Extent Of Ablation Research Articles

Precise laser poration to control drug delivery into and through human nail

Drug treatment of diseases of the human nail remains a difficult challenge; topical therapy, in particular, is limited by very poor transport of active agents across the nail itself. The objective of this research was to examine the potential of controlled, and fibre-optic delivered, femtosecond laser light pulses to provide new pathways and opportunities for drug access to targets within and beneath the nail plate. Optical, confocal fluorescence and scanning electron microscopies demonstrated partial and complete laser poration of human nail samples, with the energy per pore and the exposure duration being the key modulating parameters that determined the extent of ablation achieved. Parallel measurements of the penetration of a model drug across laser-treated nails showed that complete poration resulted in essentially complete circumvention of the diffusion barrier, an array of 100 pores in 0.2cm2 area of nail permitting a 103-fold increase in initial drug uptake. Partial ablation of the nail created pores that extended to a range of depths; the nail material adjacent to the ablated area was rendered porous in appearance presumably due to local thermal perturbation of the nail structure. These openings offer, as a result, potential sites in which topical drug formulations might be sequestered post-poration and from which slow, sustained delivery of the active agent into and through the nail may be envisaged.

119P wave duration and spectral analysis of signal averaged P wave: can this guide us in deciding the extent of af ablation required beyond pulmonary vein isolation? - A prospective study

119P wave duration and spectral analysis of signal averaged P wave: can this guide us in deciding the extent of af ablation required beyond pulmonary vein isolation? - A prospective study

Use of low-dose radioiodine ablation for Graves' orbitopathy: results of a pilot, perspective study in a small series of patients.

Elimination of thyroid antigens by total thyroid ablation (TTA), namely, thyroidectomy followed by radioiodine, may be beneficial for Graves' Orbitopathy (GO). TTA is usually performed with a 131I dose of 30mCi. In Italy, this dose must be followed by a 24-h protected hospitalization, with increase in the waiting lists. In contrast, a 15mCi dose can be given without hospitalization and with lower costs. Here, we investigated whether a lower dose of radioiodine can be used to ablate thyroid remnants in patients with GO, after thyroidectomy. The study was performed in two small groups of consecutive thyroidectomized patients (six patients per group) with Graves' hyperthyroidism and GO. Patients underwent ablation with either 15 or 30mCi of 131I following treatment with recombinant human TSH (rhTSH). The primary outcome was rhTSH-stimulated serum thyroglobulin (Tg) at 6months. The secondary outcome was baseline Tg at 6months. Baseline Tg and rhTSH-stimulated Tg after at 6months did not differ between two groups, suggesting a similar extent of ablation. rhTSH-stimulated Tg was reduced significantly compared with rhTSH-stimulated Tg at ablation in both groups. GO outcome following treatment with intravenous glucocorticoids did not differ between the two groups. Our findings may provide a preliminary basis for the use of a 15mCi dose of radioiodine upon rhTSH stimulation in thyroidectomized patients with Graves' hyperthyroidism and GO.

Conditioning of vitrified and resin bond CBN grinding wheels using a picosecond laser

Laser ablation is a novel non-mechanical wheel preparation method for optimizing thetreatment costs of superabrasive tools. In this study, the thermal effects of picosecond laser radiationon vitrified and resin bond CBN superabrasive grinding wheel surfaces was analytically andexperimentally investigated. The analytical approach is intended to find threshold process parametersfor selective ablation of cutting grains and bond material. A picosecond Yb:YAG laser device wasintegrated with a cylindrical grinding machine which facilitates the treatment of grinding wheel as itis mounted on the grinding spindle. It has been shown that, the extent of material ablation is definedby the maximum surface temperature induced by the laser radiation which is in turn defined by thelaser pulse energy. It is also suggested that, the depth of laser thermal effects is governed by therelative speed of the laser scanner with respect to the wheel surface

An Image Fusion System for Estimating the Therapeutic Effects of Radiofrequency Ablation on Hepatocellular Carcinoma.

