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Focal Ablation

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https://www.readbyqxmd.com/read/28733070/spatial-relationship-of-sites-for-atrial-fibrillation-drivers-and-atrial-tachycardia-in-patients-with-both-arrhythmias
#1
Tina Baykaner, Junaid A B Zaman, Albert J Rogers, Rachita Navara, Mahmood AlHusseini, Ryan T Borne, Shirley Park, Paul J Wang, David E Krummen, William H Sauer, Sanjiv M Narayan
INTRODUCTION: Atrial fibrillation (AF) often converts to and from atrial tachycardia (AT), but it is undefined if these rhythms are mechanistically related in such patients. We tested the hypothesis that critical sites for AT may be related to regional AF sources in patients with both rhythms, by mapping their locations and response to ablation on transitions to and from AF. METHODS: From 219 patients undergoing spatial mapping of AF prior to ablation at 3 centers, we enrolled 26 patients in whom AF converted to AT by ablation (n=19) or spontaneously (n=7; left atrial size 42±6cm, 38% persistent AF)...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28725242/focal-application-of-low-dose-rate-brachytherapy-for-prostate-cancer-a-pilot-study
#2
S Sara Mahdavi, Ingrid T Spadinger, Septimiu E Salcudean, Piotr Kozlowski, Silvia D Chang, Tony Ng, Julio Lobo, Guy Nir, Hamid Moradi, Michael Peacock, W James Morris
PURPOSE: To evaluate the feasibility and to report the early outcomes of focal treatment of prostate cancer using low-dose-rate brachytherapy (LDR-PB). MATERIAL AND METHODS: Seventeen patients were screened with multi-parametric magnetic resonance imaging (mpMRI), 14 of whom proceeded to receive trans-perineal template mapping biopsy (TTMB). Focal LDR-PB was performed on five eligible patients using dual air kerma strength treatment plans based on planning target volumes derived from cancer locations and determined by TTMB...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28721494/a-comprehensive-characterization-of-parameters-affecting-high-frequency-irreversible-electroporation-lesions
#3
Tyler Miklovic, Eduardo L Latouche, Matthew R DeWitt, Rafael V Davalos, Michael B Sano
Several focal therapies are being investigated clinically to treat tumors in which surgery is contraindicated. Many of these ablation techniques, such as radiofrequency ablation and microwave ablation, rely on thermal damage mechanisms which can put critical nerves or vasculature at risk. Irreversible electroporation (IRE) is a minimally invasive, non-thermal technique to destroy tumors. A series of short electric pulses create nanoscale defects in the cell membrane, eventually leading to cell death. Typical IRE protocols deliver a series of 50-100 µs monopolar pulses...
July 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#4
Marcia Irene Canto, Julian Abrams, Hannah Kunzli, Bas Weusten, Yoshihiro Komatsu, Blair Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or radiofrequency ablation (RFA). A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system (CbFAS) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 15, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28708182/multi-beam-pulsed-laser-patterning-of-plasmonic-films-using-broadband-diffractive-optical-elements
#5
A A Kuchmizhak, A P Porfirev, S A Syubaev, P A Danilov, A A Ionin, O B Vitrik, Yu N Kulchin, S N Khonina, S I Kudryashov
Multi-sector broadband diffractive optical elements (DOEs) were designed and fabricated from fused silica for high-efficiency multiplexing of femtosecond and nanosecond Gaussian laser beams into multiple (up to one 100) optically tunable microbeams with increased high-numerical aperture (NA) focal depths. Various DOE-related issues, such as high-NA laser focusing, laser pulsewidth, and DOE symmetry-dependent heat conduction effects, as well as the corresponding spatial resolution, were discussed in the context of high-throughput laser patterning...
July 15, 2017: Optics Letters
https://www.readbyqxmd.com/read/28705474/rf-ablation-in-periventricular-heterotopia-related-epilepsy
#6
Massimo Cossu, Laura Mirandola, Laura Tassi
Drug-resistant focal epilepsy is a common occurrence in patients with gray matter nodular heterotopia (NH), and surgical treatment is often considered in these cases. NH-related epileptogenicity is sustained by complex networks, which may involve the nodules and extralesional cortex in various combinations. Therefore, invasive EEG is usually required to identify the structures involved in seizure generation. It has been reported that surgery may be effective in cases with unilateral lesions, whereas bilateral cases are not optimal candidates for surgical success...
