This study was supported by grants from the American Medical Society for Sports Medicine. The authors would like to acknowledge and show our appreciation for our undergraduate research students including David Lawton, Drew Gardner, Mark Sundman, Kelsey Evans, Graham Cochrane, Jordan Cottle and Jack Halligan for their assistance in data collection over the past four years.

아래에 설명 된 모든 절차는 엘론의 임상 시험 심사위원회의 승인되었습니다. 1. 전산화 신경인지 검사 <ol><li> 질문 참가자는 컴퓨터 앞에 앉아있다. 시스템에 참가자를 기록하고 인구 통계 학적 및 배경 정보 섹션,자가보고 증상 체크리스트, 6 모듈 (워드 차별, 디자인 메모리, X의와 O의 기호 매칭, 색상 일치로 구성 전산화 신경 심리 테스트를 완료하도록 지시하고, 세 글자). </li><li> 요약 보고서를 다운로드 및 언어 적 기억, 시각 기억, 반응 시간 및 모터 처리 속도에 대한 네 가지 복합 점수를 입력합니다. </li></ol> 2. 이벤트 관련 전위 <ol><li> EEG 그물의 크기는 사용되는 결정하기 위해 측정하는 테이프를 사용하여 둘레 머리를 측정합니다. 해부학 적 랜드 마크를 측정하여 EEG 그물의 위치를​​ 결정합니다. </li><li> 그래서에서 EEG 그물을 적시염화나트륨과 5 분 아기 샴푸의 기술인 것. </li><li> 참가자의 머리에 뇌파 그물을 놓습니다. 우리가 사용하는 시스템은 32 개 채널을 포함한다. </li><li> 컴퓨터에서 사이트의 임피던스 수준을 확인합니다. 우리의 시스템의 경우, 100 킬로 오옴 이하 임피던스는 허용되는 것으로 간주된다. </li><li> 인지 적 작업을 설명하고 참가자가 각 작업을 연습 할 수 있습니다. <ol><li> 청각 괴짜 작업 : 헤드폰에 넣고 테이블에 편안하게 앉아있는 참가자를 지시한다. 그들은 낮은과 높은 톤의 시리즈를들을 수 고주파 청각 톤 버튼을 클릭하여 신속하고 가능한 한 정확하게 응답 할 것을 그들에게 알려주십시오. </li><li> 측면에 붙인 작업 : 그들이 화면에 영사 화살표의 시리즈를 제공 할 위치를 컴퓨터 화면 앞에 앉아 참가자를 지시합니다. 이 왼쪽을 가리키는 경우 마우스 왼쪽 버튼을 클릭하거나 장비를 가리키는 경우 마우스 오른쪽 버튼을 클릭하여 중간 화살표 방향에 대응하는 참가자 지시신속하고 정확하게 가능한 HT. </li></ol></li><li> 청각 괴짜 작업과 우 측면에 작업 모두 두 가지 시험을 완료하기 위해 참가자를 지시한다. </li><li> 참가자 EEG 그물을 제거하고 10 분 동안 살균제 소독제에 몸을 담글하여 EEG 그물을 청소합니다. </li></ol> 3. 체성 지각 응답 <ol><li> 감각 자극 장치에 쉬고 복와 그들의 왼손으로 편안 참가자 시트와 그들의 손가락 자극 프로브와 접촉하여 배치 숫자 (2) 및 (3)의 패딩 팁 장치의 윤곽을 따라 위치. 23 </li><li> 컴퓨터 모니터에 작업 관련 지침과 단서를 확인하고 두 버튼 컴퓨터 마우스를 사용하여 응답을 입력 할 참가자를 요청합니다. 