この作品はR21CA134819（CH）、T32CA009035（SD）、およびP30CA006927（がんセンターコアグラント）によって賄われていた。著者は、原稿の準備と彼女の支援を受けて、参加者の募集、ライアボイル、エヴァPanigrahi、および手順の開発における彼らの支援のためのケイトのメネゼスと彼女の援助のためにエリザベスCulnanに感謝したい、とジャンヌPomentiう。我々はまた、彼らの役立つ提案のためにジャーナル査読に感謝。

1。紫外線照射の準備<ol><li> &quot;私は約20分であり、明日の過程で紫外線にあなたの腕にいくつかの皮膚を公開するつもりだ、我々は決定するために、お肌のそのセクションをチェックするつもりだ（MEDテストがどのように機能するかを参加者に説明しどのように敏感なあなたには、光にされています。あなたは、私たちは、UVに公開する小さな領域で日焼けが発生する可能性があります。日焼けが痛いですか、気になる場合は、あなたが他の日焼けと同じように扱うことができます。 &quot;） </li><li>スタッフと参加者は、UV保護メガネを着用しなければならない。 </li><li>参加者は、半袖のシャツを身に着けているか、または彼女の袖をロールアップされるべきである。 </li><li>参加者が彼女の手で肌を保護するために手袋を入れている。 </li><li>パッチの左右にDaavlinパッチ1バッキングを取り外し、既存の皮膚の傷を避け、手袋のすぐ隣接する内側下部アームの上に置きます。 </li><li>アームのWi上の任意の付加的な肌をカバー参加者のシャツや他の材料番目。 </li><li>パッチの穴をUV光源にさらされるように腕を置きます。他の皮膚は紫外線にさらされるべきではありません。 </li><li>彼女は暖かさを感じるだろうが、彼女の腕が試験中に燃焼されることはありません参加者に知らせる。 </li></ol> 2。 UV露光を行う<ol><li>パッチ穴（ 例えば、6）は暴露期間を通して間隔で紫外線にさらされるべきである。 </li><li>穴1を開いた状態で起動します。 </li><li>光源と参加者のフィッツパトリック皮膚のタイプI-VI（非常に暗いと非常に公正で、フィッツパトリック、1988）については、製造元の仕様に基づいて露出の合計時間を選択します。2より公平な皮膚が火傷する可能性が高くなります。 </li><li>エクスポージャーの合計時間（ 例えば 20分）のタイマーを設定します。 2番目のバックアップタイマーを用いてもよい。 （S）タイマーを起動します。 </li><li> 4の後に例えば、オープン2分後の穴2、開いた穴3分、8分、16分後の12分であり、開孔6の後の開孔5後に開く穴4。このように、皮膚のUV露光時間は5穴のために8分、と穴6 4分ホール1、ホール2、ホール3、穴4の12分16分18分20分になります。 </li><li>ためには、より簡単に24〜48時間後に露出された領域を特定するために、パッチの最初と最後の穴の遠端に露出した皮膚をマークし、肌が検査された後にまで、マークを洗い流していないため、参加者に依頼してください。 </li><li>参加者は、手袋とパッチを削除している。 </li><li>皮膚は24-48時間で見直さなければならないことを参加者に繰り返す。 </li></ol> 3。 MEDを評価<ol><li> 24〜48時間後、肌の露出部分を調べます。赤やピンクの皮膚が紅斑または燃焼を示しています。 UVの最短持続時間に露出Erythemetous皮膚を最小紅斑量またはMEDとして定義される。 </li><li> UVに将来のエクスポージャーは、Tより短い期間のためでなければなりません彼は燃えて避けるためにMED。 </li><li>暴露の領域を識別することが困難である場合には、露出した皮膚に合わせてマークを使用してバックパッチを置きたいと思うことがあります。分光光度計などの皮膚の色測定装置を用いた場合にも有用である。 </li><li>分光光度計は、L *（闇）及びb *（色相）の対策を提供します。 *は、皮膚の赤みを指します。高い*値は赤く、皮膚を示しています。 </li><li>このような分光光度計、皮膚の色測定装置を使用する場合は、測定されるべき穴の中心に分光光度計の開口部を配置する。 </li><li>比較のために他人の近くの数値ご注文いただくと、未露光部で6露光領域のそれぞれを測定します。各穴の中心ではなく、そばかすやほくろまたは他の非UV変色を測定してみます。測定のそれぞれにラベルを付けます。未露光部からの測定は、0分とラベル付けされるべきであり、エリア6（最短露光エリア - 4分）の横に表示される。 </li><li> *値の増加は、UV照射時間の増加に対応している必要があります。再測定に対応するためにない値を試してみてください。 </li><li>露出した皮膚に比べて未露光皮膚の*で2.5ポイント差は、潜在的な燃焼を示唆し、赤みに有意な差を示している。 </li><li>最小*値に2.5を追加します。この値で、または上記のものは、潜在的に燃えると考えられるでしょう。この値を超える最小の露光時間がMED考えられる。 </li></ol>

