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Vergleich der peroralen endoskopischen Myotomie (POEM) und der laparoskopischen Heller Myotomie (LHM) in der Therapie der primär idiopathischen Achalasie und anderer Ösophagusmotilitätsstörungen / Comparison of peroral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) in the therapy of primary idiopathic achalasia and other esophageal motility disordersAl-Nasser, Mohammed Mohammed Ali January 2020 (has links) (PDF)
Hier wird über den objektiven Vergleich der Kurz- und Langzeitergebnisse, die mit der laparoskopischen Heller-Myotomie plus Dor-Fundoplikatio (LHM + Dor) und der per-oralen endoskopischen Myotomie (POEM) an einer einzigen Institution erzielt wurden und über die Entwicklung eines "maßgeschneiderten Ansatzes" berichtet. Die laparosko-pischen Heller Myotomie (LHM) gilt aktuell als das Standardverfahren zur Therapie der Achalasie. Die perorale endoskopische Myotomie (POEM) bietet eine neue Alternative zur Durchführung der Heller-Myotomie auf endoskopischem und natural orifice translu-minal endoscopic surgery (NOTES) Wege.
Wir berichten über unsere unselektierte konsekutive Patientenserien (n = 238), die zwi-schen 2009 und 2017 entweder einer LHM + Dor Prozedur (n = 100) oder einer POEM Operation (n = 138) unterzogen wurden.
Es gab keine Unterschiede hinsichtlich des Behandlungserfolgs (Eckardt-Score ≤ 3) nach 3 - 6 Monaten (LHM: 90,1% vs. POEM: 90,5%; p = 0,735), 12 Monate (LHM 84,4% vs. POEM 84,0%; p = 0,766 und> 2 Jahre (LHM 81,1% vs. POEM 79,2%; p = 0,432). Die Verbesserung der Lebensqualität (GIQLI-Score) und die Patientenzufriedenheit waren in beiden Gruppen ebenfalls ver-gleichbar gut (~ 90%) und zu jedem Zeitpunkt der Nachbeobachtung. Refluxraten sind ebenfalls ähnlich (Sodbrennen LHM: 32,9% vs. POEM: 30,1%; Ösophagitis LHM: 16,3% vs. POEM: 14,6%; PPI-Aufnahme 21,2% vs. 32,5%, pathologischer pH-Wert -Meter-LHM: 8,8% vs. POEM: 23,3%) ohne Signifikanz der Unterschiede.
Die „maßgeschneiderte Verfahrenswahl POEM vs. LHM“ könnte geeignet sein und sollte in weiteren Studien weiter untersucht werden. / This article reports on the objective comparison of the short and long-term results obtained with the laparoscopic Heller myotomy plus Dor fundoplication (LHM + Dor) and per-oral endoscopic myotomy (POEM) at a single institution and on the development of a " tailored approach". The laparoscopic Heller Myotomy (LHM) is currently considered the standard procedure for the treatment of achalasia. Peroral endoscopic myotomy (POEM) offers a new alternative to Heller myotomy by endoscopic and natural orifice transluminal endoscopic surgery (NOTES).
We report on our unselected consecutive patient series (n = 238) who underwent either an LHM + Dor procedure (n = 100) or POEM surgery (n = 138) between 2009 and 2017.
There were no differences in treatment success (Eckardt-Score ≤ 3) after 3 - 6 months (LHM: 90.1% vs. POEM: 90.5%; p = 0.735), 12 months (LHM 84.4% vs.POEM 84.0%; p = 0.766 and> 2 years (LHM 81.1% vs. POEM 79.2%; p = 0.432). The improvement of quality of life (GIQLI-Score) and patient satisfaction were also comparably good (~ 90%) in both groups and at all times of follow-up. Reflux rates are also similar (heartburn LHM: 32.9% vs. POEM: 30.1%; esophagitis LHM: 16.3% vs. POEM: 14.6%; PPI uptake 21.2% vs. 32.5%, pathological pH meter-LHM: 8.8% vs. POEM: 23.3%) without significance of the differences.
