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1.
J Voice ; 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39112119

RESUMO

OBJECTIVES/HYPOTHESIS: We will describe the treatment of patients with subglottic and tracheal stenosis using instruments and techniques utilized by otolaryngologists and interventional pulmonologists (IP), with a focus on IP-favored approaches that may be less familiar to otolaryngologists. We will present two cases that were treated cooperatively by otolaryngology and IP and will highlight the advantages of certain techniques. STUDY DESIGN: Case series METHODS: This is a case-based presentation highlighting procedures done cooperatively by otolaryngology and IP. Instruments and techniques typically utilized by each specialty will be presented, including rigid and flexible bronchoscopy, laser, balloon dilation, medical adjuncts, fiberoptic electrocautery, fiberoptic cryoablation, and fiberoptic argon plasma coagulation. Patient outcomes for these techniques will also be discussed based on the current literature. RESULTS AND CONCLUSIONS: A dichotomy exists in the approaches typically utilized by otolaryngology and IP to address laryngotracheal stenosis. Our IP colleagues utilize techniques via a flexible bronchoscope that are often not considered in a typical otolaryngology practice. We discussed these techniques to educate otolaryngologists who may be looking to contribute to their armamentarium, as current literature suggests promising patient outcomes. Ultimately, a team approach to these often-complex patients can result in excellent outcomes.

2.
Artigo em Inglês | MEDLINE | ID: mdl-39036587

RESUMO

Gastric Antral Vascular Ectasia (GAVE) is an uncommon cause of chronic gastrointestinal bleeding and iron deficiency anemia in the geriatric population. It is often associated with cirrhosis of the liver and is hypothesized to result from synthetic liver dysfunction. Treatment options include argon plasma coagulation, endoscopic band ligation, and radiofrequency ablation. An orthotopic liver transplant may be effective for patients with advanced liver disease. In this case report, we describe a 60-year-old woman with a history of cirrhosis secondary to nonalcohol-related steatohepatitis (NASH) and GAVE syndrome who presented with abdominal pain and melena. She had multiple prior episodes of gastrointestinal bleeding, leading to long-term transfusion dependency. An urgent esophagogastroduodenoscopy revealed the presence of GAVE with active bleeding. The patient was supported with blood transfusions and transferred to a transplant center, where she underwent orthotopic liver transplantation. Following the transplantation, her hemoglobin levels improved and remained stable. She was no longer noted to require any further blood transfusions during outpatient follow-up visits. This case report substantiates the role of synthetic liver dysfunction in the development of GAVE. Also, it suggests that patients with advanced cirrhosis and refractory GAVE may benefit from liver transplantation as a potential treatment option.

3.
Dig Endosc ; 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-39031614

RESUMO

OBJECTIVES: No definitive treatment has been established for refractory gastroesophageal reflux disease (GERD). Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) using argon plasma coagulation are promising methods. However, no study has compared these two. This study compared the efficacy and safety of the two procedures. METHODS: This multicenter, retrospective, observational study included 274 patients; 96 and 178 patients underwent ARMA and ARMS, respectively. The primary outcome was subjective symptom improvement based on GERD questionnaire (GERDQ) scores. The secondary outcomes included changes in the presence of Barrett's esophagus, Los Angeles grade for reflux esophagitis, flap valve grade, and proton pump inhibitor withdrawal rates. RESULTS: The ARMS group had higher baseline GERDQ scores (10.0 vs. 8.0, P < 0.001) and a greater median postprocedure improvement than the ARMA group (4.0 vs. 2.0, P = 0.002), and even after propensity score matching adjustment, these findings remained. ARMS significantly improved reflux esophagitis compared with ARMA, with notable changes in Los Angeles grade (P < 0.001) and flap valve grade scores (P < 0.001). Improvement in Barrett's esophagus was comparable between the groups (P = 0.337), with resolution rates of 94.7% and 77.8% in the ARMS and ARMA groups, respectively. Compared with the ARMA group, the ARMS group experienced higher bleeding rates (P = 0.034), comparable stricture rates (P = 0.957), and more proton pump inhibitor withdrawals (P = 0.008). CONCLUSIONS: Both ARMS and ARMA showed improvements in GERDQ scores, endoscopic esophagitis, flap valve grade, and the presence of Barrett's esophagus after the procedures. However, ARMS demonstrated better outcomes than ARMA in terms of both subjective and objective indicators.

