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简介:BackgroundUltrasound-guidedtemporarypacemakerimplantationhasbeenprovensafeandefficient.However,fewstudieshavefocusedonelderandcriticalpatients.MethodsTwelveelderandcriticalpatientsunderwenttemporarycardiacpacingthroughthejugularveinorsubclavianvein,withbedsideultrasoundimagestoassisttheplacementofelectrodewithintherightventricle.ResultsUltrasound-guidedtemporarycardiacpacemakerinsertionwassuccessfulinallofthe12patients.Electrodesweresentintotherightventriclecorrectlywiththehelpofultrasoundimaging.Inallcases,temporarypacemakerfunctionedwellwithoutprocedure-relatedcomplications.ConclusionTemporarycardiacpacingguidedbyultrasoundissafeandeffectiveinelderandcriticalpatients,whichisworthofpromoting,especiallyinintensivecareunit.
简介:Applicabilityofguidedmoderesonantstructurestotunableopticalfilteringandsensingisdemonstratedusingnematicliquidcrystals.Asasensor,aminimumrefractiveindexdetectivityof10-5isdemonstratedwhileasatunablefilter,tunabilityrangeoffewtensofnanometerswith2-nmbandwidthispresented.Theoptimumdesignisachievedbymaximizingtheevanescentfieldregionintheanalytewhichmaximizestheoverlapintegral.Thedevicecanbeoperatedinreflectionortransmissionmodesatnormalincidence.Itcanalsobeoperatedatasinglewavelengthbymeasuringtheangularprofileofthelightbeam.
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简介:Percutaneouscoronaryintervention(PCI)improvessymptomsandprognosisinischemia-inducing,functionallysignificant,coronarylesions.Useoffractionalflowreserveallowsphysicianstoinvestigatetheischemia-inducingpotentialofaspecificlesionandcanbeusedtoguidecoronaryrevascularization,especiallyinmultivesselcoronaryarterydisease.Fractionalflowreserve-guidedPCIhasbeenextensivelyinvestigated.Resultsshowthatdeferralofstentinginnon-significantlesionsissafe,whereasdeferralofstentinginfunctionallysignificantlesionsworsensoutcome.FFR-guidedPCIimprovesoutcomeinmultivesseldiseaseoverangiography-guidedPCI.Untilrecently,therewaslittleknownaboutthelong-termoutcomeofFFR-guidedrevascularizationanditsvalidityinacutecoronarysyndromes.Thisreviewaimstoaddressthenewevidenceregardinglong-termappropriatenessofFFR-guidedPCI,theneedforhyperemiatoevaluatefunctionalseverity,andtheuseofFFRinacutecoronarysyndromes.
简介:Inthispaper,weproposeanovelautomaticobjectextractionalgorithm,namedtheTemplateGuidedLiveWire,basedonthepopularlyusedlivewiretechniques.Wediscussindetailsthenovelmethod'sapplicationsontongueextractionindigitalimages.Withtheguidesofagiventemplatecurvewhichapproximatesthetongue'sshape,ourmethodcanfinishtheextractionoftonguewithoutanyhumanintervention.Inthepaper,wealsodiscussedindetailshowthetemplateguidesthelivewire,andwhyourmethodfunctionsmoreeffectivelythanotherboundarybasedsegmentationmethodsespeciallythesnakealgorithm.Experimentalresultsonsometongueimagesareaswellprovidedtoshowourmethod'sbetteraccuracyandrobustnessthanthesnakealgorithm.
简介:瞄准:为了评估胰腺的织物的组织学的评估的诊断精确性,一个修改方法为恢复并且处理内视镜的超声(EUS)获得的样品指导了好针渴望(FNA)在胰腺的固体的鉴别诊断的材料集中。方法:有胰腺的群众的62个连续病人有希望地被学习。EUS被线性扫描PentaxFG-38UX回响内诊镜执行。三FNA(22G针)在每个过程期间被执行。与第一和第二根刺获得的材料为cytological学习被处理。第三根刺的材料被盐溶液的小心的注射通过针为摩尔答案恢复进10%,并且为组织学的学习处理了。结果:一些为组织学的分析获得的核心标本是6.5+/-5.3公里(范围1-22公里)。Cytological和组织学的样品在51被看作足够(82.3%)并且52个盒子(83.9%)分别地。为恶意的诊断的胰腺的细胞学和组织学的全面敏感是68.4%。与细胞学相反,组织学能诊断除煽动性的群众的腺癌,和所有情况以外的瘤。细胞学和组织学的联合允许在56种情况(90.3%)中获得一件足够的样品,与84.21%的全球敏感,100%的特性和90.32%的全面精确性。复杂并发症率是1.6%。结论:为组织学的检查的足够的胰腺的核心标本能被指导EUS的FNA获得。这种技术为胰腺的瘤的不同类型和良性的疾病的评估的诊断主要是有用的。
简介:Preoperativestagingoftheaxillainwomenwithinvasivebreastcancerusingultrasound-guidedneedlebiopsy(UNB)identifiesapproximately50%ofpatientswithaxillarynodalmetastasespriortosurgicalintervention.Althoughmoderatelysensitive,itisahighlyspecificstagingstrategythatisrarelyfalsely-positive,henceapositiveUNBallowspatientstobetriagedtoaxillarylymph-nodedissection(ALND)avoidingpotentiallyunnecessarysentinelnodebiopsy(SNB).Inthisreview,weextendourpreviousworkthroughanupdatedliteraturesearch,focusingonstudiesthatreportdataonUNButility.Basedondatafor10,934breastcancerpatients,sourcedfrom35studies,apositiveUNBallowedtriageof1,745cases(simpleproportion16%)toaxillarysurgicaltreatment:theutilityofUNBwasamedian19.8%[interquartilerange(IQR)11.6%-26.7%]acrossthesestudies.Wealsomodelleddatafromasubgroupofstudies,andestimatedthatamongstpatientswithmetastasestoaxillarynodes,theoddsratio(OR)forhighnodaldiseaseburdenforapositiveUNBversusanegativeUNBwas4.38[95%confidenceinterval(95%CI):3.13,6.13],P<0.001.Fromthismodel,theestimatedproportionwithhighnodaldiseaseburdenwas58.9%(95%CI:50.2%,67.0%)forapositiveUNB,whereastheestimatedproportionwithhighnodaldiseaseburdenwas24.6%(95%CI:17.7%,33.2%)ifUNBwasnegative.Overall,axillaryUNBhasgoodclinicalutilityandapositiveUNBcaneffectivelytriagetoALND.However,theevolvinglandscapeofaxillarysurgicaltreatmentmeansthatUNBwillhaverelativelylessutilitywheresurgeonshavemodifiedtheirpracticetoomissionofALNDforminimalnodalmetastaticdisease.
