Search results for: endoscopic ultrasound (EUS)

Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho

Abstract:

Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.

Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided

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Authors: A. Kachmazova, A. Shadiev, Y. Teterin, P. Yartcev

Abstract:

Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose.

Keywords: endoscopic ultrasonography, choledocholithiasis, common bile duct, concrement, ERCP

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Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

Abstract:

Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi

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Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.

Keywords: Ascaris, biliary, ERCP, ultrasound

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Authors: Tran Trong Thang, Nguyen Phan Kien, Trinh Quang Duc

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The phased-array ultrasound transducer types are utilities for medical ultrasonography as well as optical imaging. However, their discontinuity characteristic limits the applications due to the artifacts contaminated into the reconstructed images. Because of the effects of the ultrasound pressure field pattern to the echo ultrasonic waves as well as the optical modulated signal, the side lobes of the focused ultrasound beam induced by discontinuity of the phased-array ultrasound transducer might the reason of the artifacts. In this paper, a simple method in approach of numerical simulation was used to investigate the limitation of discontinuity of the elements in phased-array ultrasound transducer and their effects to the ultrasound pressure field. Take into account the change of ultrasound pressure field patterns in the conditions of variation of the pitches between elements of the phased-array ultrasound transducer, the appropriated parameters for phased-array ultrasound transducer design were asserted quantitatively.

Keywords: phased-array ultrasound transducer, sound pressure pattern, discontinuous sound field, numerical visualization

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Authors: Karim Mohamed Fawzy Ghuiba, Alaa Aldeen Abd Al Hakeem Balbaa, Shams Elbaz

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Objectives: To compare between the effects continuous and pulsed ultrasound on pain and function in patient with knee osteoarthritis. Design: Randomized-Single blinded Study. Participants: 6 patients with knee osteoarthritis with mean age 53.66±3.61years, Altman Grade II or III. Interventions: Subjects were randomly assigned into two groups; Group A received continuous ultrasound and Group B received pulsed ultrasound. Outcome measures: Effects of pulsed and continuous ultrasound were evaluated by pain threshold assessed by visual analogue scale (VAS) scores and function assessed by the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores. Results: There was no significant decrease in VAS and WOMAC scores in patients treated with pulsed or continuous ultrasound; and there were no significant differences between both groups. Conclusion: there is no difference between the effects of pulsed and continuous ultrasound in pain relief or functional outcome in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, pulsed ultrasound, ultrasound therapy, continuous ultrasound

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Authors: Faezeh Mohammadi, Ebrahim Ebrahimi, Neda Azimi

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Use of ultrasound waves is one of the techniques for increasing the mixing and mass transfer in the microdevices. Ultrasound propagation into liquid medium leads to stimulation of the fluid, creates turbulence and so increases the mixing performance. In this study, CFD modeling of two-phase flow in a pitted micromixer equipped with a piezoelectric with frequency of 1.7 MHz has been studied. CFD modeling of micromixer at different velocity of fluid flow in the absence of ultrasound waves and with ultrasound application has been performed. The hydrodynamic of fluid flow and mixing efficiency for using ultrasound has been compared with the layout of no ultrasound application. The result of CFD modeling shows well agreements with the experimental results. The results showed that the flow pattern inside the micromixer in the absence of ultrasound waves is parallel, while when ultrasound has been applied, it is not parallel. In fact, propagation of ultrasound energy into the fluid flow in the studied micromixer changed the hydrodynamic and the forms of the flow pattern and caused to mixing enhancement. In general, from the CFD modeling results, it can be concluded that the applying ultrasound energy into the liquid medium causes an increase in the turbulences and mixing and consequently, improves the mass transfer rate within the micromixer.

Keywords: CFD modeling, ultrasound, mixing, mass transfer

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: A. Askerov, Y. Teterin, P. Yartcev, S. Novikov

Abstract:

Introduction: Acute pancreatitis (AP) is a socially significant problem for public health and continues to be one of the most common causes of hospitalization of patients with pathology of the gastrointestinal tract. It is characterized by high mortality rates, which reaches 62-65% in infected pancreatic necrosis. Aims & Methods: The study group included 63 patients who underwent transluminal drainage (TLD) fluid collection (FC). All patients were performed transabdominal ultrasound, computer tomography of the abdominal cavity and retroperitoneal organs and endoscopic ultrasound (EUS) of the pancreatobiliary zone. The EUS was used as a final diagnostic method to determine the characteristics of FC. The indications for TLD were: the distance between the wall of the hollow organ and the FC was not more than 1 cm, the absence of large vessels on the puncture trajectory (more than 3 mm), and the size of the formation was more than 5 cm. When a homogeneous cavity with clear, even contours was detected, a plastic stent with rounded ends (“double pig tail”) was installed. The indication for the installation of a fully covered self-expanding stent was the detection of nonhomogeneous anechoic FC with hyperechoic inclusions and cloudy purulent contents. In patients with necrotic forms after drainage of the purulent cavity, a cystonasal drainage with a diameter of 7Fr was installed in its lumen under X-ray control to sanitize the cavity with a 0.05% aqueous solution of chlorhexidine. Endoscopic necrectomy was performed every 24-48 hours. The plastic stent was removed in 6 month, the fully covered self-expanding stent - in 1 month after the patient was discharged from the hospital. Results: Endoscopic TLD was performed in 63 patients. The FC corresponding to interstitial edematous pancreatitis was detected in 39 (62%) patients who underwent TLD with the installation of a plastic stent with rounded ends. In 24 (38%) patients with necrotic forms of FC, a fully covered self-expanding stent was placed. Communication with the ductal system of the pancreas was found in 5 (7.9%) patients. They underwent pancreaticoduodenal stenting. A complicated postoperative period was noted in 4 (6.3%) cases and was manifested by bleeding from the zone of pancreatogenic destruction. In 2 (3.1%) cases, this required angiography and endovascular embolization a. gastroduodenalis, in 1 (1.6%) case, endoscopic hemostasis was performed by filling the cavity with 4 ml of Hemoblock hemostatic solution. The combination of both methods was used in 1 (1.6%) patient. There was no evidence of recurrent bleeding in these patients. Lethal outcome occurred in 4 patients (6.3%). In 3 (4.7%) patients, the cause of death was multiple organ failure, in 1 (1.6%) - severe nosocomial pneumonia that developed on the 32nd day after drainage. Conclusions: 1. EUS is not only the most important method for diagnosing FC in AP, but also allows you to determine further tactics for their intraluminal drainage.2. Endoscopic intraluminal drainage of fluid zones in 45.8% of cases is the final minimally invasive method of surgical treatment of large-focal pancreatic necrosis. Disclosure: Nothing to disclose.

Keywords: acute pancreatitis, fluid collection, endoscopy surgery, necrectomy, transluminal drainage

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Authors: Abdulrahman Algaeed

Abstract:

The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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Authors: Jamal Abd Awadallak, Thiago Olinek Reinehr, Eduardo Raizer, Deise Molinari, Edson Antonio, Camila da Silva da Silva

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The hydrolysis of soy oil catalyzed by 1,3-specific enzyme (Lecitase Ultra) in a well-stirred bioreactor was studied. Two forms of applications of the ultrasound were evaluated aiming to increase reaction rates, wherein the use of probe ultrasound associated with the use of surfactant to pre-emulsify the substrate showed the best results. Two different reaction periods were found: the first where the ultrasound has great influence on reaction rates, and the second where ultrasound influence is minimal. Studies on the time of pre-emulsification, surfactant concentration and enzyme concentration showed that the initial rate of hydrolysis depends on the interfacial area between the oil phase and the aqueous phase containing the enzyme.

Keywords: specific enzyme, free fatty acids, Hydrolysis, lecitase ultra, ultrasound

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Authors: Ghaleb A. Husseini, Salma E. Ahmed, Hesham G. Moussa, Ana M. Martins, Mohammad Al-Sayah, Nasser Qaddoumi

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This abstract aims to investigate the use of targeted liposomes as anticancer drug carriers in vitro in combination with ultrasound applied as drug trigger; in order to reduce the side effects caused by traditional chemotherapy. Pegylated liposomes were used to encapsulate calcein and then release this model drug when 20-kHz, 40-kHz, 1-MHz and 3-MHz ultrasound were applied at different acoustic power densities. Fluorescence techniques were then used to measure the percent drug release of calcein from these targeted liposomes. Results showed that as the power density increases, at the four frequencies studied, the release of calcein also increased. Based on these results, we believe that ultrasound can be used to increase the rate and amount of chemotherapeutics release from liposomes.

