저자 아무 승인 있다.

헬싱키의 선언, 연구 프로토콜을 준수 하 고 모든 환자는 연구에 참여 하기 전에 서 면된 동의 제공.
1. 비-활성화 A-PRP 준비
<ol><li>주변 정 맥 튜브를 사용 하 여 로컬 혈액 컬렉션 프로토콜에 따라 나비 바늘으로 팔에서 혈액 헌 혈의 55 mL 수확.</li>
	<li>항 응고 제로 혈액 튜브를 산 시트르산 포도 당 (ACD) 솔루션 (시트르산의 112 m m)의 7 mL를 추가 합니다.</li>
	<li>원심 분리기는 혈액 10 분 260 x g에서 튜브에 수집. 참고: A-PRP + 헌 혈소판 가난한 플라스마 (A-PPP)의 23 mL 및 적혈구 현 탁 액 (Rbc)의 20 mL 생산 되었다.</li>
	<li>A-PRP + A PPP와 Rbc는 원심 분리기에서 포함 된 튜브를 꺼내와 레이저 광 선택기 장치에 삽입.</li>
	<li>별도 A-PRP + A-PPP 기계 흡입 키트 배치 됩니다 레이저 선택기에 의해 수행에 의해 살 균 가방. Rbc는 기계적인 흡입에 의해 자동으로 제거 됩니다. 참고: A PPP의 14 mL 수동으로 수확 이었고 키트에서 멸 균 봉투에 의해 제거. A-PRP의 9 mL 얻은 했다.</li>
</ol>2. 비-활성화 A-PRP 주사
<ol><li>AGA 정면, 정수 리, 정점, 및 후 두 영역에는 영향을 받는 환자의 두 피를 나눕니다. 주의: 마 취 (로컬 또는 조직)를 수행 하지 마십시오.</li>
	<li>Interfollicular A-PRP 주사 (0.20 mL x cm2) 의료 인젝터에 의해 수행 ( 재료의 표참조) 두 피의 선택 된 분야에 총.<ol>
<li>환자에서 탈모 정면 그리고 정수 리 지역에 지역화, 정면 지역에 독점적으로 A-PRP 주사를 수행 하 고 정수 리 영역에 위약으로 식 염 수를 사용 합니다.</li>
		<li>환자에서 탈모는 정수 리와 정점 지역 지역화, A-정수 리 영역에서 PRP를 주사 하 고 정점 영역에 위약으로 식 염 수를 사용 합니다.</li>
	</ol>
</li>
	<li>각 환자에 대 한 A-PRP와 위약 주사의 동등한 수를 수행 합니다.</li>
	<li>의료 인젝터 총 30 G 바늘, 10 mL 주사기를 사용 하 여 5 m m의 깊이에서 interfollicular A-PRP 주사 수행 합니다.</li>
	<li>30 일 따로따로 간격을 둔 3 개의 세션을 수행 합니다.</li>
</ol>

