우리는 특히 우리의 Goeckerman 코디네이터, 사라 헐스 RN 자신의 작품에 대한 UCSF 건선 피부 치료 센터의 직원을 감사드립니다

1. 평가 및 준비 <ol><li> 전체 역사 이전에 치료를 시작하는 물리를 수행합니다. 과거 건선 치료, 주변 광선이나 광선 요법, 가려움증의 정도, 수면의 질에 불리한 반응의 역사와 역사 등의 현재 / 과거 약물과 같은 물리적, 문서의 중요한 정보를 응답합니다. </li><li> 약물 및 폐쇄 [참조 자료 섹션과 그림 1]의 피부 응용 프로그램에 필요한 모든 재료와 클리닉 방을 설정합니다. 또한, 장갑, 플라스틱 포장, 양말, 그리고 스크럽 / 잠옷 가운 같은 방에 다른 재료를 놓습니다. </li><li> 이전에 치료를 시작하는 확산 강렬한 홍반을위한 환자를 평가합니다. </li><li> 환자가 광범위하거나 심한 홍반이 나타나는 경우에는 홍반이 크게 감소 될 때까지 &quot;냉각&quot;절차 (아래 참조)를 수행. 더 광범위하거나 심한 홍반이 볼 수없는 경우, &quot;광선 + 타르&quot;단계로 진행합니다. </리&gt; </ol> 2. (필요한 경우) 냉각 <ol><li> 영향을받는 지역에 국소 코르티코 스테로이드를 적용합니다. 트렁크 및 사지, desonide 0.05 %면 / 겨드랑이 / 사타구니 크림 / 연고 및 fluocinolone 0.01 % 오일이나 두피에 트리암시놀론 0.1 % 로션.에 트리암시놀론 0.1 % 연고를 적용 가장 강렬한 염증이 영역에 대한 예약 클로 베타 솔 0.05 % 연고. </li><li> 발을위한 양말 안쪽에 손 샤워​​ 모자, 그리고 두피 샤워 캡 트렁크 및 사지, 불 침투성 장갑을위한 플라스틱 포장으로 국소 약물을 막다. </li><li> 홍반이 크게 (3~14일에서 범위) 줄어들 때까지 환자를 진정. </li></ol> 3. 광선 요법 + 타르 <ol><li> 환자가 냉각 기간을 완료 한 후, 원유 석탄 타르의 적용 [그림 2] 이전에 아침에 매일 광선을 관리 할 수 있습니다. 광선 요법 옵션 협 대역 UVB 등 (가장 일반적으로 psori에 사용아시시) 또는 광대역 UVB (가장 일반적으로 습진에 사용). 피츠 패트릭 피부 타입으로 초기 광선 량을 결정하면 [표 1과 표 2 참조]. </li><li> 천천히 위쪽으로 허용 이후 광선의 용량을 적정한다. 투약 처방 및 일정은 광선 요법에 대한 환자의 반응에 따라 개별화해야합니다. </li><li> 광선 요법 후 신체의 영향을받는 영역 [그림 3]에 붙이기 aquaphor 2 % 원유 석탄 타르 (CCT)을 적용합니다. 환자가 두피의 참여가있는 경우, 두피에 nutraderm 20 % 액체 carbonis detergens (LCD)를 적용합니다. </li><li> 처음 2 % CCT (낮은 강도)를 사용합니다. 후속 처리 일에 더 나은 결과를 달성하기 위해 10 %에 그 2 % ~ 5 %의 환자가 허용하고 타르의 강도를 높일 수 있습니다. </li><li> 건선의 농축 된 영역에 대한, plaques의 확장 및 경화를 줄일 수 살리실산 (2 % / 5 % / 10 % 살리실산)과 혼합 타르를 사용합니다. 