4.
World J Clin Cases ; 12(19): 3866-3872, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38994274

RESUMO

BACKGROUND: The incidence of Barrett's esophagus (BE) in China is lower compared to the Western populations. Hence, studies conducted in the Chinese population has been limited. The current treatment options available for BE treatment includes argon plasma coagulation (APC), radiofrequency ablation and cryoablation, all with varying degrees of success. AIM: To determine the efficacy and safety of HybridAPC in the treatment of BE. METHODS: The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment. These procedures were performed by seven endoscopists from different tertiary hospitals. The duration of the procedure, curative rate, complications and recurrent rate by 1-year follow-up were recorded. RESULTS: Eighty individuals were enrolled for treatment from July 2017 to June 2020, comprising of 39 males and 41 females with a median age of 54 years (range, 30 to 83 years). The technical success rate of HybridAPC was 100% and the overall curative rate was 98.15%. No severe complications occurred during the operation. BE cases were classified as short-segment BE and long-segment BE. Patients with short-segment BE were all considered cured without complications. Thirty-six patients completed the one-year follow-up without recurrence. Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment. The mean duration of the procedure was 10.94 ± 6.52 min. CONCLUSION: Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up, especially in cases of short-segment BE. This technique could be considered as a feasible alternative ablation therapy for BE.

5.
Colorectal Dis ; 26(8): 1515-1534, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38957108

RESUMO

AIM: Solitary rectal ulcer syndrome (SRUS) is a benign and poorly understood disorder with complex management. Typical symptoms include straining during defaecation, rectal bleeding, tenesmus, mucoid secretion, anal pain and a sense of incomplete evacuation. Diagnosis is based on characteristic clinical symptoms and endoscopic/histological findings. Several treatments have been reported in the literature with variable ulcer healing rates. This study aimed to evaluate the efficacy of different treatments for SRUS. MATERIALS AND METHODS: A systematic review and network meta-analysis were performed according to the PRISMA guidelines. Studies in English, French and Spanish languages were included. Papers written in other languages were excluded. Other exclusion criteria were reviews, case reports or clinical series enrolling less than five patients, study duplications, no clinical data of interest and no article available. A systematic literature search was conducted from January 2000 to March 2024 using the following databases: PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus. The biases of the studies were assessed using the Newcastle-Ottawa scale or the Jadad scale when appropriate. Types of treatment and their efficacy for the cure of SRUS were collected and critically assessed. The study's primary outcome was to estimate the rate of patients with ulcer healing. RESULTS: A total of 22 studies with 911 patients (men 361, women 550) diagnosed with SRUS were analysed in the final meta-analysis. The pooled effect estimates of treatment efficacy revealed that surgery showed the highest ulcer healing rate (70.5%; 95% CI 0.57-0.83). Surgery was superior in the cure of ulcers with respect to medical therapies and biofeedback (OR 0.09 and OR 0.14). CONCLUSION: Solitary rectal ulcer syndrome is a challenging clinical entity to manage. Proficient results have been reported with the surgical approach, suggesting its positive role in cases refractory to medical and biofeedback therapy. Further studies in homogeneous populations are required to evaluate the efficacy of surgery in this setting. (PROSPERO registration number CRD42022331422).


