ABSTRACT
Focal spot precise localization highly contributes to the accuracy and safety of High Intensity Focused Ultrasound (HIFU) therapies, and it is usually performed by means of Magnetic Resonance-Acoustic Radiation Force Impulse imaging (MR-ARFI). Acoustic Radiation Force Impulse imaging using ultrasound (US-ARFI) is herein proposed as a valid alternative to MR-ARFI for an accurate and non-destructive detection of the focal spot position during the pre-treatment phase. To this aim, a system composed of a HIFU transducer for generating the acoustic radiation force and a 2D confocal ultrasound probe for measuring the induced micro-displacement have been used. Then, an algorithm based on the Normalized Cross Correlation was implemented for the creation of a displacement map in which the highest displacement area, corresponding to the focal spot region, is unequivocally visualized. The feasibility of the proposed USARFI method for HIFU focal spot localization was successfully demonstrated in a tissue mimicking phantom model.
Subject(s)
Elasticity Imaging Techniques , High-Intensity Focused Ultrasound Ablation , Algorithms , Phantoms, Imaging , Robotics , UltrasonographyABSTRACT
The Versatile Ion Source (VIS) is a microwave discharge ion source installed at INFN-LNS and here used as test-bench for the production of high intensity low emittance proton beams and for studies on plasma physics. A series of measurements have been carried out with VIS in order to test the source with light ions. In particular a He(+) beam has been characterized in terms of plasma discharge parameters. The experiment has been triggered by the observation of X-radiation emission from the plasma for some configuration of the magnetic field profile. The plasma electron energy distribution function is in fact modified when in some regions of the plasma chamber under-resonance discharge takes place, fulfilling the condition that allows the electromagnetic wave to electrostatic wave conversion. These tests allowed obtaining more than 50 mA of He(+) beams.
ABSTRACT
A microwave discharge ion source (MDIS) operating at the Laboratori Nazionali del Sud of INFN, Catania has been used to compare the traditional electron cyclotron resonance (ECR) heating with an innovative mechanisms of plasma ignition based on the electrostatic Bernstein waves (EBW). EBW are obtained via the inner plasma electromagnetic-to-electrostatic wave conversion and they are absorbed by the plasma at cyclotron resonance harmonics. The heating of plasma by means of EBW at particular frequencies enabled us to reach densities much larger than the cutoff ones. Evidences of EBW generation and absorption together with X-ray emissions due to high energy electrons will be shown. A characterization of the discharge heating process in MDISs as a generalization of the ECR heating mechanism by means of ray tracing will be shown in order to highlight the fundamental physical differences between ECR and EBW heating.
ABSTRACT
The most interesting aspects of parathyroid disease are the increased incidence of primary hyperparathyroidism, which nowadays is diagnosed more and more frequently through the casual discovery of hypercalcaemia, the various diagnostic methodologies used, the ongoing debate as to the function of parathyroidectomy in asymptomatic patients and the new video-assisted surgical techniques which have recently been developed. The authors retrospectively review 31 consecutive cases of primary hyperparathyroidism. The clinical onset was characterised in 26 cases by an osteoarthralgic syndrome associated with renal and biliary pathology. Five cases were asymptomatic. Prior to surgery, all patients underwent both biochemical and instrumental tests. MIB scintigraphy was found to yield the most reliable diagnosis, leading to identification of 83.6% of diseased parathyroids. As regards surgical treatment, 29 cases were treated with a simple parathyroidectomy, 1 with a bilateral inferior parathyroidectomy and 1 with a thyroid lobectomy. Associated thyroid surgery was performed in 8 cases for concomitant thyroid disease: 1 total thyroidectomy, 2 subtotal thyroidectomies and 5 lobectomies. In 3 cases radioimmunoguided surgery was used. There were no cases of mortality, and 9.6% of patients presented specific morbidity characterised by some degree of paraesthesia. As stated by other researchers, the authors argue that MIBI scintigraphy is the most reliable test for the diagnosis of hyperparathyroidism and that surgical treatment is the first choice for symptomatic primary hyperparathyroidism. The surgical strategy depends on the abnormality underlying the hyperparathyroidism: in the event off an adenoma, a bilateral exploration of the neck and removal of the diseased parathyroid are required; in the case of hyperplasia, a subtotal parathyroidectomy is necessary with marking of the residual parathyroid which will simplify any possible reoperation; in the event of carcinoma, a thyroid loboisthmectomy and ipsilateral parathyroidectomy are performed with removal of the fatty tissue of the antero-superior mediastinum and ipsilateral cervical functional lymphadenectomy.