Keywords: liposomes, calcein release, high frequency ultrasound, low frequency ultrasound, fluorescence techniques

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Authors: Kwazikwenkosi Sikhakhane, Suvendi Rimer, Mpho Gololo, Khmaies Oahada, Adnan Abu-Mahfouz

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Medical ultrasound imaging is a crucial diagnostic technique due to its affordability and non-invasiveness compared to other imaging methods. However, the presence of speckle noise, which is a form of multiplicative noise, poses a significant obstacle to obtaining clear and accurate images in ultrasound imaging. Speckle noise reduces image quality by decreasing contrast, resolution, and signal-to-noise ratio (SNR). This makes it difficult for medical professionals to interpret ultrasound images accurately. To address this issue, various techniques have been developed to reduce speckle noise in ultrasound images, which improves image quality. This paper aims to review some of these techniques, highlighting the advantages and disadvantages of each algorithm and identifying the scenarios in which they work most effectively.

Keywords: image processing, noise, speckle, ultrasound

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Authors: Christakis Damianou, Christos Christofi, Nicos Mylonas

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The aim of the proposed study was to evaluate mechanical mode ultrasound using a flat rectangular (3x10 mm2) MRI compatible transducer operating at 5 MHz for destroying atherosclerotic plaque. The system was tested initially in a Hydroxyapatite-polyalactide (HA/PLA) model. An optimized protocol was decided and then applied in atherosclerotic plaque of a rabbit. The plaque in the rabbit was created using a high cholesterol diet. The atherosclerotic plaque was imaged using MRI. This study shows that the destruction of atherosclerotic plaque is feasible.

Keywords: mri, ultrasound, atherosclerotic, plaque, pulse

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Authors: Rafael A. B. De Medeiros, Zilmar M. P. Barros, Carlos B. O. De Carvalho, Eunice G. Fraga Neta, Maria I. S. Maciel, Patricia M. Azoubel

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The use of the sugar substitution technique (D3S) in mango was studied. It consisted of two stages and the use of ultrasound in one or both stages was evaluated in terms of water loss and solid gain. Higher water loss results were found subjecting the fruit samples to ultrasound in the first stage followed by immersion of the samples in Stevia-based solution with application of ultrasound in the second stage, while higher solids gain were obtained without application of ultrasound in second stage. Samples were evaluated in terms of total carotenoids content and total color difference. Samples submitted to ultrasound in both D3S stages presented higher carotenoid retention compared to samples sonicated only in the first stage. Color of man goes after the D3S process showed notable changes.

Keywords: Mangifera indica L., quality, Stevia rebaudiana, ultrasound

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Authors: Naglaa A. Abd Elkader, Haithem A. Farghali

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The present study carried out on fifteen clinical cases of different species of dogs which admitted to surgical clinic of veterinary medicine with different symptoms (Acute vomiting, hematemesis and anorexia). There was diagnostic march which including plain radiograph and endoscopic examination. Treatment was including surgical interference and endoscopic retrieval followed by medicinal treatment. This study was aimed the detection of different foreign bodies by the most suitable method according to the type of the foreign bodies.

Keywords: stomach, endoscopy, foreign bodies, dogs

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Authors: Fathi Kallel, Saida Khachira, Mohamed Ben Slima, Ahmed Ben Hamida

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Speckle noise is a main characteristic of cardiac ultrasound images, it corresponding to grainy appearance that degrades the image quality. For this reason, the ultrasound images are difficult to use automatically in clinical use, then treatments are required for this type of images. Then a filtering procedure of these images is necessary to eliminate the speckle noise and to improve the quality of ultrasound images which will be then segmented to extract the necessary forms that exist. In this paper, we present the importance of the pre-treatment step for segmentation. This work is applied to cardiac ultrasound images. In a first step, a comparative study of speckle filtering method will be presented and then we use a segmentation algorithm to locate and extract cardiac structures.

Keywords: medical image processing, ultrasound images, Speckle noise, image enhancement, speckle filtering, segmentation, snakes

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Authors: Nabilah Ibrahim, Hafiz Mohd Zaini, Wan Fatin Liyana Mutalib

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Ultrasound equipment or machine is capable to scan in two dimensional (2D) areas. However there are some limitations occur during scanning an object. The problem will occur when scanning process that involving the asymmetric object. In this project, the ultrasound probe holder for asymmetric reflector scanning in 3D image is proposed to make easier for scanning the phantom or object that has asymmetric shape. Initially, the constructed asymmetric phantom that construct will be used in 2D scanning. Next, the asymmetric phantom will be interfaced by the movement of ultrasound probe holder using the Arduino software. After that, the performance of the ultrasound probe holder will be evaluated by using the various asymmetric reflector or phantom in constructing a 3D image