July 3, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28687623/nonmuscle-myosin-ii-b-regulates-epicardial-integrity-and-epicardial-derived-mesenchymal-cell-maturation
#7
Xuefei Ma, Derek C Sung, Yanqin Yang, Yoshi Wakabayashi, Robert S Adelstein
Nonmuscle myosin II-B (NMII-B) is essential for cardiac myocyte cytokinesis. The role of NMII-B in other cardiac cells is not known. Here we show that NMII-B is required in epicardial formation and function to support myocardial proliferation and coronary vessel development. Ablation of NMII-B in epicardial cells results in disruption of epicardial integrity with a loss of E-cadherin at cell-cell junctions and a focal detachment of epicardial cells from the myocardium. NMII-B ablated or blebbistatin inhibited epicardial explants demonstrate impaired mesenchymal cell maturation during epicardial epithelial-mesenchymal transition...
July 7, 2017: Journal of Cell Science
https://www.readbyqxmd.com/read/28681404/integration-of-deployable-fluid-lenses-and-reflectors-with-endoluminal-therapeutic-ultrasound-applicators-preliminary-investigations-of-enhanced-penetration-depth-and-focal-gain
#8
Matthew S Adams, Vasant A Salgaonkar, Serena Scott, Graham Sommer, Chris J Diederich
PURPOSE: Catheter-based ultrasound applicators can generate thermal ablation of tissues adjacent to body lumens, but have limited focusing and penetration capabilities due to the small profile of integrated transducers required for the applicator to traverse anatomical passages. This study investigates a design for an endoluminal or laparoscopic ultrasound applicator with deployable acoustic reflector and fluid lens components, which can be expanded after device delivery to increase the effective acoustic aperture and allow for deeper and dynamically adjustable target depths...
July 6, 2017: Medical Physics
https://www.readbyqxmd.com/read/28678805/ablation-as-targeted-perturbation-to-rewire-communication-network-of-persistent-atrial-fibrillation
#9
Susumu Tao, Samuel F Way, Joshua Garland, Jonathan Chrispin, Luisa A Ciuffo, Muhammad A Balouch, Saman Nazarian, David D Spragg, Joseph E Marine, Ronald D Berger, Hugh Calkins, Hiroshi Ashikaga
Persistent atrial fibrillation (AF) can be viewed as disintegrated patterns of information transmission by action potential across the communication network consisting of nodes linked by functional connectivity. To test the hypothesis that ablation of persistent AF is associated with improvement in both local and global connectivity within the communication networks, we analyzed multi-electrode basket catheter electrograms of 22 consecutive patients (63.5 ± 9.7 years, 78% male) during persistent AF before and after the focal impulse and rotor modulation-guided ablation...
