AIM: To analyze the results of ultrasound guided percu- taneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess. METHODS: Thirty-six patients (14 females and 22 mal...AIM: To analyze the results of ultrasound guided percu- taneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess. METHODS: Thirty-six patients (14 females and 22 males, with an average age of 54.1 ± 14.1 years) with splenic abscess were treated with ultrasound guided PNA and/or PCD. Patients with splenic abscess < 50 mm in diameter were initially treated by PNA and those with abscess ≥ 50 mm and bilocular abscesses were initially treated by an 8-French catheter drainage. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, and mortality rates were analyzed. RESULTS: Twenty-seven patients had unilocular and 9 bilocular abscess. PNA was performed in 19 patients (52.8%), and 8 of them (42.1%) required PCD because of recurrence of abscess. In 17 patients (47.2%), PCD was performed initially. PCD was performed twice in six patients and three times in two. PNA was defi nitive treatment for 10 and PCD for 21 patients. One patient with PCD was referred for splenectomy, with successful outcome. In all 4 deceased patients, malignancy was the underlying condition. Twenty-one patients (58.3%) underwent 33 surgical interventions on abdomen before treatment. Cultures were positive in 30 patients (83.3%). Gram-negative bacillus predominated (46.7%). There were no complications related to the procedure. CONCLUSION: Percutaneous treatmnet of splenic abscess is an effective alternative to surgery, allowing preservation of the spleen. This treatment is especially indicative for the patients in critical condition postoperatively. We recommend PNA as primary treatment for splenic abscesses < 50 mm, and PCD for those ≥ 50 mm in diameter and for bilocular abscesses.展开更多
In order to analyze the possibility of detecting defects in bend pipe using low-frequency ultrasonic guided wave, the propagation of T(0,1) mode and L(0,2) mode through straight-curved-straight pipe sections was studi...In order to analyze the possibility of detecting defects in bend pipe using low-frequency ultrasonic guided wave, the propagation of T(0,1) mode and L(0,2) mode through straight-curved-straight pipe sections was studied. FE(finite element) models of bend pipe without defects and those with defects were introduced to analyze energy distribution, mode transition and defect detection of ultrasonic guided wave. FE simulation results were validated by experiments of four different bend pipes with circumferential defects in different positions. It is shown that most energy of T(0,1) mode or L(0,2) mode focuses on extrados of bend but little passes through intrados of bend, and T(0,1) mode or L(0,2) mode is converted to other possible non-axisymmetric modes when propagating through the bend and the defect after bend respectively. Furthermore, L(0,2) mode is more sensitive to circumferential notch than T(0,1) mode. The results of this work are beneficial for practical testing of pipes.展开更多
Background P-wave dispersion （PWD）, a measure of heterogeneity of atrial refractoriness, is defined as the difference between the maximum and minimum P-wave duration. In patients with severe aortic stenosis （AS）, ...Background P-wave dispersion （PWD）, a measure of heterogeneity of atrial refractoriness, is defined as the difference between the maximum and minimum P-wave duration. In patients with severe aortic stenosis （AS）, P-wave duration and PWD were shown to be increased, indicating atrial electrical remodeling. However, the effect of transcatheter aortic valve replacement （TAVR） on P-wave morphology has not been established yet. The aim of this study is to assess the short and long-term effects of TAVR with two types of bioprosthetic valves on P-wave duration and PWD in association with left atrial （LA） size. Methods Fifty-two （36 female） eligible patients in sinus rhythm who underwent transfemoral TAVR between June 01, 2012 and July 31, 2014 with either a Medtronic CoreValve （MCV） （n = 32） or an Edwards SAPIEN XT Valve （n = 20） were enrolled. Standard 12-lead electrocardiogram and echocardiographic evaluations were per- formed pre-procedurally, post-TAVR day one and 6 months post-TAVR. P-wave duration and PWD were measured and correlation analyses with echocardiographic variables were performed. Results P-wave duration and PWD were significantly decreased on post-TAVR day one （P 〈 0.05）. They continued to decrease during the six month follow-up period, but were not significantly different from short-term values （P 〉 0.05）. The decrease of LA diameter was found significant at the sixth-months of follow-up （P 〈 0.05）. These changes were independent from the types of bioprosthetic valves implanted （P 〉 0.05）. A positive correlation was detected between minimum P-wave duration and maximum aortic valve gradients at post-TAVR day one （r = 0.297, P = 0.032）. Conclusions P-wave duration and PWD were significantly reduced early after TAVR indicating early reverse atrial electrical remodeling. Moreover, structural reverse remodeling of atrium was detected at the 6-months of follow-up. The effects of two types of bioprosthetic valves on atrial remodeling were similar.展开更多
