A surgical device comprising a container and a tether used for delivering a sterile appliance into a body cavity during endoscopic procedures. Once positioned in the body cavity, a force is applied to the container through the tether. The force opens the container and releases the sterile appliance into the body cavity. In various embodiments, gas or liquid may be used to open the container.

Sterile appliance delivery device for endoscopic procedures

High-frequency oscillations (100–200 Hz), termed ripples, have been identified in hippocampal (Hip) and entorhinal cortical (EC) areas of rodents and humans. In contrast, higher-frequency oscillati...

https://www.physiology.org/doi/pdf/10.1152/jn.2002.88.4.1743

Quantitative analysis of high-frequency oscillations (80-500 Hz) recorded in human epileptic hippocampus and entorhinal cortex.

Surgical instruments and methods for closing a gastrotomy. In various embodiments, the surgical instrument may comprise an overtube that supports a clip magazine therein that houses a plurality of tissue apposition clips in an orientation wherein the upper and lower clip arms thereof are releasably supported in an open orientation. Various embodiments are configured to operably accommodate one or more tissue grasping members for grasping the tissue. Other embodiments comprise clip dispensing adapters that may be affixed to the distal end of an endoscope. The various adapters are configured to support a tissue apposition clip such that the upper and lower clip arms thereof are initially supported in an open orientation relative to each other to enable grasped tissue to be drawn therein. Various tissue apposition clips are disclosed which may be used in connection with conventional tissue anchors and/or sutures.

Tissue apposition clip application devices and methods

In an embodiment, a system includes one or one or more reservoirs responsive to control circuitry for receiving target(s) associated with one or more blood or lymph vessel of a subject. The system includes one or more first energy source associated with the one or more reservoirs for providing energy to elicit image response(s) associated with the target(s). The system includes one or more sensors associated with the one or more reservoirs for capturing the image response(s). Control circuitry is provided and coupled to the sensors for at least partially identifying the target(s) based at least partially on the captured image response(s) during an expected transit time of the target(s) through a detection area. Attachment unit(s) responsive to the control circuitry are provided for attaching the one or more reservoirs to the blood or lymph vessel.

Vasculature and lymphatic system imaging and ablation associated with a reservoir

Thirty percent to 40% of patients with focal epilepsy are medically intractable,1 and for some, surgical removal of epileptogenic areas is the best option to gain seizure freedom. Intracranial electroencephalographic (iEEG) investigations are indicated for patients in whom noninvasive methods fail to identify a single focal seizure generator.2

iEEG is used to define the seizure onset zone (SOZ).3 Removal of the SOZ alone, however, does not always predict the surgical benefit.4,5 It is uncertain whether the outcome can be improved by removing areas of interictal spiking, often more widespread than the SOZ.6,7 Intracranial studies also have limitations, as their results depend on electrode location and type of implantation (intracortical vs subdural). For instance, iEEG electrodes only record neuronal activity in their direct vicinity and are blind for other areas,8 making it hard to judge whether the activity at seizure onset really represents the seizure generator or is the result of propagation from else-where. Thus the actual focus and its extent may be missed, leading to unsuccessful surgery.

Microelectrode-recorded high-frequency oscillations (HFOs), ripples (80 –250Hz), and fast ripples (FRs, 250 –500Hz), were found predominantly in epileptogenic tissue.9 –11 They can also be recorded with macroelectrodes during clinical iEEG investigation.12,13 HFOs were more specific in indicating the SOZ than spikes.14 Additionally, they were linked to the SOZ independently of the underlying lesion and were infrequent in lesional areas outside the SOZ.15 Evidence therefore suggests that HFOs are good markers of epileptic tissue and may help to identify epileptogenic areas. We hypothesize that removing areas generating HFOs results in good surgical outcome. The correlation between removal of HFO-generating areas and seizure outcome was compared to that coming from spikes and to the current gold standard, removing the SOZ.

High-frequency electroencephalographic oscillations correlate with outcome of epilepsy surgery.

Localization of evoked neuromagnetic 600 Hz activity in the cerebral somatosensory system.

Ictal and interictal epileptic activity was recorded for the first time by multichannel magnetoencephalography (MEG) in three patients with partial epilepsy. Pre- and intra-operative localization of the epileptogenic region was compared. The interictal epileptic activity was localized at the same region of the temporal or frontal lobe as the ictal activity. Main zones of ictal activity were shown to evolve from the tissue at the centers of interictal activity. Pre- and intra-operative electrocorticography (ECoG) as well as postoperative outcome confirmed localization in the temporal and frontal lobe. Results also correlated with findings from scalp EEG, interictal and ictal single photon emission computed tomography (SPECT), positron emission tomography (PET), and magnetic resonance imaging (MRI). Combined multichannel MEG/EEG recording permitted dipole localization of interictal and ictal activity.

Ictal and interictal activity in partial epilepsy recorded with multichannel magnetoelectroencephalography: correlation of electroencephalography/electrocorticography, magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography findings.

Objective: To survey individuals with acquired brain injury to assess multiple facets of interest, access, and familiarity necessary to implement new telerehabilitation technologies. Design: Anonymous mail survey. Setting: Community. Participants: Seventy-one respondents to a survey. These individuals had experienced acquired brain injury (predominantly severe traumatic brain injury [TBI]) and were living in the community. Surveys were mailed by a state chapter of the Brain Injury Association to a random selection of members with acquired brain injury. Main Outcome Measure: Survey designed specifically for this investigation. Results: The survey responses indicate that there is great interest in the possibility of accessing telerehabilitative services among individuals with acquired brain injury. In particular, there was strong interest expressed in services that could be used to assist with problems in memory, attention, problem-solving, and activities of daily living. Conclusions: Telemedicine, and more specifically telerehabilitation, holds great promise as an adjunct to traditional clinical service delivery. Little research in this area has been applied, however, to individuals with acquired brain injuries. Although on the surface, telerehabilitation seems to be an appropriate assessment and treatment modality for individuals with brain injury, it will only succeed if those individuals have the interest-and the access-necessary to use new and evolving technologies.

Telerehabilitation needs: a survey of persons with acquired brain injury.

A system and method for endoscopic optical imaging using an endo-robot is provided. The method for performing endoscopic optical imaging using a capsule endoscope comprises: navigating the capsule endoscope through a lumen of a patient that has been introduced with an optical contrast agent; illuminating a portion of the lumen that is not penetrable by an external light source with light emitted from the capsule endoscope to enhance an image intensity of the portion of the lumen; and powering the capsule endoscope with an externally applied magnetic field.

System and method for endoscopic optical constrast imaging using an endo-robot

In a method and system for monitoring the posture of a user during the use of a training apparatus, sensors are attached to the body of the user and possibly to specific locations of the training apparatus for acquiring specific kinematic parameters. The measurement data acquired by these sensors is analyzed in an evaluating unit in order to detect a faulty motion or posture of the user during the use of the training apparatus and to emit a corresponding acknowledging message to the user or to the training apparatus in this case.

Klaus Abraham-Fuchs

Papers

Localization of evoked neuromagnetic 600 Hz activity in the cerebral somatosensory system.

Ictal and interictal activity in partial epilepsy recorded with multichannel magnetoelectroencephalography: correlation of electroencephalography/electrocorticography, magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography findings.

Telerehabilitation needs: a survey of persons with acquired brain injury.

System and method for endoscopic optical constrast imaging using an endo-robot

Method and system for monitoring the posture of a user at a training apparatus