프로젝트 5 가지 시험 :이 단순한 단일 부위 반응 시간 작업 현장 듀얼 진폭 차별, 단일 사이트 자극, 24과 24 적응 듀얼 사이트 진폭 태스크시간적 순서 판단 작업. (25) </li><li> 전에 각 테스트 실행의 시작에, 컴퓨터의 큐는 작업에 익숙해 연습 시험을 완료하기 위해 참가자를 지시합니다. 컴퓨터 (; 잘못된 예 올바른) 각 시험 후 참가자 성능 피드백을 제공 할 것입니다. </li></ol> 4. 균형 프로토콜 <ol><li> 미끄럼 방지 양말에 넣어 참가자를 지시 한 다음 장비에 익숙해되기 위해 균형 시스템에 서있다. </li><li> 화면의 중앙 점과 압력 점의 중심을 일치, 편안한 자세로 서서 참가자를 지시한다. 연구진은 장치에 서있는 동안 모든 테스트가 동일한 발 위치에 자리를 차지할 있도록이 편안하게 시작 위치를 기록합니다. </li><li> 네 가지 조건 각각에 대해 30 초 동안 서 참가자에게 질문 (오픈 눈 / 회사 표면, 눈은 거품 표면 / 눈을 감 으면, / 회사 표면을 눈을 감고 열기 / 거품면). 참가자들에게 각 조건 및 각 기록의 시작하기 전에 3 초 카운트 다운 사이에 10 초 휴식을 제공합니다. </li><li> 보조 작업을 완료하는 동안 각 조건을 반복합니다. 그들 (예를 들어, 843)에 주어진 임의의 3 자리 숫자에서 7 시작하여 거꾸로 계산하도록 지시합니다. </li><li> 흔들림 지수를, 추가 분석을 위해 나중에 사용하기 위해 각 압력 조건과 데이터 센터를위한 흔들림 량의 표준 편차의 측정 값을 기록한다. </li></ol> 5. 보행 평가 <ol><li> 참가자의 footfalls를 감지 카펫의 길이에 걸쳐 현재의 압력 센서와 긴 카펫 계측 보행 분석 시스템 &#39;휴대용 15 사용하여 보행&#39;을 참가자를 평가합니다. </li><li> 매트를 떠난 후 &#39;매트의 시작과 3 전&#39;3의 거리에서 시작하여 편안한 속도로 매트 맨발에 걸쳐 다섯 번 걸어 참가자를 요청합니다. </li><li> participa 지시동시인지 이중 작업으로 임의의 3 자리 숫자에서 일곱에 의해 거꾸로 계산하는 동안 국세청은 추가로 5 도보 시험을 완료합니다. </li><li> 보행 분석에서 출력으로 얻은 종속 변수는 속도, 케이던스 단계 길이 등 여러 시공간 매개 변수의 절대 및 변동성 조치를 포함한다. </li></ol> 6. 유전학 <ol><li> (단 면봉 스틱의 스틱 끝을 터치에주의하면서), 조심스럽게 무균 용기에있는 면봉 스틱을 제거하는 참가자에게 물어 자신의 입으로 면봉을 이동하고, 적극적으로 20 초 총 두 뺨의 안쪽에 면봉을 문질러 . </li><li> 라텍스 또는 니트릴 장갑을 착용 기술자에 면봉 스틱을 손입니다. 만 스틱 끝을 잡고 즉시 얼음에 배치, (식별 번호 만 표지) 멸균 1.7 ML 튜브에 면봉 팁을 배치합니다. </li><li> 24 시간 전송 내에서 시료는 -20 ° C 냉장고에 있습니다. </li><li> DNA를 사용하여 추출제조사의 프로토콜에 따라 표준 DNA 정제 키트. 농축 된 샘플을 얻기 위해, 추출 후, 이소프로판올 침전 단계를 수행하고 EDTA 완충액 (pH 8.0) 20 μL에 DNA를 재수. </li><li> 형광 태그 표준 폴리머 라제 연쇄 반응 (PCR) 분석을 이용하여 유전자형을 분석 할 때까지 -80 ° C에서 추출 된 DNA를 저장한다. </li><li> PCR 소프트웨어에 의한 유전자형을 &quot;전화&quot;다음 PCR 증폭 플롯을 확인하여 수동으로 확인합니다. </li></ol>