<ol>
	<li>Fitzpatrick, T. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+validity+and+practicality+of+sun-reactive+skin+types+I+through+VI.">The validity and practicality of sun-reactive skin types I through VI.</a> Archives of Dermatology. 124, 869-871 (1988).</li><li>Bodekaer, M., Akerstrom, U., Wulf, H. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accumulation+of+sunscreen+in+human+skin+after+daily+applications:+a+study+of+sunscreens+with+different+ultraviolet+radiation+filters.">Accumulation of sunscreen in human skin after daily applications: a study of sunscreens with different ultraviolet radiation filters.</a> Photodermatol. Photoimmunol. Photomed. 28, 127-132 (2012).</li><li>Kwon, I. H., Kwon, H. H., Na, S. J., Youn, J. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Could+colorimetric+method+replace+the+individual+minimal+erythemal+dose+(MED)+measurements+in+determining+the+initial+dose+of+narrow-band+UVB+treatment+for+psoriasis+patients+with+skin+phototype+III-V?.">Could colorimetric method replace the individual minimal erythemal dose (MED) measurements in determining the initial dose of narrow-band UVB treatment for psoriasis patients with skin phototype III-V?.</a> J. Eur. Acad. Dermatol. Venereol. , (2012).</li><li>Youn, J. I., Park, J. Y., Jo, S. J., Rim, J. H., Choe, Y. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+the+usefulness+of+skin+phototype+and+skin+color+as+the+parameter+of+cutaneous+narrow+band+UVB+sensitivity+in+psoriasis+patients.">Assessment of the usefulness of skin phototype and skin color as the parameter of cutaneous narrow band UVB sensitivity in psoriasis patients.</a> Photodermatol. Photoimmunol. Photomed. 19, 261-264 (2003).</li><li>Henriksen, M., Na, R., Agren, M. S., Wulf, H. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Minimal+erythema+dose+after+multiple+UV+exposures+depends+on+pre-exposure+skin+pigmentation.">Minimal erythema dose after multiple UV exposures depends on pre-exposure skin pigmentation.</a> Photodermatol. Photoimmunol. Photomed. 20, 163-169 (2004).</li><li>Kraemer, C. K., Menegon, D. B., Cestari, T. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determination+of+the+minimal+phototoxic+dose+and+colorimetry+in+psoralen+plus+ultraviolet+A+radiation+therapy.">Determination of the minimal phototoxic dose and colorimetry in psoralen plus ultraviolet A radiation therapy.</a> Photodermatol. Photoimmunol. Photomed. 21, 242-248 (2005).</li><li>Sachdeva, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fitzpatrick+skin+typing:+applications+in+dermatology.">Fitzpatrick skin typing: applications in dermatology.</a> Indian J. Dermatol. Venereol. Leprol. 75, 93-96 (2009).</li><li>Webb, A. R., Kift, R., Berry, J. L., Rhodes, L. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+vitamin+D+debate:+translating+controlled+experiments+into+reality+for+human+sun+exposure+times.">The vitamin D debate: translating controlled experiments into reality for human sun exposure times.</a> Photochem. Photobiol. 87, 741-745 (2011).</li><li>Otman, S. G., Edwards, C., Gambles, B., Anstey, A. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validation+of+a+semiautomated+method+of+minimal+erythema+dose+testing+for+narrowband+ultraviolet+B+phototherapy.">Validation of a semiautomated method of minimal erythema dose testing for narrowband ultraviolet B phototherapy.</a> Br. J. Dermatol. 155, 416-421 (2006).</li><li>Taylor, D. K., Anstey, A. V., Coleman, A. J., Diffey, B. L., Farr, P. M., Ferguson, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidelines+for+dosimetry+and+calibration+in+ultraviolet+radiation+therapy:+a+report+of+a+British+Photodermatology+Group+workshop.">Guidelines for dosimetry and calibration in ultraviolet radiation therapy: a report of a British Photodermatology Group workshop.</a> Br. J. Dermatol. 146, 755-763 (2002).</li></ol>