<ol>
	<li>Rousso, D. E., Kim, S. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+review+of+medical+and+surgical+treatment+options+for+androgenetic+alopecia.">A review of medical and surgical treatment options for androgenetic alopecia.</a> JAMA Facial Plast Surg. 16, 444-450 (2014).</li><li>Schweiger, E. S., Boychenko, O., Bernstein, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Update+on+the+pathogenesis,+genetics+and+medical+treatment+of+patterned+hair+loss.">Update on the pathogenesis, genetics and medical treatment of patterned hair loss.</a> J Drugs Dermatol. 9, 1412-1419 (2010).</li><li>Price, V. H., 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=Lack+of+efficacy+of+finasteride+in+postmenopausal+women+with+androgenetic+alopecia.">Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia.</a> J Am Acad Dermatol. 43, 768-776 (2000).</li><li>Imperato-McGinley, J., Guerrero, L., Gautier, T., Peterson, R. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Steroid+5alpha-reductase+deficiency+in+man:+An+inherited+form+of+male+pseudohermaphroditism.">Steroid 5alpha-reductase deficiency in man: An inherited form of male pseudohermaphroditism.</a> Science. 186, 1213-1215 (1974).</li><li>Drake, L., 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=The+effects+of+finasteride+on+scalp+skin+and+serum+androgen+levels+in+men+with+androgenetic+alopecia.">The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.</a> J Am Acad Dermatol. 41, 550-554 (1999).</li><li>Van Neste, D., 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=Finasteride+increases+anagen+hair+in+men+with+androgenetic+alopecia.">Finasteride increases anagen hair in men with androgenetic alopecia.</a> Br J Dermatol. 143, 804-810 (2000).</li><li>Kaufman, K. D., 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=Finasteride+in+the+treatment+of+men+with+androgenetic+alopecia.">Finasteride in the treatment of men with androgenetic alopecia.</a> J. Am Acad Dermatol. 39, 578-589 (1998).</li><li>Afifi, L., 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=Low-level+laser+therapy+as+a+treatment+for+androgenetic+alopecia.">Low-level laser therapy as a treatment for androgenetic alopecia.</a> Lasers Surg Med. 49, 27-39 (2017).</li><li>Uebel, C. O., 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=The+role+of+platelet+plasma+growth+factors+in+male+pattern+baldness+surgery.">The role of platelet plasma growth factors in male pattern baldness surgery.</a> Plast Reconstr Surg. 118, 1458-1466 (2006).</li><li>Cervelli, V., 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=The+effect+of+autologous+activated+platelet+rich+plasma+(AA-PRP)+injection+on+pattern+hair+loss:+Clinical+and+histomorphometric+evaluation.">The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: Clinical and histomorphometric evaluation.</a> BioMed Res Int. , 760709 (2014).</li><li>Gkini, M. A., 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=Study+of+platelet-rich+plasma+injections+in+the+treatment+of+androgenetic+alopecia+through+an+one-year+period.">Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period.</a> J Cutan Aesthet Surg. 7, 213-219 (2014).</li><li>Gentile, P., Garcovich, S., Bielli, A., Scioli, M. G., Orlandi, A., Cervelli, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+platelet-rich+plasma+in+hair+regrowth:+A+randomized+placebo-controlled+trial.">The effect of platelet-rich plasma in hair regrowth: A randomized placebo-controlled trial.</a> Stem Cells Transl Med. 4, 1317-1323 (2015).</li><li>Gentile, P., 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=Evaluation+of+Not-Activated+and+Activated+PRP+in+Hair+Loss+Treatment:+Role+of+Growth+Factor+and+Cytokine+Concentrations+Obtained+by+Different+Collection+Systems.">Evaluation of Not-Activated and Activated PRP in Hair Loss Treatment: Role of Growth Factor and Cytokine Concentrations Obtained by Different Collection Systems.</a> Int J Mol Sci. 18 (2), 14 (2017).</li></ol>

저자는 공개 없다.

저자는 기계 및 제어 A PRP의 주사 가능한 아가 치료 옵션, 외과 의사의 손에 의해 수행 하는 수동 주입에 비해 절차 동안 통증의 감소와 함께 대표를 시연 했다. 이 프로토콜 치료 환자는 머리 수와 총 머리 밀도 수동 주사로 치료 하는 환자 보다 더 큰 증가를 발견 됐다.
머리 수와 머리 밀도의 향상을 얻기 위해 가장 중요 한 측?...