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The authors declare that they have no competing financial interests.

기준선 진동 시험이 다차원 접근법의 목적은 두 가지이다 : 1) 더 신경근 시스템 뇌진탕 (급성 및 장기)의 영향을 이해하기 위해; 2) 스포츠 의학 직원 메이크업 복귀 결정 (맥 크로 리에서 제시 한 바와 같이 그들은 주로 신경인지 검사를 사용한다). (26) 평가 뇌진탕의 원인, 기능 변경 및 복구에 관한 유용한 정보를 제공 뇌진탕 할 수있는 이러한 다각적 인 접근 방식을 재생할 수 있도록 도?...

진탕 미국에서 놀라운 속도로 발생하고 공중 보건 문제로 주목 꽤 많이 얻고있다. 질병 통제 및 예방 (CDC) 1-3 미국 센터 1.6-3800000 뇌진탕 스포츠 및 레크리에이션 활동에서 발생하는 것으로 추정 매년. 2013 뇌진탕 합의 문 (2)에 의해 정의 된 4,5 뇌진탕은 &quot;하나의 머리에 전달 &#39;충동&#39;힘으로 몸에 다른 곳에서 머리, 얼굴, 목, 또는에 직접 타격에 의해 발생할 수 있습니다.&quot;뇌진탕 월 기능 장애 발생할 수 있습니다 신경 병리학 및 / 또는 substructural 변화의 결과입니다. 이러한 적자는 몇 주 동안 지속 할 수있다 2. 운동 선수가 초기 부상 다음과 같은 자세 제어에 증가자가보고 증상 감소를 경험, 심지어 십사일 신경인지 기능이 감소하는 것은 드문 일이 아니다. 6 증상의 장기간 자연에게,에일관된 뇌진탕의 식별 및 preinjury 능력의 변화는 종종 의사, 불확실한 복구 시간, 그리고 아마도 장기 후유증으로 복잡하고 비 표준화 복귀에 플레이 의사 결정으로 이어질. 7-9 뇌진탕 후, 각각의 단기 및 장기 효과 모두를 경험할 수있다. 스포츠 관련 뇌진탕의 단기 효과는 반응 시간이 느려지 능력, 착란, 기억 장애, 의식 상실 재생의 변화, 조정, 두통, 현기증, 구토, 수면 패턴 및 기분 변화의 변화를 포함 할 수있다. 이러한 현상은 일반적으로 일 만에 해결. 2,10을하지만, 어떤 사람들은 오히려 빨리 하나의 충격에서 부상 다음 몇 주 또는 몇 달 동안 지속 할 수있는 많은 경험 느린 효과를 복구합니다. 10, 11, 12이 증상 교란을 매일 기능은인지 및 성능과 관련하여 정량화 할 수있다D 테스트합니다. 어떤 하나의 시험은 뇌진탕, 테스트 배터리의 진단을 결정 안 및 테스트 사이에 알려진 관계는 진단을 만드는 의료진 도움을 교실로 돌아가, 의사 결정을 재생 반환 할 수있다. (2) 뇌진탕에 대한 개인의 위험과 대응 복구에 큰 변화가있다. 감수성 및 복구 시간 코스를 진동 관련 (11) 요인은 잘 알려져 또는 이해되지 않습니다. 여러 가지 요인은 개인의 뇌진탕 감수성 및 복구에 영향을 미칠 수있는이 제안되었다. 이러한 요인들은 개인의 뇌진탕 역사, 초기 부상의 심각도, 편두통의 역사, 학습 장애의 역사, 정신 동반 질환의 역사, 그리고 아마도 유전 적 요인. 7, 9, 13, 14을 포함 많은 연구는 각각의 단기 및 장기 효과를 위해 특정 요소를 조사 하였다뇌진탕의 요인으로 뇌진탕, 복구 시간 코스, 유전학. 4,8,15-17 명확하게 설정되지 않은 어떤 효과적인 다각적 인 원인, 기능 변경에 관한 유용한 정보를 얻을 것입니다 평가를 충격하는 방법 및 복구입니다 변화로부터. 때문에 증상의 다양성과 회복의 불확실한 시간 코스로, 뇌진탕 평가에 대한 다각적 인 접근 방식은 보증이 사전 연습과 경쟁에 참여하는 모든 선수의 기본 테스트뿐만 아니라 적시에 평가 후 부상을 포함해야한다. 최근 리뷰는 신경인지 평가 혼자 증상을 모니터링보다 뇌진탕 회복에 더 민감 할 수 있음을 시사한다. (18)이 충격에서 회복의 좋은 지표가 될 수있는 다른 객관적인 측정이 있다는 것을있을 수 있습니다. 이 프로토콜을 위해, 우리는 그들이 얼마나 영향 b를보고 시스템의 다양한 구성 요소를 평가하기 위해 여러 작업을 사용나중에 뇌진탕. 전산화 신경인지 시험은 메모리, 처리 속도, 문제 해결 능력,인지 효율과 충동 조절을 평가할 수있다.도 6 EEG을 청각 및 시각 처리 태스크 이벤트와 관련된 전위의 시험을 통해 neuroefficiency을 평가하는데 사용될 수있다. 19 체성 차별 태스크가 될 수있다 말초 및 중앙 감각 처리 능력을 평가하기 위해 사용된다. (20)과 균형 보용 대책 기능적 성능을 평가하기 위해 사용될 수있다. 6,21 또, 역사, 뇌진탕 복구 및인지 기능을 충격하는 관계를 가질 수있는 다양한 유전자형을 평가. (22)에게 우리를 기준선은 시험이 배터리에 우리 학교 대표 학생 운동 선수를 테스트하고 무증상 때 충격이 발생할 경우 테스트를 반복합니다. 이 프로젝트의 목적은 유전, neuroc 진탕을 사용의 결과로서 성능의 잠재적 장단기 감소를 평가하는 것이다ognitive, 전기 생리, 행동, 감각, 균형과 보행 측정합니다. 충격에 대한 우리의 지식을 발전에 중요하다 뇌진탕 발생하는 다양한 증상과 장애와 관련 될 수있는 잠재적 메커니즘을 이해. 큰 뇌진탕 진단의 미래 원조 이러한 변화는 약 knowledgle뿐만 아니라 뇌진탕 관리는 재생 및 학계로 돌아가려면 복귀 관련하여. 아래에 설명 된 모든 조치 기준에서 촬영 (스포츠 학생 선수 참여 전). 우리의 현재 프로토콜은 우리가이 복구 가​​능한 리턴 투 플레이와 리턴 투 학자에 관한 유용한 정보를 제공하고 있다고 생각하기 때문에 균형 프로토콜과 함께 48 시간의 전산화 신경인지 테스트를 완료하는 것입니다. 학생 운동 선수는 증상이보고하면 그들은 다시 모든 기본 조치가 다시 유전자 검사를 제외하고, 실시하고 실험실로 돌아갑니다. 전체 프로토콜, BASeline과 증상은, 하나의 시험 기간에 완료하는 데 약 90 분 소요됩니다.