2017: PloS One
https://www.readbyqxmd.com/read/28675362/liver-resections-in-a-high-volume-center-form-standard-procedures-to-extreme-surgery-and-ultrasound-guided-resections
#10
Florin Botea, Mihnea Ionescu, Vladislav Braşoveanu, Doina Hrehoreţ, Sorin Alexandrescu, Mihai Grigorie, Oana Stanciulea, Diana Nicolaescu, Dana Tomescu, Gabriela Droc, Daniela Ungureanu, Ruxandra Fota, Adina Croitoru, Liana Gheorghe, Cristian Gheorghe, Ioana Lupescu, Mugur Grasu, Mirela Boroş, Radu Dumitru, Mihai Toma, Vlad Herlea, Irinel Popescu
Background: Liver resection (LR) is the treatment of choice for most benign and malignant focal liver lesions, as well as in selected patients with liver trauma. Few other therapies can compete with LR in selected cases, such as liver transplantation in hepatocellular carcinoma (HCC) and ablative therapies in small HCCs or liver metastases. The present paper analyses a single center experience in LR, reviewing the indications of LR, the operative techniques and their short-term results. MATERIAL AND METHOD: Between January 2000 and December 2016, in "œDan Setlacec" Center of General Surgery and Liver Transplantation were performed 3165 LRs in 3016 patients, for pathologic conditions of the liver...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28670858/rotors-exhibit-greater-surface-ecg-variation-during-ventricular-fibrillation-than-focal-sources-due-to-wavebreak-secondary-rotors-and-meander
#11
Gordon Ho, Christopher T Villongco, Omid Yousefian, Aaron Bradshaw, Andrew Nguyen, Yonatan Faiwiszewski, Justin Hayase, Wouter-Jan Rappel, Andrew D McCulloch, David E Krummen
INTRODUCTION: Ventricular fibrillation is a common life-threatening arrhythmia. The ECG of VF appears chaotic but may allow identification of sustaining mechanisms to guide therapy. HYPOTHESIS: We hypothesized that rotors and focal sources manifest distinct features on the ECG, and computational modeling may identify mechanisms of such features. METHODS: VF induction was attempted in 31 patients referred for ventricular arrhythmia ablation...
July 3, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28655432/diagnostic-accuracy-of-different-magnetic-resonance-imaging-sequences-for-detecting-local-tumor-progression-after-radiofrequency-ablation-of-hepatic-malignancies
#12
Jakob Weiss, Hansjoerg Rempp, Stephan Clasen, Mike Notohamiprodjo, David-Emanuel Keßler, Philippe L Pereira, Gunnar Blumenstock, Konstantin Nikolaou, Rüdiger Hoffmann
OBJECTIVE: To evaluate the diagnostic accuracy of the individual sequences of a clinical routine liver MRI protocol for the detection of local tumour progression after radiofrequency (RF) ablation of hepatic malignancies. MATERIAL AND METHODS: A cohort of 93 patients treated for 140 primary and secondary hepatic malignancies with RF ablation was assembled for this retrospective study. The cohort contained 31 cases of local tumour progression, which occurred 8.3±6...
June 17, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28654336/focal-therapy-for-prostate-cancer-with-in-bore-mr-guided-focused-ultrasound-two-year-follow-up-of-a-phase-i-trial-complications-and-functional-outcomes
#13
Kae Jack Tay, Christopher W S Cheng, Weber K O Lau, James Khoo, Choon Hua Thng, Jin Wei Kwek
Purpose To report the safety profile and 2-year functional outcomes of in-bore magnetic resonance (MR)-guided focused ultrasound on single cancer foci in men with prostate cancer. Materials and Methods Ethics approval was obtained from the centralized institutional review board for this prospective single-arm study, and patients provided informed consent. Patients with untreated low-volume low-grade prostate cancer (clinical stage T2a or lower; Gleason score, 3+3; index tumor ≤10 mm(3)) underwent MR-guided focused ultrasound between July 2011 and February 2013...
June 26, 2017: Radiology
https://www.readbyqxmd.com/read/28650888/false-positive-uptake-of-radioiodine-in-renal-hamartoma-in-a-patient-with-differentiated-thyroid-cancer
#14
Guohua Shen, Zhongzhi Qi, Rui Huang, Bin Liu, Anren Kuang
A 46-year-old woman with a history of papillary thyroid cancer status post total thyroidectomy underwent the second I radioiodine ablation therapy for lung metastases. Posttherapeutic whole-body I planar images showed diffuse uptake in the lungs and intense focal activity in both sides of the upper abdomen. SPECT/CT of the abdomen localized the uptake in the upper pole of the left kidney and the lower pole of the right kidney. The patient received bilateral partial nephrectomy with pathology demonstrating that these 2 renal lesions were renal hamartomas...