简介:Itisfoundthatthereisanupper-limitcriticalpowerforself-guidedpropagationofintenselasersinplasmainadditiontothewell-knownlower-limitcriticalpowersetbytherelativisticeffect.Abovethisupper-limitcriticalpower,thelaserpulseexperiencesdefocusingduetoexpulsionoflocalplasmaelectronsbythetransverseponderomotiveforce.Associatedwiththeupper-limitpower,alower-limitcriticalplasmadensityisalsofoundforagivenlaserspotsize,belowwhichself-focusingdoesnotoccurforanylaserpower.Boththeupper-limitpowerandthelower-limitdensityarederivedtheoreticallyandverifiedbytwo-dimensionalparticle-in-cellsimulations.Thepresentstudyprovidesnewguidanceforexperimentaldesigns,whereself-guidedpropagationoflasersisessential.
简介:镇静可以在指导的transrectal超声(TRUS)期间疼痛地导致减小前列腺活体检视。我们试图在在护理费用的指导TRUS的前列腺活体检视和相关增加期间评估propofol和remifentanil注入的联合的功效和安全。从1月到2010年9月,经历transrectal前列腺活体检视的100个人被使随机化进二个组。在组1,50个病人收到了propofol和remifentanil的联合注入;在组2,50个病人收到了lidocaine果冻。在指导TRUS的活体检视被执行以后,疼痛和耐心的满足被一个10点评估视觉模拟规模(管),和一张费用相关的耐心的满足问询表被所有病人完成。病人们也被问他们是否将愿意由一样的方法经历重复活体检视。在1看了显著地更低的管的组的病人在组2比那些得分(吝啬的管分数:0.9±;1.1对6.3±;2.5;P<;0.001)。另外,耐心的满足规模在组1是显著地更高的(P=0.002)。尽管全面费用在组1是显著地更高的(P=0.006),就费用而言的耐心的满足规模在这个组(P=0.009)也是更高的。propofol和remifentanil的联合在指导TRUS的前列腺活体检视期间是到减少病人疼痛和增加病人满足的一条安全、有效的路。尽管费用在收到了镇静,期望的组是更高的,病人展出了提高的满足和心甘情愿由一样的方法重复活体检视。
简介:ThephotonicspinHalleffect(SHE)hasbeenintensivelystudiedandwidelyapplied,especiallyinspinphotonics.However,theSHEisweakandisdifficulttodetectdirectly.Inthispaper,weproposeamethodtoenhanceSHEwiththeguided-wavesurface-plasmonresonance(SPR).Bycoveringadielectricwithhighrefractiveindexonthesurfaceofsilverfilm,thephotonicSHEcanbegreatlyenhanced,andagianttransverseshiftofhorizontalpolarizationstateisobservedduetotheevanescentfieldenhancementneartheinterfaceatthetopdielectriclayerandair.Themaximumtransverseshiftofthehorizontalpolarizationstatewith11.5μmisobtainedwhenthethicknessofSifilmisoptimum.ThereisatleastanorderofmagnitudeenhancementincontrastwiththetransverseshiftintheconventionalSPRconfiguration.OurresearchisimportantforprovidinganeffectivewaytoimprovethephotonicSHEandmayoffertheopportunitytocharacterizetheparametersofthedielectriclayerwiththehelpofweakmeasurementsanddevelopmentofsensorsbasedonthephotonicSHE.
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简介:Toimproveglobalcontrolofdiseaseandreduceglobaltoxicity,acomplexseeddistributionpatternshouldbeachievedwithgreataccuracyduringbrachytherapy.However,theinteractionbetweentheneedleandprostatewillcauselargedeformationofsofttissue.Asaresult,seedswillbemisplaced,sharpdemarcationbetweenirradiatedvolumeandhealthystructuresisunavailableandthiswillcausesideeffectssuchasimpotenceandurinaryincontinence.Inthispaper,a3Dnonlineardynamicfiniteelements...