초기의 준비를 사용하여2 % 살리실산 10 % CCT와 산, 그리고 다음 날 환자가 견딜로서 살리실산의 비율을 적정. 살리실산은 당뇨병이나 위궤양 환자에서 금기 할 수 있습니다. </li><li> 절차 아래로 냉각 단계 2.2에서 설명한 것과 같은 방법으로 국소 타르를 막다. </li><li> 최소 4 시간 동안 피부에 국소 약물을 유지합니다. 4 시간의 최소 후, 폐색 물질을 제거하고 미네랄 오일과 비누 [그림 4]와 샤워 타르 씻어. </li><li> 집에서, 각각 몸과 두피에 적용 할 aquaphor에서 환자 20 % LCD와 nutraderm 20 % LCD를 제공합니다. </li><li> 습진 환자는 민감한 피부를 가지고 경향이있다. 습진 환자에 대한 초기 2 % CCT를 사용합니다. 습진 환자는 민감한 피부를 가지고 경향, 5 % CCT까지 적정 할 때주의해야합니다. 10 % CCT (또는 5 % 이상 CCT의 비율)을 사용하지 않고 살리실산있는 모든 준비를 사용하지 마십시오. </li></ol> 4.매일 평가 <ol><li> 매일, 평가를 수행하고 환자의 피부와 치료에 대한 반응을 평가합니다. 타르 및 / 또는 플라스틱 포장에서 자극을 나타낼 수있는 빛 치료, 또는 가려움증을 허용하는 환자의 무능력을 표시 할 수 있습니다 레코딩의 느낌에 대해 구체적으로 평가할 수 있습니다. </li><li> 환자의 증상을 나타내 경우에 의해 발생했을 수 있으므로, (선량이 더욱 증가되는 경우 임박한 화상의 선구자로 감각 상당한 증가 홍반, 또는 거의 증가하지 가려움 굽기) 굽기 감소 광선 량이나 그 날 광선을주지 않는다 이전의 자외선 량에 대한 광독성 반응. </li><li> 환자가 광선에 서로 다른 지역의 해부학 적 반응과 내약성을하는 것은 드문 일이 아니다. 최적의 치료를 위해 환자의 반응에 따라 신체의 다른 영역에 노출 광선 량의 양을 조정합니다. 예를 들어, 환자가 가벼운 BU를 경험트렁크 rning하면 먼저 트렁크 커버보다 하향 광선 요법 복용량 몸 전체를 치료하고 사지에 추가 빛을 제공합니다. </li></ol> 5. 퇴원 계획 및 유지 관리 <ol><li> 질병이 제거 될 때까지 Goeckerman 치료를 계속하고 환자가 퇴원 할 준비가되어 있습니다. </li><li> 외래 광선 요법 및 국소 약물을 포함 할 수있는 유지 보수 프로그램에 장소 환자, </li><li> 외래 광선 일주일에 세 번 (최소 첫 달)을 관리합니다. 결국 주파수는 점차적으로 일주일에 두 번 아래로 가늘게하고 일주일에 한 번)입니다 </li><li> 외래 국소 약물은​​ 다음을 포함한다 : 트리암시놀론 크림 / 하루에 두 번 몸에 연고, 반항적 인 병변 클로 베타 솔 (필요한 경우)를 두 번 매일 몸에 aquaphor 20 % LCD와 두피에 nutraderm 20 % LCD합니다. </li><li> 방전 개월 이내에, 질병 상태를 모니터링하는 환자와 의사 방문 후속 예약 할 수 있습니다. </li></ol>