임상 비 활성화 A-PRP 주사 대상으로 머리카락의 성장을 위한 매력적인 자원 되고있다. 여기, AGA에서 A-PRP 응용 프로그램의 프로토콜은 보고, 기계 및 제어 주사를 사용 하 여. 현재, 구두만 선택적 5-α-reductase 억제제, 국 소 diaminopirimidilpiperidin-N-ossido (2.0% 및 5.0%), 그리고 낮은 수준의 레이저 치료 (LLLT) 전투 MPHL1,2 미국 식품 및 의약품 안전 청 (FDA) 승인 .
Diaminopirimidilpiperidin-N-ossido 5% 거품은 또한 FPHL에 대 한 FDA에 의해 승인 됩니다. 선택적 5-α-reductase 억제제는 주로 FPHL3, 치료에 효과가 입증 그리고, 주어진 약물의 남성 태아 외부 생식 기에 이상이 발생할 수 있습니다, 미리 폐 경기 여성4사용에 적합 하지 않습니다. 반대로, 선택 5-α-reductase 억제제의 1 밀리 그램으로 매일 치료 70% 혈 청 dihydrotestosterone (DHT) 수치를 줄이기 위해 표시 되었습니다 고 anagen 머리 머리 직경에 있는 점진적 증가 및 남성 AGA 연신 율 머리의 머리카락 성장을 촉진합니다 환자5,6, 머리 밀도에 상당한 개선을 통해. 구두 선택 5 α 환 원 효소 억제제를 사용 하 여 치료의 최대 1 년 해야 하 고 사용자 후 약물 중단된7유지 수 리비도의 상실을 개발할 수 있습니다.
최근, LLLT 사용 머리 regrowth을 자극 하 제안 되었습니다. Afifi 외. 8 LLLT 아가 대 한 효과적인 치료 여부를 결정 하는 기존 연구 결과 검토 합니다. 이식 전에 수확된 낭 활성화 헌 혈소판이 풍부한 혈장 (PRP AA)의 국 소 응용 프로그램 뿐만 아니라 전시 증가 머리 아가9, 영향을 받는 환자에서 15%로 그들의 생존 율을 증가 표시 되었습니다 이미 그 시간10동안 19% 증가 하는 터미널 머리 밀도와 밀도 3 개월 후 수술. 이러한 결과 다음 AGA 환자 1 년11에 걸쳐 칼슘 활성화 PRP로 치료 연구에서 확인 되었다.
탈모 증 치료, 및 데이터의 부족으로 임상 주사 시스템에 대 한 AA PRP12 A PRP13 의 긍정적인 결과 감안할 때,이 작품의 기본 목표는 기계적 표시 PRP 주사 프로토콜 제어.
18 남성 5 여성 환자 세 21-70 MPHL 노우 드 해밀턴 분류 규모에 의해 결정 된 대로 단계 5 단계 2에서 표시 하 고 1 단계 2 단계에서에서 FPHL로 치료 했다 루드비히 분류 규모에 의해 결정 된 대로 기계 및 A-prp 주사를 제어. AGA 진단 의료 역사, trichoscopic 분석, 부정적인 머리 풀 테스트, 실험실 검사 및 소변 검사와 임상 평가 의해 만들어졌다.
아가의 무대 노우 드 해밀턴 및 루드비히 규모를 사용 하 여 평가 되었습니다. 이 연구에 포함 된 참가자의 모든 의료에 의해 평가 했다 의사 전문 피부과 및 재생 성형 수술과 탈모 증에 두 성형 외과 의사 전문가. 저자는 모든 환자에 대 한 지역화 및 조직의 제외 기준 간주 됩니다. 체계적인 기준 혈액 및 혈소판 질환, 항 응 혈 약 그리고/또한 antiaggregation 치료, 패 혈 증, 면역 억제, 암, 이전 12 개월 동안에 구두 선택 5-α-reductase 억제제 또는 antiandrogens의 사용에 의해 대표 되었다.
지역화 된 제외 기준 이전 12 개월 동안에 국 소 치료에 대 한 diaminopirimidilpiperidin-N-ossido (2.0% 및 5.0%) 이나 코르 티 코 스테로이드의 사용에 의해 대표 되었다.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>C-PunT system</td>
			<td>Biomed Device, Modena, Italy</td>
			<td>www.biomeddevice.it</td>
			<td>a closed system medical device to obtain autologous concentrated platelet-rich plasma from the blood</td>
		</tr>
		<tr>
			<td>Ultim Gun</td>
			<td>Anti-Aging Medical System</td>
			<td>www.aamedicalsystems.fr</td>
			<td>a gun medical device to perform a mechanical and controlled injections of autologous platelet-rich plasma in a selected area of the scalp</td>
		</tr>
		<tr>
			<td>Trichoscan</td>
			<td>Tricolog GmbH, Freiburg, Germany).</td>
			<td>www.tricholog.de</td>
			<td>trihoScan is a digital 
			software-supported epiluminescence technique for measuring hair count (number of hairs per 0.65 cm2), hair density (number of hairs per cm2), hair diameter, anagen-to-telogen ratio, and vellus 
			hair-to-terminal hair ratio.</td>
		</tr>
		<tr>
			<td>sodium citrate ACD-A</td>
			<td>S.A.L.F.</td>
			<td>SAAS2205GPO</td>
			<td>anticoagulant for PRP preparation</td>
		</tr>
		<tr>
			<td>&#160;30-Gauge needle&#160;</td>
			<td>Becton Dickinson&#160;</td>
			<td>Z192368</td>
			<td>needle for injections</td>
		</tr>
		<tr>
			<td>10 mL mL Luer-Lock syringe</td>
			<td>Becton Dickinson&#160;</td>
			<td>BD309695</td>
			<td>syringe for PRP collection</td>
		</tr>
	</tbody>
</table>

mechanical and controlled prp injections in patients affected by androgenetic alopecia

