Wallace, Michael J. | Engineering Papers

DOE OSTI2017

Efficacy of a Self-expanding Tract Sealant Device in the Reduction of Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsy: A Matched Controlled Study Using Propensity Score Analysis

PurposeTo evaluate the use of a self-expanding tract sealant device (BioSentry™) on the rates of pneumothorax and chest tube insertion after percutaneous lung biopsy.Materials and MethodsIn this retrospective study, we compared 318 patients who received BioSentry™ during percutaneous lung biopsy (treated group) with 1956 patients who did not (control group). Patient-, lesion-, and procedure-specific variables, and pneumothorax and chest tube insertion rates were recorded. To adjust for potential selection bias, patients in the treated group were matched 1:1 to patients in the control group using propensity score matching based on the above-mentioned variables. Patients were considered a match if the absolute difference in their propensity scores was ≤equal to 0.02.ResultsBefore matching, the pneumothorax and chest tube rates were 24.5 and 13.1% in the control group, and 21.1 and 8.5% in the treated group, respectively. Using propensity scores, a match was found for 317 patients in the treatment group. Chi-square contingency matched pair analysis showed the treated group had significantly lower pneumothorax (20.8 vs. 32.8%; p = 0.001) and chest tube (8.2 vs. 20.8%; p < 0.0001) rates compared to the control group. Sub-analysis including only faculty who had >30 cases of both treatment and control cases demonstrated similar findings: the treated group had significantly lower pneumothorax (17.6 vs. 30.2%; p = 0.002) and chest tube (7.2 vs. 18%; p = 0.001) rates.ConclusionsThe self-expanding tract sealant device significantly reduced the pneumothorax rate, and more importantly, the chest tube placement rate after percutaneous lung biopsy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

Electrostatics

Quantum mechanics should be able to generate the basic properties of a particle. One of the most basic properties are charge and the associated electrostatic electric field. Electrostatic force is a fundamental characteristics of a charged fermion and should have its nature described by the fermion’s structure. To produce the particle properties require two spaces that define both their dynamics and their base structure. Relativity and the conservation of energy dictate how these two separate spaces are connected and the differential equations that describe behavior within these two spaces. The main static characteristic of an elementary fermion are mass and charge. Mass represents a scale measure of the fermion and it appears that charge results from the detailed structure of the fermion, which must merge into the electric field description of Maxwell. Coulomb’s law is a good approximation for large distances, but it is a poor approximation at dimension on the order of a particle’s Compton wavelength. The relativistic description of the fermion in its own frame of reference contains the information required for producing the electrostatic field over all space without a singularity as a source. With this description it is possible to understand the first order correction to the ionization energy of hydrogen. The role of nuclear effects on ionization energies can now be better defined for nuclei heavier than hydrogen.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