Keywords: ultrasound 3D images, axial and lateral resolution, asymmetric reflector, Arduino software

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Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

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Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

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Authors: Gulcin Yildiz

Abstract:

Drying (dehydration) is the process of removing water from food in order to preserve the food and an alternative to reduce post-harvest loss of fruits. Different pre-treatment methods have been developed for fruit drying, such as ultrasound. If no pre-treatment is done, the fruits will continue to darken after they are dried. However, the effects of ultrasound as pre-treatment on drying of apples has not been well documented. This study was undertaken to investigate the effect of ultrasound as pre-treatment before oven drying of red delicious and golden delicious apples. Red delicious and golden delicious apples were dried in different temperatures. Before performing drying experiments in an oven at 50, 75 and 100 °C, ultrasound as pretreatment was applied in 5, 10, and 15 minutes. Colors of the dried apples were measured with a Minolta Chroma Meter CR-300 (Minolta Camera Co. Ltd., Osaka, Japan) by directly holding the device vertically to the surface of the samples. Content of total phenols was determined spectrophotometrically with the FolinCiocalteau assay, and the antioxidant capacity was evaluated by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. The samples (both red delicious and golden delicious apples) with longer ultrasound treatment produced higher weight loss due to the changes in tissue structure. However less phenolic content and antioxidant capacity were observed for the samples with longer ultrasound pre-treatment. The highest total phenolic content (TPC) was determined in dried apples at 75 °C with 5 minutes pre-treatment ultrasound and the lowest TPC was determined in dried apples at 50 °C with 15 minutes pre-treatment ultrasound which was subjected to the longest ultrasound pre-treatment and drying. The combination of 5 min of ultrasound pre-treatment and 75 °C of oven-drying showed to be the best combination for an energy efficient process. This combination exhibited good antioxidant properties as well. The present study clearly demonstrated that applying ultrasound as pre-treatment for drying of apples is an effective process in terms of quality of dried products, time, and energy.

Keywords: golden delicious apples, red delicious apples, total phenolic content, Ultrasound

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Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

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Authors: Shuge Lei, Haonan Hu, Dasheng Sun, Huabin Zhang, Kehong Yuan, Jian Dai, Yan Tong

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It remains challenging to measure reliability from classification results from different machine learning models. This paper proposes a reliable soup optimization algorithm based on the model weight fusion algorithm Model Soup, aiming to improve reliability by using dual-channel reliability as the objective function to fuse a series of weights in the breast ultrasound classification models. Experimental results on breast ultrasound clinical datasets demonstrate that reliable soup significantly enhances the reliability of breast ultrasound image classification tasks. The effectiveness of the proposed approach was verified via multicenter trials. The results from five centers indicate that the reliability optimization algorithm can enhance the reliability of the breast ultrasound image classification model and exhibit low multicenter correlation.

Keywords: breast ultrasound image classification, feature attribution, reliability assessment, reliability optimization

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Authors: Shady S. Hassan, Brijesh K. Tiwari, Gwilym A. Williams, Amit K. Jaiswal

Abstract:

EU is known as the destination with the highest rate of the coffee consumption per capita in the world. Spent coffee grounds (SCG) are the main by-product of coffee brewing. SCG is either disposed as a solid waste or employed as compost, although the polysaccharides from such lignocellulosic biomass might be used as feedstock for fermentation processes. However, SCG as a lignocellulose have a complex structure and pretreatment process is required to facilitate an efficient enzymatic hydrolysis of carbohydrates. However, commonly used pretreatment methods, such as chemical, physico-chemical and biological techniques are still insufficient to meet optimal industrial production requirements in a sustainable way. Ultrasound is a promising candidate as a sustainable green pretreatment solution for lignocellulosic biomass utilization in a large scale biorefinery. Thus, ultrasound pretreatment of SCG without adding harsh chemicals investigated as a green technology to enhance enzyme hydrolysis. In the present work, ultrasound pretreatment experiments were conducted on SCG using different ultrasound frequencies (25, 35, 45, 130, and 950 kHz) for 60 min. Regardless of ultrasound power, low ultrasound frequency is more effective than high ultrasound frequency in pretreatment of biomass. Ultrasound pretreatment of SCG (at ultrasound frequency of 25 kHz for 60 min) followed by enzymatic hydrolysis resulted in total reducing sugars of 56.1 ± 2.8 mg/g of biomass. Fourier transform Infrared Spectroscopy (FTIR) was employed to investigate changes in functional groups of biomass after pretreatment, while high-performance liquid chromatography (HPLC) was employed for determination of glucose. Pretreatment of lignocellulose by low frequency ultrasound in water only was found to be an effective green approach for SCG to improve saccharification and glucose yield compared to native biomass. Pretreatment conditions will be optimized, and the enzyme hydrolysate will be used as media component substitute for the production of ethanol.