BackgroundDuring ultrasound-guided radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), high echoic areas due to RFA-induced microbubbles can help calculate the extent of ablation. However, these areas also decrease visualization of target tumors, making it difficult to assess whether they completely cover the tumors. To estimate the effects of RFA more precisely, we used an image fusion system (IFS).Patients and methodsWe enrolled patients with a single HCC who received RFA with or without the IFS. In the IFS group, we drew a spherical marker along the contour of a target tumor on reference images immediately after administering RFA so that the synchronized spherical marker represented the contour of the target tumor on real-time ultrasound images. When the high echoic area completely covered the marker, we considered the ablation to be complete. We compared outcomes between the IFS and control groups.ResultsWe enrolled 25 patients and 20 controls, and the baseline characteristics were similar between the two groups. The complete ablation rates during the first RFA session were significantly higher in the IFS group compared with those in the control group (88.0% vs. 60.0%, P = 0.041). The number of RFA sessions was significantly smaller in the IFS group compared with that in the control group (1.1 ± 0.3 vs. 1.5 ± 0.7, P = 0.016).ConclusionsThe study suggested that the IFS enables a more precise estimation of the effects of RFA on HCC, contributing to enhanced treatment efficacy and minimized patient burden.

P1703P wave duration and spectral analysis of signal averaged p wave: can this guide us in deciding the extent of af ablation required beyond pulmonary vein isolation? - A prospective study

P1703P wave duration and spectral analysis of signal averaged p wave: can this guide us in deciding the extent of af ablation required beyond pulmonary vein isolation? - A prospective study

High-intensity focused ablation (HIFU) of single benign thyroid nodule rarely alters underlying thyroid function

Background: High intensity focused ultrasound (HIFU) is a promising ablation technique for benign thyroid nodules. However, its effect on underlying thyroid function remains unknown. We aimed to evaluate the 6 months changes in serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) after HIFU treatment.Methods: Eighty-three consecutive patients who underwent single HIFU ablation for symptomatic benign thyroid nodule were analysed. Eligible patients had serum TSH and FT4 checked before treatment (baseline), 1 week, 3 and 6 months following HIFU treatment. Primary endpoints were hypothyroidism (FT4 < 12 pmol/L) and hyperthyroidism (FT4 > 23 pmol/L) in the 6 months following treatment. To express extent of nodule ablation relative to the total gland volume, an ablation volume ratio was calculated by [(Ablated nodule volume/total thyroid volume)/(total thyroid volume)] × 100.Results: Relative to baseline, 1-week serum TSH significantly dropped (from 1.16 to 0.76 mIU/L, p < 0.001) while 1-week serum FT4 significantly rose (from 16.0 to 17.8 pmol/L, p < 0.001). However, 3- and 6-months TSH and FT4 did not changed significantly from baseline (p > 0.05). No patients developed hyperthyroidism while one (1.4%) developed hypothyroidism (FT4 = 11 pmol/L) at 3 months and 6 months. Interestingly, this patient had a previous lobectomy and an ablation volume ratio of 64.00%.Conclusions: Hypothyroidism following single HIFU ablation occurred rarely (1.4%) and resulted in little clinical relevance. Given that only one patient developed hypothyroidism following single HIFU ablation, it remains unclear how patients with different amount of parenchyma and relative extent of ablation may affect subsequent thyroid function.

Single exponential decay waveform; a synergistic combination of electroporation and electrolysis (E2) for tissue ablation.

BackgroundElectrolytic ablation and electroporation based ablation are minimally invasive, non-thermal surgical technologies that employ electrical currents and electric fields to ablate undesirable cells in a volume of tissue. In this study, we explore the attributes of a new tissue ablation technology that simultaneously delivers a synergistic combination of electroporation and electrolysis (E2).MethodA new device that delivers a controlled dose of electroporation field and electrolysis currents in the form of a single exponential decay waveform (EDW) was applied to the pig liver, and the effect of various parameters on the extent of tissue ablation was examined with histology.ResultsHistological analysis shows that E2 delivered as EDW can produce tissue ablation in volumes of clinical significance, using electrical and temporal parameters which, if used in electroporation or electrolysis separately, cannot ablate the tissue.DiscussionThe E2 combination has advantages over the three basic technologies of non-thermal ablation: electrolytic ablation, electrochemical ablation (reversible electroporation with injection of drugs) and irreversible electroporation. E2 ablates clinically relevant volumes of tissue in a shorter period of time than electrolysis and electroporation, without the need to inject drugs as in reversible electroporation or use paralyzing anesthesia as in irreversible electroporation.

