Marking multi-channel silicon-substrate electrode recording sites using radiofrequency lesions

Silicon-substrate multi-channel electrodes (multiprobes) have proven useful in a variety of electrophysiological tasks. When using multiprobes it is often useful to identify the site of each channel, e.g., when recording single-unit activity from a heterogeneous structure. Lesion marking of electrode sites has been used for many years. Electrolytic, or direct current (DC) lesions, have been used successfully to mark multiprobe sites in rat hippocampus [Townsend G, Peloquin P, Kloosterman F, Hetke JF, Leung LS. Recording and marking with silicon multichannel electrodes. Brain Res Brain Res Protoc 2002;9:122–9]. The present method used radio-frequency (rf) lesions to distinctly mark each of the 16 recording sites of 16-channel linear array multiprobes, in chinchilla inferior colliculus. A commercial radio-frequency lesioner was used as the current source, in conjunction with custom connectors adapted to the multiprobe configuration. In vitro bench testing was used to establish current–voltage–time parameters, as well as to check multiprobe integrity and radio-frequency performance. In in vivo application, visualization of individual-channel multiprobe recording sites was clear in 21 out of 33 sets of collicular serial-sections (i.e., probe tracks) obtained from acute experimental subjects, i.e., maximum post-lesion survival time of 2 h. Advantages of the rf method include well-documented methods of in vitro calibration as well as low impact on probe integrity. The rf method of marking individual-channel sites should be useful in a variety of applications.     

肺癌多弹头射频术后并发症的观察与护理对策

多弹头射频术是目前不用手术就能杀灭肿瘤的一种安全可靠的方法 ,但术后可能会出现各种并发症。探讨射频围手术期护理 ,是降低术后并发症的关键。本文通过对 1 36例肺癌射频术并发症的观察与护理 ,强调重视术前心理护理、术后出血观察的护理及术后出院康复指导与护理 ,对减少术后并发症 ,促进病人早日康复具有重要临床意义     

Use of bone wax during laparoscopic renal ablative procedures: optimizing port utilization and reducing tract-site exposure.

PURPOSE: We describe the use of a hemostatic wax sealant during laparoscopic renal ablative procedures to allow airtight transabdominal access of the treatment probe through a standard 5-mm port. METHODS: Following Tru-cut biopsy of the renal mass, Bone Wax was used to occlude the external opening of an established 5-mm laparoscopic port. The cryotherapy or radiofrequency treatment probe was then passed through the waxy material and inserted appropriately into the renal lesion while pneumoperitoneal pressure was maintained. RESULTS: In all cases, the Bone Wax provided a sufficient airtight seal to allow use of the 5-mm port during ablative therapy of renal masses. CONCLUSIONS: Use of Bone Wax during laparoscopic renal ablative surgery allows the use of an established 5-mm port, thus obviating a separate skin incision and reducing the tract-site exposure to the needle probe.     

射频消融治疗心律失常的疗效观察

目的 探讨射频消融在治疗心律失常中的作用。方法 对心律失常患者中AVNRT 102例、AVRT 118例、AT 6例、IVT 8例均行射频消融治疗。结果 234例患者消融成功230例(占98．3％)，失败4例(占1．71％)。结论 射频消融治疗心律失常创伤小，成功率高，复发率低。     

不同手术方法治疗大隐静脉曲张的临床对比分析

目的:对比研究使用三种不同方法治疗大隐静脉曲张的疗效。方法:对近5年来收治的大隐静脉曲张患者180例，分别采用新型微创剥脱器，传统金属剥脱器，血管腔内激光或射频治疗,每组60例。比较3组手术时间、术中出血量、术后出院时间、住院费用、并发症的发生率等指标。结果:新型微创剥脱器组比传统金属剥脱器组的手术时间、术中出血量均显著降低(P＜0.01)，术后住院时间、住院费用无显著性差异；与血管腔内激光或射频治疗组比较，新型微创剥脱器组手术时间、住院费用显著降低(P＜0.01)，术中出血量较激光或射频组有所增加，术后住院时间无显著性差异；3组并发症的发生率差异无统计学意义。结论:使用新型微创塑料剥脱器临床综合疗效优于使用传统金属剥脱器并可与血管腔内激光或射频治疗相媲美。     

Radiofrequency ablation as a treatment for hilar cholangiocarcinoma

AIM： To explore the role of radio-frequency ablation （RFA） as a treatment for hilar cholangiocarcinoma.
METHODS： Eleven patients with obstructive cholestasis underwent Computed Tomography （CT） examination, occupying lesions were observed in the hepatic hilar region in each patient. All lesions were confirmed as cholangioadenocarcinoma by biopsy and were classified as type Ⅲ or Ⅳ by percutaneous transhepatic cholangiography. Patients were treated with multiple electrodes RFA combined with other adjuvant therapy. The survival rate, change of CT attenuation coefficient of the tumor and tumor size were studied in these patients after RFA.
RESULTS： In a follow-up CT scan one month after RFA, a size reduction of about 30% was observed in six masses, and two masses were reduced by about 20% in size, three of the eleven masses remained unchanged. In a follow-up CT scan 6 mo after RFA, all the masses were reduced in size （overall 35%）, in which the most significant size reduction was 60%. The survival follow-up among these eleven cases was 18 mo in average. Ongoing follow-up showed that the longest survival case was 30 mo and the shortest case was 10 mo.
CONCLUSION： RFA is a microinvasive and effective treatment for hilar cholangiocarcinoma.     

Incidence of oesophageal wall injury post-pulmonary vein antrum isolation for treatment of patients with atrial fibrillation.