Assuntos
Metanálise em Rede , Doenças Retais , Úlcera , Humanos , Úlcera/cirurgia , Doenças Retais/cirurgia , Síndrome , Resultado do Tratamento , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Reto/cirurgia
7.
Respiration ; : 1, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38857571

RESUMO

INTRODUCTION: Patients with central neoplasms and haemoptysis show low survival rates. Symptom control without recurrence 48 h after bronchoscopic interventions may improve the prognosis of these patients. Bronchoscopic argon plasma coagulation (APC) is a useful technique for endobronchial management of haemoptysis in patients with central malignancies. Nevertheless, limited data are available in the literature on its efficacy and safety and the main predictors of success are still unclear. METHODS: An observational, prospective, single-centre cohort study was carried out to assess the efficacy (i.e., immediate bleeding cessation without recurrence during the following 48 h) of bronchoscopic APC in the treatment of patients with haemoptysis caused by endobronchial malignancies and the main predictors of success. RESULTS: A total of 76 patients with median age 75 years (interquartile range: 65-79) were enrolled. 67 (88.2%) patients had bleeding cessation without recurrence 48 h after bronchoscopic APC. A low rate of non-serious adverse events (5.3%) was recorded and a low (7.6%) recurrence rate of haemoptysis at 3.5 months after the procedure was also shown. No clinical, demographic and endoscopic variables related to a successful procedure at 48 h were found. CONCLUSION: This study demonstrates that bronchoscopic APC is an effective procedure in the treatment of patients with haemoptysis caused by endobronchial malignancies, regardless of the clinical characteristics of the patients, the endoscopic and histological features of the neoplasm and the severity of the symptom. Furthermore, it shows a low rate of complications and long-term efficacy in bleeding control.

8.
Cureus ; 16(5): e60916, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38910726

RESUMO

Pulmonary hamartomas (PH) are rare but are the most common benign tumors found in the lungs. They are slow-growing and are usually found incidentally on chest imaging during the sixth decade of life. Approximately 10% of pulmonary hamartomas are endobronchial. Rarely, pulmonary hamartomas can cause a spectrum of pulmonary symptoms depending on their size and location. We present a case of endobronchial hamartoma causing airway obstruction and recurrent post-obstructive pneumonia.

9.
Arch Gynecol Obstet ; 310(1): 561-569, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38683394

RESUMO

PURPOSE: This study aimed to evaluate the clinical efficacy and safety of argon plasma coagulation (APC) therapy and interferon therapy in patients with grade I and II vaginal intraepithelial neoplasia (VaIN). METHODS: A total of 112 patients with VaIN were diagnosed via colposcopy-induced biopsy and classified into the APC group (n = 77) and interferon group (n = 35). Clinical data including age, grade, symptoms, historical or concomitant neoplasia of the lower genital tract, indications for hysterectomy, pregnancy history, cytology, human papillomavirus (HPV) subtype, treatment modalities, and clinical outcomes were analyzed, retrospectively. Complications and clinical outcomes were assessed at 6- and 12-month follow-ups. RESULTS: There was no significant difference in the HPV clearance rate between the APC (53.42%) and interferon (33.33%) groups at 6 months after treatment. However, the 12-month follow-up of the APC group showed a significantly higher HPV clearance rate as compared to the interferon group (87.67% vs. 51.52%, P < 0.05). The APC group exhibited a significantly higher cure rate (79.22% vs. 40.0%) and lower persistence rate (12.99% vs. 37.14%) than the interferon group (P < 0.05). Adverse reaction analysis revealed that the primary reaction in the APC group was vaginal drainage, in contrast to the increased vaginal discharge in the interferon group; though the difference was significant (68.83% vs. 28.57%, P < 0.05), no serious complications were observed. CONCLUSIONS: Treatment with APC is a safe and more effective procedure against VaIN I and II, compared to interferon. APC may serve as a viable alternative to other physiotherapies.