文摘AIM: To analyze the results of ultrasound guided percu- taneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess. METHODS: Thirty-six patients (14 females and 22 males, with an average age of 54.1 ± 14.1 years) with splenic abscess were treated with ultrasound guided PNA and/or PCD. Patients with splenic abscess < 50 mm in diameter were initially treated by PNA and those with abscess ≥ 50 mm and bilocular abscesses were initially treated by an 8-French catheter drainage. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, and mortality rates were analyzed. RESULTS: Twenty-seven patients had unilocular and 9 bilocular abscess. PNA was performed in 19 patients (52.8%), and 8 of them (42.1%) required PCD because of recurrence of abscess. In 17 patients (47.2%), PCD was performed initially. PCD was performed twice in six patients and three times in two. PNA was defi nitive treatment for 10 and PCD for 21 patients. One patient with PCD was referred for splenectomy, with successful outcome. In all 4 deceased patients, malignancy was the underlying condition. Twenty-one patients (58.3%) underwent 33 surgical interventions on abdomen before treatment. Cultures were positive in 30 patients (83.3%). Gram-negative bacillus predominated (46.7%). There were no complications related to the procedure. CONCLUSION: Percutaneous treatmnet of splenic abscess is an effective alternative to surgery, allowing preservation of the spleen. This treatment is especially indicative for the patients in critical condition postoperatively. We recommend PNA as primary treatment for splenic abscesses < 50 mm, and PCD for those ≥ 50 mm in diameter and for bilocular abscesses.
基金Project(51265044)supported by the National Natural Science Foundation of ChinaProject(2013TT2028)supported by the Science and Technology Project of Hunan Province of ChinaProject(2012QK162)supported by the Science and Technology Project of General Administration of Quality Supervision,Inspection and Quarantine of China
文摘In order to analyze the possibility of detecting defects in bend pipe using low-frequency ultrasonic guided wave, the propagation of T(0,1) mode and L(0,2) mode through straight-curved-straight pipe sections was studied. FE(finite element) models of bend pipe without defects and those with defects were introduced to analyze energy distribution, mode transition and defect detection of ultrasonic guided wave. FE simulation results were validated by experiments of four different bend pipes with circumferential defects in different positions. It is shown that most energy of T(0,1) mode or L(0,2) mode focuses on extrados of bend but little passes through intrados of bend, and T(0,1) mode or L(0,2) mode is converted to other possible non-axisymmetric modes when propagating through the bend and the defect after bend respectively. Furthermore, L(0,2) mode is more sensitive to circumferential notch than T(0,1) mode. The results of this work are beneficial for practical testing of pipes.
文摘Background P-wave dispersion （PWD）, a measure of heterogeneity of atrial refractoriness, is defined as the difference between the maximum and minimum P-wave duration. In patients with severe aortic stenosis （AS）, P-wave duration and PWD were shown to be increased, indicating atrial electrical remodeling. However, the effect of transcatheter aortic valve replacement （TAVR） on P-wave morphology has not been established yet. The aim of this study is to assess the short and long-term effects of TAVR with two types of bioprosthetic valves on P-wave duration and PWD in association with left atrial （LA） size. Methods Fifty-two （36 female） eligible patients in sinus rhythm who underwent transfemoral TAVR between June 01, 2012 and July 31, 2014 with either a Medtronic CoreValve （MCV） （n = 32） or an Edwards SAPIEN XT Valve （n = 20） were enrolled. Standard 12-lead electrocardiogram and echocardiographic evaluations were per- formed pre-procedurally, post-TAVR day one and 6 months post-TAVR. P-wave duration and PWD were measured and correlation analyses with echocardiographic variables were performed. Results P-wave duration and PWD were significantly decreased on post-TAVR day one （P 〈 0.05）. They continued to decrease during the six month follow-up period, but were not significantly different from short-term values （P 〉 0.05）. The decrease of LA diameter was found significant at the sixth-months of follow-up （P 〈 0.05）. These changes were independent from the types of bioprosthetic valves implanted （P 〉 0.05）. A positive correlation was detected between minimum P-wave duration and maximum aortic valve gradients at post-TAVR day one （r = 0.297, P = 0.032）. Conclusions P-wave duration and PWD were significantly reduced early after TAVR indicating early reverse atrial electrical remodeling. Moreover, structural reverse remodeling of atrium was detected at the 6-months of follow-up. The effects of two types of bioprosthetic valves on atrial remodeling were similar.