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박사 쿠 애보트, 레오, 그리고 스티 펠-GSK를위한 스피커입니다. 박사 쿠 암젠, 얀센, 노바티스, PhotoMedex는, 갈데, 화이자에 대한 연구를 실시하고 있습니다. 박사 쿠는 제약 회사와 아무 주식, 고용, 또는 이사회 구성원이 없습니다. 관심 없음 충돌은 다른 저자에 대한 공개하지 않습니다.

위에서 설명한 Goeckerman식이 요법 프로토콜은 UCSF에서 활용되고 치료에 대한 환자의 반응에 따라 여러 가지 방법으로 변화 될 수있다. 환자를 볼 매일 검사되기 때문에, 프로토콜은 최대의 효과를 보장하기 위해 각 환자에 대해 개별적인 할 수 있습니다. 전통 Goeckerman 치료는 전적으로 CCT와 UVB 광선 요법의 사용으로 구성되어있다. 2 그러나식이 요법 (그리고 같은 칼시 포트리, 스랄과 타자?...

건선은 인구의 2 ~ 3 %에 영향을 미치는 만성, 면역 매개 성 염증 피부 질환입니다. 1 환자의 3 분의 1이 쇠약 물리적 및 심리적 효과를 일으키는 일반적인 건선을 경험한다. 먼저 일반 건선의 치료를 위해 1925 년에 발표 된 Goeckerman식이 요법, 자외선 B (UVB) 빛과 원유 석탄 타르의 응용 프로그램 (CCT)에 노출로 구성되어 있습니다. 2는 생물 같은 새로운 내부 에이전트가 건선의 치료를 강화했다지만, 죄 사함의 긴 기간을 제공하면서 Goeckerman 치료는 매우 효과적인 옵션으로 남아있다. UCSF에서 실시한 출판 연구 3,4, Goeckerman 치료에 대한 환자의 100 % PASI75 (75 % 위험 지수의 건선 평가의 향상을 실현 [PASI] 3개월으로)베이스 라인에서. 비교 5 (아니지만 머리에 머리), 가장 강력한 생물에 환자는 3 월에만 67~68% PASI75 달성THS. 6 Goeckerman 요법은 빠른 발병을 가지고 있으며, 광선 또는 내부 약물에 난치성 치료 저항 건선 환자에서의 성공으로 활용하고있다. 7 Goeckerman 요법도 있습니다 근본적으로 내부의 부작용이 매우 안전하고 독성 프로파일을 가지고 더 심각한 위험이 다른 건선의 치료와 관련된. 또한, 치료는 일반적인 건선 환자의 삶의 질에 상당한 긍정적 인 효과를 가지고 표시되었습니다. 8 환자가 자신의 건선에서 벗어날 때까지 Goeckerman 요법은 이전에 입원 시설에서 24 시간 하루를 투여 하였다. 자신의 질병이 해제 될 때까지하지만, 보상 및 관리 치료의 변화로 인해, 환​​자는 현재 보육 4-8 시간 / 일 최소 시설 5 일 / 주에 처리됩니다. Goeckerman 치료는 초기 건선의 치료를 위해 공식화하지만 수정 된 버전이었다최근 이러한 성공 습진 등의 피부 질환의 치료에 사용되어왔다. 다음과 같은 프로토콜은 건선을 위해 특별히 UCSF에서 활용되고 있지만, 절차에 약간의 변화가 습진, 전신 가려움증, prurigo nodularis, pityriasis lichenoides chronica, erythroderma 및 기타 관련 피부 질환에 맞게 조정 할 수 있습니다. 9 이 건선에 사용할 수있는 가장 오래된 치료법의 하나이지만, 그 과정을 설명 게시 된 비디오 어떤의 부재가있다. 이 과정을 이해하고 치료를 권장 편안하게하는 의료 종사자 (일차 진료 의사와 피부과)를 참조하기위한 자료로 이용 될 수있는 비디오는 다양한 매력을 가질 수 있습니다. 나는 이런 종류의를 제공하기 위해 계속 남아있는 몇 기관이 있기 때문에 Goeckerman 과정을 보여주는 영상은식이 요법에 노출되지 거주자 및 의료 학생 교육을위한 수단이 될 것입니다ntensive 치료. 비디오는 Goeckerman 치료를 받고에 관심이 잠재 환자에 대한 도움이 될 것입니다.

<table border="1">
	<tbody>
		<tr>
			<td>Name of Medication </td>
			<td>Company</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>2% Crude Coal Tar in White Petrolatum or Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>5% Crude Coal Tar in White Petrolatum or Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>10% Crude Coal Tar in White Petrolatum +/- 2/5/10% Salicyclic Acid</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>10% Crude Coal Tar in Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>20% Liquid Carbonis Detergenis in Nutraderm</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>20% Liquid Carbonis Detergenis in Aquaphor or Cetaphil</td>
			<td>Compounded at Pharmacy</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Triamcinolone 0.1% ointment/cream/lotion</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Desonide 0.05% cream/ointment</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Fluocinolone 0.01% oil</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Clobetasol 0.05% ointment/cream</td>
			<td>Prescription Medication - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Hydrophillic Ointment</td>
			<td>Over the Counter - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Mineral Oil</td>
			<td>Over the Counter - Generic</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Name of Equipment </td>
			<td>Company</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Narrow-Band Phototherapy Unit</td>
			<td>National Biologic Corporation</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Broad-Band Phototherapy Unit</td>
			<td>National Biologic Corporation</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
	</tbody>
</table>

