Intraoperative ICG-NIR Fluorescence Angiography Visualization of Intestinal Perfusion in Primary Pull-Through for Hirschsprung Disease

Purpose: Assessment of anastomotic perfusion in Hirschsprung disease using Indocyanine Green (ICG)-near-infrared (NIR) fluorescence angiography. Introduction: Anastomotic stricture and leak are well-known complications of Hirschsprung pull-through procedures. Complications are due to tension, infection, and/or poor perfusion. While a surgeon can visually determine and control the amount of tension and contamination, assessment of perfusion is subject to surgeon determination. Intraoperative use of ICG-NIR enhances this decision-making process by illustrating perfusion intensity and adequacy in the pulled-through bowel segment. This technique, proven to reduce anastomotic stricture and leak in adults, has not been studied in children to our knowledge. ICG, an FDA approved, nontoxic, non-immunogenic, intravascular (IV) dye, has been used in adults and children for over 60 years, with few side effects. ICG-NIR was used in this report to demonstrate the adequacy of perfusion during transanal pullthrough for Hirschsprung’s disease. Method: 8 patients with Hirschsprung disease were evaluated with ICG-NIR technology. Levels of affected area ranged from sigmoid to total colonic Hirschsprung disease. After leveling, but prior to anastomosis, ICG was administered at 1.25 mg (< 2 mg/kg) and perfusion visualized using an NIR camera, before and during anastomosis. Video and photo imaging was performed and perfusion of the bowel was compared to surrounding tissues. This showed the degree of perfusion and demarcation of perfused and non-perfused bowel. The anastomosis was completed uneventfully and the patients all did well. Results: There were no complications of stricture or leak. 5 of 8 patients (62.5%) had modification of the plan based on ICG-NIR imaging. Conclusion: Technologies that enhance surgeons’ ability to visualize bowel perfusion prior to anastomosis in Hirschsprung’s patients may help reduce post-operative complications. Further studies are needed to assess the potential benefits.

A Study of the Assistant Application for Tourists Taking Metros

With the proliferation and development of mobile devices, various mobile apps have appeared to satisfy people’s needs. Metro, with the feature of convenient, punctuality and economic, is one of the most popular modes of transportation in cities. Yet, there are still some inconveniences brought by various factors, impacting tourists’ riding experience. The aim of this study is to help tourists to shorten the time of purchasing tickets, to provide them clear metro information and direct navigation, detailed schedule as well as a way to collect metro cards as souvenir. The study collects data through three phases, including observation, survey and test. Data collected from 106 tourists totally in Wuhan metro stations are discussed in the study. The result reflects tourists’ demand when they take the metro. It also indicates the feasibility of using mobile technology to improve passenger’s experience.

Investigation of Short Time Scale Variation of Solar Radiation Spectrum in UV, PAR, and NIR Bands due to Atmospheric Aerosol and Water Vapor

Long terms variation of solar insolation had been widely studied. However, its parallel observations in short time scale is rather lacking. This paper aims to investigate the short time scale evolution of solar radiation spectrum (UV, PAR, and NIR bands) due to atmospheric aerosols and water vapors. A total of 25 days of global and diffused solar spectrum ranges from air mass 2 to 6 were collected using ground-based spectrometer with shadowband technique. The result shows that variation of solar radiation is the least in UV fraction, followed by PAR and the most in NIR. Broader variations in PAR and NIR are associated with the short time scale fluctuations of aerosol and water vapors. The corresponding daily evolution of UV, PAR, and NIR fractions implies that aerosol and water vapors variation could also be responsible for the deviation pattern in the Langley-plot analysis.