23 환자 (18 남성과 5 여성) 21-70 세 남성 패턴 머리 손실 (MPHL) 단계 1 단계 5 노우 드 해밀턴 분류 규모에 의해 결정 되 고 여성 패턴 탈모 (FPHL)는 루드비히에 의해 결정 된 대로 단계 2 단계 1 표시 분류 규모, 비 활성화 헌 혈소판이 풍부한 혈장 (PRP A)로 치료 했다. 자가 혈액 헌 혈 (55 mL)으로 항 응고 제 시트르산 나트륨을 사용 하 여 수확 했다. A-PRP (23 mL) 수혈 서비스 프로토콜에 따라 폐쇄 시스템을 사용 하 여 모든 경우에 대 한 제작 되었습니다. 원심 (260 x g 10 분에 대 한) 다음 A-PRP 레이저 빛 선택기 장치에 삽입 했다 하 고, 원심 분리 후 A-PRP의 9 mL 수집 했다.
Androgenetic 탈모 증 (AGA)에 의해 영향을 받는 환자의 두 피 (정면, 정수 리, 정점, 및 후 두); 4 개의 지역으로 분할 되었다 취는 수행 되지 않습니다. Interfollicular A-PRP 주사 (0.2 mL x cm2) 의료 인젝터 총을 사용 하 여 5 m m의 깊이 제어 및 기계 주사에 의해 수행 되었습니다. 치료 세션 30 일 간격으로 수행 했다. 각 환자에 대 한 3 개의 치료 세션 수행 했다.
PRP는 두 피 탈모의 영향을의 안 드로 겐 관련 영역에 주입 했다. 위약 (정상적인 염 분 해결책) 다른 주사기 (10 mL)에 로드 된 하 고 비슷한 방식으로 인접 한 측에 주입.

머리 성장 매개 변수 측정 3 개월 후에 tricoscopic 분석에 의해 3 A-PRP 주사 A PRP 치료 영역 제어 영역으로 생리 식 염 수 주사를 받은 사이 기준선 측정와 비교 했다 위약입니다. 기준선에 첫 번째 치료 전에 머리 수 (122 ± 10) 통계 차이 없고 머리 밀도 (218 ± 17) 대상된 지역 및 제어 영역 (126 ± 9 기준선 머리 수 제어 영역), 사이 보고 했다 (225 ± 15 기준 머리 밀도 제어 영역)입니다.
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Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia

이 종이 androgenetic 탈모 증 30 게이지 바늘을 갖춘 의료 인젝터 총을 사용 하 여 5 m m의 깊이에 의해 영향을 받는 23 환자의 두 피에 interfollicular 헌 혈소판이 풍부한 혈장 주사 (0.20 mL x2cm)를 설명 하는 것을 목표로 3 세션입니다.

Androgenetic 탈모 증에 의해 영향을 받는 환자에서 기계 및 제어 PRP 주사

23 patients (18 male and 5 female) aged 21-70 years who displayed male pattern hair loss (MPHL) in Stage 1 to Stage 5 as determined by the ...

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JoVE Journal

Medicine

15.0K 조회수.  University of Rome Tor Vergata. 이 종이 androgenetic 탈모 증 30 게이지 바늘을 갖춘 의료 인젝터 총을 사용 하 여 5 m m의 깊이에 의해 영향을 받는 23 환자의 두 피에 interfollicular 헌 혈소판이 풍부한 혈장 주사 (0.20 mL x2cm)를 설명 하는 것을 목표로 3 세션입니다.

