Citations

Arterial elasticity is an independent predictor of cardiovascular disease and mortality. Measurment of waves in thin shells can be used to estimate the circumferential and the longitudinal elastic moduli. Latex tubes and excised pig arteries were used as isotropic and anisotropic models. Waves were generated using focused ultrasound (1 ms, 3 MHz) in different locations of the wall. The modes of propagation of the waves were detected with a laser vibrometer or an ultrasound pulse echo tool while the excitation was moved known distances. Bending waves were predominant when exciting in the center of the wall, while a combination of torsion and bending waves resulted from exciting off center. Wave speeds of 15 m/s and 5 m/s respectively, were measured for the bending waves. Using the Moens-Korteweg equation, values of 1.1 and 0.350 MPa were found for the longitudinal elastic modulus in the tube and artery respectively. Generation of different modes in the tubes and arteries is possible using focused ultrasound. Elastic components of the tubes and vessels in the longitudinal and the circumferential direction can be estimated from the speed of propagation and the frequency of the bending and the torsional waves.

Vibro-acoustography (VA) is an imaging modality that uses the radiation force of ultrasound to vibrate tissue at a low frequency and records the resulting acoustic field to produce an image that is represents object characteristics at both ultrasound as well as low (audio) frequencies. Currently, B-mode ultrasound is used for prostate imaging. This imaging method has some limitations, including the speckle noise, which limit its ability in detection of lesions and calcifications. The purpose of this study is to explore the potentials of VA for prostate imaging. VA, B-mode ultrasound, and radiography were performed on 12 excised human prostate samples and the resulting images were compared. VA system parameters were, center frequency 3 MHz, Δf=50 kHz, image area 5×5 cm, pixel size 0.2×0.2 mm. Images evaluated in terms of visibility of anatomical and pathological structures and contrast. Results showed that prostate anatomical structures, mass lesions, and calcifications were visible in the VA images taken at different depths, and VA image quality was superior to B-mode. VA images exhibited significant contrast between the central and peripheral zones with enhanced borders. It is concluded that, with further development, VA may become suitable modality for in prostate imaging.

High-resolution ultrasound imaging systems for inspection of defects and flaws in materials are of great demand in many industries. Among these systems, Vibro-acoustography (VA) has shown excellent capabilities as a non-contact method for non-destructive high-resolution imaging applications. This method consists of mixing two confocal ultrasound beams, slightly shifted in frequency, to produce an acoustic emission field at the difference frequency of the primary incident ultrasound beams. In addition to the difference frequency signal, there exists another signal at the sum frequency, formed in the intersection region of the two primary beams. The goal of this study is to investigate the formation of high-resolution images using the sum frequency of ultrasound waves in VA while concurrently forming the conventional difference-frequency VA image, thereby increasing the amount of information acquired during a single scan. A theoretical model describing the sum frequency wave propagation, including beam forming and image formation in the confocal configuration is developed and verified experimentally. Moreover, sample experiments are performed on a flawed fiber-reinforced ceramic composite plate. Images at both the difference and sum frequencies are compared and discussed. Results show that the sum frequency image produces a high-resolution C-scan of the plate by which the flaws and structural details of the plate can be detected.

Background: Studies have failed to show a survival difference between intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT). Comparative cost analyses are limited and fail to control for differences in patient disease severity and comorbid conditions. The authors retrospectively estimated clinical and economic outcomes associated with CRRT and IHD among critically ill patients experiencing acute renal failure (ARF) in 2 tertiary care hospitals in Rochester, Minnesota, between January 1, 2000, and December 12, 2001. Methods: 161 critically ill patients requiring dialysis for ARF were analyzed. Patient demo-graphics, comorbid conditions, ARF etiology, mode of renal replacement therapy (RRT), renal recovery, and survival were abstracted from medical chart. APACHE II scores at dialysis initiation were calculated. Administrative data tracked length of stay (LOS) and direct medical costs from initiation of RRT to death or intensive care unit (ICU) and hospital discharge. Multivariate modeling was used to adjust outcomes for baseline differences. Results: 84 (52%) of the patients received CRRT and 77 (48%) received IHD. CRRT-treated patients were younger (58 vs 65 years), less likely male (58% vs 77%), had higher APACHE II scores (32 vs 27) with a higher incidence of sepsis (46% vs 30%) and respiratory disease (56% vs 39%), and were less likely to have chronic renal insufficiency (32% vs 49%). With adjustment for differences in baseline patient characteristics, the RRT method did not affect the likelihood of renal recovery, in-hospital survival, or survival during follow-up. Mean adjusted ICU LOS was 9.5 days shorter for IHD-treated than CRRT-treated patients ( P < .001), and the adjusted mean difference in hospital and total costs associated with ICU stay was $56 564 and $60 827, in favor of IHD ( P < .001). Mean adjusted total costs through hospital discharge were $93 611 and $140 733 among IHD-treated and CRRT-treated patients, respectively ( P < .001). Conclusions: This observational study suggests that costs may significantly differ by mode of RRT despite similar severity-adjusted patient outcomes. Future prospective comparisons of renal replacement modalities will need to include both clinical and economic outcomes.

Purpose This study was undertaken to examine five possible prognostic factors in patients with recurrent stage II and III colon cancer: time from randomization on an adjuvant therapy clinical trial to tumor recurrence (< 1 year, 1 to 2 years, 2 to 3 years, 3 to 4 years, > 4 years), initial stage (II v III), initial adjuvant treatment (fluorouracil [FU]-based v surgery alone), the era in which the patient entered an adjuvant therapy clinical trial (1978 to 1985, 1986 to 1992, 1993 to 1999), and patient age at recurrence. Methods The Adjuvant Colon Cancer End Points (ACCENT) data set was analyzed using univariate and multivariate Cox proportional hazards models, stratified by study. Results 5,722 (32.9%) of 17,381 patients experienced recurrence. Median survival following recurrence was 13.3 months. Time from randomization to recurrence was highly prognostic of survival following recurrence (P < .0001). Longer survival following recurrence was seen in patients with initial stage II versus III disease (P < .0001; 14.3% 6-year overall survival after recurrence in initial stage II patients), patients entered more recently onto trials (P < .0001), and patients initially treated with surgery alone versus FU adjuvant treatment (P = .0005). All relationships were maintained in multivariate models. Conclusion Time from initial treatment to recurrence and initial stage are important prognostic factors in patients with recurrent colon cancer. Survival following recurrence increased modestly from 1978 to 1999. Patients who had a recurrence following adjuvant therapy had poorer prognosis than those who progressed after surgery alone. These prognostic factors may be useful for clinical trial design and treatment decisions in patients with recurrent colon cancer.