<table border="0" cellpadding="0" cellspacing="0" width="858">
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			<td height="42" style="height:42px;width:216px;">Name of Material/ Equipment</td>
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			<td>Software for task presentation for flanker task and auditory oddball</td>
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			<td style="width:356px;">EGI, Eugene, OR</td>
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			<td>Software for data collection and analysis of EEG</td>
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			<td>Biodex Medical Systems, Inc., Shirley, NY</td>
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			<td>balance testing</td>
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			<td>AMTI Corp., Watertown, MA, USA</td>
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			<td height="19" style="height:19px;">GAITRite&#160;</td>
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			<td>Gait analysis</td>
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			<td height="19" style="height:19px;width:216px;">PCR</td>
			<td style="width:356px;">Applied Biosystems, Foster City, CA</td>
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			<td>Genetic Analysis</td>
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			<td height="24" style="height:24px;">Matlab</td>
			<td style="width:356px;">Mathworks, Natick, MA, USA</td>
			<td style="width:119px;"></td>
			<td>Gait and balance analysis</td>
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			<td height="20" style="height:20px;width:216px;">Visual 3D</td>
			<td style="width:356px;">C Motion, Inc, Germantown, MD, USA</td>
			<td style="width:119px;"></td>
			<td>3D analysis&#160;</td>
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a neuroscientific approach to the examination of concussions in student-athletes