The "tailored approach for choosing the procedure POEM vs. LHM" might be appropriate and should be further investigated in further studies.
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Analysis and design of novel electromagnetic metamaterialsGuo, Yunchuan January 2006 (has links)
This thesis introduces efficient numerical techniques for the analysis of novel electromagnetic metamaterials. The modelling is based on a Method of Moments modal analysis in conjunction with an interpolation scheme, which significantly accelerates the computations. Triangular basis functions are used that allow for modelling of arbitrary shaped metallic elements. Unlike the conventional methods, impedance interpolation is applied to derive the dispersion characteristics of planar periodic structures. With these techniques, the plane wave and the surface wave responses of fractal structures have been studied by means of transmission coefficients and dispersion diagrams. The multiband properties and the compactness of the proposed structures are presented. Based on this method, novel planar left-handed metamaterials are also proposed. Verifications of the left-handedness are presented by means of full wave simulation of finite planar arrays using commercial software and lab measurement. The structures are simple, readily scalable to higher frequencies and compatible with low-cost fabrication techniques.
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Numerical Simulations of Wave Propagation between a Left-Handed Material and a Right-Handed Material / Numeriska simuleringar av vågutbredning mellan ett vänsterhänt material och ett högerhänt materialRana, Balwan January 2021 (has links)
The discovery of metamaterials has led to major advances in different fields of physics including optics, microwave engineering and acoustics. Specific to theoretical electromagnetism, the introduction of metamaterials have led to the development of negative-index materials (NIMs) with simultaneous negative permittivity and negative permeability with backward-wave propagation. In recent studies, exact analytical solutions for wave propagation from a step/graded-index interface between a right-handed material (RHM) and a left-handed material (LHM) have been obtained. This study attempts to provide numerical validation of the analytical solutions obtained by Dalarsson et al. by using the simulation tool CST. An square-SRR/strip-wire unit element was designed, with real part of relative permittivity equal to -1.96 and real part of relative permeability equal to -1.01. Such unit elements were orderly structured to produce a NIM structure. Furthermore, a positive-index material (PIM) structure was produced by reversing the sign of the material properties of the NIM. Both the results for the step- and graded-index interfaces have shown to possess backward-wave propagation for a normal incidence angle. The graded-index interface profiles have a more smooth and continuous wave propagation between the materials, which counteracts the effects of discontinuous material transitions present in step-index interface profiles. However, because the results of the present study were considerably affected by unwanted field effects, the analytical solutions are only qualitatively validated, and not validated in terms of their numerical accuracy. / Upptäckten av metamaterial har lett till stora framsteg inom olika fysikområden inklusive optik, mikrovågsteknik och akustik. Specifikt för teoretisk elektromagnetism, har introduktionen av metamaterial lett till utvecklingen av negativa indexmaterial (NIM) med samtidig negativ permittivitet och negativ permeabilitet med bakåtvågsutbredning. I nyligen genomförda studier, har exakta analytiska lösningar för vågutbredning över ett steg-/graderat- indexgränssnitt mellan ett högerhänt material (RHM) och ett vänsterhänt material (LHM) erhållits. Denna studie försöker tillhanda-hålla numerisk validering, med hjälp av simuleringsverktyget CST, av de analytiska lösningar som erhållits av Dalarsson et al. En square-SRR/strip-wire enhetselement designades, med realdelen av relativ permittivitet lika med -1,96 och realdelen av relativ permeabilitet lika med -1,01. Sådana enhetselement strukturerades för att producera en materialstruktur med negativt index. Dessutom producerades en materialstruktur med positivt index (PIM) genom att vända tecknet av materialegenskaperna hos det negativa indexmaterialet (NIM). Både resultaten för steggränssnittet och det graderade indexgränssnittet har visat sig ha bakåtvågutbredning för vinkelrätt infall. De graderade indexgränssnittsprofilerna har en mer jämn och kontinuerlig vågutbredning mellan materialen, vilket motverkar effekterna av diskontinuerliga materialövergångar som finns i stegindexgränssnittsprofiler. Men eftersom resultaten av den aktuella studien påverkades avsevärt av oönskade fälteffekter, har de analytiska lösningarna validerats endast kvalitativt och valideras inte i termer av deras numeriska noggrannhet.