我々は、開示することは何もありません。

紫外線（UV）療法は、しばしば乾癬、座瘡およびアトピー性皮膚炎を含む様々な一般的な皮膚の状態、の治療薬として使用されている。 UV光の投与量は、個人のフィッツパトリックの肌はVI（非常に暗いと非常に公正な）を通してI型の関数として決定される個々の皮膚の感度に応じて規定されている。2人間の皮膚が原因で様々な物のUV放射線に対する感度で変化皮膚の色素沈着、厚さ...

minimal erythema dose (med) testing

紫外線（UV）療法は、しばしば乾癬、座瘡およびアトピー性皮膚炎を含む様々な一般的な皮膚の状態、の治療薬として使用されている。 UV光の投与量は、個人の肌の感度に応じて規定されている。したがって、患者に投与するUV光の適切な投与量を確立するために、患者は、時々鬱血に起因する最小の紅斑（または日焼け赤みを生成するUV放射線の量である、最小紅斑量（MED）を決定するためにスクリーニングされている暴露後数時間内の個々の皮膚の）毛細血管の。この記事では、最小紅斑量（MED）テストを実施する方法について説明します。正式なMED試験を行うことなく、臨床や研究目的のための適切なUV線量を決定する簡単な方法は、アンダーまたはオーバー投与のリスクに観察試験後の時間、または非公式の試行錯誤のテストを必要とし、現在のところありません。しかし、いくつかの代替方法が記載されている。

<img alt="図1" fo:content-width="4in" fo:src="/files/ftp_upload/50175/50175fig1highres.jpg" src="/files/ftp_upload/50175/50175fig1.jpg" /> 図1 MEDテストを行う4つのステップ：。MEDを評価する、紫外線照射を行うと、MEDを決定し、紫外線照射の準備。 <img alt="図2" src="/files/ftp_upload/50175/50175fig2.jpg" /><p class="jove_content" fo:k...

Watch this Scientific Journal Video about Minimal Erythema Dose MED Testing at JoVE.com

Minimal Erythema Dose MED Testing

この記事では、個々に投与された場合に紅斑（燃焼）が発生します紫外線の最低用量を決定するために、最小紅斑量（MED）テストを実施する方法について説明します。

最小紅斑量（MED）試験

Ultraviolet radiation (UV) therapy is  sometimes used as a treatment for various common skin conditions, including  psoriasis, acne, and eczema. The ...

Research

JoVE Journal

Medicine

Minimal Erythema Dose (MED) Testing

41.2K ビュー.  Fox Chase Cancer Center. この記事では、個々に投与された場合に紅斑（燃焼）が発生します紫外線の最低用量を決定するために、最小紅斑量（MED）テストを実施する方法について説明します。

ビデオ: Minimal Erythema Dose MED Testing

Quantitative Autonomic Testing

Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be invaluable tool for evaluation of these disorders, both in clinic and research. There are number of autonomic tests, however, only few were validated clinically or are quantitative. Here, fully quantitative and clinically validated protocol for testing of autonomic functions is presented. As a bare minimum the clinical autonomic laboratory should have a tilt table, ECG monitor, continuous noninvasive blood pressure monitor, respiratory monitor and a mean for evaluation of sudomotor domain. The software for recording and evaluation of autonomic tests is critical for correct evaluation of data. The presented protocol evaluates 3 major autonomic domains: cardiovagal, adrenergic and sudomotor. The tests include deep breathing, Valsalva maneuver, head-up tilt, and quantitative sudomotor axon test (QSART). The severity and distribution of dysautonomia is quantitated using Composite Autonomic Severity Scores (CASS). Detailed protocol is provided highlighting essential aspects of testing with emphasis on proper data acquisition, obtaining the relevant parameters and unbiased evaluation of autonomic signals. The normative data and CASS algorithm for interpretation of results are provided as well.

