Hayır finansman kaynakları.

1. Doğum sırasında plasenta hazırlanması <ol><li> (Ilk doğan) ya da iki (ikinci doğumlu) kelepçeler ile ikizlerin göbek kordonu etiketleyin. </li><li> Bütünlüğü veya bozulması için plasentanın maternal ve fetal yüzey inceleyin. </li><li> Aşağıdaki verileri kaydedin: kablosu ekleme türü (merkezi, eksantrik, marjinal ya da velamentöz), göbek kordonu (genellikle bir damar ve iki arterler, bazen sadece bir arter) ve iki plasental hisse arasındaki renk farkı kan damarlarının sayısı. Koriyonisitenin türünü onaylamak için bölme membranlar bir bölümü Patoloji gönderilebilir. </li><li> Plasenta sonra plastik bir kaba yerleştirilir ve final sınavı (en geç bir hafta içinde) ve renk boya enjeksiyon kadar buzdolabında olabilir. </li><li> Plasenta dondurulmuş veya sabit (formalin kullanmayın) olmamalıdır. </li></ol> 2. Göbek damarlarının kateterizasyonu <ol><li> Plasenta sıcak su veya tuzlu su ile yıkayın. </li><li> Periferik membranlar Trim, amnions kapalı inter-ikiz bölünmesi membran ve kabuğu (vasküler anastomozlar ve plasental resimlerin daha kaliteli daha iyi bir görünüm için) çıkarın. </li><li> Kordon ekleme yaklaşık 5 cm mesafeden her göbek kordonu transect. </li><li> Yavaşça göbek damarları ve plasental damarların kan pıhtıları sıkın. </li><li> Umbilikal ven genellikle iki umbilikal arterlerin küçük çaplı göre, büyük çaplı nedeniyle tespit etmek kolaydır. </li><li> Uygun boyutta bir kateter ile umbilikal ven Cannulate. Yanlış pasajlar kaçının. </li><li> Küçük bir kateter ile tek umbilikal arter Cannulate. Umbilikal arter lümen genişletmek için cımbız kullanın. Yanlış pasajlar kaçının. 2 umbilikal arterlerin Sadece tek bir anastomoz (Hyrtl) kablosu ekleme yakın 2 arter bağlanır kateterize gerekir. </li><li> Diğer göbek kordonu için her iki adımları tekrarlayın. </li><li> Kateterin yerleştirilmesi nazik bel ve göbek damarlarının ileri masaj kolaylaştırılabilir. Herhangi bir tip kateter bu işlem için kullanılabilir. Biz yenidoğanlarda umblikal kateterizasyon için bizim neonatoloji koğuş kullanılan kateter (geri dönüşüm) kullanmayı tercih. </li><li> Boya enjeksiyon sırasında renkli boya akışını önlemek için her iki kabloları etrafında bir bant bağlayın. </li></ol> 3. Renkli boya ile enjeksiyon <ol><li> Her kateter renkli boya ile dolu bir 20 ml şırınga bağlayın. </li><li> Herhangi bir viskoz renkli boya plasental anjiyo-mimarlık görselleştirmek için kullanılabilir. Anastomozlar (arterler için koyu renkler, parlak renkler damarlar için) iyi bir görüntüleme sağlamak için zıt renkler kullanın. </li><li> Bir asistan hafifçe ayrıca tüm plasental damarlar, küçük olanları doldurmak için renkli boya izin vermek için boya iter yavaşça ven renkli boya enjekte (alçak basınç). </li><li> Damar (vasküler ekvator ya ikiz anastomozlar birbirleriyle bağlantı yerdir) ekvator yakınlarındaki küçük damarlarda özellikle dikkat edin. </li><li> Arter renkli bir boya enjekte etmek için önceki adımları tekrarlayın. Not: arterler, daha fazla sabır enjekte gerektirir ve daha zor olabilir. </li><li> Diğer göbek kordonu için her iki adımları tekrarlayın. </li></ol> 4. Değerlendirme ve renkli boya enjeksiyon sonrası plasenta dokümantasyon <ol><li> Vasküler ekvator dikkatlice incelemek ve anastomozların sayısını ve türünü kayıt. </li><li> Dijital resim çap ve plasental hisse plasenta ölçmek için bir ölçüm bandı yerleştirin. </li><li> Yüksek-çözünürlüklü dijital kamera ve fotoğraf çekmek enjekte plasenta. Resimleri dik plasenta alınır emin olun. </li></ol> 5. Temsilcisi Sonuçlar: Monokoryoniklerde anjiyo mimarisi plasental monokoryonik ikiz gebelik türüne göre değişir. Enjeksiyon