Background and Aims:Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations.Subjects and Methods:Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study. Patients were divided into two groups with regard to technique of epidural catheter insertion; ultrasound group (done ultrasound screening to determine the needle insertion point, angle of insertion, and depth of epidural space) and manual palpation group (used the traditional manual palpation technique). Number of puncture attempts, number of puncture levels, and number of needle redirection attempts were reported. Time of catheter insertion and complications were also reported in both groups.Results:Ultrasound group showed lower number of puncture attempts (1 [1, 1.25] vs. 1.5 [1, 2.75], P = 0.008), puncture levels (1 (1, 1) vs. 1 [1, 2], P = 0.002), and needle redirection attempts (0 [0, 2.25] vs. 3.5 [2, 5], P = 0.00). Ultrasound-guided group showed shorter time for catheter insertion compared to manual palpation group (140 ± 24 s vs. 213 ± 71 s P = 0.00).Conclusion:Preprocedural ultrasound imaging increased the incidence of first pass success in thoracic epidural catheter insertion and reduced the catheter insertion time compared to manual palpation method.

The main idea to correct sight disorders using lasers is to modify corneal curvature by applying laser to specific layers of the cornea. Intrastromal photorefractive keratectomy (ISPRK) is a laser technique used to correct sight disorders by evaporating corneal tissue from the stroma. Evaporating such tissue produces small cavities that may coincide to form a larger cavity. The composed big cavity is assumed to collapse to deform the overall curvature of the cornea. In this work, we provide finite element models to simulate the ISRPK procedure using a three-dimensional (3D) model of the cornea with typical parameters. The model outcome was compared with an earlier 2D model used for the same purpose, so as to determine its accuracy. In addition, a 3D finite element simulation of the procedure was made for a virtual astigmatic case to visualize the corneal curvature change. The results of this work show that this finite element models provide an accurate simulation of the corneal deformation expected after performing the procedure.

No abstract

Breast cancer comprises about 29% of all types of cancer in women worldwide. This type of cancer caused what is equivalent to 14% of all female deaths due to cancer. Nowadays, tissue biopsy is routinely performed, although about 80% of the performed biopsies yield a benign result. Biopsy is considered the most costly part of breast cancer examination and invasive in nature. To reduce unnecessary biopsy procedures and achieve early diagnosis, ultrasound elastography was proposed.