Assuntos
Coagulação com Plasma de Argônio , Carcinoma in Situ , Neoplasias Vaginais , Humanos , Feminino , Estudos Retrospectivos , Neoplasias Vaginais/tratamento farmacológico , Neoplasias Vaginais/virologia , Neoplasias Vaginais/cirurgia , Neoplasias Vaginais/terapia , Adulto , Pessoa de Meia-Idade , Carcinoma in Situ/tratamento farmacológico , Carcinoma in Situ/cirurgia , Carcinoma in Situ/terapia , Carcinoma in Situ/virologia , Carcinoma in Situ/patologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/terapia , Resultado do Tratamento , Interferons/uso terapêutico , Colposcopia , Terapia Combinada
10.
J Clin Med ; 13(5)2024 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-38592137

RESUMO

(1) Background: Large colonic polyps during colonoscopy can be managed by Endoscopic mucosal resection (EMR). To decrease the polyp recurrence rate, thermal ablation methods like argon plasma coagulation (APC) and snare tip soft coagulation (STSC) have been introduced. We performed this network meta-analysis to assess the efficacy and safety of these modalities. (2) Methods: We performed a comprehensive literature review, through 5 January 2024, of databases including Embase, PubMed, SciELO, KCI, Cochrane Central, and Web of Science. Using a random effects model, we conducted a frequentist approach network meta-analysis. The risk ratio (RR) with 95% confidence interval (CI) was calculated. Safety and efficacy endpoints including rates of recurrence, bleeding, perforation, and post polypectomy syndrome were compared. (3) Results: Our search yielded a total of 13 studies with 2686 patients. Compared to placebo, both APC (RR: 0.33 CI: 0.20-0.54, p < 0.01) and STSC (RR: 0.27, CI: 0.21-0.34, p < 0.01) showed decreased recurrence rates. On ranking, STSC showed the lowest recurrence rate, followed by APC and placebo. Regarding individual adverse events, there was no statistically significant difference between either of the thermal ablation methods and placebo. (4) Conclusions: We demonstrated the efficacy and safety of thermal ablation after EMR for decreasing recurrence of adenoma.

11.
Cureus ; 16(2): e53930, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38465074

RESUMO

Gastric antral vascular ectasia (GAVE) is an uncommon cause of upper gastrointestinal (GI) bleeds. Due to the high vascularity of the region, transient bacteremia due to manipulation of the GI tract can very rarely cause the translocation of bacteria. We present a rare case in which endoscopic manipulation to treat GAVE led to native valve infective endocarditis (IE). Our patient had a prior history of GAVE and presented with worsening dizziness and shortness of breath (SOB). After an esophagogastroduodenoscopy (EGD) and subsequent argon plasma coagulation (APC) for active preantral bleeding, the patient was noted to have repeated fevers, a new cardiac murmur, and positive blood cultures for Staphylococcus epidermidis, leading to a diagnosis of native infective endocarditis. With high clinical suspicion and early recognition of a new cardiac murmur, a transesophageal echocardiogram (TEE) was key in identifying vegetation. This case highlights the importance of combining history, a physical exam, and diagnostic lab tests and imaging to identify endocarditis. Management included two months of intravenous (IV) vancomycin and repeat TEE for close monitoring of vegetation improvement.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38425713

RESUMO

Treatment guidelines for esophageal squamous cell carcinoma (ESCC) with concomitant esophageal varices (EVs), which increase the risk of bleeding, are unavailable. A 66-year-old man with a history of total gastrectomy was admitted to the hospital owing to hematemesis. Emergency upper gastrointestinal endoscopy revealed variceal bleeding near the anastomosis between the esophagus and jejunum, and endoscopic clipping stopped the bleeding. Upper gastrointestinal endoscopy following hemostasis revealed four EVs and a two-thirds ESCC circumference. The ESCC depth was suspected to be up to the mucosa. The patient underwent intravariceal endoscopic injection sclerotherapy (EIS) for EVs, followed by paravariceal EIS. However, after these treatments, blood flow in the EVs just below the ESCC remained, and endoscopic resection of the ESCC was judged to be difficult to perform. Therefore, we prioritized EV treatment and performed a second EIS on the ESCC, followed by argon plasma coagulation (APC). APC was expected to not only solidify the EVs but also eliminate the ESCC existing in the mucosa. Finally, EVs and ESCC were treated by EIS and APC. EIS followed by APC may be useful for treating concurrent EVs and intramucosal ESCC in patients with liver cirrhosis when embolization of the EVs is ineffective.

