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MOTIVATION: This paper proposes a small-sized hologram system for the 3D imaging of lesions in a clinical environment. In a general hologram system, the distance between the beam-generating device and the screen (400 mm) and the size of the screen must be increased proportionally to obtain excellent image quality. However, in a clinical environment, the beam spread distance and screen size must be reduced. This paper proposes a method for reducing the beam divergence distance and screen size for clinical applications. METHODS: To reduce the beam spread distance and screen size, a beam prism with a 45° refractive index is used to reduce the beam spread distance by 1/3. The direction of the bent light must be adjusted such that it can reach the screen accurately. However, because the reflected light may be refracted owing to the material properties of the mirror and cause loss, this problem can be solved by using a full reflection mirror. RESULTS: The beam spread distance of the designed hologram system is 200 mm. The types of lesions obtained from the 3D images of the hologram include the lung, liver, and colon. The image resolution is 300 × 145. CONCLUSION: If the proposed method is used in a clinical environment, doctors can improve their understanding of the patient quickly and efficiently; thereby, shortening the treatment time. The proposed hologram system is expected to be useful in treatment rooms, operating rooms, and educational programs in medical schools.
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Diagnóstico por Imagem , Imageamento Tridimensional , Humanos , Imageamento Tridimensional/métodos , Diagnóstico por Imagem/métodosRESUMO
The light emitting diodes (LEDs) used in surgical fluorescence microscopes have weak power, to induce fluorescence emission. The LED induces fluorescence emission throughout a lesion due to its large beam width; however, the beam irradiation intensity is not uniform within the beam width, resulting in a fluorescence emission induction difference. To overcome this problem, this study proposes an asymmetric irradiation array for supplying power uniformly throughout the beam width of the LED and increasing the intensity of the LED. To increase the irradiation power of the LEDs, a multi-asymmetric irradiation method with a ring-type array structure was used. The LED consisted of eight rings, and the space between the LEDs, the placement position, and the placement angle were analyzed to devise an experimental method using 3D printing technology. To test the irradiation power of the LED, the working distance (WD) between the LED and target was 30 cm. The bias voltage of the LED for irradiating the light source was 5.0 V and the measured power was 4.63 mW. The brightness (lux) was 1153 lx. Consequently, the LED satisfied the fluorescence emission induction conditions. The diameter of the LED-irradiated area was 9.5 cm. Therefore, this LED could be used to observe fluorescent emission-guided lesions. This study maximized the advantages of LEDs with optimal conditions for fluorescence emission by increasing the beam width, irradiation area, and energy efficiency, using a small number of LEDs at the maximum WD. The proposed method, optimized for fluorescence expression-induced surgery, can be made available at clinical sites by mass producing them through semiconductor processes.
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IMPORTANCE: Acute isovolemic anemia occurs when blood loss is replaced with fluid. It is often observed after surgery and negatively influences short-term and long-term outcomes. OBJECTIVE: To evaluate the efficacy and safety of ferric carboxymaltose to treat acute isovolemic anemia following gastrectomy. DESIGN, SETTING, AND PARTICIPANTS: The FAIRY trial was a patient-blinded, randomized, phase 3, placebo-controlled, 12-week study conducted between February 4, 2013, and December 15, 2015, in 7 centers across the Republic of Korea. Patients with a serum hemoglobin level of 7 g/dL to less than 10 g/dL at 5 to 7 days following radical gastrectomy were included. INTERVENTIONS: Patients were randomized to receive a 1-time or 2-time injection of 500 mg or 1000 mg of ferric carboxymaltose according to body weight (ferric carboxymaltose group, 228 patients) or normal saline (placebo group, 226 patients). MAIN OUTCOMES AND MEASURES: The primary end point was the number of hemoglobin