PD23-05 INFERIOR TISSUE ABLATION AFTER 120W GREENLIGHT LASER VAPORIZATION DOES NOT TRANSLATE INTO INFERIOR CLINICAL OUTCOME COMPARED CONVENTIONAL TURP: 3-YEAR RESULTS OF A PROSPECTIVE 3D ULTRASOUND VOLUMETRY STUDY

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III1 Apr 2017PD23-05 INFERIOR TISSUE ABLATION AFTER 120W GREENLIGHT LASER VAPORIZATION DOES NOT TRANSLATE INTO INFERIOR CLINICAL OUTCOME COMPARED CONVENTIONAL TURP: 3-YEAR RESULTS OF A PROSPECTIVE 3D ULTRASOUND VOLUMETRY STUDY Benedikt Kranzbühler, Oliver Gross, Christian D. Fankhauser, Marian S. Wettstein, Nico C. Grossmann, Etienne X. Keller, Daniel Eberli, Tullio Sulser, Cédric Poyet, and Thomas Hermanns Benedikt KranzbühlerBenedikt Kranzbühler More articles by this author , Oliver GrossOliver Gross More articles by this author , Christian D. FankhauserChristian D. Fankhauser More articles by this author , Marian S. WettsteinMarian S. Wettstein More articles by this author , Nico C. GrossmannNico C. Grossmann More articles by this author , Etienne X. KellerEtienne X. Keller More articles by this author , Daniel EberliDaniel Eberli More articles by this author , Tullio SulserTullio Sulser More articles by this author , Cédric PoyetCédric Poyet More articles by this author , and Thomas HermannsThomas Hermanns More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1069AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Functional short-term outcome following 120W greenlight laser vaporization (LV) has been shown to be comparable to conventional transurethral resection of the prostate (TURP). However, mid-term results following 80W greenlight LV revealed that high retreatment rates are common after the procedure most likely due to insufficient tissue ablation. Short-term outcome of our 3D ultrasound volumetry study revealed a significantly lower volume reduction one year after 120W LV compared to TURP. Additional follow-up was now performed to investigate further changes in volume reduction and associated clinical outcome 3 years after LV and TURP. METHODS A total of 174 patients (120W LV; n=98, 56% vs. TURP; n=76, 44%) were included in this prospective study and were followed for 3 years. Transrectal 3D ultrasound and planimetric volumetry of the prostate was performed preoperatively, after catheter removal, 6W, 6M, 12M and 3Y. Clinical outcome parameters (PSA, IPSS, Qmax, residual volume) were recorded preoperatively and at each follow-up visit. RESULTS Median initial prostate volume was not significantly different between the groups (LV: 44.1ml, TURP: 44.8ml; p=0.47). After catheter removal, the relative prostate volume reduction (RVR) was significantly lower following LV (table). Six weeks and six months after LV RVR increased significantly (both p<0.001). However, RVR remained significantly lower after LV throughout the entire 3-year observation period (table). All clinical outcome parameters improved significantly and remained so for 3 years without relevant differences between the groups. No significant differences in overall re-treatment rates were observed (LV: 5 (5.1%), TURP: 5 (6.5%), p=0.75) CONCLUSIONS After 3 years, prostate volume reduction remained inferior after 120W greenlight LV compared to TURP. However, as yet the lower volume reduction did not translate into inferior functional outcome or higher retreatment rates. Further follow-up of our cohort will reveal if the extent of tissue ablation impacts the long-term outcome of the procedures. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e448-e449 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Benedikt Kranzbühler More articles by this author Oliver Gross More articles by this author Christian D. Fankhauser More articles by this author Marian S. Wettstein More articles by this author Nico C. Grossmann More articles by this author Etienne X. Keller More articles by this author Daniel Eberli More articles by this author Tullio Sulser More articles by this author Cédric Poyet More articles by this author Thomas Hermanns More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Comprehensive preclinical evaluation of a multi-physics model of liver tumor radiofrequency ablation.

We aim at developing a framework for the validation of a subject-specific multi-physics model of liver tumor radiofrequency ablation (RFA). The RFA computation becomes subject specific after several levels of personalization: geometrical and biophysical (hemodynamics, heat transfer and an extended cellular necrosis model). We present a comprehensive experimental setup combining multimodal, pre- and postoperative anatomical and functional images, as well as the interventional monitoring of intra-operative signals: the temperature and delivered power. To exploit this dataset, an efficient processing pipeline is introduced, which copes with image noise, variable resolution and anisotropy. The validation study includes twelve ablations from five healthy pig livers: a mean point-to-mesh error between predicted and actual ablation extent of 5.3 ± 3.6mm is achieved. This enables an end-to-end preclinical validation framework that considers the available dataset.