çalışmaları, AA, AV ve VV anastomozlar sırasıyla% 80,% 95 ve% 20 komplikasyonsuz Monokoryonik ikiz gebeliklerin 1 (Şekil 1) mevcut olduğunu göstermiştir . AA anastomozlar TTTS ve ÜNYONLARI 6 gelişmesine karşı korumak için kabul edilir. Enjeksiyonlar çalışmalar AA anastomozlar TTTS plasenta sadece% 20 ve% 10 ÜNYONLARI plasenta 1,2,7 (Şekil 2) meydana geldiğini göstermiştir. Fetoscopic lazer cerrahisi ile tedavi edilen TTTS plasenta, plasenta yüzey (Şekil 3 ve 4), vasküler anastomozlar lazer koagülasyonu neden izleri görülebilir. ÜNYONLARI plasenta sadece birkaç ufacık AV anastomozlar 2 (Şekil 5) varlığı ile karakterizedir. ÜNYONLARI alıcının plasental payı donör plasental payı (Şekil 6) soluk ise, sık sık kan çokluğu. Monokoryonik ikiz gebeliklerde doğum ağırlığı uyumsuzluk, büyüme fetus sınırlıgenellikle bir velamentöz kord ekleme ve çok daha küçük bir plasental payı (Şekil 7). AA anastomozlar ikizlerin doğum ağırlığı uyumsuzluk 8 Monokoryonik plasenta sık sık bulunmaktadır. Monokoryonik-monoamniyotik plasenta arasında kısa bir mesafe ile her iki kord insersiyon (Şekil 8), karakteristik bir anjiyo-mimarisi vardır. Monoamniyotik Monokoryonik plasenta AA anastomozlar oranı neredeyse% 100 ve monoamniyotik ikizler 9 TTTS gelişimi engeller. Bu makalede rakamlar renk boya ile merkezimizde enjekte Monokoryonik plasenta karakteristik bulgular göstermektedir. Biz rutin arterler ve damarlar için hafif renk (sarı, pembe ya da turuncu), koyu renkler (mavi ya da yeşil) kullanın. <img alt="Şekil 1" src="/files/ftp_upload/3208/3208fig1.jpg" /> Şekil 1, yeşil arterlerden, pembe damarlar (beyaz yıldız), mavi arterlerden sarı damarlar (yeşil yıldız) ve 1 büyük AA anastomoz (tarafından belirlenen birkaç VA anastomozlar birçok AV anastomozlar gösteren bir normal, komplikasyonsuz monokoryonik ikiz gebelik monokoryonik plasenta mavi yıldız, mavi ve yeşil boya karıştırma). <img alt="Şekil 2" src="/files/ftp_upload/3208/3208fig2.jpg" /> Şekil 2 sadece AV (beyaz yıldız) ve VA varlığını gösteren seri amnioreduction ile tedavi edilen bir TTTS gebelikte monokoryonik plasenta (yeşil yıldız), AA anastomoz olmadan anastomozlar. <img alt="Şekil 3" src="/files/ftp_upload/3208/3208fig3.jpg" /> Şekil 3 TTTS plasenta fetoscopic lazer koagülasyon sonra küçük bir rezidüel anastomoz yanlışlıkla (beyaz yıldız) patent kaldı selektif lazer tekniği kullanılarak vasküler anastomozlar. Selektif lazer tekniği ile, vasküler anastomozlar ilk tanımlanan ve daha sonra tek tek koagüle. <img alt="Şekil 4" src="/files/ftp_upload/3208/3208fig4.jpg" /> Şekil 4 TTTS plasenta, her bireyin anastomoz kimlik ve pıhtılaşma sonra, tam damar ekvator diğer bir plasental marjı koagüle olduğu Solomon tekniği kullanılarak fetoscopic lazer koagülasyonu. <img alt="Şekil 5" src="/files/ftp_upload/3208/3208fig5.jpg" /> Şekil 5 vasküler ekvator boyunca sadece birkaç ufacık VA anastomozlar (beyaz yıldız) görünür olduğu ÜNYONLARI plasenta. <img alt="Şekil 6" src="/files/ftp_upload/3208/3208fig6.jpg" /> Şekil 6 ÜNYONLARI plasenta (Şekil 5) anne tarafı hem plasental hisseler arasında karakteristik bir renk farkı göstermektedir . <img alt="Şekil 7" src="/files/ftp_upload/3208/3208fig7.jpg" /> Şekil 7, bir ikiz seçici intrauterin gelişme geriliği olan bir ikiz gebelik monokoryonik plasentayı . Büyüme sınırlı fetus velamentöz kablosu ekleme ve çok daha küçük bir plasental payı vardır. Beyaz yıldız, AA anastomoz gösterir. <img alt="Şekil 8" src="/files/ftp_upload/3208/3208fig8.jpg" /> Şekil 8 monoamniyotik plasenta: Not çeşitli AV (yeşil yıldız), VA (mavi yıldız) ve 2 adet AA anastomozlar (beyaz yıldız) ve her iki kordon eklemeler arasında kısa bir mesafe.