진탕는 미국에서 놀라운 속도로 발생하는 심각한 공중 보건 문제가되고있다. CDC는 1.6-3800000 뇌진탕 매년 스포츠와 레크리에이션 활동에서 발생하는 것으로 추정하고있다. 2013 뇌진탕 합의 문에 의해 정의 된 뇌진탕은 &quot;하나의 머리에 전달 &#39;충동&#39;힘으로 몸의 다른 부분에 머리, 얼굴, 목, 또는에 직접 타격에 의해 발생할 수 있습니다.&quot;진탕은 단기 모두 개인을 떠나 장기 효과. 스포츠 관련 뇌진탕의 단기 효과는 반응 시간이 느려지 능력, 착란, 기억 장애, 의식 상실 재생의 변화, 조정, 두통, 현기증, 구토, 수면 패턴 및 기분 변화의 변화를 포함 할 수있다. 이러한 현상은 일반적으로 일 만에 해결. 어떤 사람들은 오히려 빨리 하나의 충격에서 회복하는 동안 그러나, 많은 경험으로는, 할 수있는 효과를 느린몇 주 또는 몇 달 동안 지속. 요인 감수성 뇌진탕 관련 및 후속 복구 시간은 잘이 시간에 알려 지거나 이해되지 않습니다. 여러 가지 요인이 제시되었다 그들은 개인의 뇌진탕 역사, 초기 부상의 심각도, 편두통의 역사, 학습 장애의 역사, 정신 동반 질환의 역사, 아마도 유전 적 요인을 포함한다. 많은 연구는 개별적으로 특정 요인 모두 뇌진탕, 복구 시간 코스, 감수성 및 복구의 단기 및 장기 효과를 조사 하였다. 무엇을 명확하게 설정되지 않은 것은 원인, 기능 변경 및 복구에 관한 유용한 정보를 얻을 것이다 뇌진탕 평가에 효과적인 다각적 인 접근 방법이다. 이 논문의 목적은 하나의 전산화 신경인지 검사, 사건 관련 전위, 감각 지각 응답을 사용하여 뇌진탕을 검사하는 접근, 균형다면 엉덩이를 보여주는 것입니다sment, 보행 평가와 유전자 검사.

전산화 신경인지 검사 전산화 신경인지 검사에 대한 결과의 예는 그림 1에서 볼 수 있습니다. 컴퓨터 프로그램은 언어 적 기억, 시각 기억, 시각 모터 속도와 자주 복귀에 플레이하고 복귀하는 데 사용되는 반응 시간에 복합 점수를 이끌어 법이나 배워 뇌진탕 관리 프로토콜. 언어 적 및 시각적 메모리 복합 주의력 프로세스, 학습과 기억을 평가. 카?...

Watch this Scientific Journal Video about A Neuroscientific Approach to the Examination of Concussions in Student-Athletes at JoVE.com

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

뇌진탕에 대한 개인의 위험과 대응 복구에 큰 변화가있다. 뇌진탕 평가에 대한 다각적 인 접근 방식은 보증; 스포츠 및 적시에 평가 후 부상에 참여하기 전에 운동 선수의 기본 테스트를 포함. 이 프로토콜의 목적은 진탕을 조사하기 적합한 다각적 접근법을 제공하는 것이다.

학생 운동 선수에 진탕의 시험에 대한 신경 과학적 접근

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 ...

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12.6K 조회수.  Elon University.  뇌진탕에 대한 개인의 위험과 대응 복구에 큰 변화가있다. 뇌진탕 평가에 대한 다각적 인 접근 방식은 보증; 스포츠 및 적시에 평가 후 부상에 참여하기 전에 운동 선수의 기본 테스트를 포함. 이 프로토콜의 목적은 진탕을 조사하기 적합한 다각적 접근법을 제공하는 것이다. 

비디오: A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

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

A Strategy to Identify de Novo Mutations in Common Disorders such as Autism and Schizophrenia