비디오: Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia

Isolation of Soluble and Insoluble PrP Oligomers in the Normal Human Brain

The central event in the pathogenesis of prion diseases involves a conversion of the host-encoded cellular prion protein PrPC into its pathogenic isoform PrPSc 1. PrPC is detergent-soluble and sensitive to proteinase K (PK)-digestion, whereas PrPSc forms detergent-insoluble aggregates and is partially resistant to PK2-6. The conversion of PrPC to PrPSc is known to involve a conformational transition of &alpha;-helical to &beta;-sheet structures of the protein. However, the in vivo pathway is still poorly understood. A tentative endogenous PrPSc, intermediate PrP* or "silent prion", has yet to be identified in the uninfected brain7.
Using a combination of biophysical and biochemical approaches, we identified insoluble PrPC aggregates (designated iPrPC) from uninfected mammalian brains and cultured neuronal cells8, 9. Here, we describe detailed procedures of these methods, including ultracentrifugation in detergent buffer, sucrose step gradient sedimentation, size exclusion chromatography, iPrP enrichment by gene 5 protein (g5p) that specifically bind to structurally altered PrP forms10, and PK-treatment. The combination of these approaches isolates not only insoluble PrPSc and PrPC aggregates but also soluble PrPC oligomers from the normal human brain. Since the protocols described here have been used to isolate both PrPSc from infected brains and iPrPC from uninfected brains, they provide us with an opportunity to compare differences in physicochemical features, neurotoxicity, and infectivity between the two isoforms. Such a study will greatly improve our understanding of the infectious proteinaceous pathogens. The physiology and pathophysiology of iPrPC are unclear at present. Notably, in a newly-identified human prion disease termed variably protease-sensitive prionopathy, we found a new PrPSc that shares the immunoreactive behavior and fragmentation with iPrPC 11, 12. Moreover, we recently demonstrated that iPrPC is the main species that interacts with amyloid-&beta; protein in Alzheimer disease13. In the same study, these methods were used to isolate Abeta aggregates and oligomers in Alzheimer's disease13, suggesting their application to non-prion protein aggregates involved in other neurodegenerative disorders.

A new species of cellular prion protein (PrPC) has recently been identified in uninfected human brains using the methods described here. These methods can be used to isolate various PrP species, while some of them are also useful in isolating other misfolded protein aggregates from human brains.

보통 인간의 뇌에 용해와 불용성 PRP의 Oligomers의 절연

The central event in the pathogenesis of prion diseases involves a conversion of the host-encoded cellular prion protein PrPC into its pathogenic isoform ...

연구

의학

Controlled Cervical Laceration Injury in Mice

Use of genetically modified mice enhances our understanding of molecular mechanisms underlying several neurological disorders such as a spinal cord injury (SCI). Freehand manual control used to produce a laceration model of SCI creates inconsistent injuries often associated with a crush or contusion component and, therefore, a novel technique was developed. Our model of cervical laceration SCI has resolved inherent difficulties with the freehand method by incorporating 1) cervical vertebral stabilization by vertebral facet fixation, 2) enhanced spinal cord exposure, and 3) creation of a reproducible laceration of the spinal cord using an oscillating blade with an accuracy of &plusmn;0.01 mm in depth without associated contusion. Compared to the standard methods of creating a SCI laceration such as freehand use of a scalpel or scissors, our method has produced a consistent lesion. This method is useful for studies on axonal regeneration of corticospinal, rubrospinal, and dorsal ascending tracts.

A novel technique to create a reproducible in vivo model of cervical spinal cord laceration injury in the mouse is described. This technique is based on spine stabilization by fixation of the cervical facets and laceration of the spinal cord using an oscillating blade with an accuracy of &plusmn;0.01 mm.

마우스의 제어 자궁 경부 열상 상해

Use of genetically modified mice enhances our  understanding of molecular mechanisms underlying several neurological disorders  such as a spinal cord ...

Performing Subretinal Injections in Rodents to Deliver Retinal Pigment Epithelium Cells in Suspension

The conversion of light into electrical impulses occurs in the outer retina and is accomplished largely by rod and cone photoreceptors and retinal pigment epithelium (RPE) cells. RPE provide critical support for photoreceptors and death or dysfunction of RPE cells is characteristic of age-related macular degeneration (AMD), the leading cause of permanent vision loss in people age 55 and older. While no cure for AMD has been identified, implantation of healthy RPE in diseased eyes may prove to be an effective treatment, and large numbers of RPE cells can be readily generated from pluripotent stem cells. Several interesting questions regarding the safety and efficacy of RPE cell delivery can still be examined in animal models, and well-accepted protocols used to inject RPE have been developed. The technique described here has been used by multiple groups in various studies and involves first creating a hole in the eye with a sharp needle. Then a syringe with a blunt needle loaded with cells is inserted through the hole and passed through the vitreous until it gently touches the RPE. Using this injection method, which is relatively simple and requires minimal equipment, we achieve consistent and efficient integration of stem cell-derived RPE cells in between the host RPE that prevents significant amount of photoreceptor degeneration in animal models. While not part of the actual protocol, we also describe how to determine the extent of the trauma induced by the injection, and how to verify that the cells were injected into the subretinal space using in vivo imaging modalities. Finally, the use of this protocol is not limited to RPE cells; it may be used to inject any compound or cell into the subretinal space.

