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John Kucewicz

Senior Engineer

Email

kucewicz@apl.washington.edu

Phone

206-221-3283

Education

Bachelor of Science Computer Engineering, Texas A&M University, 1995

Doctor of Philosophy Bioengineering, University of Washington, 2004

Publications

2000-present and while at APL-UW

Towards a non-invasive cardiac arrest monitor: An in vivo pilot study

Kucewicz, J.C., D.D. Salcido, A.A. Adedipe, K. Truong, G. Nichol, and P.D. Mourad, "Towards a non-invasive cardiac arrest monitor: An in vivo pilot study," Resuscitation, 124, 76-80, doi:10.1016/j.resuscitation.2018.10.021, 2019.

More Info

1 Jan 2019

Introduction
Hemodynamic-guided cardiopulmonary resuscitation (HGCPR) achieves better outcomes than standard resuscitation. Currently, HGCPR requires an invasive procedure, infeasible during resuscitation. Non-invasive measures of blood flow could provide useful hemodynamic guidance to rescuers.

Objective
We describe initial efforts to develop a device that detects, analyzes, and measures the velocity of carotid artery blood flow (CABF) towards the brain at pre-arrest baseline ('baseline') and during cardiopulmonary resuscitation, here tested in a swine model of cardiac arrest (CA). A key element of that device consists of non-imaging diagnostic ultrasound, due to its simplicity and small form factor, hence potential for deployment during HGCPR in a bandage placed on the neck.

Methods
Sixteen mixed-breed domestic swine were sedated, anesthetized and paralyzed, followed by endotracheal intubation and mechanical ventilation. Cardiac arrest was induced with a 3-s 100 mA transthoracic shock or bolus of fentanyl, after which all animals received mechanical CPR. A non-imaging ultrasound probe was manually applied to the neck over the carotid artery to capture CABF during baseline, as verified with diagnostic ultrasound imaging, and during mechanical resuscitation.

Results
We successfully collected CABF measurements at baseline in 14/16 swine and during attempted resuscitation with mechanical chest compression in 5/16 swine. Signal characteristics include peak blood flow both towards (90.4 ±20.4 cm/s) and away from the brain (–44.2 ±31.8 cm/s) during resuscitation, each larger than flow towards (41.7±14.8 cm/s) and away from brain (–3.0 ± 7.8 cm/s) during baseline.

Conclusion
Measurement of CABF before and during CPR in swine with a non-imaging ultrasound probe is feasible before CA and informative when achieved during CPR. For example, observations of reverse flow within the carotid artery during CPR merits further study for its prevalence and effect on resuscitation outcomes. Also, tissue motion represents a significant obstacle for CABF measurement during CPR. Additional work will determine the feasibility and utility of non-imaging ultrasound measurements of CABF during resuscitation.

Ultrasound-based cell sorting with microbubbles: A feasibility study

Matula, T.J. O.A. Sapozhnikov, L.A. Ostrovsky, A.A. Brayan, J. Kucewicz, B.E. MacConaghy, and D. De Raad, "Ultrasound-based cell sorting with microbubbles: A feasibility study," J. Acoust. Soc. Am., 144, doi:10.1121/1.5044405, 2018.

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1 Jul 2018

The isolation and sorting of cells is an important process in research and hospital labs. Most large research and commercial labs incorporate fluorescently or magnetically labeled antibodies adherent to cell surface antigens for cell identification and separation. In this paper, a process is described that merges biochemical labeling with ultrasound-based separation. Instead of lasers and fluorophore tags, or magnets and magnetic particle tags, the technique uses ultrasound and microbubble tags. Streptavidin-labeled microbubbles were mixed with a human acute lymphoblastic leukemia cell line, CCL 119, conjugated with biotinylated anti-CD7 antibodies. Tagged cells were forced under ultrasound, and their displacement and velocity quantified. Differential displacement in a flow stream was quantified against erythrocytes, which showed almost no displacement under ultrasound. A model for the acoustic radiation force on the conjugated pairs compares favorably with observations. This technology may improve on current time-consuming and costly purification procedures.