Standardized, comprehensive and fully quantitative testing of autonomic functions is described. The autonomic tests consist of evaluation of all three major autonomic domains including cardiovagal, adrenergic and sudomotor. The severity and distribution of dysautonomia is quantitated using Composite Autonomic Severity Scores.

定量的な自律神経系検査

Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be ...

医学

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging

X-ray fluoroscopy is widely used for image guidance during cardiac intervention. However, radiation dose in these procedures can be high, and this is a significant concern, particularly in pediatric applications. Pediatrics procedures are in general much more complex than those performed on adults and thus are on average four to eight times longer1. Furthermore, children can undergo up to 10 fluoroscopic procedures by the age of 10, and have been shown to have a three-fold higher risk of developing fatal cancer throughout their life than the general population2,3.
We have shown that radiation dose can be significantly reduced in adult cardiac procedures by using our scanning beam digital x-ray (SBDX) system4-- a fluoroscopic imaging system that employs an inverse imaging geometry5,6 (Figure 1, Movie 1 and Figure 2). Instead of a single focal spot and an extended detector as used in conventional systems, our approach utilizes an extended X-ray source with multiple focal spots focused on a small detector. Our X-ray source consists of a scanning electron beam sequentially illuminating up to 9,000 focal spot positions. Each focal spot projects a small portion of the imaging volume onto the detector. In contrast to a conventional system where the final image is directly projected onto the detector, the SBDX uses a dedicated algorithm to reconstruct the final image from the 9,000 detector images.
For pediatric applications, dose savings with the SBDX system are expected to be smaller than in adult procedures. However, the SBDX system allows for additional dose savings by implementing an electronic adaptive exposure technique. Key to this method is the multi-beam scanning technique of the SBDX system: rather than exposing every part of the image with the same radiation dose, we can dynamically vary the exposure depending on the opacity of the region exposed. Therefore, we can significantly reduce exposure in radiolucent areas and maintain exposure in more opaque regions. In our current implementation, the adaptive exposure requires user interaction (Figure 3). However, in the future, the adaptive exposure will be real time and fully automatic.
We have performed experiments with an anthropomorphic phantom and compared measured radiation dose with and without adaptive exposure using a dose area product (DAP) meter. In the experiment presented here, we find a dose reduction of 30%.

We are developing a dynamic adaptive exposure technique using our scanning beam digital X-ray system. Rather than exposing an object uniformly, the exposure is adapted depending on the opacity of the object. Here we show an experiment on an anthropomorphic phantom that resulted in a dose saving of 30%.

透視イメージングの適応暴露によるX線の線量低減

X-ray fluoroscopy is widely used for image guidance during cardiac intervention. However, radiation dose in these procedures can be high, and this is a ...

Preparation and Pathogen Inactivation of Double Dose Buffy Coat Platelet Products using the INTERCEPT Blood System

Blood centers are faced with many challenges including maximizing production yield from the blood product donations they receive as well as ensuring the highest possible level of safety for transfusion patients, including protection from transfusion transmitted diseases. This must be accomplished in a fiscally responsible manner which minimizes operating expenses including consumables, equipment, waste, and personnel costs, among others.
Several methods are available to produce platelet concentrates for transfusion. One of the most common is the buffy coat method in which a single therapeutic platelet unit (&ge; 2.0 x1011 platelets per unit or per local regulations) is prepared by pooling the buffy coat layer from up to six whole blood donations. A procedure for producing "double dose" whole blood derived platelets has only recently been developed.
Presented here is a novel method for preparing double dose whole blood derived platelet concentrates from pools of 7 buffy coats and subsequently treating the double dose units with the INTERCEPT Blood System for pathogen inactivation. INTERCEPT was developed to inactivate viruses, bacteria, parasites, and contaminating donor white cells which may be present in donated blood. Pairing INTERCEPT with the double dose buffy coat method by utilizing the INTERCEPT Processing Set with Dual Storage Containers (the "DS set"), allows blood centers to treat each of their double dose units in a single pathogen inactivation processing set, thereby maximizing patient safety while minimizing costs. The double dose buffy coat method requires fewer buffy coats and reduces the use of consumables by up to 50% (e.g. pooling sets, filter sets, platelet additive solution, and sterile connection wafers) compared to preparation and treatment of single dose buffy coat platelet units. Other cost savings include less waste, less equipment maintenance, lower power requirements, reduced personnel time, and lower collection cost compared to the apheresis technique.

