Cryoneurolysis for Digital Neuralgia in Professional Baseball Players: A Case Series

ObjectiveWe describe a non-surgical approach to refractory digital neuralgia using cryoneurolysis in a series of 3 professional baseball players.BackgroundThumb injuries are common in baseball players and can sometimes be challenging to effectively manage. Depending on the injury, current treatments include anti-inflammatories, immobilization, physical therapy, corticosteroid injections, and/or surgery. A subset of patients, however, fail nonoperative management yet do not have a clear indication for surgery. Cryoneurolysis or cyroanalgesia is an FDA-approved form of neuromodulation, which has been used safely and effectively on a variety of peripheral nerves. The mechanism of action involves percutaneous introduction of a small probe under local anesthetic to nerve tissue using ultrasound guidance. The probe is then cooled to −88°C using nitrous oxide, which results in secondary Wallerian degeneration. Axonal and myelin regeneration occurs completely in 3–6 months.Design/MethodsVisualization of the superficial radial sensory and ulnar digital nerve were obtained under ultrasound. The skin was prepared in sterile fashion. A 22-gauge 1-½ inch needle was then advanced with ultrasound guidance, and local anesthetic was applied. Both treatment sites were marked with skin marker. Cryoneurolysis was employed using a 5 mm tip. 60-second treatment cycles were performed at each site. Each of the cycles resulted in a 5 × 7 mm lesion visible as hypoechoic signal.ResultsAll 3 players endorsed significant and prolonged relief and were able to return to an elite level of play.ConclusionsThis manuscript is subject to all of the limitations of a case series, and larger rigorous studies are needed to illuminate causal inferences. Novel, complex technologies may also be more susceptible to placebo effect. Nonetheless, we are able to report marked efficacy and safety from cryoneurolysis of the ulnar digital nerve and the superficial radial sensory nerve in a small group of elite baseball players with refractory digital neuralgia.

Copolymer Coatings for DNA Biosensors: Effect of Charges and Immobilization Chemistries on Yield, Strength and Kinetics of Hybridization

The physical–chemical properties of the surface of DNA microarrays and biosensors play a fundamental role in their performance, affecting the signal’s amplitude and the strength and kinetics of binding. We studied how the interaction parameters vary for hybridization of complementary 23-mer DNA, when the probe strands are immobilized on different copolymers, which coat the surface of an optical, label-free biosensor. Copolymers of N, N-dimethylacrylamide bringing either a different type or density of sites for covalent immobilization of DNA probes, or different backbone charges, were used to functionalize the surface of a Reflective Phantom Interface multispot biosensor made of a glass prism with a silicon dioxide antireflective layer. By analyzing the kinetic hybridization curves at different probe surface densities and target concentrations in solution, we found that all the tested coatings displayed a common association kinetics of about 9 × 104 M−1·s−1 at small probe density, decreasing by one order of magnitude close to the surface saturation of probes. In contrast, both the yield of hybridization and the dissociation kinetics, and hence the equilibrium constant, depend on the type of copolymer coating. Nearly doubled signal amplitudes, although equilibrium dissociation constant was as large as 4 nM, were obtained by immobilizing the probe via click chemistry, whereas amine-based immobilization combined with passivation with diamine carrying positive charges granted much slower dissociation kinetics, yielding an equilibrium dissociation constant as low as 0.5 nM. These results offer quantitative criteria for an optimal selection of surface copolymer coatings, depending on the application.

Hard X-ray nanoprobe scanner

X-ray scientists are continually striving to improve the quality of X-ray microscopy, due to the fact that the information obtained from X-ray microscopy of materials can be complementary to that obtained from optical and electron microscopes. In contrast to the ease with which one can deflect electron beams, the relative difficulty to deflect X-ray has constrained the development of scanning X-ray microscopes (SXMs) based on a scan of an X-ray small probe. This restriction has caused severe complications that hinder progress toward achieving ultimate resolution. Here, a simple and innovative method for constructing an SXM equipped with a nanoprobe scanner is proposed. The nanoprobe scanner combines X-ray prisms and advanced Kirkpatrick–Baez focusing mirrors. By rotating the prisms on the order of degrees, X-ray probe scanning with single-nanometre accuracy can be easily achieved. The validity of the concept was verified by acquiring an SXM image of a test pattern at a photon energy of 10 keV, where 50 nm line-and-space structures were resolved. This method is readily applicable to an SXM with a single-nanometre resolution and will assist effective utilization of increasing brightness of fourth-generation synchrotron radiation sources.

Synthetic Wavelength Holography: Snapshot Non-Line-of-Sight Imaging with High-Resolution and Wide Field of View

The presence of a scattering medium in the imaging path between an object and an observer is known to severely limit the visual acuity of the imaging system. We present an approach to circumvent the deleterious effects of scattering, by exploiting spectral correlations in scattered wavefronts. Our Synthetic Wavelength Holography (SWH) method is able to recover a holographic representation of hidden targets with high resolution over a wide field of view. The complete object field is recorded in a snapshot-fashion, by monitoring the scattered light return in a small probe area. This unique combination of attributes opens up a plethora of new Non-Line-of-Sight imaging applications ranging from medical imaging and forensics, to early-warning navigation systems and reconnaissance. Adapting the findings of this work to other wave phenomena will help unlock a wider gamut of applications beyond those envisioned in this paper.