Keywords: lignocellulose, ultrasound, pretreatment, spent coffee grounds

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

Abstract:

Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Nais Pinta Adetya, H. Hadiyanto

Abstract:

Microalgae has a potential to be utilized as food and natural colorant. The microalgae components consists of three main parts, these are lipid, protein, and carbohydrate. Crucial step in producing lipid and protein from microalgae is extraction. Microalgae has high water level (70-90%), it causes drying process of biomass needs much more energy and also has potential to distract lipid and protein from microalgae. Extraction of lipid from wet biomass is able to take place efficiently with cell disruption of microalgae by osmotic shock method. In this study, osmotic shock method was going to be integrated with ultrasound to maximalize the extraction yield of lipid and protein from wet biomass Spirulina sp. with osmotic shock method assisted ultrasound. This study consisted of two steps, these were osmotic shock process toward wet biomass and ultrasound extraction assisted. NaCl solution was used as osmotic agent, with the variation of concentrations were 10%, 20%, and 30%. Extraction was conducted in 40°C for 20 minutes with frequency of ultrasound wave was 40kHz. The optimal yield of protein (2.7%) and (lipid 38%) were achieved at 20% osmotic agent concentration.

Keywords: extraction, lipid, osmotic shock, protein, ultrasound

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Authors: Hanan Moawad, Naglaa M. Abd EL-Rahman

Abstract:

Erwinia carotovora var. carotovora is the main cause of soft rot in potatoes. Hyphaene thebaica was studied for biocontrol of E. carotovora which inhibited growth of E. carotovora on solid medium, a comparative study of classical and ultrasound-assisted extractions of Hyphaene thebaica fruit. The use of ultrasound decreased significant the total time of treatment and increase the total amount of crude extract. The crude extract was subjected to determine the in vitro, by a bioassay technique revealed that the treatment of paper disks with ultrasound extraction of Hyphaene thebaica reduced the growth of pathogen and produced inhibition zones up to 38mm in diameter. The antioxidant activity of ultrasound-ethanolic extract of Doum fruits (Hyphaene thebaica) was determined. Data obtained showed that the extract contains the secondary metabolites such as Tannins, Saponin, Flavonoids, Phenols, Steroids, Terpenoids, Glycosides and Alkaloids.

Keywords: ultrasound, classical extract, biological control, Erwinia carotovora, Hyphaene thebaica

Procedia PDF Downloads 492

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

Abstract:

Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal

Abstract:

Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.

Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil

Procedia PDF Downloads 347

Authors: Ravindra B. Patil, P. Krishnamoorthy, Shriram Sethuraman

Abstract:

This work proposes a novel Gaussian Mixture Model (GMM) based approach for accurate tracking of the arterial wall and subsequent computation of the distension waveform using Radio Frequency (RF) ultrasound signal. The approach was evaluated on ultrasound RF data acquired using a prototype ultrasound system from an artery mimicking flow phantom. The effectiveness of the proposed algorithm is demonstrated by comparing with existing wall tracking algorithms. The experimental results show that the proposed method provides 20% reduction in the error margin compared to the existing approaches in tracking the arterial wall movement. This approach coupled with ultrasound system can be used to estimate the arterial compliance parameters required for screening of cardiovascular related disorders.

Keywords: distension waveform, Gaussian Mixture Model, RF ultrasound, arterial wall movement

Procedia PDF Downloads 473

Authors: Hayder Raad Hafuze, Munqith Saleem Dawood, Jamal Abdul Jabbar

Abstract:

The effect of using both ultrasounds with laser in medical imaging of the biological tissue has been studied in this paper. Different wave lengths of incident laser light (405 nm, 532 nm, 650 nm, 808 nm and 1064 nm) were used with different ultrasound frequencies (1MHz and 3.3MHz). The results showed that, the change of acoustic intensity enhance the laser penetration of the tissue for different thickness. The existence of the ideal Raman-Nath diffraction pattern were investigated in terms of phase delay and incident angle.

Keywords: tissue, laser, ultrasound, effect, imaging

Procedia PDF Downloads 392