Hidden danger in the neck-a problem of differential diagnostics: benign chronic lymphadenitis following carotid endarterectomy and patch angioplasty (CEAP) or a metastasis due to a squamous cell cancer of the tongue.

INTRODUCTION: Oncological head and neck operations as well as carotid endarterectomy are common surgical procedures. In some occasions, both procedures have occurred in the past, leading to possible diagnostic and therapeutic challenges when follow-up operations seem indicated. CASE REPORT: We report of a patient presenting with carotid endarterectomy including patch operation 8 years ago and neck dissection due to a squamous cell cancer of the tongue 3 months ago, now showing up with a suspected metastatic tumor of the neck during routine follow-up. Intraoperatively, nearly fatal bleeding occurs due to a partial release of the carotid patch and needs to be managed immediately. DISCUSSION: The primarily pre-operated neck remains challenging for the radiologist in terms of differentiating between chronic lymphadenitis and metastasis. Furthermore, it remains challenging for the oncological surgeon in case these entities are in the near proximity of the previously operated carotid artery. The operative treatment according to the guidelines can lead to major bleeding during the second surgery. During the diagnostic process, metastases and chronic lymphadenitis after alloplastic carotid operations must be differentiated remaining however difficult, due to only scarce data in the literature. CONCLUSION: In the case of previous neck surgery, the decision to operate must be chosen individually regarding the specific conditions and their sometimes vital risks. In case an operation is indicated, the team must be trained to treat life-threatening intraoperative bleeding. In reviewing the literature, we were unable to find published recommendations on how to tackle these challenges.

Electromagnetic Analysis, Characterization and Discussion of Inductive Transmission Parameters for Titanium Based Housing Materials in Active Medical Implantable Devices.

The growing demand for active medical implantable devices requires data and or power links between the implant and the outside world. Every implant has to be encapsulated from the body by a specific housing and one of the most common materials used is titanium or titanium alloy. Titanium thas the necessary properties in terms of mechanical and chemical stability and biocompatibility. However, its electrical conductivity presents a challenge for the electromagnetic transmission of data and power. The proposed paper presents a fast and practical method to determine the necessary transmission parameters for titanium encapsulated implants. Therefore, the basic transformer-transmission-model is used with measured or calculated key values for the inductances. Those are then expanded with correction factors to determine the behavior with the encapsulation. The correction factors are extracted from finite element method simulations. These also enable the analysis of the magnetic field distribution inside of the housing. The simulated transmission properties are very close to the measured values. Additionally, based on lumped elements and magnetic field distribution, the influential parameters are discussed in the paper. The parameter discussion describes how to enhance the transmitted power, data-rate or distance, or to reduce the size of the necessary coils. Finally, an example application demonstrates the usage of the methods.

An Ultra-Low-Power RFID/NFC Frontend IC Using 0.18 µm CMOS Technology for Passive Tag Applications.

Battery-less passive sensor tags based on RFID or NFC technology have achieved much popularity in recent times. Passive tags are widely used for various applications like inventory control or in biotelemetry. In this paper, we present a new RFID/NFC frontend IC (integrated circuit) for 13.56 MHz passive tag applications. The design of the frontend IC is compatible with the standard ISO 15693/NFC 5. The paper discusses the analog design part in details with a brief overview of the digital interface and some of the critical measured parameters. A novel approach is adopted for the demodulator design, to demodulate the 10% ASK (amplitude shift keying) signal. The demodulator circuit consists of a comparator designed with a preset offset voltage. The comparator circuit design is discussed in detail. The power consumption of the bandgap reference circuit is used as the load for the envelope detection of the ASK modulated signal. The sub-threshold operation and low-supply-voltage are used extensively in the analog design—to keep the power consumption low. The IC was fabricated using 0.18 μ m CMOS technology in a die area of 1.5 mm × 1.5 mm and an effective area of 0.7 m m 2 . The minimum supply voltage desired is 1.2 V, for which the total power consumption is 107 μ W. The analog part of the design consumes only 36 μ W, which is low in comparison to other contemporary passive tags ICs. Eventually, a passive tag is developed using the frontend IC, a microcontroller, a temperature and a pressure sensor. A smart NFC device is used to readout the sensor data from the tag employing an Android-based application software. The measurement results demonstrate the full passive operational capability. The IC is suitable for low-power and low-cost industrial or biomedical battery-less sensor applications. A figure-of-merit (FOM) is proposed in this paper which is taken as a reference for comparison with other related state-of-the-art researches.

RFID Technology for Continuous Monitoring of Physiological Signals in Small Animals.

Telemetry systems enable researchers to continuously monitor physiological signals in unrestrained, freely moving small rodents. Drawbacks of common systems are limited operation time, the need to house the animals separately, and the necessity of a stable communication link. Furthermore, the costs of the typically proprietary telemetry systems reduce the acceptance. The aim of this paper is to introduce a low-cost telemetry system based on common radio frequency identification technology optimized for battery-independent operational time, good reusability, and flexibility. The presented implant is equipped with sensors to measure electrocardiogram, arterial blood pressure, and body temperature. The biological signals are transmitted as digital data streams. The device is able of monitoring several freely moving animals housed in groups with a single reader station. The modular concept of the system significantly reduces the costs to monitor multiple physiological functions and refining procedures in preclinical research.