Here we present a community accepted protocol in multimedia format for subretinally injecting a bolus of RPE cells in rats and mice. This approach can be used for determining rescue potentials, safety profiles, and survival capacities of grafted RPE cells upon implantation in animal models of retinal degeneration.

서스펜션에 망막 색소 상피 세포를 제공하기 위해 설치류에서 망막 주사를 수행

The conversion of light into electrical impulses occurs in the outer retina and is accomplished largely by rod and cone photoreceptors and retinal pigment ...

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea

Neurological diseases can be complicated by sialorrhea, an excessive flow of saliva. Patients suffering from moderate to severe sialorrhea have an impaired quality of life, often worsened by correlated complications such as aspiration pneumonia, oral infections, dental caries, and maceration of the skin. Diverse therapeutic approaches have been proposed for the treatment of sialorrhea, including surgery and the use of anticholinergic agents, with limited results and the possible occurrence of serious adverse events. Recently, botulinum toxin (BoNT) injection within the major salivary glands has been proposed in patients refractory to anticholinergic therapy, with the aim of inhibiting local acetylcholine release and gland activity. 
In order to obtain a better outcome in terms of reduction of saliva production, efficacy, duration, and avoidance of major adverse events, we developed an ultrasound-guided BoNT-type A injection technique accurately described in the text. Here we present a method of treating sialorrhea with bilateral parotid and submandibular gland BoNT-type A injections under ultrasound guidance. Four quadrants of the parotid gland and two quadrants of the submandibular gland are visualized and injected using two accesses and one access, respectively. 
The ultrasound-guided procedure provides a simple, non-invasive, real-time visualization of the muscular and glandular tissues and their surrounding structures, optimizing treatment efficacy and safety.

Botulinum toxin is injected into the salivary glands for the treatment of sialorrhea. The ultrasound-guided botulinum toxin injection in both the parotid and submandibular glands demonstrates a sustained efficacy and the absence of serious side effects.

보툴리눔 독소-A 주사를 초음파 유도 : Sialorrhea을 치료하는 방법

Neurological diseases can be complicated by sialorrhea, an excessive flow of saliva. Patients suffering from moderate to severe sialorrhea have an ...

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

In patients with small aortic roots who need an aortic valve replacement with biological valve substitutes, the implantation of the stented pericardial valve might not meet the functional needs. The implantation of a too-small stented pericardial valve, leading to an effective orifice area indexed to a body surface area less than 0.85 cm2/m2, is regarded as prosthesis-patient mismatch (PPM). A PPM negatively affects the regression of left ventricular hypertrophy and thus the normalization of left ventricular function and the alleviation of symptoms. Persistent left ventricular hypertrophy is associated with an increased risk of arrhythmias and sudden cardiac death. In the case of predictable PPM, there are three options: 1) accept the PPM resulting from the implantation of a stented pericardial valve when comorbidities of the patient forbid the more technically demanding operative technique of implanting a larger prosthesis, 2) enlarge the aortic root to accommodate a larger stented valve substitute, or 3) implant a stentless biological valve or a homograft. Compared to classical aortic valve replacement with stented pericardial valves, the full-root implantation of stentless aortic xenografts offers the possibility of implanting a 3-4 mm larger valve in a given patient, thus allowing significant reduction in transvalvular gradients. However, a number of cardiac surgeons are reluctant to transform a classical aortic valve replacement with stented pericardial valves into the more technically challenging full-root implantation of stentless aortic xenografts. Given the potential hemodynamic advantages of stentless aortic xenografts, we have adopted full-root implantation to avoid PPM in patients with small aortic roots necessitating an aortic valve replacement. Here, we describe in detail a technique for the full-root implantation of stentless aortic xenografts, with emphasis on the management of the proximal suture line and coronary anastomoses. Limitations of this technique and alternative options are discussed.