There are several lines of evidence supporting the role of de novo mutations as a mechanism for common disorders, such as autism and schizophrenia. First, the de novo mutation rate in humans is relatively high, so new mutations are generated at a high frequency in the population. However, de novo mutations have not been reported in most common diseases. Mutations in genes leading to severe diseases where there is a strong negative selection against the phenotype, such as lethality in embryonic stages or reduced reproductive fitness, will not be transmitted to multiple family members, and therefore will not be detected by linkage gene mapping or association studies. The observation of very high concordance in monozygotic twins and very low concordance in dizygotic twins also strongly supports the hypothesis that a significant fraction of cases may result from new mutations. Such is the case for diseases such as autism and schizophrenia. Second, despite reduced reproductive fitness1 and extremely variable environmental factors, the incidence of some diseases is maintained worldwide at a relatively high and constant rate. This is the case for autism and schizophrenia, with an incidence of approximately 1% worldwide. Mutational load can be thought of as a balance between selection for or against a deleterious mutation and its production by de novo mutation. Lower rates of reproduction constitute a negative selection factor that should reduce the number of mutant alleles in the population, ultimately leading to decreased disease prevalence. These selective pressures tend to be of different intensity in different environments. Nonetheless, these severe mental disorders have been maintained at a constant relatively high prevalence in the worldwide population across a wide range of cultures and countries despite a strong negative selection against them2. This is not what one would predict in diseases with reduced reproductive fitness, unless there was a high new mutation rate. Finally, the effects of paternal age: there is a significantly increased risk of the disease with increasing paternal age, which could result from the age related increase in paternal de novo mutations. This is the case for autism and schizophrenia3. The male-to-female ratio of mutation rate is estimated at about 4&#x2013;6:1, presumably due to a higher number of germ-cell divisions with age in males. Therefore, one would predict that de novo mutations would more frequently come from males, particularly older males4. A high rate of new mutations may in part explain why genetic studies have so far failed to identify many genes predisposing to complexes diseases genes, such as autism and schizophrenia, and why diseases have been identified for a mere 3% of genes in the human genome. Identification for de novo mutations as a cause of a disease requires a targeted molecular approach, which includes studying parents and affected subjects. The process for determining if the genetic basis of a disease may result in part from de novo mutations and the molecular approach to establish this link will be illustrated, using autism and schizophrenia as examples.

Molecular genetic strategy for finding de novo mutations causing common disorders such as autism and schizophrenia.

같은 자폐증과 정신 분열증과 같은 일반적인 장애에 드 노보 변이를 식별하는 전략

There are several lines of evidence supporting the role of de novo mutations as a mechanism for common disorders, such as autism and schizophrenia. First, ...

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 ...

Clinical Examination Protocol to Detect Atypical and Classical Scrapie in Sheep

The diagnosis of scrapie, a transmissible spongiform encephalopathy (TSEs) of sheep and goats, is currently based on the detection of disease-associated prion protein by post mortem tests. Unless a random sample of the sheep or goat population is actively monitored for scrapie, identification of scrapie cases relies on the reporting of clinical suspects, which is dependent on the individual&#39;s familiarization with the disease and ability to recognize clinical signs associated with scrapie. Scrapie may not be considered in the differential diagnosis of neurological diseases in small ruminants, particularly in countries with low scrapie prevalence, or not recognized&#160;if it presents as nonpruritic form like atypical scrapie. To aid in the identification of clinical suspects, a short examination protocol is presented to assess the display of specific clinical signs associated with pruritic and nonpruritic forms of TSEs in sheep, which could also be applied to goats. This includes assessment of behavior, vision (by testing of the menace response), pruritus (by testing the response to scratching), and movement (with and without blindfolding). This may lead to a more detailed neurologic examination&#160;of reporting animals as scrapie suspects. It&#160;could also be used in experimental TSE studies of sheep or goats to evaluate disease progression or to identify clinical end-point.

A short clinical examination protocol is presented to aid in the detection of classical and atypical scrapie in sheep and goats.

양에서 비정형 및 고전적인 스크레이키를 감지하는 임상 시험 프로토콜

The diagnosis of scrapie, a transmissible spongiform encephalopathy (TSEs) of sheep and goats, is currently based on the detection of disease-associated ...

Echocardiographic and Histological Examination of Cardiac Morphology in the Mouse

An increasing number of genetically modified mouse models has become available in recent years. Moreover, the number of pharmacological studies performed in mice is high. Phenotypic characterization of these mouse models also requires the examination of cardiac function and morphology. Echocardiography and magnetic resonance imaging (MRI) are commonly used approaches to characterize cardiac function and morphology in mice. Echocardiographic and MRI equipment specialized for use in small rodents is&#160;expensive and requires a dedicated space. This protocol describes cardiac measurements in mice using a clinical echocardiographic system with a 15 MHz human vascular probe. Measurements are performed on anesthetized adult mice. At least three image sequences are recorded and analyzed for each animal in M-mode in the parasternal short-axis view. Afterwards, cardiac histological examination is performed, and cardiomyocyte diameters are determined on hematoxylin-eosin- or wheat germ agglutinin (WGA)-stained paraffin sections. Vessel density is determined morphometrically after Pecam-1 immunostaining. The protocol has been applied successfully to pharmacological studies and different genetic animal models under baseline conditions, as well as after experimental myocardial infarction by the permanent ligation of the left anterior descending coronary artery (LAD). In our experience, echocardiographic investigation is limited to anesthetized animals and is feasible in adult mice weighing at least 25 g.