AIMS: Oesophageal injury has been reported with delivery of radio-frequency lesions at the left atrium posterior wall in catheter ablation procedures for atrial fibrillation (AF). In this observational study we prospectively assessed endoscopical oesophageal wall changes after pulmonary vein antrum isolation (PVAI) in patients presenting for treatment of AF. METHODS AND RESULTS: Twenty eight patients (18 men; mean age 55 +/- 11 years) were ablated using either a cooled-tip or an 8 mm tip ablation catheter. Endoscopy of the oesophagus was performed 24 h after PVAI. If oesophageal wall changes were detected post ablation, a proton-pump inhibitor (PPI) was started and repeat endoscopy was considered. Within 24 h post ablation oesophageal wall changes were confirmed in 47% of our study patients. Erythema was identified in 29% and necrotic or ulcer-like changes in 18% of patients. None of study patients experienced left atrial-oesophageal fistula. A significant correlation between Reflux-like symptoms and oesophageal wall changes was demonstrated. Complete recovery of oesophageal lesions was shown in all study patients 2-4 weeks post ablation. CONCLUSION: A significant number of patients experienced oesophageal wall injury post PVAI. Initiating PPIs in this group of patients might facilitate recovery of oesophageal wall injuries caused by radio-frequency energy delivery.     

Hepatocellular carcinoma in viral hepatitis: Improving standard therapy

The prognosis of hepatocellular carcinoma (HCC) patients depends not only on tumour stage but also on the background liver function reservoir. For years, surgical resection has been considered as the sole potentially curative option, but currently it competes with transplantation and percutaneous ablation. Resection is usually indicated in patients with solitary HCC and preserved liver function. In cases of poor liver function reservoir and/or multiplicity of lesions, liver transplantation is the treatment option of choice. However, liver transplantation is frequently not feasible because of the shortage or absence of a donor or the condition of the recipient. Image-guided local ablation therapies, such as percutaneous ethanol injection and radiofrequency ablation, have been playing important roles because they are potentially curative, less invasive, and easily repeatable. TACE has been widely performed for unresectable HCC. However, complete necrosis of whole lesions is rarely achieved, and TACE should be indicated for advanced HCC that cannot be treated by resection or ablation. Recently, various agents that interfere with VEGFR signalling are being investigated, although their safety and effectiveness have yet to be confirmed. Short-term prognosis of HCC patients has been much improved recently due to advances in early diagnosis and treatment. However, long-term prognosis is as yet far from satisfactory, as indicated by the fact that overall survival at 10 years after apparently curative treatment of HCC is as low as 22–35%. Prevention of recurrence of HCC is one of the most challenging tasks in current hepatology.

• hepatocellular carcinoma (HCC) is one of the most common cancers worldwide.

• the prognosis of HCC patients depends not only on tumour stage but also on the background liver function reservoir.

• the short-term prognosis of HCC patients has been much improved recently by advances in early diagnosis and treatment.

• the choice of optimal treatment for individual patients, especially those at an earlier cancer stage, is sometimes controversial.

• prevention of recurrence of HCC, or tertiary prevention, is one of the most challenging tasks in current hepatology.

对比普通与灌注冷却射频消融电极在Ⅰ型心房扑动消融中的作用

目的　对比普遍与灌注冷却射频消融电极在Ⅰ型心房扑动（CAFL）消融中的作用。方法　60例CAFL患者随机分为两组普通射频消融电极治疗组（CRF）和灌注冷却射频消融电极治疗组（IRF）,分别比较两组取得下腔静脉与三尖瓣环峡部双向阻滞的手术时间、X线照射时间、射频消融放电次数及放电时间、并观察消融时电能、阻抗以及温度的改变。结果　IRF组的手术时间、X线照射时间、射频消融时间均较CRF组短（P<0.01）,放电次数也少（P<0.05）,IRF组消融过程中阻抗变化小、电能稳定,温度差异不明显,而CRF组则相反,且有19例出现碳化现象,两组痛感差异无显著性,均无心包填塞、栓塞等并发症。结论　灌注冷却射频消融电极在CAFL消融中优越于普通射频消融电极。     

低温等离子射频治疗阻塞性睡眠呼吸暂停低通气综合征60例

目的探讨低温等离子射频减容(RFA)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床方法和疗效。方法采用ENTec-CobatorTM手术系统治疗仪和一次性Reflex45、Reflex55刀头,对60例OSAHS患者肥厚的下鼻甲、软腭、悬雍垂、咽侧索及舌根等进行黏膜下打孔减容手术(RFA)。术中根据患者的阻塞部位不同而采取不同的手术方法,变应性鼻炎患者并行抗过敏治疗。手术均在局麻下进行。结果所有患者术中、术后无明显并发症发生。手术后6个月、12个月呼吸暂停低通气指数(AHI)最低血氧饱和度(LSaO2)指标均明显改善(P<0.01),手术后软腭、舌根部体积较术前明显缩小,咽腔扩大,症状明显减轻或消失,呼吸暂停次数明显减少,白天嗜睡消失或基本消失,精力充沛。按照OSAHS诊断依据和疗效评定标准,6个月后治愈18例,显效28例,有效10例,无效4例,总有效率为93.33%;12个月后治愈15例,显效25例,有效13例,无效7例,总有效率为88.33%;轻度较中重度有效率高(分别为100%,67.3%)。结论低温等离子射频减容(RFA)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)简便、省时、无并发症,患者易接受且可重复治疗,临床疗效确切,值得临床推广,但其远期疗效尚有待观察和探讨。