Full-root aortic valve replacement by stentless aortic xenograft is a viable option in patients with small aortic roots. We describe, a technique for the full-root implantation of stentless aortic xenografts, with emphasis on the management of the proximal suture line and coronary anastomoses, and discuss its limitations and alternative options.

작은 대동맥 근위 대동맥을 가진 환자에서 스텐트리스 대동맥 이식편을 이용한 대동맥 판막 치환술

In patients with small aortic roots who need an aortic valve replacement with biological valve substitutes, the implantation of the stented pericardial ...

Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion surgery to obtain results about altered variables of gait and posture. These observed changes can then be correlated with the patient-reported outcome measure of pain relief. The rasterstereographic device projects lines of parallel light onto the surface of the tested subject&#39;s back. The deformation of these lines is recognized by the device. From these data, a special software then generates a 3-D profile based on the principle of triangulation. With an inaccuracy of only 0.2 mm it can measure changes in posture at very high precision. Gait and stance parameters are recorded using a treadmill equipped with an electric sensor mat that contains 10,200 miniature force sensors in the registering zone under the belt. Initial walking speed on the treadmill is 0.5 km/h. Speed is then gradually increased by increments of 0.1 km/h until each subject reaches his or her individual maximum well tolerable walking speed. At this speed, parameters are recorded during a 20 s measurement interval. Subjects are tested barefoot and without holding a handrail. Among various other parameters, stride width, step length, stance phase and foot rotation are measured. Both methods used reportedly have a high intra- and inter-observer reliability. The advantage of these highly accurate techniques is that they offer an objective and very detailed perspective on changes in the patient&#39;s posture and gait. Due to the amount of data generated, these techniques are, however, not so much suitable for everyday routine use, but rather interesting to scientifically evaluate long term alterations in posture and gait in patients like for example after lumbar fusion surgery.

Here, we present a protocol to analyze the posture and the gait of patients after lumbar fusion surgery by means of high-resolution video rasterstereography and a treadmill equipped with an integrated sensor mat. Allowing critical functional postoperative evaluation on a less subjective level may enhance accuracy and reliability of indication for surgery.

환자의 자세와 걸음 걸이 프로필 비디오 Rasterstereography 및 디딜 방 아 걸음 걸이 분석 하 여 요 추 융합 수술 후의 평가

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion ...

A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application

Cardiovascular disease remains the leading cause of death and disability worldwide, in part due to atherosclerosis. Atherosclerotic plaque narrows the luminal surface area in arteries thereby reducing adequate blood flow to organs and distal tissues. Clinically, revascularization procedures such as balloon angioplasty with or without stent placement aim to restore blood flow. Although these procedures reestablish blood flow by reducing plaque burden, they damage the vessel wall, which initiates the arterial healing response. The prolonged healing response causes arterial restenosis, or re-narrowing, ultimately limiting the long-term success of these revascularization procedures. Therefore, preclinical animal models are integral for analyzing the pathophysiological mechanisms driving restenosis, and provide the opportunity to test novel therapeutic strategies. Murine models are cheaper and easier to operate on than large animal models. Balloon or wire injury are the two commonly accepted injury modalities used in murine models. Balloon injury models in particular mimic the clinical angioplasty procedure and cause adequate damage to the artery for the development of restenosis. Herein we describe the surgical details for performing and histologically analyzing the modified, pressure-controlled rat carotid artery balloon injury model. Additionally, this protocol highlights how local periadventitial application of therapeutics can be used to inhibit neointimal hyperplasia. Lastly, we present light sheet fluorescence microscopy as a novel approach for imaging and visualizing the arterial injury in three-dimensions.

The rat carotid artery balloon injury mimics the clinical angioplasty procedure performed to restore blood flow in atherosclerotic vessels. This model induces the arterial injury response by distending the arterial wall, and denuding the intimal layer of endothelial cells, ultimately causing remodeling and an intimal hyperplastic response.

쥐 경동맥 압력 제어 세그먼트 풍선 부상 과식 치료 응용 프로그램

Cardiovascular disease remains the leading cause of death and disability worldwide, in part due to atherosclerosis. Atherosclerotic plaque narrows the ...