Efficacy and safety of ultrasound‐guided radiofrequency ablation of hyperplastic parathyroid gland for secondary hyperparathyroidism associated with chronic kidney disease

The purpose of this study was to determine if ultrasound-guided radiofrequency ablation (RFA) of hyperplastic parathyroid glands could be used to treat secondary hyperparathyroidism (HPT) in patients with chronic kidney disease. RFA of the hyperplastic parathyroid glands was performed in 34 patients with secondary HPT. Intact parathyroid hormone (iPTH), calcium, and phosphorus were measured. The outcome was based on the ablation extent (ie, 4, 3, and 1-2 glands). The iPTH, calcium, and phosphorus levels decreased in all groups after RFA. One year after ablation, these parameters remained significantly lower in the 4-gland ablation group compared with the 3-gland and 1 to 2-gland groups. The same tendency was observed for the symptom score. The iPTH levels of <272 pg/mL on the day after ablation was the best predictor for maintaining parathyroid hormone (PTH) levels in a reasonable range 1 year after ablation. RFA of hyperplastic parathyroid glands for treating secondary HPT is feasible in selected patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 564-571, 2017.

Magnetic resonance imaging-transrectal ultrasound fusion focal cryotherapy of the prostate: A prospective development study

ObjectivesThe use of software-based magnetic resonance-transrectal ultrasound fusion to deliver focal therapy may increase the precision of treatment. This is a prospective development study assessing the feasibility of Magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion focal cryotherapy. Methods and materialsConsecutive patients undergoing focal cryotherapy were included in an academic registry (December 2013–June 2014). MRI-TRUS fusion focal cryotherapy was offered to men with visible clinically significant prostate cancer (Galil SeedNet system). Eligibility was determined by multiparametric MRI (mpMRI), and transperineal template mapping or targeted biopsies. A rigid fusion platform (Biojet) was used with the operator ensuring the ice ball covered at least the lesion. Adverse events were scored using the NCICTC V4. Genitourinary toxicity was assessed using patient-reported outcome measures (IPSS, IIEF-15, and UCLA-EPIC). Early contrast-enhanced MRI and mpMRI at 6 to 12 months were used to assess extent of lesion ablation. ResultsOf 23 patients scheduled, 5 did not have image fusion owing to surgeon preference. Overall, 18 patients undergoing image-fusion cryotherapy had median age of 68 (interquartile range [IQR]: 65–73) years and median preoperative prostate-specific antigen = 9.54 (5.65–16)ng/ml. In all, 13 (72.2%) and 5 (27.8%) patients had intermediate and high-risk cancer, respectively. In total, 10 adverse events were reported with one of these as serious (grade 3) because of admission for hematuria requiring wash out only. There was no difference in the IIEF-15 between baseline and study end (P = 0.24). The IPSS remained stable (P = 0.12), whereas the UCLA-EPIC tended to improve (P = 0.065). The prostate-specific antigen level significantly decreased at 1.8 (1.04–2.93) ng/ml (P<0.001). Both early and late mpMRI showed no residual disease in the treated area. In 2 men, radiological progression of known contralateral disease was observed; both underwent focal high intensity focused ultrasound. ConclusionMRI-TRUS fusion focal cryotherapy is feasible in most patients and seems to accurately guide ablation demonstrated by posttreatment imaging. Additional studies are needed to determine efficacy using postcryotherapy biopsy.

Determination of scattering properties and damage thresholds in tissue using ultrafast laser ablation.

Ultrafast laser surgery of tissue requires precise knowledge of the tissue’s optical properties to control the extent of subsurface ablation. Here, we present a method to determine the scattering lengths, ?s, and fluence thresholds, Fth, in multilayered and turbid tissue by finding the input energies required to initiate ablation at various depths in each tissue layer. We validated the method using tissue-mimicking phantoms and applied it to porcine vocal folds, which consist of an epithelial (ep) layer and a superficial lamina propia (SLP) layer. Across five vocal fold samples, we found ?s,ep=51.0±3.9???m, Fth,ep=1.78±0.08??J/cm2, ?s,SLP=26.5±1.6???m, and Fth,SLP=1.14±0.12??J/cm2. Our method can enable personalized determination of tissue optical properties in a clinical setting, leading to less patient-to-patient variability and more favorable outcomes in operations, such as femto-LASIK surgery.

Optimization of Irreversible Electroporation Protocols for In-vivo Myocardial Decellularization.

