Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) u...Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.展开更多
Cold-junction compensation(CJC)and disconnection detection circuit design of various thermocouples(TC)and multi-channel TC interface circuits were designed.The CJC and disconnection detection circuit consists of a CJC...Cold-junction compensation(CJC)and disconnection detection circuit design of various thermocouples(TC)and multi-channel TC interface circuits were designed.The CJC and disconnection detection circuit consists of a CJC semiconductor device,an instrumentation amplifier(IA),two resistors,and a diode for disconnection detection.Based on the basic circuit,a multi-channel interface circuit was also implemented.The CJC was implemented using compensation semiconductor and IA,and disconnection detection was detected by using two resistors and a diode so that IA input voltage became-0.42 V.As a result of the experiment using R-type TC,the error of the designed circuit was reduced from 0.14 mV to 3μV after CJC in the temperature range of 0°C to 1400°C.In addition,it was confirmed that the output voltage of IA was saturated from 88 mV to-14.2 V when TC was disconnected from normal.The output voltage of the designed circuit was 0 V to 10 V in the temperature range of 0°C to 1400°C.The results of the 4-channel interface experiment using R-type TC were almost identical to the CJC and disconnection detection results for each channel.The implemented multi-channel interface has a feature that can be applied equally to E,J,K,T,R,and S-type TCs by changing the terminals of CJC semiconductor devices and adjusting the IA gain.展开更多
文摘Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.
文摘Cold-junction compensation(CJC)and disconnection detection circuit design of various thermocouples(TC)and multi-channel TC interface circuits were designed.The CJC and disconnection detection circuit consists of a CJC semiconductor device,an instrumentation amplifier(IA),two resistors,and a diode for disconnection detection.Based on the basic circuit,a multi-channel interface circuit was also implemented.The CJC was implemented using compensation semiconductor and IA,and disconnection detection was detected by using two resistors and a diode so that IA input voltage became-0.42 V.As a result of the experiment using R-type TC,the error of the designed circuit was reduced from 0.14 mV to 3μV after CJC in the temperature range of 0°C to 1400°C.In addition,it was confirmed that the output voltage of IA was saturated from 88 mV to-14.2 V when TC was disconnected from normal.The output voltage of the designed circuit was 0 V to 10 V in the temperature range of 0°C to 1400°C.The results of the 4-channel interface experiment using R-type TC were almost identical to the CJC and disconnection detection results for each channel.The implemented multi-channel interface has a feature that can be applied equally to E,J,K,T,R,and S-type TCs by changing the terminals of CJC semiconductor devices and adjusting the IA gain.
