among perovskite semiconductors due to its exceptional charge carrier properties, extraordinary optophysics, precise structural geometries, and superior material stabilities. However, it exhibits mediocre performance in light emission, which can be attributed to its excessive carrier diffusion lengths and extremely low recombination rates. To address this challenge, this study puts forward a controllable high-temperature annealing treatment strategy concentrating on multimillimeter-scale MAPbBr3 micrometer-thick platelet single crystals (MPSCs). Through the utilization of thermal ablation effects to convert the surface monocrystalline lattices into polycrystalline perovskite nanocrystals (PNCs) with a remarkably increased specific surface area, the fluorescence intensity arising from the rapid recombination of free carriers on the PNC surface is enhanced by 320 times compared to the pristine MPSC surface. These PNCs produced through surface annealing, with the characteristic of loose adhesion to surfaces, can be mechanically wiped away and regenerated in situ via reannealing the residual MAPbBr3 MPSCs, guaranteeing high intensity, durability, and standard geometric fluorescence. Moreover, by regulating the surface distributions of thermal ablation effects and carrying out embossing annealing treatment or laser direct writing, we can design and fabricate relatively complex, high-contrast (255×), and clearly resolved fluorescence patterns on MPSC surfaces.

Investigating the combinatorial effects of radiofrequency ablation and anticoagulants in patients with atrial fibrillation and left atrial appendage thrombosis after successful thrombolysis.

The present study investigated the synergistic effects of radiofrequency ablation and various anticoagulants on adverse outcomes in patients with atrial fibrillation (AF) and left atrial appendage thrombosis following successful thrombolysis. Patients diagnosed with AF and left atrial appendage thrombosis post-successful thrombolysis (n=92) were retrospectively analysed. They were divided into two groups: Group A received radiofrequency ablation combined with an anticoagulant, while Group B received an anticoagulant alone and in combination with antiarrhythmic drugs. Subgroup analyses were conducted based on left atrial diameter (>45 mm), duration of AF (>1 year) and types of anticoagulants. Univariate and multivariate logistic regression analyses were performed to assess stroke and mortality risks in patients with AF with left atrial appendage thrombosis after dissolution. Multivariate logistic regression analysis identified AF duration (>1 year), left atrial diameter (>45 mm) and BNP level as significant risk factors for stroke (P<0.05). Compared with NOACs, the traditional anticoagulants (warfarin) demonstrated higher survival rates and lower stroke incidence in Group B (P<0.05); however, no significant difference was observed within Group A (P>0.05). Radiofrequency ablation combined with anticoagulants appeared to be more effective in treating AF with left atrial appendage thrombosis post-dissolution compared with anticoagulants alone. Attention to AF duration and left atrial diameter is crucial during early patient management. However, the choice between warfarin or NOACs for patients with AF and left atrial appendage thrombosis warrants further investigation.

Development of a murine laser interstitial thermotherapy system.

The objective of this study was to develop a murine system for the delivery of laser interstitial thermotherapy (LITT) with probe-based thermometry as a model for human glioblastoma treatment to investigate thermal diffusion in heterogeneous brain tissue. First, the tissue heating properties were characterized using a diode-pumped solid-state near-infrared laser in a homogeneous tissue model. The laser was adapted for use with a repurposed stereotactic surgery frame utilizing a micro laser probe and Hamilton syringe. The authors designed and manufactured a stereotactic frame attachment to work as a temperature probe stabilizer. Application of this novel design was used as a precise method for real-time thermometry at known distances from the thermal ablative center mass during murine LITT studies. Temperature measurements were achieved during LITT that verified the direct thermometry capability of the system without the need for MR-based thermal monitoring. Application of multiple stereotactic design iterations led to an accurately reproducible surgical laser ablation procedure. Histological staining confirmed precise thermal ablation and controllable lesion size based on time and temperature control. Treatment of a syngeneic intracranial glioma model highly resistant to conventional therapy resulted in a modest survival benefit. The authors have successfully developed a murine model system of LITT with direct in situ thermometry for investigation into the effects of thermal ablation and combinatorial treatments in murine brain tumor models.

Combined left atrial appendage occlusion and catheter ablation for atrial fibrillation versus isolated left atrial appendage occlusion: A systematic review and meta-analysis.

Data on the effects of combined left atrial appendage occlusion (LAAO) and catheter ablation (CA) for atrial fibrillation (AF) remain limited. We aimed to perform a systematic review and meta-analysis comparing LAAO and CA versus isolated LAAO. We systematically searched PubMed, Embase, and Cochrane Library for studies comparing combined LAAO and CA versus isolated LAAO in patients with atrial fibrillation. Statistical analyses were performed using R software version 4.3.1. We pooled odds ratios (OR) with 95% confidence intervals (CI) for binary outcomes. We included eight studies comprising 51,802 patients, of whom 1375 (2.6%) underwent combined LAAO and CA. There were no significant differences between combined LAAO and CA versus isolated LAAO in terms of major bleeding (OR 0.55; 95% CI 0.09, 3.41; p=0.52; I2=0%), major adverse cardiovascular events (OR 0.88; 95% CI 0.40, 1.93; p=0.74; I2=0%), stroke (OR 1.03; 95% CI 0.35, 3.00; p=0.96; I2=0%), thromboembolism (OR 0.60; 95% CI 0.18, 1.98; p=0.40; I2=0%), minor bleeding (OR 1.32; 95% CI 0.63, 2.80; p=0.46; I2=0%), or pericardial effusion (OR 1.18; 95% CI 0.60, 2.33; p=0.63; I2=24%). In this meta-analysis of observational studies, combined LAAO and CA for AF was similar to isolated LAAO in terms of efficacy and safety. Further large randomized controlled trials are needed to explore the long-term effects of combining these procedures.