Echocardiographic examination is frequently used in mice. Expensive high-resolution ultrasound devices have been developed for this purpose. This protocol describes an affordable echocardiographic procedure combined with histological morphometric analyses to determine cardiac morphology.

마우스의 심장 형태학의 echocardiographic 및 조직학 검사

An increasing number of genetically modified mouse models has become available in recent years. Moreover, the number of pharmacological studies performed ...

An In Vitro Approach to Photodynamic Therapy

Photodynamic therapy (PDT) is a medical procedure that involves incubation of an exogenously applied photosensitizer (PS) followed by visible light photoactivation to induce cell apoptosis. The Federal Drug Administration has approved PDT for the treatment of actinic keratosis, and clinical guidelines recommend PDT as a treatment for certain non-melanoma skin cancers and acne vulgaris. PDT is an advantageous therapeutic modality as it is low cost, non-invasive, and associated with minimal adverse events and scaring. In the first step of PDT, a PS is applied and allowed to accumulate intracellularly. Subsequent light irradiation induces reactive oxygen species formation, which may ultimately lead to cell apoptosis, membrane disruption, mitochondrial damage, immune modulation, keratinocyte proliferation, and collagen turnover. Herein, we present an in vitro method to study PDT in an adherent cell line. This treatment protocol is designed to simulate PDT and may be adjusted to studying the use of PDT with various cell lines, photosensitizers, incubation temperatures, or photoactivation wavelengths. Squamous cell carcinoma cells were incubated with 0, 0.5, 1.0, and 2 mM 5-aminolevulinic acid (5-ALA) for 30 min and photoactivated with 417 nm blue light for 1,000 s. The primary outcome measure was apoptosis and necrosis, as measured by annexin-V and 7-aminoactinomycin D flow cytometry. There was a dose-dependent increase in cell apoptosis following thirty-minute incubation of 5-ALA. To achieve high inter-test validity, it is important to maintain consistent incubation and light parameters when performing in vitro PDT experiments. PDT is a useful clinical procedure and in vitro research may allow for the development of novel PSs, optimization of protocols, and new indications for PDT.

An In Vitro Approach to Photodynamic Therapy

Photodynamic therapy (PDT) is a medical procedure that involves incubation of an exogenously applied photosensitizer (PS) followed by visible light photoactivation to induce apoptosis. We present an in vitro PDT protocol designed to simulate PDT that may be used to study differences in PS incubation and light treatment parameters.

Photodynamic 치료 체 외에서 접근

Photodynamic therapy (PDT) is a medical procedure that involves incubation of an exogenously applied photosensitizer (PS) followed by visible light ...

A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts

Clinical case reports (CCRs) are a valuable means of sharing observations and insights in medicine. The form of these documents varies, and their content includes descriptions of numerous, novel disease presentations and treatments. Thus far, the text data within CCRs is largely unstructured, requiring significant human and computational effort to render these data useful for in-depth analysis. In this protocol, we describe methods for identifying metadata corresponding to specific biomedical concepts frequently observed within CCRs. We provide a metadata template as a guide for document annotation, recognizing that imposing structure on CCRs may be pursued by combinations of manual and automated effort. The approach presented here is appropriate for organization of concept-related text from a large literature corpus (e.g., thousands of CCRs) but may be easily adapted to facilitate more focused tasks or small sets of reports. The resulting structured text data includes sufficient semantic context to support a variety of subsequent text analysis workflows: meta-analyses to determine how to maximize CCR detail, epidemiological studies of rare diseases, and the development of models of medical language may all be made more realizable and manageable through the use of structured text data.

We present a protocol and associated metadata template for the extraction of text describing biomedical concepts in clinical case reports. The structured text values produced through this protocol can support deep analysis of thousands of clinical narratives.

있도록 임상 사례 보고서에 대 한 메타 데이터 추출 방법 고급 생물 의학 개념의 이해

Clinical case reports (CCRs) are a valuable means of sharing observations and insights in medicine. The form of these documents varies, and their content ...