13.
Front Oncol ; 14: 1367173, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38444684

RESUMO

Background: No previous studies have reported on the use of minimally invasive endoscopic therapy for colon cancer in older patients. Case presentation: An 80-year-old man was admitted to our hospital with haematochezia and diagnosed with advanced colon cancer in 2018. Traditional surgical care was rejected by his family. We successfully treated the patient with multiple minimally invasive endoscopic therapies, such as argon plasma coagulation, from 2018 to 2021. Conclusion: Invasive endoscopic therapy is a feasible way to treat colon cancer in older patients.

14.
JGH Open ; 8(3): e13052, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38533237

RESUMO

Background and Aim: Snare resection of nonlifting colonic lesions often requires supplemental techniques. We compared the success rates of neoplasia eradication using hot avulsion and argon plasma coagulation in colonic polyps when complete snare polypectomy had failed. Methods: Polyps that were not completely resectable by snare polypectomy were randomized to argon plasma coagulation or hot avulsion for completion of resection. Argon plasma coagulation was delivered using a forward shooting catheter, using a nontouch technique (flow 1.2 L, 35 watts). Hot avulsion was performed by grasping the neoplastic tissue with hot biopsy forceps and applying traction away from the bowel wall while using EndoCut I or soft coagulation for avulsion. Surveillance colonoscopies were performed at 6, 12, and 18 months. Results: From November 2013 to July 2017, 59 patients were randomized to argon plasma coagulation (28) or hot avulsion (31). The median age was 69 (60-75), with 46% being female. The median residual tissue size was 10 mm (6-12). The residual adenoma rate at 6 months (hot avulsion 6% vs argon plasma coagulation 21% P = 0.09) and 18 months was not different between the groups (6.6% vs 3.6% P = 0.25). One patient in the argon plasma coagulation arm was diagnosed with metastatic cancer of likely colorectal origin despite benign histology in the original polypectomy specimen, supporting the importance of tissue acquisition. Conclusion: Both hot avulsion and argon plasma coagulation are effective and safe modalities to complete resection of non-ensnarable colonic polyps.

15.
Neurogastroenterol Motil ; 36(4): e14768, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38487993

RESUMO

INTRODUCTION: Gastric inlet patches are often incidental, but can also be a treatable cause of laryngo-esophageal symptoms. METHODS: We retrospectively reviewed all patients whose gastric inlet patches were diagnosed following assessment for laryngopharyngeal and swallowing symptoms. Improvement following Argon Plasma Coagulation (APC) was assessed using Minimum Clinically-Important Difference methodology combining voice, throat, and swallowing domains. Correlations between APC response and measures of reflux and mucosal barrier integrity, measured during 24-h pH-impedance manometry, were obtained. Proximal and Distal Mean Nocturnal Baseline Impedance (MNBI) values were separately calculated and the novel variable of Mucosal Impedance Gradient was derived as [((Distal MNBI-Proximal MNBI)/((Distal MNBI + Proximal MMBI)/2)) x 100]. KEY RESULTS: Inlet patches were detected in 57 of 651 patients who had Transnasal Panendoscopy (8.7 ± 2.2%). There were 34 males. Mean age was 58 years. Mean duration of symptoms was 2 years. The commonest symptoms were hoarseness (n = 33), throat symptoms (n = 24), and dysphagia (n = 21), respectively. APC was used to ablate patches in 34 patients. Treatment response was 71% at a mean followup of 5.5 months. MIG > - 25% predicted response to APC, with area under the receiver operating characteristic curve of 0.875 (Sensitivity = 81%; Specificity = 100%; p < 0.0001). CONCLUSIONS: Gastric inlet patches are common and under-recognized. They can cause protracted pharyngo-esophageal symptoms. Patch ablation is an effective treatment for carefully selected patients. Optimal patient selection requires multidisciplinary teamwork. Mucosal Impedance Gradient could further refine patient selection.