Radial EBUS combined with a GS and VBN for diagnosis of peripheral lung lesions: a retrospective study

Background More and more peripheral pulmonary lesions (PPL) have been found following the increased utilization of chest CT in China. But how to identify the nature of PPL accurately, safely and economically is the concern of Chinese doctors. The combination of radial endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation was a deluxe scheme to indicate the pathology of peripheral pulmonary lesions in nation’s current medical level. This study aimed to compare the diagnostic yield, safety and health economics of EBUS-GS-VBN versus radial ultrasonic small probe plus thin bronchoscopy (EBUS) for diagnosis of PPLs. Methods This study was a single-institution retrospective review of PLLs examined by using EBUS-GS-VBN or radial EBUS between March 2018 and September 2018 consecutive. The diagnostic yields, accuracy, operation time, complications, factors influencing the diagnostic outcome, tissue genetic test rate and medical cost were analyzed separately. Results there was no significant difference in the diagnostic yield between the two groups (92.31% vs 88.57%, p = 0.594). Although the searching time of EBUS-GS-VBN was shorter (1.47 ± 0.49 min vs 2.12 ± 1.36 min, p < 0.001), procedure time was extended (24.07 ± 5.53 min vs 17.41 ± 4.38 min, p < 0.001). The diagnosis yield of malignancy and benign disease were equal (84.62% vs 100% and 95.35% vs 84%). There was no difference in the rate of gene testing between the two groups (75% vs 70.58%), while the incidence of Intrapulmonary hemorrhage in the EBUS-GS-VBN group was significantly descended. Moreover, the average expense of EBUS-GS-VBN was higher than that of EBUS-GS (6315 ± 1817 RMB vs 3128 ± 1086RMB). Conclusion When performing TBLB of PLLs, we found EBUS-GS-VBN to be similar to EBUS in accuracy. Although the founding lesion time of EBUS-GS-VBN group were significantly shorter, the total examination time was longer. Furthermore, the complications of EBUS-GS-VBN group were fewer. There was no difference in genetic testing between the two groups. It is worth noting that the cost and radiation exposure was lower of EBUS group patients. Trial registration: retrospectively registered

Molecule Sensitive Optical Imaging and Monitoring Techniques—A Review of Applications in Micro-Process Engineering

This paper provides an overview of how molecule-sensitive, spatially-resolved technologies can be applied for monitoring and measuring in microchannels. The principles of elastic light scattering, fluorescence, near-infrared, mid-infrared, and Raman imaging, as well as combination techniques, are briefly presented, and their advantages and disadvantages are explained. With optical methods, images can be acquired both scanning and simultaneously as a complete image. Scanning technologies require more acquisition time, and fast moving processes are not easily observable. On the other hand, molecular selectivity is very high, especially in Raman and mid-infrared (MIR) scanning. For near-infrared (NIR) images, the entire measuring range can be simultaneously recorded with indium gallium arsenide (InGaAs) cameras. However, in this wavelength range, water is the dominant molecule, so it is sometimes necessary to use complex learning algorithms that increase the preparation effort before the actual measurement. These technologies excite molecular vibrations in a variety of ways, making these methods suitable for specific products. Besides measurements of the fluid composition, technologies for particle detection are of additional importance. With scattered light techniques and evaluation according to the Mie theory, particles in the range of 0.2–1 µm can be detected, and fast growth processes can be observed. Local multispectral measurements can also be carried out with fiber optic-coupled systems through small probe heads of approximately 1 mm diameter.

The Preoperative Endoscopic Ultrasonography Staging and Its Clinical Pathological Texture Feature in Patients Gastric Cancer

In order to study the clinical value of small probe endoscopic ultrasonography (EUS) in preoperative pathological staging and pathological texture features of gastric cancer, we selected some patients with gastric cancer to prospectively analyze and all patients were confirmed by postoperative pathological examination. The postoperative pathology and preoperative texture analysis were compared so as to determine the difference in pathological stage and depth of tumor invasion. The results have shown that the coincidence rate of preoperative EUS judgment and postoperative pathology degree was: the coincidence rate of 1/3 of the lesion site was 90.00%, the coincidence rate of middle 1/3 was 89.47%, and the coincidence rate of the lower 1/3 was 95.65%; Diameter: the coincidence rate of ≥3 cm is 91.84%, the coincidence rate of <3 cm is 89.09%; the type of lesion differentiation: 82.80% of differentiated type, 72.73% of undifferentiated type; Kappa value = 0.680, P < 0.001. Therefore, EUS has a high degree of consistency and coincidence with pathology in preoperative pathological staging and pathological features of gastric cancer.

Nonlinearity of Microwave Electric Field Coupled Rydberg Electromagnetically Induced Transparency and Autler-Townes Splitting

An electromagnetically induced transparency (EIT) of a cascade-three-level atom involving Rydberg level in a room-temperature cell, formed with a cesium 6 S 1 / 2 -6 P 3 / 2 -66 S 1 / 2 scheme, is employed to detect the Autler-Townes (AT) splitting resulted with a 15.21-GHz microwave field coupling the 66 S 1 / 2 →65 P 1 / 2 transition. Microwave field induced AT splitting, f A T , is characterized by the distance of peak-to-peak of an EIT-AT spectrum. The f A T dependence on the microwave Rabi frequency, Ω M W , demonstrates two regions, the strong-coupling linear region, f A T ≈ Ω M W and the weak-coupling nonlinear region, f A T ≲ Ω M W . The f A T dependencies on the probe and coupling Rabi frequency are also investigated. Using small probe- and coupling-laser, the Rabi frequency is found to enlarge the linear regime and decrease the uncertainty of the microwave field measurements. The measurements agree with the calculations based on a four-level atomic model.