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Počítačové modelování metamateriálů / Computer modeling of meta-materialsBeran, Jaroslav January 2008 (has links)
The diploma thesis deals with metamaterial structures. Metamaterials are periodic structures, which have got permittivity or permeability, eventually both parameters, negative. Test is applied on three basic structures: Split Loop Array; Spiral Array a Double Spiral Array. For each structure is made dispersion diagram and are monitored S – parameters. Test is run in Ansoft High Frequency Structure Simulator and CST Microwave Studio software. Are monitored bandgaps and when structure is as left – handed medium or right – handed medium. Results are compared with results in literature.
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Asymptotic limits of negative group delay phenomenon in linear causal mediaKandic, Miodrag 07 October 2011 (has links)
Abnormal electromagnetic wave propagation characterized by negative group velocity and consequently negative group delay (NGD) has been observed in certain materials as well as in artificially built structures. Within finite frequency intervals where an NGD phenomenon is observed, higher frequency components of the applied waveform are propagated with phase advancement, not delay, relative to the lower frequency components. These media have found use in many applications that require positive delay compensation and an engineered phase characteristic, such as eliminating phase variation with frequency in phase shifters, beam-squint minimization in phased array antenna systems, size reduction of feed-forward amplifiers and others.
The three principal questions this thesis addresses are: can a generic formulation for artificial NGD structures based on electric circuit resonators be developed; is it possible to derive a quantitative functional relationship (asymptotic limit) between the maximum achievable NGD and the identified trade-off quantity (out-of-band gain); and, can a microwave circuit exhibiting a fully loss-compensated NGD propagation in both directions be designed and implemented? A generic frequency-domain formulation of artificial NGD structures based on electric circuit resonators is developed and characterized by three parameters, namely center frequency, bandwidth and the out-of-band gain. The developed formulation is validated through several topologies reported in the literature. The trade-off relationship between the achievable NGD on one hand, and the out-of-band gain on the other, is identified. The out-of-band gain is shown to be proportional to transient amplitudes when waveforms with defined “turn on/off” times are propagated through an NGD medium. An asymptotic limit for achievable NGD as a function of the out-of-band gain is derived for multi-stage resonator-based NGD circuits as well as for an optimally engineered linear causal NGD medium.
Passive NGD media exhibit loss which can be compensated for via active elements. However, active elements are unilateral in nature and therefore do not allow propagation in both directions. A bilateral gain-compensated circuit is designed and implemented, which overcomes this problem by employing a dual-amplifier configuration while preserving the overall circuit stability.
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Asymptotic limits of negative group delay phenomenon in linear causal mediaKandic, Miodrag 07 October 2011 (has links)
Abnormal electromagnetic wave propagation characterized by negative group velocity and consequently negative group delay (NGD) has been observed in certain materials as well as in artificially built structures. Within finite frequency intervals where an NGD phenomenon is observed, higher frequency components of the applied waveform are propagated with phase advancement, not delay, relative to the lower frequency components. These media have found use in many applications that require positive delay compensation and an engineered phase characteristic, such as eliminating phase variation with frequency in phase shifters, beam-squint minimization in phased array antenna systems, size reduction of feed-forward amplifiers and others.