This article describes the process used by &#214;rebro University Hospital to produce double dose buffy coat platelet concentrates prepared from whole blood donations and treated with the INTERCEPT Blood System for pathogen inactivation. The in vitro quality of the final platelet units are evaluated over 7 days of storage.

準備とINTERCEPT血液系を使用してDouble線量バフィーコート血小板製剤の病原体不活化

Blood centers are faced with many challenges including maximizing production yield from the blood product donations they receive as well as ensuring the ...

A Novel Application of Musculoskeletal Ultrasound Imaging

Ultrasound is an attractive modality for imaging muscle and tendon motion during dynamic tasks and can provide a complementary methodological approach for biomechanical studies in a clinical or laboratory setting. Towards this goal, methods for quantification of muscle kinematics from ultrasound imagery are being developed based on image processing. The temporal resolution of these methods is typically not sufficient for highly dynamic tasks, such as drop-landing. We propose a new approach that utilizes a Doppler method for quantifying muscle kinematics. We have developed a novel vector tissue Doppler imaging (vTDI) technique that can be used to measure musculoskeletal contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities using ultrasound. The goal of this preliminary study was to investigate the repeatability and potential applicability of the vTDI technique in measuring musculoskeletal velocities during a drop-landing task, in healthy subjects. The vTDI measurements can be performed concurrently with other biomechanical techniques, such as 3D motion capture for joint kinematics and kinetics, electromyography for timing of muscle activation and force plates for ground reaction force. Integration of these complementary techniques could lead to a better understanding of dynamic muscle function and dysfunction underlying the pathogenesis and pathophysiology of musculoskeletal disorders.

We describe a new ultrasound-based vector tissue Doppler imaging technique to measure muscle contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities. This approach provides complementary measurements of dynamic muscle function and could lead to a better understanding of mechanisms underlying musculoskeletal disorders.

筋骨格超音波画像の新規応用

Ultrasound is an attractive modality for imaging muscle and tendon  motion during dynamic tasks and can provide a complementary methodological  approach ...

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these techniques, patients hold their breath while radiotherapy is delivered, pushing the heart down and away from the radiotherapy field. Despite clear dosimetric benefits, these techniques are not yet in widespread use. One reason for this is that commercially available solutions require specialist equipment, necessitating not only significant capital investment, but often also incurring ongoing costs such as a need for daily disposable mouthpieces. The voluntary breath-hold technique described here does not require any additional specialist equipment. All breath-holding techniques require a surrogate to monitor breath-hold consistency and whether breath-hold is maintained. Voluntary breath-hold uses the distance moved by the anterior and lateral reference marks (tattoos) away from the treatment room lasers in breath-hold to monitor consistency at CT-planning and treatment setup. Light fields are then used to monitor breath-hold consistency prior to and during radiotherapy delivery.

The current priority in breast cancer radiotherapy is to reduce cardiac doses without compromising target tissue coverage. The voluntary breath-hold technique described here is a simple, inexpensive solution to this problem and capable of being instituted widely without the need for specialized equipment.

左胸放射線治療における心臓線量を削減するための自​​主的な息止め法

Breath-holding techniques reduce the amount of radiation received by cardiac structures during tangential-field left breast radiotherapy. With these ...