Subject(s)
Hyperparathyroidism/diagnosis , Hyperparathyroidism/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
The authors report a case of Kawasaki disease observed in a 3-years and 6-months-old girl, with pericardial effusion and premature cardiac beats. The pericardial effusion disappeared after gamma-globulin i.v. treatment (2 gr/kg); the premature cardiac beats, although progressively reducing, completely disappeared only after 6 months.
Subject(s)
Cardiac Complexes, Premature/diagnosis , Mucocutaneous Lymph Node Syndrome/diagnosis , Pericardial Effusion/diagnosis , Aspirin/administration & dosage , Cardiac Complexes, Premature/etiology , Cardiac Complexes, Premature/therapy , Child, Preschool , Female , Humans , Immunoglobulins, Intravenous/administration & dosage , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/therapy , Pericardial Effusion/etiology , Pericardial Effusion/therapy , Remission Induction , Time FactorsABSTRACT
The Authors report one case of suppurative thyroiditis in a 21-months-old girl and debate the principal aspects.
Subject(s)
Thyroiditis, Suppurative/diagnosis , Thyroiditis/diagnosis , Acute Disease , Diagnosis, Differential , Female , Humans , Infant , UltrasonographySubject(s)
Arrhythmias, Cardiac/therapy , Age Factors , Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/diagnosis , Cardiac Complexes, Premature/diagnosis , Cardiac Complexes, Premature/therapy , Child , Child, Preschool , Heart Block/congenital , Heart Block/therapy , Humans , Infant , Infant, Newborn , Tachycardia, Paroxysmal/diagnosis , Tachycardia, Paroxysmal/therapy , Tachycardia, Supraventricular/diagnosis , Tachycardia, Supraventricular/therapyABSTRACT
Serum thyroglobulin (Tg) was measured in the cord blood of 635 newborns and serum thyroxine (T4) reverse triiodothyronine (rT3), TSH and T3 were measured in about 200 of them. Cord Tg was detectable in all newborns with a mean +/- SE value (50 +/- 1.3 ng/ml) higher than that found in the serum of adult subjects (n = 144; Tg = 13 +/- 1.1; p less than 0.0001). Cord Tg had a log-normal distribution. A low, but positive correlation was found between cord Tg and cord TSH (n = 242; r = 0.17; p less than 0.05) but not with cord T4 or cord rT3. Gestational age was negatively correlated with cord Tg or cord rT3 (rS = 0.97; p less than 0.01; rS = -0.89; p less than 0.02, respectively) while was positively correlated with cord T4 or cord TSH (rS = 0.85; p less than 0.05; rS = 0.86; p less than 0.01, respectively). Birth weight, maternal diabetes, induction of labor with oxitocin, cesarian section and newborns' illness showed no influence on cord Tg levels when considered alone, but decreased cord Tg levels were found in ill newborns delivered by cesarian section. On the contrary, increased cord Tg levels were present in cord blood of newborns who developed hypoglycemia soon after birth and in small for gestational age newborns. In 24 newborns studied daily for the first 6 days of life, serum Tg was always detectable with mean values not different from those found in the cord blood.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Fetal Blood/analysis , Thyroglobulin/analysis , Thyroid Gland/physiology , Adolescent , Adult , Age Factors , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pregnancy , Thyrotropin/blood , Thyroxine/blood , Triiodothyronine/blood , Triiodothyronine, Reverse/bloodABSTRACT
The value of serum thyroglobulin (Tg) determination in the differential diagnosis of congenital hypothyroidism was assessed by serum Tg measurements in 14 patients with proven congenital hypothyroidism, in 3 subjects with transient perinatal hypothyroidism, in 3 newborns with congenital thyroxine binding globulin (TBG) deficiency and in 34 normal controls. Serum Tg was undetectable in all 6 cases with thyroid agenesis, normal or moderately elevated in the 4 cases with ectopic thyroid, markedly increased in the 4 cases with dyshormonogenic goiter and normal in the 3 cases with transient hypothyroidism and in the 3 with TBG deficiency. The present data indicate that serum Tg measurements may be useful in the differentiation of athyreotic hypothyroidism from other conditions of congenital hypothyroidism.