BackgroundIrreversible electroporation (IRE) is a non-thermal cell ablation approach that induces selective damage to cell membranes only. The purpose of the current study was to evaluate and optimize its use for in-vivo myocardial decellularization.MethodsForty-two Sprague-Dawley rats were used to compare myocardial damage of seven different IRE protocols with anterior myocardial infarction damage. An in-vivo open thoracotomy model was used, with two-needle electrodes in the anterior ventricular wall. IRE protocols included different combinations of pulse lengths (70 vs. 100 μseconds), frequency (1, 2, 4 Hz), and number (10 vs. 20 pulses), as well as voltage intensity (50, 250 and 500 Volts). All animals underwent baseline echocardiographic evaluation. Degree of myocardial ablation was determined using repeated echocardiography measurements (days 7 and 28) as well as histologic and morphometric analysis at 28 days.ResultsAll animals survived 28 days of follow-up. Compared with 50V and 250V, electroporation with 500V was associated with significantly increased myocardial scar and reduction in ejection fraction (67.4%±4% at baseline vs. 34.6%±20% at 28 days; p <0.01). Also, compared with pulse duration of 70 μsec, pulses of 100 μsec were associated with markedly reduced left ventricular function and markedly increased relative scar area ratio (28%±9% vs. 16%±3%, p = 0.02). Decreasing electroporation pulse frequency (1Hz vs. 2Hz, 2Hz vs. 4Hz) was associated with a significant increase in myocardial damage. Electroporation protocols with a greater number of pulses (20 vs. 10) correlated with more profound tissue damage (p<0.05). When compared with myocardial infarction damage, electroporation demonstrated a considerable likeness regarding the extent of the inflammatory process, but with relatively higher levels of extra-cellular preservation.ConclusionsIRE has a graded effect on the myocardium. The extent of ablation can be controlled by changing pulse length, frequency and number, as well as by changing electric field intensity.

Ultrasound-guided percutaneous laser ablation of unifocal T1N0M0 papillary thyroid microcarcinoma: Preliminary results.

To evaluate the efficacy and safety of percutaneous laser ablation (PLA) for unifocal T1N0M0 papillary thyroid microcarcinoma(PTMC). A retrospective study was conducted in 30 patients with single PTMC which was diagnosed by fine-needle aspiration biopsy (FNAB). PLA was performed for proper time to achieve adequate ablation zones. The extent of ablation was assessed by contrast-enhanced ultrasound (CEUS) immediately and 7days after PLA. Complications were recorded. The size and volume of the ablation area and thyroid hormones were measured, and clinical evaluations were performed at 1, 3, 6 and12 months, and every half year thereafter. The procedure was well tolerated without serious complications. Of the 30 patients, 29 were treated successfully under local anaesthesia in a single session. Only one incomplete ablation was detected by immediate CEUS after PLA, and a second ablation was performed. At the last follow-up, ten (33.3%) ablation zones had disappeared, and 20 (66.67%) ablation zones remained as scar-like lesions. No regrowth of treated tumours, local recurrence or distant metastases were detected. During the short-term follow-up period, ultrasound-guided PLA appears to be effective and safe for treating solitary T1N0M0 PTMC in selected patients who are ineligible for surgery. • Ultrasound is a useful tool in percutaneous laser ablation (PLA). • PLA is safe for treating papillary thyroid microcarcinoma. • PLA is effective for single papillary thyroid microcarcinoma.

Percutaneous laser ablation for treatment of locally recurrent papillary thyroid carcinoma

To evaluate the efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for recurrent papillary thyroid carcinomas (PTC) <15 mm in the neck. A retrospective study was conducted in 21 patients with 27 recurrent PTC lesions who underwent PLA. The extent of ablation was assessed by contrast-enhanced ultrasonography (CEUS) after PLA. Measurement of the volume of tumour and serum thyroglobulin, and clinical evaluation were performed at 7 days, and 1, 3, 6, and 12 months, and every 6 months thereafter. The procedure was well tolerated. Of 21 patients, 18 were successfully treated in a single session. Incomplete ablation was detected by CEUS in three patients, and a second ablation was performed. The mean largest diameter and the average baseline volume were reduced from 7.5±2.8mm and 105.4±114mm3 to 0.4±1mm and 0.8±2.4mm3 at the final follow-up. Ultrasound-guided PLA is effective for the treatment of recurrent PTCs with a comparable success rate to radio-iodine therapy, and it may become a primary choice of treatment for recurrent PTCs in selected patients who are ineligible for surgery and/or prefer not to have further surgery.