Assuntos
Baías , Refluxo Gastroesofágico , Masculino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Mucosa Gástrica/cirurgia , Refluxo Gastroesofágico/diagnóstico , Estômago , Impedância Elétrica , Monitoramento do pH Esofágico/métodos
16.
Materials (Basel) ; 17(2)2024 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-38276445

RESUMO

Flexible organic light-emitting diodes (FOLEDs) have promising potential for future wearable applications because of their exceptional mechanical flexibility. Silver nanowire (Ag NW) networks are the most promising candidates to replace indium tin oxide (ITO), which is limited by its poor bendability. In this study, three different methods including methanol impregnation, argon plasma treatment, and ultraviolet radiation were used to reduce the junction resistance of Ag NWs to optimize the flexible transparent electrodes (FTEs); which were prepared using Ag NWs and poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) (PEDOT: PSS). Then, the optoelectronic properties of the FTEs were further improved by using a co-doped system of silver nanowires and silver nanoparticles (Ag NPs), the structure of which consisted of PET/Ag NWs: Ag NPs/PEDOT: PSS/DMSO. The largest FOM value of 1.42 × 10-2 ohm-1 and a low sheet resistance value of 13.86 ohm/sq were obtained using the optimized FTEs. The prepared FOLED based on the optimized FTEs had a luminous efficiency of 6.04 cd/A and a maximum EQE of 1.92%, and exhibited no observed decline in efficiency when reaching maximum luminance. After 500 bending tests, the luminance still reached 82% of the original value. It is demonstrated that the FTEs prepared via the co-doped system have excellent optoelectronic properties as well as high mechanical stability.

17.
Clin Implant Dent Relat Res ; 26(1): 226-236, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37853303

RESUMO

OBJECTIVE: To assess the peri-implant soft tissue profiles between argon plasma treatment (PT) and non-treated (NPT) healing abutments by comparing clinical and histological parameters 2 months following abutment placement. MATERIALS AND METHODS: Thirty participants were randomly assigned to argon-plasma treatment abutments group (PT) or non-treated abutments (NPT) group. Two months after healing abutment placement, soft peri-implant tissues and abutment were harvested, and histological and clinical parameters including plaque index, bleeding on probing, and keratinized mucosa diameter (KM) were assessed. Specialized stainings (hematoxylin-eosin and picrocirious red) coupled with immunohistochemistry (vimentin, collagen, and CK10) were performed to assess soft tissue inflammation and healing, and the collagen content keratinization. In addition to standard statistical methods, machine learning algorithms were applied for advanced soft tissue profiling between the test and control groups. RESULTS: PT group showed lower plaque accumulation and inflammation grade (6.71% vs. 13.25%, respectively; p-value 0.02), and more advanced connective tissue healing and integration compared to NPT (31.77% vs. 23.3%, respectively; p = 0.009). In the control group, more expressed keratinization was found compared to the PT group, showing significantly higher CK10 (>47.5%). No differences in KM were found between the groups. SIGNIFICANCE: PT seems to be a promising protocol for guided peri-implant soft tissue morphogenesis reducing plaque accumulation and inflammation, and stimulating collagen and soft tissue but without effects on epithelial tissues and keratinization.


Assuntos
Implantes Dentários , Placa Dentária , Gases em Plasma , Dente , Humanos , Argônio , Colágeno , Inflamação , Dente Suporte , Titânio
18.
Intern Med ; 63(7): 957-962, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37612086

RESUMO

A 93-year-old man presented to our hospital with a fever, abdominal pain, and jaundice. Computed tomography revealed bilateral bile duct dilation, cystic lesions with bile duct communication, and intraluminal solid nodules arising from the bile duct wall. The patient was diagnosed with intraductal papillary neoplasm of the bile duct. Surgery was not performed, considering the patient's age. It was impossible to control cholangitis using conventional endoscopic therapy. We therefore created an access route to the bile duct using endoscopic ultrasound-guided choledochoduodenostomy and inserted a lumen-apposed metal stent. Thereafter, we performed argon plasma coagulation of the tumor in the bile duct, which successfully prevented cholangitis recurrence.