A Novel Approach to Monitoring Graft Neovascularization in the Human Gingiva

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids direct contact with the measured area, it is suitable for monitoring blood flow changes during wound healing in human patients. Vestibuloplasty is periodontal surgery to the oral vestibule, aiming to restore vestibular depth with simultaneous enlargement of the keratinized gingiva. In this special clinical case, a split thickness flap was elevated at the first upper premolar and a xenogenic collagen matrix was adapted to the resulting recipient bed. LSCI was used to monitor the re- and neovascularization of the graft and the surrounding mucosa for one year. A protocol is introduced for the correct adjustment of microcirculation measurement in the oral mucosa, highlighting difficulties and possible failures.
The clinical case study presented demonstrated that &#8212; following the appropriate protocol &#8212; LSCI is a suitable and reliable method for following up microcirculation in a healing wound in the human oral mucosa and gives useful information on graft integration.

This study introduces a protocol for measuring microcirculation in human oral mucosa by laser speckle contrast imaging. The monitoring of wound healing after vestibuloplasty combined with a xenogenic collagen graft is presented on a clinical case.

새로운 접근 방식을 접목 Neovascularization 인간의 Gingiva에 모니터링

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids ...

Transthoracic Echocardiographic Examination in the Rabbit Model

Large animal models such as the rabbit are valuable for translational preclinical research. Rabbits have a similar cardiac electrophysiology compared to that of humans and that of other large animal models such as dogs and pigs. However, the rabbit model has the additional advantage of lower maintenance costs compared to other large animal models. The longitudinal evaluation of cardiac function using echocardiography, when appropriately implemented, is a useful methodology for preclinical assessment of novel therapies for heart failure with reduced ejection fraction (e.g. cardiac regeneration). The correct use of this non-invasive tool requires the implementation of a standardized examination protocol following international guidelines. Here we describe, step by step, a detailed protocol supervised by veterinary cardiologists for performing echocardiography in the rabbit model, and demonstrate how to correctly obtain the different echocardiographic views and imaging planes, as well as the different imaging modes available in a clinical echocardiography system routinely used in human and veterinary patients.

Here we describe, step by step, a detailed protocol for performing echocardiography in the rabbit model. We show how to correctly obtain the different echocardiographic views and imaging planes, as well as the different imaging modes available in a clinical echocardiography system routinely used in human and veterinary patients.

토끼 모델의 흉부 심초음파 검사

Large animal models such as the rabbit are valuable for translational preclinical research. Rabbits have a similar cardiac electrophysiology compared to ...

인간의 미세혈관 기능 장애의 새로운 메커니즘 조사

Intradermal Microdialysis: An Approach to Investigating Novel Mechanisms of Microvascular Dysfunction in Humans

The cutaneous vasculature is an accessible tissue that can be used to assess microvascular function in humans. Intradermal microdialysis is a minimally invasive technique used to investigate mechanisms of vascular smooth muscle and endothelial function in the cutaneous circulation. This technique allows for the pharmacological dissection of the pathophysiology of microvascular endothelial dysfunction as indexed by decreased nitric oxide-mediated vasodilation, an indicator of cardiovascular disease development risk. In this technique, a microdialysis probe is placed in the dermal layer of the skin, and a local heating unit with a laser Doppler flowmetry probe is placed over the probe to measure the red blood cell flux. The local skin temperature is clamped or stimulated with direct heat application, and pharmacological agents are perfused through the probe to stimulate or inhibit intracellular signaling pathways in order to induce vasodilation or vasoconstriction or to interrogate mechanisms of interest (co-factors, antioxidants, etc.). The cutaneous vascular conductance is quantified, and mechanisms of endothelial dysfunction in disease states can be delineated.

저자 스포트라이트: 심혈관 질환 위험 집단의 메커니즘을 밝히기 위한 약리해부 접근법 

Intradermal microdialysis is a minimally invasive technique used to investigate microvascular function in health and disease. Both dose-response and local heating protocols can be utilized for this technique to explore mechanisms of vasodilation and vasoconstriction in the cutaneous circulation.

피내 미세투석: 인간의 미세혈관 기능 장애의 새로운 메커니즘을 조사하기 위한 접근 방식

The cutaneous vasculature is an accessible tissue that can be used to assess microvascular function in humans. Intradermal microdialysis is a minimally ...

Methods Article

학생 운동 선수에 진탕의 시험에 대한 신경 과학적 접근