the goeckerman regimen for the treatment of moderate to severe psoriasis

건선은 인구의 2 ~ 3 %에 영향을 미치는 만성, 면역 매개 성 염증 피부 질환입니다. Goeckerman 요법은 자외선 B (UVB) 빛과 원유 석탄 타르 (CCT)의 적용에 노출로 구성되어 있습니다. Goeckerman 치료는 건선의 치료와 환자의 삶의 질 향상을위한 매우 효과적이고 비교적 안전합니다. 다음 문서에서, 우리는 캘리포니아 대학, 샌프란 시스코에서 특별히 사용된다 Goeckerman 치료를위한 우리의 프로토콜을 제시한다. 이 프로토콜 세부 사항을 공급 준비, 광선 요법 및 국소 타르 응용 프로그램의 관리. 이 프로토콜은 또한 매일 환자를 평가하는 부작용 (가려움 및 굽기 등)에 대한 모니터링 및 환자의 반응에 따라 치료를 조정하는 방법에 대해 설명합니다. 이 건선에 사용할 수있는 가장 오래된 치료법의 하나이지만, DETA의 과정을 보여주는 게시 된 비디오 어떤의 부재가일리노이. 비디오 프로세스에 대한 자세한 내용을 원하는 연수생에 대한 그들의 피부 질환에 대한 치료를 받아야 할 잠재 환자를위한 치료를 관리 할 의료 공급자에 대한 유용합니다.

캘리포니아 샌프란시스코 대학에서 우리 센터에서 수행 된 연구에서, PASI75 응답 (건선 평가 위험 지수 75 % 개선) 3 개월 기간 동안 Goeckerman (N에게 = 25)을 투여받은 환자의 100 % 달성했다 5. 25분의 24 환자는 남아있는 환자 ​​3 개월 PASI75 반응을 얻은 반면, PASI75을 달성하기에 2 달 필요합니다. 또 다른 연구에서는, Menter 등은. 300 환자 Goeckerman 처방을 투여하고 환자의 100 %가 90 % 또는 ?...

Watch this Scientific Journal Video about The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis at JoVE.com

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

건선은 만성, 면역 매개 성 염증 피부 질환입니다. 건선의 치료를 위해 공식화 Goeckerman식이 요법, 자외선 B (UVB) 빛과 원유 석탄 타르 (CCT)의 적용에 노출로 구성되어 있습니다. 다음 프로토콜은 중등도 건선의 치료를위한 Goeckerman 치료의 관리입니다.

심한 건선에 중간의 치료를위한 Goeckerman 처방

Psoriasis is a  chronic, immune-mediated inflammatory skin disease affecting approximately 2-3%  of the population. The Goeckerman regimen consists of ...

the-goeckerman-regimen-for-treatment-moderate-to-severe

Research

JoVE Journal

Medicine

38.7K 조회수.  University of Southern California. 건선은 만성, 면역 매개 성 염증 피부 질환입니다. 건선의 치료를 위해 공식화 Goeckerman식이 요법, 자외선 B (UVB) 빛과 원유 석탄 타르 (CCT)의 적용에 노출로 구성되어 있습니다. 다음 프로토콜은 중등도 건선의 치료를위한 Goeckerman 치료의 관리입니다.

비디오: The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Bronchial Thermoplasty:  A Novel Therapeutic Approach to Severe Asthma

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Reducing airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks. Bronchial thermoplasty is delivered by the Alair System and is performed in three outpatient procedure visits, each scheduled approximately three weeks apart. The first procedure treats the airways of the right lower lobe, the second treats the airways of the left lower lobe and the third and final procedure treats the airways in both upper lobes. After all three procedures are performed the bronchial thermoplasty treatment is complete.
Bronchial thermoplasty is performed during bronchoscopy with the patient under moderate sedation. All accessible airways distal to the mainstem bronchi between 3 and 10 mm in diameter, with the exception of the right middle lobe, are treated under bronchoscopic visualization. Contiguous and non-overlapping activations of the device are used, moving from distal to proximal along the length of the airway, and systematically from airway to airway as described previously. Although conceptually straightforward, the actual execution of bronchial thermoplasty is quite intricate and procedural duration for the treatment of a single lobe is often substantially longer than encountered during routine bronchoscopy. As such, bronchial thermoplasty should be considered a complex interventional bronchoscopy and is intended for the experienced bronchoscopist. Optimal patient management is critical in any such complex and longer duration bronchoscopic procedure. This article discusses the importance of careful patient selection, patient preparation, patient management, procedure duration, postoperative care and follow-up to ensure that bronchial thermoplasty is performed safely.
Bronchial thermoplasty is expected to complement asthma maintenance medications by providing long-lasting asthma control and improving asthma-related quality of life of patients with severe asthma. In addition, bronchial thermoplasty has been demonstrated to reduce severe exacerbations (asthma attacks) emergency rooms visits for respiratory symptoms, and time lost from work, school and other daily activities due to asthma.