Design and characterization of a research phantom for shock-wave enhanced irradiations in high intensity focused ultrasound therapy

Kreider, W., B. Dunmire, J. Kucewicz, C. Hunter, T. Khokhlova, G. Schade, A. Maxwell, O. Sapozhnikov, L. Crum, and V. Khokhlova, "Design and characterization of a research phantom for shock-wave enhanced irradiations in high intensity focused ultrasound therapy," Proc., IEEE International Ultrasonics Symposium, 6-9 September, Washington, D.C., doi:10.1109/ULTSYM.2017.8092866 (IEEE, 2017).

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2 Nov 2017

The use of shock waves for enhancing thermal effects and mechanically ablating tissue is gaining increased attention in high intensity focused ultrasound (HIFU) applications such as tumor treatment, drug delivery, noninvasive biopsy, and immunotherapy. For abdominal targets, the presence of ribs and inhomogeneous adipose tissue can affect shock formation through aberration, absorption, and diffraction. The goal of this study was to design and validate a phantom for investigating the impact of different tissue structures on shock formation in situ. A transducer with driving electronics was developed to operate at 1.2 MHz with the ability to deliver either short pulses at high powers (up to 5 kW electric power) or continuous output at moderate powers (up to 700 W). Fat and muscle layers were represented by phantoms made from polyvinyl alcohol. Ribs were 3D-printed from a photopolymer material based on 3D CT scan images. Representative targeted tissue was comprised of optically transparent alginate or polyacrylamide gels. The system was characterized by hydrophone measurements free-field in water and in the presence of a body wall or rib phantoms. Shocked waveforms with peak positive/negative pressures of +100 / –20 MPa were measured at the focus in a free field at 1 kW electric source power. When ribs were present, shocks formed at about 50% amplitude at the same power, and higher pressures were measured with ribs positioned closer to the transducer. A uniform body wall structure attenuated shock amplitudes by a smaller amount than non-uniform, and the measurements were insensitive to the axial position of the phantom. Signal magnitude loss at the focus for both the rib phantoms and abdominal wall tissue were consistent with results from real tissues. In addition, boiling histotripsy lesions were generated and visualized in the target gels. The results demonstrate that the presence of ribs and absorptive tissue-mimicking layers do not prevent shock formation at the focus. With real-time lesion visualization, the phantom is suitable for adaptation as a training tool.

More Publications

Inventions

Non-invasive Cardiac Arrest Monitor Guided by Ultrasound and Impedance Plethymography

Record of Invention Number: 48108

Graham Nichol, Adeyinka Adedipe, John Kucewicz, Pierre Mourad, David Salcido, Matthew Sundermann

Disclosure

28 Jun 2017

Ultrasound Based Method and Apparatus for Stone Detection and to Facilitate Clearance Thereof

Patent Number: 9,597,103

Mike Bailey, John Kucewicz, Barbrina Dunmire, Neil Owen, Bryan Cunitz

More Info

Patent

21 Mar 2017

Described herein are methods and apparatus for detecting stones by ultrasound, in which the ultrasound reflections from a stone are preferentially selected and accentuated relative to the ultrasound reflections from blood or tissue. Also described herein are methods and apparatus for applying pushing ultrasound to in vivo stones or other objects, to facilitate the removal of such in vivo objects.

System and Methods for Tracking Finger and Hand Movement Using Ultrasound

Record of Invention Number: 47931

John Kucewicz, Brian MacConaghy, Caren Marzban

Disclosure

10 Jan 2017

More Inventions

Acoustics Air-Sea Interaction & Remote Sensing Center for Environmental & Information Systems Center for Industrial & Medical Ultrasound Electronic & Photonic Systems Ocean Engineering Ocean Physics Polar Science Center
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