Long-Term Success for the Convergent Atrial Fibrillation Procedure: 4-Year Outcomes

The objective of this single-center study was to report long-term efficacy outcomes of the convergent procedure for the treatment of atrial fibrillation. Outcomes for the convergent procedure were determined by clinical presentation and interrogating implanted loop recorders. Rhythm status and required interventions for atrial fibrillation recurrence (antiarrhythmic drugs, cardioversions, and repeat ablations) were quantified 1 to 4 years after the procedure. Long-term outcomes, atrial fibrillation burden quantified with continuous monitoring, and patient baseline characteristics were analyzed and reported. Seventy-six consecutive patients with paroxysmal (5%), persistent (16%), or longstanding atrial fibrillation (79%) underwent the convergent procedure between January 2009 and July 2013. Clinical presentation in sinus rhythm at isolated timepoints was 88% at 6 months, 85% at 1 year, 85% at 2 years, 84% at 3 years, and 81% at 4 years of follow-up. Total patients requiring repeat catheter ablation was 18% through 4 years. Single procedure 1-year success (freedom from atrial fibrillation/atrial flutter/atrial tachycardia through 1 year and off antiarrhythmic drugs) was 56%; and long-term success (freedom from atrial fibrillation/atrial flutter/atrial tachycardia through at least 36 months and off antiarrhythmic drugs) was 45%. Four-year outcomes for the convergent procedure are promising and demonstrate the ability to maintain sinus rhythm in a predominantly persistent and longstanding atrial fibrillation population. Increasing the extent of posterior ablation should be evaluated for patients with enlarged atria to account for the potential increase in fibrosis distribution and other atrial remodeling markers that produce arrhythmogenic substrates.

A Systematic Review and Meta-Analysis of Studies Examining the Use of Brain Laser Interstitial Thermal Therapy versus Craniotomy for the Treatment of High-Grade Tumors in or near Areas of Eloquence: An Examination of the Extent of Resection and Major Complication Rates Associated with Each Type of Surgery

Background: The extent of resection (EOR) of high-grade gliomas (WHO grade III or IV) in or near areas of eloquence is associated with overall patient survival, but with higher major neurocognitive complications. Methods: A systematic review and meta-analysis was undertaken of the peer-reviewed literature in order to identify studies which examined EOR or extent of ablation (EOA) and major complications (defined as neurocognitive or functional complications which last >3 months duration after surgery) associated with either brain laser interstitial thermal therapy (LITT) or open craniotomy in high-grade tumors in or near areas of eloquence. Results: Eight studies on brain LITT (n = 79 patients) and 12 craniotomy studies (n = 1,036 patients) were identified which examined either/both EOR/EOA and complications. Meta-analysis demonstrated an EOA/EOR of 85.4 ± 10.6% with brain LITT versus 77.0 ± 40% with craniotomy (mean difference: 8%; 95% CI: 2-15; p = 0.01; inverse variance, random effects model). Meta-analysis of proportions of major complications for each individual therapy demonstrated major complications of 5.7% (95% CI: 1.8-11.6) and 13.8% (95% CI: 10.3-17.9) for LITT and craniotomy, respectively. Conclusion: In patients presenting with high-grade gliomas in or near areas of eloquence, early results demonstrate that brain LITT may be a viable surgical alternative.

A Time-Limited and Partially Reversible Model of Hypoganglionosis Induced by Benzalkonium Chloride Treatment.

Serosal application of benzalkonium chloride (BAC) has been previously applied to produce a model of aganglionosis; however, confusion remains regarding the extent of chemical ablation of enteric myenteric plexus after BAC treatment. The time sequence of BAC-induced effects on the myenteric plexus of the rat colon was determined and followed the morphologic changes. After sacrifice of animals 7, 14, 28, 56, 84 or 168days postintervention, colonic tissue samples were removed, fixed in formalin, and cut into 5-μm longitudinal sections for histological analysis. The neural analysis was used to re-evaluate BAC treatments for the appropriate model. Compared with rats in sham groups, rats in 0.1%-30-min BAC group maintained only 15.27±4.80% of ganglia per section in a 1-cm/5-μm slice and 11.76±2.30% of ganglionic cells after 28days, the lower and stable number of ganglionic cells between Day 7 and 84 (from 11.67±2.10 to 19.05±5.10%). Although an increase, ganglionic cell numbers did not recover at Day168 when compared with the numbers in sham groups. The results showed that characteristics of rats in the 0.1%-30-min BAC group between Day 7 and 84 most closely kept in stable state, suggesting that these treatment parameters are ideal for producing a hypoganglia model of hypoganglionosis.

ChemInform Abstract: Space Science Applications for Conducting Polymer Particles: Synthetic Mimics for Cosmic Dust and Micrometeorites

AbstractReview: 118 refs.