Minimal Invasive Surgical Procedure of Inducing Myocardial Infarction in Mice

Myocardial infarction still remains the main cause of death in western countries, despite considerable progress in the stent development area in the last decades. For clarification of the underlying mechanisms and the development of new therapeutic strategies, the availability of valid animal models are mandatory. Since we need new insights into pathomechanisms of cardiovascular diseases under in vivo conditions to combat myocardial infarction, the validity of the animal model is a crucial aspect. However, protection of animals are highly relevant in this context. Therefore, we establish a minimally invasive and simple model of myocardial infarction in mice, which assures a high reproducibility and survival rate of animals. Thus, this models fulfils the requirements of the 3R principle (Replacement, Refinement and Reduction) for animal experiments and assure the scientific information needed for further developing of therapeutical strategies for cardiovascular diseases.

A highly reproducible model for myocardial infarction in mice with minimal invasive manipulations is described. The model can be easily performed, resulting in a high reproducibility and survival rate. Thus, the described model will reduce the number of required animals as requested by the 3R principle (Replacement, Refinement and Reduction).

マウスにおける心筋梗塞を誘発する低侵襲手術手順

Myocardial infarction still remains the main cause of death in western countries, despite considerable progress in the stent development area in the last ...

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The incidence of the pathology increases with growing age after 65 years. Conventional surgical aortic valve replacement through median sternotomy has been the gold standard of patient care for symptomatic aortic valve stenosis. However, as the risk profile of patients worsens, other therapeutic strategies have been introduced in an attempt to maintain the excellent results obtained by the established surgical treatment. One of these approaches is represented by transcatheter aortic valve implantation. Although the outcomes of high-risk patients undergoing treatment for symptomatic aortic valve stenosis have improved with transcatheter aortic valve replacement, many patients with this condition remain candidates for surgical aortic valve replacement. In order to reduce the surgical trauma in patients who are candidates for surgical aortic valve replacement, minimally invasive approaches have garnered interest during the past decade. Since the introduction of right anterior thoracotomy for aortic valve replacement in 1993, right anterior mini-thoracotomy and upper hemi-sternotomy have become the predominant incisional approaches among cardiac surgeons performing minimal access aortic valve replacement. Beside the location of the incision, the arterial cannulation site represents the second major landmark of minimal access techniques for aortic valve replacement. The two most frequently used arterial cannulation sites include central aortic and peripheral femoral approaches. With the purpose of reducing surgical trauma in these patients, we have opted for a right anterior mini-thoracotomy approach with a central aortic cannulation site. This protocol describes in detail a technique for minimally invasive aortic valve replacement and provides recommendations for patient selection criteria, including cardiac computer tomography measurements. The indications and limitations of this technique, as well as its alternatives, are discussed.

The goal of this protocol is to describe in detail the technique of minimally invasive aortic valve replacement through a right anterior mini-thoracotomy and central aortic cannulation. This technique can potentially enhance patients&#39; comfort and, by reducing post-operative morbidity, promote lowering the length of stay and global costs.

技術と最小限のアクセス大動脈弁置換のミニ開胸右前の患者選択基準

Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The ...

Precision Implementation of Minimal Erythema Dose (MED) Testing to Assess Individual Variation in Human Inflammatory Response

Minimal erythema dose (MED) testing is frequently used in clinical settings for determining the smallest amount of ultraviolet (UV) irradiation necessary to produce erythema (inflammatory reddening) on the surface of the skin. In this context, the MED is regarded as a key factor in determining starting doses for UV phototherapy for common skin conditions such as psoriasis and eczema. In research settings, MED testing also has potential to be a powerful tool for assessing within- and between-persons variation in inflammatory responses. However, MED testing has not been widely adopted for use in research settings, likely owing to a lack of published guidelines, which is a barrier to obtaining reproducible results from this assay. Also, protocols and equipment for establishing MED vary widely, making it difficult to compare results across laboratories. Here, we describe a precise and reproducible method to induce and measure superficial erythema using newly designed protocols and methods that can easily be adapted to other equipment and laboratory environments. The method described here includes detail on procedures that will allow extrapolation of a standardized dosage schedule to other equipment so that this protocol can be adapted to any UV radiation source.

Precision Implementation of Minimal Erythema Dose MED Testing to Assess Individual Variation in Human Inflammatory Response

Minimal erythema dose (MED) testing is used to establish dosage schedules for ultraviolet radiation phototherapy. It can assess individual variation in inflammatory response but lacks methodology for achieving reproducible results. Here, we present a precision implementation of MED and demonstrate its ability to capture individual variation in inflammatory response.