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Reducing airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks.

기관지 Thermoplasty : 심한 천식에 소설 치료 접근

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled ...

연구

의학

Thermal Ablation for the Treatment of Abdominal Tumors

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ablation procedure, a thin applicator is guided into the target tumor under imaging guidance. Energy is then applied to the tissue until temperatures rise to cytotoxic levels (50-60 &deg;C). Various energy sources are available to heat biological tissues, including radiofrequency (RF) electrical current, microwaves, laser light and ultrasonic waves. Of these, RF and microwave ablation are most commonly used worldwide.
During RF ablation, alternating electrical current (~500 kHz) produces resistive heating around the interstitial electrode. Skin surface electrodes (ground pads) are used to complete the electrical circuit. RF ablation has been in use for nearly 20 years, with good results for local tumor control, extended survival and low complication rates1,2. Recent studies suggest RF ablation may be a first-line treatment option for small hepatocellular carcinoma and renal-cell carcinoma3-5. However, RF heating is hampered by local blood flow and high electrical impedance tissues (eg, lung, bone, desiccated or charred tissue)6,7. Microwaves may alleviate some of these problems by producing faster, volumetric heating8-10. To create larger or conformal ablations, multiple microwave antennas can be used simultaneously while RF electrodes require sequential operation, which limits their efficiency. Early experiences with microwave systems suggest efficacy and safety similar to, or better than RF devices11-13.
Alternatively, cryoablation freezes the target tissues to lethal levels (-20 to -40 &deg;C). Percutaneous cryoablation has been shown to be effective against RCC and many metastatic tumors, particularly colorectal cancer, in the liver14-16. Cryoablation may also be associated with less post-procedure pain and faster recovery for some indications17. Cryoablation is often contraindicated for primary liver cancer due to underlying coagulopathy and associated bleeding risks frequently seen in cirrhotic patients. In addition, sudden release of tumor cellular contents when the frozen tissue thaws can lead to a potentially serious condition known as cryoshock 16.
Thermal tumor ablation can be performed at open surgery, laparoscopy or using a percutaneous approach. When performed percutaneously, the ablation procedure relies on imaging for diagnosis, planning, applicator guidance, treatment monitoring and follow-up. Ultrasound is the most popular modality for guidance and treatment monitoring worldwide, but computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used as well. Contrast-enhanced CT or MRI are typically employed for diagnosis and follow-up imaging.

A thermal tumor ablation procedure is described. The entire procedure is detailed, including pretreatment planning and imaging studies, anesthesia, adjuvant techniques to facilitate a percutaneous approach, imaging guidance of the ablation device to the tumor, thermal treatment, post-treatment care and follow-up.

복부 종양의 치료를위한 열 절제

Percutaneous thermal ablation is an emerging treatment option for many tumors of the abdomen not amenable to conventional treatments. During a thermal ...