The three principal questions this thesis addresses are: can a generic formulation for artificial NGD structures based on electric circuit resonators be developed; is it possible to derive a quantitative functional relationship (asymptotic limit) between the maximum achievable NGD and the identified trade-off quantity (out-of-band gain); and, can a microwave circuit exhibiting a fully loss-compensated NGD propagation in both directions be designed and implemented? A generic frequency-domain formulation of artificial NGD structures based on electric circuit resonators is developed and characterized by three parameters, namely center frequency, bandwidth and the out-of-band gain. The developed formulation is validated through several topologies reported in the literature. The trade-off relationship between the achievable NGD on one hand, and the out-of-band gain on the other, is identified. The out-of-band gain is shown to be proportional to transient amplitudes when waveforms with defined “turn on/off” times are propagated through an NGD medium. An asymptotic limit for achievable NGD as a function of the out-of-band gain is derived for multi-stage resonator-based NGD circuits as well as for an optimally engineered linear causal NGD medium.
Passive NGD media exhibit loss which can be compensated for via active elements. However, active elements are unilateral in nature and therefore do not allow propagation in both directions. A bilateral gain-compensated circuit is designed and implemented, which overcomes this problem by employing a dual-amplifier configuration while preserving the overall circuit stability.
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Antenna Performance Control using Metamaterials / Contrôle des performances des antennes par les métamatériauxAyad, Houssam 02 June 2012 (has links)
Le travail de cette thèse est en rapport avec les métamatériaux et ses applications. Tout d’abord, un état de l’art est dressé en présentant leur évolution depuis leur apparition en 19ème siècle jusqu’au nos jours. Les notions sur les milieux chirale, bi-anisotrope, cristaux photoniques et quelques applications dans ces milieux sont données. Ensuite, nous présentons les équations classiques de Maxwell dans les milieux complexes. L’effet bi-anisotrope dans les métamatériaux est ensuite validé par l’extraction des paramètres caractéristiques du matériau main gauche (LHM). La validation a été faite en utilisant deux types différents du résonateur avec inclusion (SRR). Les métamatériaux sont également étudiés comme des cristaux photoniques quand les dimensions utilisées sont de l’ordre de la longueur d’onde correspondant.De plus, les résonateurs SRR et multi-SRR sont analysés du point de vue analytique et électromagnétique afin d’extraire leur fréquence de résonance. Par conséquent, ces composants peuvent être introduits dans différents types de conception; La surface conductrice magnétique artificielle (AMC) illustre un cas explicite et efficace de ces derniers. Une antenne dipôle, placée sur cette surface à la place d’un plan de masse conventionnel, a été étudiée comme une application des métamatériaux. Les résultats relatifs sur la directivité, le gain et le coefficient de réflexion montrent une nette amélioration. Une antenne multi-bandes, comme une autre application des métamatériaux, a également été conçue et simulée. Le résonateur SRR est inséré dans l’antenne de départ afin de créer une autre résonance, et par conséquent une autre bande est ainsi créée. / The work in this thesis deals with metamaterials, its components and applications. A historical overview about these materials, features and researches in the domain are presented. Chiral media, binaisotropic materials and photonic crystals are also studied in order to visualize physics behind metamaterials.Electromagnetic properties in complex media are widely investigated. Starting from Maxwell’s equations, bi-anisotropic materials and their effect are deeply analyzed whereas two types of Split Ring Resonator (SRR) are treated to determine constitutive parameters of Left Handed Materials (LHM). The metamaterials are also studied as photonic crystals since the effective medium approach is not applicable when the dimensions of the inclusions tend to the operating wavelength.Moreover, SRRs and Multi SRRs are synthesized analytically and electromagnetically in order to extract their resonant frequencies. Consequently, these components could be introduced in any design; Artificial Magnetic Conductor (AMC) surface is an efficient case. Thus, a low profile antenna positioned over such surface is examined as an application of metamaterials. The results of directivity, gain and reflection coefficient are of great importance and affirm the employing of metamaterials in such applications. A dual band PCB antenna, as another application of metamaterials, is designed and simulated. The SRR element studied in the previous chapters is used as the trap which inserted in the arm of the antenna in order to create another resonance, and consequently another band is created.
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