Articles: surgery.
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We tried to evaluate the clinical outcomes (mortality, postoperative bleeding and perioperative myocardial infarction) of patients who underwent first elective coronary artery bypass grafting and received aspirin during the preoperative period. ⋯ Preoperative aspirin administration increased postoperative bleeding and red blood cell requirements with no effect on mortality, re-exploration rate and perioperative myocardial infarction. We recommend withdrawal of aspirin seven days prior to surgery. (Cardiol J 2007; 14: 453-457).
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The objective of our work has been to investigate the use of ultrasound image-guided high-intensity focused ultrasound (HIFU) to non-invasively produce conduction block in rabbit sciatic nerves in vivo, a technique that could become a treatment of spasticity and pain. The work reported here involved the investigation of the duration of such conduction blocks after HIFU treatment and whether they resulted in axon degeneration. The right sciatic nerves of 12 rabbits were treated, under guidance of ultrasound imaging, with repeated 5-s applications of 3.2 MHz HIFU with in situ intensity of 1930 W/cm(2) (spatial-average, temporal-average) until conduction block was achieved. ⋯ The volume of necrosis of adjacent muscle was measured to be 1.59+/-1.1 cm(3) (mean+/-SD). For all nerves, conduction block remained at the survival endpoint and the block resulted in degeneration of axons distal to the HIFU site, as confirmed by electrophysiological and histological methods. Potential clinical applications include treatment of spasticity in patients with spinal cord injury or pain in cancer patients.
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Ultrasound Med Biol · Jan 2007
Image-guided acoustic hemostasis for hemorrhage in the posterior liver.
We investigated the use of ultrasound image-guided high intensity focused ultrasound (HIFU) to stop bleeding from injuries in the posterior liver. A HIFU transducer with focal length of 3.5 cm and frequency of 3.2 MHz was integrated with an intraoperative high-resolution ultrasound-imaging probe. Wedge tissue extractions, 30-mm long, 5-mm wide and 8-mm deep, were made in the posterior liver surface of five pigs to induce bleeding. ⋯ Hemostasis was achieved in 66 +/- 18 s (mean +/- standard deviation) for 17 HIFU treatments. During 7 min of sham HIFU treatment, none of the control incisions (n = 7) became hemostatic. Ultrasound image-guided HIFU offers a promising method for hemostasis in surgical settings in which the hemorrhage site is hidden and/or not accessible.
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Comparative Study
[Comparison of C-arm CT and standard imaging in osteosyntheses of fractured distal radius specimens].
The purpose of this study was to evaluate the value of C-arm CT imaging of the distal radius with standard patient positioning in intraoperative assessment of plate osteosynthesis. ⋯ With standard patient positioning, the performance of C-arm CT was equivalent to and not better than that of current standard procedures, i.e. intraoperative fluoroscopy and postoperative radiography. Further studies should examine whether this holds true in clinical practice with representative patient collectives when titanium implants are used and/or optimized patient positioning is practised.
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Translational Research is the research to apply and mediate a fundamental research result to the clinical field effectively. The integration of the diagnosis and the treatment is an important item in the life science field from the viewpoint of quality of therapy and minimally invasive therapy. ⋯ A high function operating robot (manipulator) as an endoscopic robot and image-guided minimally invasive device are important in the point of view of the development of a medical device shown with a medical device industry vision. We describe an outline of our ongoing development of endoscope system, intraoperative MRI (intelligent operating theater) and robot surgery system in neurosurgical field.