The Measurement and Treatment of Suppression in Amblyopia

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current estimates put the prevalence of amblyopia at approximately 1-3%1-3, the majority of cases being monocular2. Amblyopia is most frequently caused by ocular misalignment (strabismus), blur induced by unequal refractive error (anisometropia), and in some cases by form deprivation.
Although amblyopia is initially caused by abnormal visual input in infancy, once established, the visual deficit often remains when normal visual input has been restored using surgery and/or refractive correction. This is because amblyopia is the result of abnormal visual cortex development rather than a problem with the amblyopic eye itself4,5 . Amblyopia is characterized by both monocular and binocular deficits6,7 which include impaired visual acuity and poor or absent stereopsis respectively. The visual dysfunction in amblyopia is often associated with a strong suppression of the inputs from the amblyopic eye under binocular viewing conditions8. Recent work has indicated that suppression may play a central role in both the monocular and binocular deficits associated with amblyopia9,10 .
Current clinical tests for suppression tend to verify the presence or absence of suppression rather than giving a quantitative measurement of the degree of suppression. Here we describe a technique for measuring amblyopic suppression with a compact, portable device11,12 . The device consists of a laptop computer connected to a pair of virtual reality goggles. The novelty of the technique lies in the way we present visual stimuli to measure suppression. Stimuli are shown to the amblyopic eye at high contrast while the contrast of the stimuli shown to the non-amblyopic eye are varied. Patients perform a simple signal/noise task that allows for a precise measurement of the strength of excitatory binocular interactions. The contrast offset at which neither eye has a performance advantage is a measure of the "balance point" and is a direct measure of suppression. This technique has been validated psychophysically both in control13,14 and patient6,9,11 populations.
In addition to measuring suppression this technique also forms the basis of a novel form of treatment to decrease suppression over time and improve binocular and often monocular function in adult patients with amblyopia12,15,16 . This new treatment approach can be deployed either on the goggle system described above or on a specially modified iPod touch device15.

Amblyopia is a developmental disorder of the visual cortex that is often accompanied by strong suppression of one eye. We present a new technique for measuring and treating interocular suppression in patients with amblyopia that can be deployed using virtual reality goggles or a portable iPod Touch device.

약시의 억제의 측정 및 치료

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

Slow-release Drug Delivery through Elvax 40W to the Rat Retina: Implications for the Treatment of Chronic Conditions

Diseases of the retina are difficult to treat as the retina lies deep within the eye. Invasive methods of drug delivery are often needed to treat these diseases. Chronic retinal diseases such as retinal oedema or neovascularization usually require multiple intraocular injections to effectively treat the condition. However, the risks associated with these injections increase with repeated delivery of the drug. Therefore, alternative delivery methods need to be established in order to minimize the risks of reinjection. Several other investigations have developed methods to deliver drugs over extended time, through materials capable of releasing chemicals slowly into the eye. In this investigation, we outline the use of Elvax 40W, a copolymer resin, to act as a vehicle for drug delivery to the adult rat retina. The resin is made and loaded with the drug. The drug-resin complex is then implanted into the vitreous cavity, where it will slowly release the drug over time. This method was tested using 2-amino-4-phosphonobutyrate (APB), a glutamate analogue that blocks the light response of the retina. It was demonstrated that the APB was slowly released from the resin, and was able to block the retinal response by 7 days after implantation. This indicates that slow-release drug delivery using this copolymer resin is effective for treating the retina, and could be used therapeutically with further testing.

This paper details how Elvax 40W can be used as a slow-release method for drug delivery to the adult rat retina. The protocol for preparing, loading, and delivering the drug-resin complex to the eye is described.

쥐의 망막에 Elvax 40W를 통해 서방 약물 전달 : 만성 질환의 치료를위한 시사점

Diseases of the retina are difficult to treat as the retina lies deep within the eye. Invasive methods of drug delivery are often needed to treat these ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area.

This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

2-Methacryloyloxyethyl Phosphorylcholine Polymer Treatment of Complete Dentures to Inhibit Denture Plaque Deposition

Removable dentures made of poly (methyl methacrylate) (PMMA) are prone to bacterial adherence and dental plaque formation, which is called denture plaque. Denture plaque-associated infection is a source of serious dental and medical complications in the elderly. 2-Methacryloyloxyethyl phosphorylcholine (MPC) is a well-known biomedical material that exhibits marked antithrombogenicity and tissue compatibility because of its high resistance to protein adsorption and cell adhesion. Therefore, MPC polymer coatings are suggested to have the potential to inhibit plaque deposition on the surface of PMMA dentures. However, coating MPC polymer on the surface of a PMMA denture is a complex procedure that requires specialized equipment, which is regarded as a major barrier to its clinical application. 
Here, we introduce a new MPC polymer treatment procedure that uses poly (MPC-co-BMA-co-MPAz) (PMBPAz) to prevent denture plaque deposition on removable dentures. This procedure enables the MPC coating of PMMA denture surfaces in a simple and stable manner that is resistant to various chemical and mechanical stresses due to the MPC layer of PMBPAz that is covalently bound to the PMMA surface by ultraviolet light irradiation. In addition, the procedure does not require any specialized equipment and can be completed by clinicians within 2 min. We applied this procedure in a clinical setting and demonstrated its clinical utility and efficacy in inhibiting plaque deposition on removable dentures.