June 24, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28644203/invasive-investigation-of-insular-cortex-epilepsy
#15
Philippe Ryvlin, Fabienne Picard
Invasive long-term EEG investigations of the insula have been performed since the mid-nineties in an expanding range of focal epilepsies suspected to involve the insular cortex. The various clinical forms of insular epilepsies were delineated during the last 2 decades, and include the following presentations: perisylvian epilepsy, temporal plus epilepsy, sleep hypermotor epilepsy, MRI-negative frontal and parietal lobe epilepsies, and insular lesions. In fact, a majority of complex stereoelectroencephalography procedures will include at least one electrode targeting the insula...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28641910/dependence-of-boiling-histotripsy-treatment-efficiency-on-hifu-frequency-and-focal-pressure-levels
#16
Tatiana D Khokhlova, Yasser A Haider, Adam D Maxwell, Wayne Kreider, Michael R Bailey, Vera A Khokhlova
Boiling histotripsy (BH) is a high-intensity focused ultrasound (HIFU)-based method of mechanical tissue fractionation that utilizes millisecond-long bursts of HIFU shock waves to cause boiling at the focus in milliseconds. The subsequent interaction of the incoming shocks with the vapor bubble mechanically lyses surrounding tissue and cells. The acoustic parameter space for BH has been investigated previously and an inverse dependence between the HIFU frequency and the dimensions of a BH lesion has been observed...
June 19, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28641381/supraventricular-tachyarrhythmias-in-patients-with-a-persistent-left-superior-vena-cava
#17
Jongmin Hwang, Hyoung-Seob Park, Jun Kim, Jeong Su Kim, Jong Sung Park, Ki-Hun Kim, Myung Hwan Bae, Sang-Hee Lee, Young Soo Lee, Seongwook Han, Dae-Kyeong Kim, Tae-Joon Cha, Dong Gu Shin, Byung Chun Jung, Yoon-Nyun Kim
Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28639746/acute-changes-in-histopathology-and-intravascular-imaging-after-catheter-based-renal-denervation-in-a-porcine-model
#18
Atsushi Sakaoka, Akiyuki Takami, Yuji Onimura, Hitomi Hagiwara, Hisako Terao, Fumiaki Kumagai, Kiyoshi Matsumura
OBJECTIVES: We first aimed to identify the histopathological changes occurring immediately after renal denervation (RDN) with radiofrequency energy, and then to assess the feasibility of determining procedural success using currently available clinical intravascular imaging techniques. BACKGROUND: Catheter-based RDN has been used as an alternative therapy for hypertension. However, no practical endpoint to determine procedural success during treatment has been established...
June 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28635336/new-advances-in-focal-therapy-for-early-stage-prostate-cancer
#19
Kae Jack Tay, Ariel A Schulman, Christina Sze, Efrat Tsivian, Thomas J Polascik
Prostate focal therapy offers men the opportunity to achieve oncological control while preserving sexual and urinary function. The prerequisites for successful focal therapy are to accurately identify, localize and completely ablate the clinically significant cancer(s) within the prostate. We aim to evaluate the evidence for current and upcoming technologies that could shape the future of prostate cancer focal therapy in the next five years. Areas covered: Current literature on advances in patient selection using imaging, biopsy and biomarkers, ablation techniques and adjuvant treatments for focal therapy are summarized...
June 28, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28633808/impact-of-mr-guided-boiling-histotripsy-in-distinct-murine-tumor-models
#20
Martijn Hoogenboom, Dylan C Eikelenboom, Renske J E van den Bijgaart, Arend Heerschap, Pieter Wesseling, Martijn H den Brok, Jurgen J Fütterer, Gosse J Adema
Interest in mechanical high intensity focused ultrasound (HIFU) ablation is rapidly growing. Boiling histotripsy (BH) is applied for mechanical fragmentation of soft tissue into submicron fragments with limited temperature increase using the shock wave and cavitation effects of HIFU. Research on BH has been largely limited to ex vivo experiments. As a consequence, the in vivo pathology after BH treatment and the relation to preexistent tissue characteristics are not well understood. This study reports on in vivo MR guided BH treatment, either with 100 or 200 pulses per focal spot, in three different subcutaneous mouse tumor models: a soft-tissue melanoma (B16OVA), a compact growing thymoma (EL4), and a highly vascularized neuroblastoma (9464D)...
September 2017: Ultrasonics Sonochemistry
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