ヒト炎症反応の個々の変動を評価するための最小紅斑用量(MED)試験の精密実施

Minimal erythema dose (MED) testing is frequently used in clinical settings for determining the smallest amount of ultraviolet (UV) irradiation necessary ...

Semi-Minimal Invasive Method to Induce Myocardial Infarction in Rats and the Assessment of Cardiac Function by an Isolated Working Heart System

Myocardial infarction (MI) remains the main contributor to morbidity and mortality worldwide. Therefore, research on this topic is mandatory. An easily and highly reproducible MI induction procedure is required to obtain further insight and better understanding of the underlying pathological changes. This procedure can also be used to evaluate the effects or potency of new and promising treatments (as drugs or interventions) in acute MI, subsequent remodeling and heart failure (HF). After intubation and pre-operative preparation of the animal, an anesthetic protocol with isoflurane was performed, and the surgical procedure was conducted&#160;quickly. Using a minimally invasive approach, the left anterior descending artery (LAD) was located and occluded by a ligature. The occlusion can be performed acutely for subsequent reperfusion (ischemia/reperfusion injury). Alternatively, the vessel can be ligated permanently to investigate the development of chronic MI, remodeling or HF. Despite common pitfalls, the drop-out rates are minimal. Various treatments such as remote ischemic conditioning can be examined for their cardioprotective potential pre-, peri- and post-operatively. The post-operative recovery was quick as the anesthesia was precisely controlled and the duration of the operation was short. Post-operative analgesia was administered for three days. The minimally invasive procedure reduces the risk of infection and inflammation. Furthermore, it facilitates rapid recovery. The &#8220;working heart&#8221; measurements were performed ex vivo and enabled precise control of preload, afterload and flow. This procedure requires specific equipment and training for adequate performance. This manuscript provides a detailed step-by-step introduction for conducting these measurements.

This article presents an efficient method to perform myocardial ischemia and subsequent chronic reperfusion in rats using a minimally invasive approach. In addition, left ventricular hemodynamic function of rats is assessed by echocardiography and isolated working heart methods.&#160;

ラットの心筋梗塞を誘導する半最小侵襲法と、単離した働く心臓システムによる心機能の評価

Myocardial infarction (MI) remains the main contributor to morbidity and mortality worldwide. Therefore, research on this topic is mandatory. An easily ...

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Since their approval for clinical use, da Vinci surgical robots have shown great advantages in gastrointestinal surgical operations, especially in complex procedures. The high-quality 3-D visual, multijoint arm and natural tremor filtration allow the surgeon to expose and dissect more accurately with minimal invasion. Total mesorectal excision is the standard surgical technique for the treatment of resectable rectal cancer. To reduce the lateral recurrence rate, lateral pelvic lymph node dissection can be performed, as it is a safe and feasible procedure for locally advanced middle-low rectal cancer with a high possibility of metastasis to the lateral lymph nodes. However, the complexity of the anatomic structures and the high postoperative complication rate limit its application. Recently, several surgeons have increasingly used robotic techniques for total mesorectal excision and lateral pelvic lymph node dissection. Compared with open and laparoscopic surgery, the robotic technique has several advantages, such as less blood loss, fewer blood transfusions, minimal trauma, shorter postoperative hospitalization, and quicker recovery. A robotic approach is generally regarded as a reasonable alternative for complicated procedures such as lateral pelvic lymph node dissection, although there are a limited number of high-quality prospective randomized controlled studies reporting direct evidence. Here, we provide the detailed steps of robot-assisted total mesorectal excision and lateral pelvic lymph node dissection performed at the First Affiliated Hospital of Xi&#39;an Jiaotong University.

The robotic technique described herein aims to detail a stepwise approach to robot-assisted total mesorectal excision and lateral pelvic lymph node dissection for locally advanced (T3/T4) rectal cancer located below the peritoneal reflection.

局所進行中低直腸癌に対するロボット支援全中腸切除および横骨盤リンパ節切断

Since their approval for clinical use, da Vinci surgical robots have shown great advantages in gastrointestinal surgical operations, especially in complex ...