<ol>
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Çıkar çatışması ilan etti.

TTTS ve ÜNYONLARI monokoryoniklerde oluşabilir iki ciddi rahatsızlıklar. Her iki bozukluk da dengesiz intertwin kan akışına neden AV anastomozlar nedeniyle. Son 2 yılda, fetoscopic lazer ameliyatı oldu ve TTTS (10) tedavi için en iyi yöntem olduğu gösterilmiştir. Fetoscopic lazer tedavisinin amacı plasenta yüzeyinde vasküler anastomozlar pıhtılaşma ile inter-ikiz sirkülasyon kesmek. Ancak, TTTS için lazer tedavisi mükemmel olmaktan uzak. Lazer ile tedavi intrauterin fetal ölüm, TTTS v...

<table border="1"><tbody><tr><th> Reaktif Adı </th><th> Şirket </th><th> Katalog numarası </th><th> Yorumlar </th></tr><tr><td> Umblikal kateter (çeşitli boyutları, Uzunluk 40 cm) </td><td> VYGON </td><td> 1270,08 (8 F) 1270,08 (5 F) 1270,04 (4 F) 1270,03 (3,5 F) 1270,02 (2.5 F) </td><td> Her tür kateter kullanılabilir </td></tr><tr><td> 20 ml Şırınga </td><td> BD Plastipak </td><td> 300613 </td><td></td></tr><tr><td> Renk boya (farklı renkte) </td><td> Royal Talens Schoolverf </td><td> 36716010 (mavi) 36.715.010 (yeşil) 36.712.350 (sarı) 36.713.570 (pembe) </td><td> Herhangi bir viskoz renkli boya kullanılabilir </td></tr></tbody></table>

accurate and simple evaluation of vascular anastomoses in monochorionic placenta using colored dye

Plasental vasküler anastomozlar varlığı bir conditio ikizden ikize transfüzyon sendromu (TTTS) ve ikiz anemi polisitemia dizisi (TAPS) 1,2 gelişimi için olmazsa olmazı. Ikiz plasenta enjeksiyon çalışmaları bu anastomozlar dikoryonik 1 hemen hemen her zaman, monokoryoniklerde mevcut ve son derece nadir olduğunu göstermiştir . Üç tip anastomozların belgelenmiştir arter arter, ven ven ve arter ven. Arteriyovenöz (AV) anastomozlar tek yönlü ve arterio-arteriyel (AA) ve veno-venöz (VV) anastomozlar çift yönlü ve atıfta ise, paylaşılan bir plasental kotiledon ile devam beri &quot;derin&quot; anastomozlar olarak adlandırılır koryonik plaka üzerinde yalan &quot;yüzeysel&quot;. Her iki TTTS ve ÜNYONLARI AV anastomozlar nedeniyle ikizler arasındaki kan akımının net dengesizlikten kaynaklanır. İkizlerden birinin (donör) Kan paylaşılan plasental kotiledon bir arter yoluyla pompalanır ve daha sonra diğer iki (alıcı) dolaşıma damar yoluyla boşaltılır. Kan zıt yönettiği derin AV anastomozlar yoluyla veya yüzeysel anastomozlar aracılığıyla alıcı donör geri pompalanır sürece, kan ciltlik yavaş yavaş TTTS veya ÜNYONLARI gelişimi için önde gelen bir dengesizlik oluşur. AA anastomoz varlığı, tek yönlü AV anastomozlar 1,2 yol açtığı dolaşım dengesizliği telafi TTTS ve ÜNYONLARI gelişmesine karşı korumak için gösterilmiştir . Enjeksiyon Monokoryonik plasenta, doğumdan kısa süre sonra monokoryoniklerde çeşitli (hematolojik) komplikasyon etyolojisini anlamak için yararlı bir ortalama ve ÜNYONLARI 2 tanıya ulaşmak için gerekli bir testtir. Buna ek olarak, fetoscopic lazer cerrahisi ile tedavi TTTS plasenta enjeksiyon mümkün artık anastomozlar 3-5 belirlenmesini sağlar. Bu ek bilgi TTTS veya ÜNYONLARI monokoryonik ikizlerin yönetimi ve bakımı konusunda ilgili tüm perinatologların için büyük önem taşımaktadır. Çeşitli plasental enjeksiyon teknikleri kullanılmaktadır. Biz, doğru bir şekilde kullanarak renkli boya enjeksiyon (rezidü) vasküler anastomozlar varlığını değerlendirmek için basit bir protokol sağlar.