Assuntos
Neoplasias dos Ductos Biliares , Colangite , Masculino , Humanos , Idoso de 80 Anos ou mais , Ductos Biliares Intra-Hepáticos/patologia , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Neoplasias dos Ductos Biliares/cirurgia , Neoplasias dos Ductos Biliares/patologia , Coledocostomia , Coagulação com Plasma de Argônio , Ductos Biliares/patologia , Ultrassonografia de Intervenção , Colangite/cirurgia
19.
ACS Appl Mater Interfaces ; 16(1): 1187-1197, 2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38126816

RESUMO

The evolving need for all-weather light detection and ranging (LiDAR) sensors and cameras for autonomous vehicles, remote sensing surveillance, and space exploration has spurred the development of transparent heaters. While LiDAR photon sources have shifted from the visible to the near-infrared (NIR) range, the use of transparent conductive oxides (TCOs) for heaters leads to significant optical losses due to their high plasmonic absorption and reflection in the NIR range. Although different TCO compositions can be employed to preserve transparency and electrical conductivity in this range, the choice of dopants, their concentrations, and the underlying mechanisms remain largely unknown. In this study, we present TCOs specifically designed for NIR applications with a focus on identifying new compositions that strike a balance between NIR transparency and electrical conductivity. We present a 4B-6B transition-metal-doped indium oxide thin-film heater that exhibits impressive NIR transmittance (>90%) surpassing that of commonly used indium tin oxide films. By incorporating effective dopants such as titanium, hafnium, and tungsten, we successfully reduced the resistivity and enhanced the electrical conductivity of indium oxide films. To enhance the practical utility of the film, we implemented post-treatments comprising argon plasma treatment and encapsulation with low-molecular-weight poly(dimethylsiloxane), which resulted in significantly improved performance. The optimized film exhibited a sheet resistance of 520 Ω/sq and excellent optical transmittance at 850 nm (89.1%), 905 nm (89.7%), and 1550 nm (92%). Moreover, we successfully integrated defogging and defrosting capabilities into a commercial LiDAR camera and demonstrated its reliable operation in challenging environments.

20.
J. coloproctol. (Rio J., Impr.) ; 43(4): 292-299, Oct.-Dec. 2023. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1528942

RESUMO

The aim of our study is to evaluate the value of Argon Plasma Coagulation in the treatment of gastrointestinal vascular abnormalities. Patients and methods: This is a descriptive and analytical retrospective study, from January 2009 to September 2020. 198 patients who have benefited from treatment with Argon Plasma Coagulation for vascular anomalies of the digestive tract divided into 2 groups: -Group A: Patients with radial rectitis lesions (n = 107). -Group B: Patients with lesions of digestive angiodysplasia (n = 91). Results: The mean age of our patients was 64.95 ± 9.88 years [43 - 83] in group A, while in group B the mean age was 65.19 ± 14.29 years [40 - 91] with a clear male predominance in 72.5%. The majority of patients in group A were followed for prostate cancer in 33,8%, and 26.3% of patients in group B had chronic renal failure, followed by stomach cancer in 15.8%, and esophageal cancer in 10.5%. Clinical symptomatology was dominated by rectories in 40.2% in group A versus 46.8% in group B. Rectal involvement was dominated in group A in 98.1%, whereas in group B the lesions were mainly located in the stomach in 60.5%. The endoscopic evolution was favorable in all our patients with a clear improvement of rectal lesions and digestive angiodysplasia lesions. The total complication rate in our series was nil. Conclusion: Plasma Argon coagulation is a very effective method in the endoscopic treatment of digestive haemorrhages with good tolerability and a low complication rate. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Angiodisplasia/terapia , Trato Gastrointestinal/lesões , Coagulação com Plasma de Argônio , Estudos Retrospectivos , Endoscopia
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