PURPOSE: To demonstrate the feasibility of irreversible electroporation (IRE) for treating biliary metal stent occlusion in an experimental liver model. METHODS AND MATERIALS: IRE was performed using an expandable tubular IRE-catheter placed in nitinol stents in the porcine liver. A 3-electrode IRE-catheter was connected to an IRE-generator and one hundred 100μs pulses of constant voltage (300, 650, 1000, and 1300 V) were applied. Stent occlusion was simulated by insertion of liver tissue both ex vivo (n = 94) and in vivo in 3 pigs (n = 14). Three scenarios of the relationship between the stent, electrodes, and inserted tissue (double contact, single contact, and stent mesh contact) were studied. Electric current was measured and resistance and power calculated. Pigs were sacrificed 72 h post-procedure. Harvested samples (14 experimental, 13 controls) underwent histopathological analysis. RESULTS: IRE application was feasible at 300 and 650 V for the single and double contact setup in both ex vivo and in vivo studies. Significant differences in calculated resistance between double contact and single contact settings were observed (ex-vivo p ˂ 0.0001, in-vivo p = 0.02; Mann-Whitney). A mild temperature increase of the surrounding liver parenchyma was noted with increasing voltage (0.9-5.9 °C for 300-1000 V). The extent of necrotic changes in experimental samples in vivo correlated with the measured electric current (r2 = 0.39, p = 0.01). No complications were observed during or after the in-vivo procedure. CONCLUSION: Endoluminal IRE using an expandable tubular catheter in simulated metal stent occlusion is feasible. The relationship of active catheter electrodes to stent ingrowth tissue can be estimated based on resistance values.
- MeSH
- Ablation Techniques * MeSH
- Electroporation * MeSH
- Catheters MeSH
- Swine MeSH
- Stents MeSH
- Models, Theoretical MeSH
- Animals MeSH
- Check Tag
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Autoři seznamují se základními principy posuzování zdravotního stavu žadatelů pro účely náhradní rodinné péče. Náhradní rodinná péče je u nás možná formou osvojení, pěstounské péče, svěřením dítěte do péče jiné fyzické osoby než rodiče nebo svěřením do osobní poručenské péče. Zprostředkování a v rámci toho posuzování zdravotního stavu žadatelů upravují právní předpisy v případech osvojení a pěstounskou péče. Výsledek posouzení zdravotního stavu žadatelů o náhradní rodinnou péči je jedním z rozhodujících podkladů pro zařazení, či nezařazení osob do evidence žadatelů o náhradní rodinnou péči. Zájem o náhradní rodinnou péči se zvyšuje, a proto autoři považují za důležité sjednotit přístup praktických a posudkových lékařů k posuzování žadatelů.
The authors present basic principles of assessing the health status of surrogate family care applicants. In the Czech Republic, surrogate family care can mean either adoption or a foster care. The result of the assessment the health status of surrogate family care applicants is one of the decisive enlistment or non-enlistment criteria. There has been an increased interest in surrogate family care therefore the authors consider it important that the approach of GPs and assessment doctors be unified and consistent when assessing applicants.
- Keywords
- sociálně-právní ochrana dětí,
- MeSH
- Adult MeSH
- Humans MeSH
- Child Care manpower legislation & jurisprudence MeSH
- Foster Home Care standards organization & administration legislation & jurisprudence MeSH
- Work Capacity Evaluation MeSH
- Parenting MeSH
- Health Status MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