Watch this Scientific Journal Video about Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye at JoVE.com

Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye

Ikizden ikize transfüzyon sendromu ve perinatal tıp ikiz anemi polisitemia dizisi iki potansiyel olarak yıkıcı sorunlar. Her iki bozukluk da sadece monokoryonik ikizlerde ve plasental vasküler anastomozlar yoluyla dengesiz kan akımı sonucu oluşur. Doğumdan sonra plasenta damarlarının renkli boya enjeksiyon kullanılarak vasküler anastomozlar varlığı doğru değerlendirmek için basit bir protokol sağlar.

Renkli Boya kullanarak Monokoryonik Plasenta vasküler anastomozlar doğru ve basit Değerlendirme

The presence of placental vascular anastomoses is a conditio sine qua non for the development of twin-to-twin transfusion syndrome (TTTS) and twin anemia ...

accurate-simple-evaluation-vascular-anastomoses-monochorionic

Research

JoVE Journal

Medicine

26.6K Görüntüleme.  Leiden University Medical Center. Ikizden ikize transfüzyon sendromu ve perinatal tıp ikiz anemi polisitemia dizisi iki potansiyel olarak yıkıcı sorunlar. Her iki bozukluk da sadece monokoryonik ikizlerde ve plasental vasküler anastomozlar yoluyla dengesiz kan akımı sonucu oluşur. Doğumdan sonra plasenta damarlarının renkli boya enjeksiyon kullanılarak vasküler anastomozlar varlığı doğru değerlendirmek için basit bir protokol sağlar.

Video: Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye

Accurate and Simple Measurement of the Pro-inflammatory Cytokine IL-1&beta; using a Whole Blood Stimulation Assay

Inflammatory processes resulting from the secretion of soluble mediators by immune cells, lead to various manifestations in skin, joints and other tissues as well as altered cytokine homeostasis. The innate immune system plays a crucial role in recognizing pathogens and other endogenous danger stimuli. One of the major cytokines released by innate immune cells is Interleukin (IL)-1. Therefore, we utilize a whole blood stimulation assay in order to measure the secretion of inflammatory cytokines and specifically of the pro-inflammatory cytokine IL-1&beta; 1, 2, 3.
Patients with genetic dysfunctions of the innate immune system causing autoinflammatory syndromes show an exaggerated release of mature IL-1&beta; upon stimulation with LPS alone. In order to evaluate the innate immune component of patients who present with inflammatory-associated pathologies, we use a specific immunoassay to detect cellular immune responses to pathogen-associated molecular patterns (PAMPs), such as the gram-negative bacterial endotoxin, lipopolysaccharide (LPS). These PAMPs are recognized by pathogen recognition receptors (PRRs), which are found on the cells of the innate immune system 4, 5, 6, 7. A primary signal, LPS, in conjunction with a secondary signal, ATP, is necessary for the activation of the inflammasome, a multiprotein complex that processes pro-IL-1&beta; to its mature, bioactive form 4, 5, 6, 8, 9, 10.
The whole blood assay requires minimal sample manipulation to assess cytokine production when compared to other methods that require labor intensive isolation and culturing of specific cell populations. This method differs from other whole blood stimulation assays; rather than diluting samples with a ratio of RPMI media, we perform a white blood cell count directly from diluted whole blood and therefore, stimulate a known number of white blood cells in culture 2. The results of this particular whole blood assay demonstrate a novel technique useful in elucidating patient cohorts presenting with autoinflammatory pathophysiologies.