responders, defined as a hemoglobin increase of 2 g/dL or more from baseline, a hemoglobin level of 11 g/dL or more, or both at week 12. Secondary end points included changes in hemoglobin, ferritin, and transferrin saturation levels over time, percentage of patients requiring alternative anemia management (oral iron, transfusion, or both), and quality of life at weeks 3 and 12. RESULTS: Among 454 patients who were randomized (mean age, 61.1 years; women, 54.8%; mean baseline hemoglobin level, 9.1 g/dL), 96.3% completed the trial. At week 12, the number of hemoglobin responders was significantly greater for ferric carboxymaltose vs placebo (92.2% [200 patients] for the ferric carboxymaltose group vs 54.0% [115 patients] for the placebo group; absolute difference, 38.2% [95% CI, 33.6%-42.8%]; P = .001). Compared with the placebo group, patients in the ferric carboxymaltose group experienced significantly greater improvements in serum ferritin level (week 12: 233.3 ng/mL for the ferric carboxymaltose group vs 53.4 ng/mL for the placebo group; absolute difference, 179.9 ng/mL [95% CI, 150.2-209.5]; P = .001) and transferrin saturation level (week 12: 35.0% for the ferric carboxymaltose group vs 19.3% for the placebo group; absolute difference, 15.7% [95% CI, 13.1%-18.3%]; P = .001); but there were no significant differences in quality of life. Patients in the ferric carboxymaltose group required less alternative anemia management than patients in the placebo group (1.4% for the ferric carboxymaltose group vs 6.9% for the placebo group; absolute difference, 5.5% [95% CI, 3.3%-7.6%]; P = .006). The total rate of adverse events was higher in the ferric carboxymaltose group (15 patients [6.8%], including injection site reactions [5 patients] and urticaria [5 patients]) than the placebo group (1 patient [0.4%]), but no severe adverse events were reported in either group. CONCLUSION AND RELEVANCE: Among adults with isovolemic anemia following radical gastrectomy, the use of ferric carboxymaltose compared with placebo was more likely to result in improved hemoglobin response at 12 weeks. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01725789.
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Anemia/tratamento farmacológico , Compostos Férricos/uso terapêutico , Gastrectomia/efeitos adversos , Hematínicos/uso terapêutico , Maltose/análogos & derivados , Complicações Pós-Operatórias/tratamento farmacológico , Adulto , Idoso , Anemia/sangue , Anemia/etiologia , Feminino , Compostos Férricos/efeitos adversos , Hematínicos/efeitos adversos , Hemoglobinas/metabolismo , Humanos , Injeções , Masculino , Maltose/efeitos adversos , Maltose/uso terapêutico , Pessoa de Meia-Idade , Método Simples-CegoRESUMO
OBJECTIVES: This study was designed to evaluate the efficacy and the safety of constitutional herbal tea for treating chronic fatigue with no diagnosed cause, which is called Mibyeong in Korea. METHODS: Males and females with ages between 40 and 59 years who had complained of fatigue for 1 month consistently or for 6 months intermittently without a definite cause were recruited. At the same time, a Chalder fatigue scale (CFS) score of 19 was essential for participation in this study. Sixty five subjects completed the entire process, including blood tests and tests with medical devices. Five assessments of health status were accomplished over 8 weeks by using the CFS and the visual analogue scale (VAS). To ensure that the constitutional herbal tea was being safely used, we conducted and analyzed renal function and liver function tests. For the diagnosis of the Sasang constitution, the Sasang Constitutional Analysis Tool (SCAT) was used, and a specialist in Sasang constitutional medicine made the final diagnosis based on the SCAT result. Constitutional herbal tea was served four weeks after the first visit. The subjects took the constitutional herbal tea twice a day for one month. RESULTS: The results are as follows: The CFS and the VAS scores were significantly improved for the subjects in the constitutional herbal tea. No abnormalities were found on the blood tests to evaluate safety after taking the constitutional herbal tea. The improvements in the CFS and the VAS scores due to the constitutional herbal tea had no significant differences according to the Sasang constitution. CONCLUSION: Constitutional herbal tea may be used to reduce fatigue and improve health and has no adverse effect on either the kidney or the liver.