Removable poly(methyl methacrylate) (PMMA) dentures are prone to bacterial adherence and plaque formation. Denture plaque-associated infection is a source of serious dental and medical complications in the elderly. This paper introduces a novel protocol to treat PMMA dentures with 2-methacryloyloxyethyl phosphorylcholine polymer, poly(MPC-co-BMA-co-MPAz), to suppress plaque deposition on PMMA dentures.

전체 틀니의 2- 메타 크릴로 일 옥시 에틸 포스 포릴 폴리머 치료는 틀니 플라크 침착을 억제하는

Removable dentures made of poly (methyl methacrylate) (PMMA) are prone to bacterial adherence and dental plaque formation, which is called denture plaque. ...

Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction

Dry eye disease (DED) is an increasingly common condition and one of the most common complaints of patients. The vast majority of DED is caused by the so-called &#34;evaporative&#34; subtype, that is mainly caused by meibomian gland dysfunction (MGD). Intense pulsed light (IPL) devices employ high intensity pulses of polychromatic lights with a broad range of wavelength (515-1200 nm). IPL treatment has been utilized for years in the field of dermatology, and then its use was applied to ophthalmology for the treatment of MGD. Recently, a new device employing IPL was specifically designed for the periocular application. This procedure determines the thermal selective coagulation and ablation of superficial blood vessels and telangiectasias of the eyelids skin, reducing the release of inflammatory mediators and tear cytokines levels, and improving meibomian glands outflow. IPL treatment is noninvasive and easy to perform, lasts for only a few minutes and can be conducted in an office setting. In the present study, 19 patients underwent 3 sessions of IPL treatment. After treatment, both mean noninvasive break-up time and lipid layer thickness grade significantly increased, as a result of an improvement of tear film stability and quality, respectively. Conversely, no statistically significant changes were found for meibomian gland loss and tear osmolarity. Furthermore, the vast majority of the treated patients (17/19; 89.5% of the total) perceived an improvement of their ocular discomfort symptoms after IPL treatment. Although IPL treatment provides an improvement of both ocular surface parameters and ocular discomfort symptoms after one cycle of three sessions, regular repeated treatments are usually required to maintain the persistence over the time of its beneficial effects.

Dry eye disease is an increasingly common condition, which strongly impair patients&#39; life quality. Recently, a new device employing intense pulsed light, specifically designed for the periocular area, has been shown to improve tear film stability and ocular discomfort symptoms in dry eye disease owing to meibomian gland dysfunction.

강렬한 펄스 빛 Meibomian 동맥 역 기능 때문에 안구 건조 치료

Dry eye disease (DED) is an increasingly common condition and one of the most common complaints of patients. The vast majority of DED is caused by the ...

Establishment of a Mouse Severe Acute Pancreatitis Model using Retrograde Injection of Sodium Taurocholate into the Biliopancreatic Duct

The prevalence of acute pancreatitis (AP), especially severe acute pancreatitis (SAP), is increasing in younger age groups annually. However, there is a lack of effective treatments in the current clinical practice. With the easy accessibility of transgenic and knockout strains and their small size, which allows minimal doses of drugs required for in vivo evaluation, a well-established experimental model in mice is preferred for AP research. Moreover, SAP induced through sodium taurocholate (TC) is currently one of the most widely used and best characterized models. This model has been investigated for novel therapies and possible molecular events during the process of AP. Here, we present the generation of an AP mouse model using sodium taurocholate and a simple homemade microsyringe. Moreover, we also provide the methodology for the subsequent histology and serological testing.

A mouse model of severe acute pancreatitis is described herein. The procedure presented here is very rapid, simple, and accessible, thereby potentially allowing the study of the molecular mechanisms and different therapeutic interventions in acute pancreatitis in a convenient way.

비리오크크레아티드 덕트에 타우로콜레이트 나트륨의 역행 주입을 사용하여 마우스 심각한 급성 췌장염 모델의 설립

The prevalence of acute pancreatitis (AP), especially severe acute pancreatitis (SAP), is increasing in younger age groups annually. However, there is a ...

Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors

In view of the shortcomings of endoscopic or laparoscopic surgeries alone in the treatment of gastric gastrointestinal stromal tumors (G-GISTs), this approach makes an innovative improvement in the treatment of G-GISTs that are less than 5 cm in size. Laparoscopy-endoscopy cooperative surgery (LECS) is used to combine endoscopic and laparoscopic surgeries, fully realizing their respective advantages and avoiding their drawbacks. The main steps are as follows. First, gastroscopy and laparoscopy are combined to confirm the location and boundary of the tumor. Tumor resection is carried out laparoscopically, guided by a gastroscope. The specimen is removed orally and the gastric wound closed laparoscopically. Then, gastroscopy and laparoscopy are combined to determine whether there is wound bleeding, if the suture is satisfactory, and if the gastric cavity is deformed.
LECS has natural advantages in the treatment of G-GISTs that are less than 5 cm in size. The accurate estimation of tumor location and boundary greatly improves the complete resection rate of tumors. The risk of tumor rupture is substantially reduced, and the long-term prognosis of patients is significantly improved. The process allows for accurate resection of the tumor, maximum preservation of normal gastric tissue and organ function, and avoids postoperative gastric deformation. The patient's postoperative rehabilitation is greatly accelerated, and oral feeding can resume on the day of the operation. The specimen is taken out through the mouth to avoid the need for an extended abdominal incision. This greatly reduces the patient's postoperative pain and scarring. The method greatly shortens the postoperative hospital stay (i.e., discharge is possible on the day after the operation), increasing the turnover of hospital beds.

Laparoscopy-endoscopy cooperative surgery is appropriate for the treatment of gastric gastrointestinal stromal tumors less than 5 cm in size. It can achieve the respective advantages of endoscopic and laparoscopic surgeries while avoiding their drawbacks.

위장 기질 종양의 치료를위한 복강경 내시경 검사 협동 수술

In view of the shortcomings of endoscopic or laparoscopic surgeries alone in the treatment of gastric gastrointestinal stromal tumors (G-GISTs), this ...

Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative asoedema, hematoma, sustaining pain, and seminal tract obstruction in patients who have undertaken nonmicroscopic epididymal cyst resection or epididymal resection. Nonmicroscopic epididymal cyst surgery is suggested for patients with childbirth plans as a precaution. The treatment of male epididymal cysts via microtechnology is obviously a beneficial option; we took the lead in carrying out microscopic epididymal exploration and cyst resection surgery in China. From September 2017 to April 2021, 41 young and middle-aged male patients diagnosed with epididymal cysts underwent microtechnology treatment in a program titled &#34;microscopic epididymal exploration and cystectomy&#34;. The postoperative follow-up lasted for 3-50 months. The results confirmed that, as microscopic manipulation largely improved visualization of the subtle tissue structures of the epididymis, the cyst could be clearly dissected apart and completely removed intact under the microscope. Bleeding during the operation was significantly reduced (2-3 mL) and wound drainage was not required. According to follow-up data, microscopic treatment significantly reduced the incidence of postoperative scrotal hematoma, edema, and long-term postoperative pain, thereby promising a higher surgical success rate as well as recurrence prevention. Besides, preliminary experience and reflection suggest that microscopic epididymal exploration and cystectomy provide efficient preservation of the epididymal patency through refined treatment, while a better prognosis can be achieved. We recommend that surgery be carried out before the epididymal cyst develops to 0.8 cm in diameter, for fear that a larger epididymal cyst (&#62;0.9 cm in diameter) could cause the complete destruction of all tubules of the ipsilateral epididymis - a more severe case with damage to the testicular output network.

Here, we present a protocol to treat patients diagnosed with an epididymal cyst using microscopic cyst resection. Based on microscopic manipulation, a largely improved visualization of the subtle tissue structures of the epididymis was obtained, so the cyst could be clearly dissected apart and completely removed intact.

부고환 낭종으로 진단된 환자의 치료를 위한 현미경적 낭종 절제술

Epididymal cysts mostly occur in men aged 20-40 years old. Previous reports have covered concerns about postoperative complexes, including postoperative ...