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, chemo- and radiation-therapies, as well as ovarian surgeries. In unmarried women with severe ovarian dysfunction, fertility preservation is important for future pregnancies. Although oocyte cryopreservation is an established method for fertility preservation, these patients could only preserve a limited number of oocytes even after ovarian hyperstimulation, leading to repeated stimulations to ensure sufficient oocytes to guarantee future pregnancy. To solve this issue, we have recently developed a drug-free in vitro activation (IVA) procedure, which enable us to stimulate early stages of ovarian follicles to develop to the preantral follicle stage. These preantral follicles can respond to the unique protocol of gonadotropin stimulation, resulting in increased number of retrieved oocytes per ovarian stimulation for cryopreservation. The drug-free IVA comprised from the surgical approach and ovarian stimulation. We removed a part of cortex from one or both ovaries from patients under laparoscopic surgery. The ovarian cortical tissues were cut into small cubes to disrupt the Hippo signaling pathway and stimulate the development of early stage follicles. These cubes were grafted orthotropically into remaining ovaries as well as beneath the serosa of both Fallopian tubes. We have already published the surgical procedure of the drug-free IVA and the protocol of subsequent ovarian stimulation, but herein we present the details of laboratory methods required for drug-free IVA.

We present details of laboratory procedures for drug-free in vitro activation (IVA) of ovarian follicles for patients with severe ovarian dysfunction. This method could increase the number of retrievable oocytes per ovarian hyperstimulation and benefit fertility preservation for those patients.

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, ...

Quality-Controlled Sputum Analysis by Flow Cytometry

Sputum, widely used to study the cellular content and other microenvironmental features to understand the health of the lung, is traditionally analyzed using cytology-based methodologies. Its utility is limited because reading the slides is time-consuming and requires highly specialized personnel. Moreover, extensive debris and the presence of too many squamous epithelial cells (SECs), or cheek cells, often renders a sample inadequate for diagnosis. In contrast, flow cytometry allows for high-throughput phenotyping of cellular populations while simultaneously excluding debris and SECs.
The protocol presented here describes an efficient method to dissociate sputum into a single cell suspension, antibody stain and fix cellular populations, and acquire samples on a flow cytometric platform. A gating strategy that describes the exclusion of debris, dead cells (including SECs) and cell doublets is presented here. Further, this work also explains how to analyze viable, single sputum cells based on a cluster of differentiation (CD)45 positive and negative populations to characterize hematopoietic and epithelial lineage subsets. A quality control measure is also provided by identifying lung-specific macrophages as evidence that a sample is derived from the lung and is not saliva. Finally, it has been demonstrated that this method can be applied to different cytometric platforms by providing sputum profiles from the same patient analyzed on three flow cytometers; Navios EX, LSR II, and Lyric. Furthermore, this protocol can be modified to include additional cellular markers of interest. A method to analyze an entire sputum sample on a flow cytometric platform is presented here that makes sputum amenable for developing high-throughput diagnostics of lung disease.

This protocol describes an efficient method for dissociating sputum into a single cell suspension and the subsequent characterization of cellular subsets on standard flow cytometric platforms.

Sputum, widely used to study the cellular content and other microenvironmental features to understand the health of the lung, is traditionally analyzed ...

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Atrial fibrillation (AF) is the most common form of arrhythmia. Atrial remodeling is considered the most critical mechanism for the presence and development of atrial fibrillation. Also, atrial remodeling can lead to the enlargement and dysfunction of the left atrium (LA), resulting in thrombosis and heart failure. Functional changes in left atrial strain and strain rate occur before structural alterations and are closely associated with structural remodeling and left atrial fibrosis. These parameters are sensitive biomarkers for atrial function. Cardiac magnetic resonance feature tracking (CMR-FT) is a novel, non-invasive, post-processing technique that can evaluate left atrial strain and strain rate. The CMR-FT was utilized in this investigation to assess the bilateral atrium strain rate in individuals with paroxysmal AF. Modifications in each segmental strain were evaluated using segmental analysis. The CMR-FT is recommended for non-invasive evaluations in the clinical assessment of atrial strain among existing strain imaging techniques. Further, it is a flexible parameter measurement with good reproducibility, high soft-tissue resolution, and post-processing based on standard cine balanced steady-state free precision (bSSFP) long-axis images without requiring a new sequence acquisition.

The atrial function is associated with the strain and strain rate. The cardiac magnetic resonance feature tracking (CMR-FT) technique was used in this study to quantify left and right atrial global and segmental longitudinal strain and strain rate in individuals with paroxysmal atrial fibrillation.