Accurate and Simple Measurement of the Pro-inflammatory Cytokine IL-1&amp;#946; using a Whole Blood Stimulation Assay

We describe a simple immunoassay to measure the production of pro-inflammatory cytokines, such as IL-1 beta production, in patients presenting with autoinflammatory phenotypes. By activating cells in whole blood cultures with pathogen-associated molecular patterns, specifically with lipopolysaccharide, cytokine secretion can be conveniently evaluated in whole blood supernatants.

Tam Kan Stimülasyon Testi kullanarak Pro-inflamatuar sitokin IL-1β Doğru ve Basit Ölçme

Inflammatory processes resulting from the secretion of soluble mediators by immune cells, lead to various manifestations in skin, joints and other tissues ...

Tıp

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC twin pregnancies develop complications arising from the shared placenta and associated vascular connections1. Severe twin-to-twin syndrome (TTTS) is reported to account for approximately 20% of these complications2,3. Inter-twin vascular connections occur in almost all MC placentas and are related to the prognosis and outcome of these high-risk twin pregnancies. The number, size and type of connections have been implicated in the development of TTTS and other MC twin conditions. Three types of inter-twin vascular connections occur: 1) artery to vein connections (AVs) in which a branch artery carrying deoxygenated blood from one twin courses along the fetal surface of the placenta and dives into a placental cotyledon. Blood flows via a deep intraparenchymal capillary network into a draining vein that emerges at the fetal surface of the placenta and brings oxygenated blood toward the other twin. There is unidirectional flow from the twin supplying the afferent artery toward the twin receiving the efferent vein; 2) artery to artery connections (AAs) in which a branch artery from each twin meets directly on the superficial placental surface resulting in a vessel with pulsatile bidirectional flow, and 3) vein to vein connections (VVs) in which a branch vein from each twin meets directly on the superficial placental surface allowing low pressure bidirectional flow. In utero obstetric sonography with targeted Doppler interrogation has been used to identify the presence of AV and AA connections4. Prenatally detected AAs that have been confirmed by postnatal placental injection studies have been shown to be associated with an improved prognosis for both twins5. Furthermore, fetoscopic laser ablation of inter-twin vascular connections on the fetal surface of the shared placenta is now the preferred treatment for early, severe TTTS. 
Postnatal placental injection studies provide a valuable method to confirm the accuracy of prenatal Doppler ultrasound findings and the efficacy of fetal laser therapy6. Using colored dyes separately hand-injected into the arterial and venous circulations of each twin, the technique highlights and delineates AVs, AAs, and VVs. This definitive demonstration of MC placental vascular anatomy may then be correlated with Doppler ultrasound findings and neonatal outcome to enhance our understanding of the pathophysiology of MC twinning and its sequelae. Here we demonstrate our placental injection technique.

Vascular mapping of monochorionic (MC) twin placentas after birth provides a means for detailed demonstration of vascular connections between the twins&#x2019; circulations. 
Imbalance of these connections is thought to play a pivotal role in the development of complications of MC twinning including twin-to-twin transfusion syndrome.

Monokoryonik ikiz plasenta Damar Haritalama Kılavuz Tel Destekli Kateterizasyon ve Renkli Boya Enjeksiyon

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC ...

A Simple Method of Mouse Lung Intubation

A simple procedure to intubate mice for pulmonary function measurements would have several advantages in longitudinal studies with limited numbers or expensive animal. One of the reasons that this is not done more routinely is that it is relatively difficult, despite there being several published studies that describe ways to achieve it. In this paper we demonstrate a procedure that eliminates one of the major hurdles associated with this intubation, that of visualizing the trachea during the entire time of intubation. The approach uses a 0.5 mm fiberoptic light source that serves as an introducer to direct the intubation cannula into the mouse trachea. We show that it is possible to use this procedure to measure lung mechanics in individual mice over a time course of at least several weeks. The technique can be set up with relatively little expense and expertise, and it can be routinely accomplished with relatively little training. This should make it possible for any laboratory to routinely carry out this intubation, thereby allowing longitudinal studies in individual mice, thereby minimizing the number of mice needed and increasing the statistical power by using each mouse as its own control.

This paper describes a striaghforward and efficient method of intubating mice for pulmonary function measurements or pulmonary instillation, that allows the mice to recover and be studied at later times. The procedure involves an inexpensive fiberoptic light source that directly illuminates the trachea.

Fare Akciğer Entübasyonun Basit Bir Yöntem

A  simple procedure to intubate mice for pulmonary function measurements would  have several advantages in longitudinal studies with limited numbers or  ...

Technical Aspects of the Mouse Aortocaval Fistula

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta and inferior vena cava (IVC) are exposed. The proximal infrarenal aorta and the distal aorta are dissected for clamp placement and needle puncture, respectively. Special attention is paid to avoid dissection between the aorta and the IVC. After clamping the aorta, a 25 G needle is used to puncture both walls of the aorta into the IVC. The surrounding connective tissue is used for hemostatic compression. Successful creation of the AVF will show pulsatile arterial blood flow in the IVC. Further confirmation of successful AVF can be achieved by post-operative Doppler ultrasound.

The goal is to produce an arteriovenous fistula that is simple and reproducible. This method does not use sutures or glue adhesive. Therefore the samples can be used with the least amount of foreign materials for analysis.

Fare Aortocaval Fistül Teknik Yönleri

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta ...

Fast and Accurate Exhaled Breath Ammonia Measurement

This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. 
Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. 
The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations.

Ammonia is an important physiologic metabolite relevant to various disease and wellness states. It is also a difficult molecule to measure in breath, which demands particular precautions be taken to obtain accurate results. Not all factors influencing ammonia are known, but progress can be difficult without accounting for these factors.

Hızlı ve Doğru Üfürükle Amonyak Ölçüm

This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that ...

Evaluation of Tumor-infiltrating Leukocyte Subsets in a Subcutaneous Tumor Model

Specialized immune cells that infiltrate the tumor microenvironment regulate the growth and survival of neoplasia.&#160; Malignant cells must elude or subvert anti-tumor immune responses in order to survive and flourish. Tumors take advantage of a number of different mechanisms of immune &#8220;escape,&#8221; including the recruitment of tolerogenic DC, immunosuppressive regulatory T cells (Tregs), and myeloid-derived suppressor cells (MDSC) that inhibit cytotoxic anti-tumor responses. Conversely, anti-tumor effector immune cells can slow the growth and expansion of malignancies: immunostimulatory dendritic cells, natural killer cells which harbor innate anti-tumor immunity, and cytotoxic T cells all can participate in tumor suppression. The balance between pro- and anti-tumor leukocytes ultimately determines the behavior and fate of transformed cells; a multitude of human clinical studies have borne this out. Thus, detailed analysis of leukocyte subsets within the tumor microenvironment has become increasingly important. Here, we describe a method for analyzing infiltrating leukocyte subsets present in the tumor microenvironment in a mouse tumor model. Mouse B16 melanoma tumor cells were inoculated subcutaneously in C57BL/6 mice. At a specified time, tumors and surrounding skin were resected en bloc and processed into single cell suspensions, which were then stained for multi-color flow cytometry. Using a variety of leukocyte subset markers, we were able to compare the relative percentages of infiltrating leukocyte subsets between control and chemerin-expressing tumors. Investigators may use such a tool to study the immune presence in the tumor microenvironment and when combined with traditional caliper size measurements of tumor growth, will potentially allow them to elucidate the impact of changes in immune composition on tumor growth. Such a technique can be applied to any tumor model in which the tumor and its microenvironment can be resected and processed.

This protocol describes a method for the detailed evaluation of leukocyte subsets within the tumor microenvironment in a mouse tumor model. Chemerin-expressing B16 melanoma cells were implanted subcutaneously into syngeneic mice. Cells from the tumor microenvironment were then stained and analyzed by flow cytometry, allowing for detailed leukocyte subset analyses.

Bir deri altı tümör modelinde tümör-süzücü lökosit subsetleri Değerlendirilmesi

Specialized immune cells that infiltrate the tumor microenvironment regulate the growth and survival of neoplasia.&#160; Malignant cells must elude or ...

Using the Sleeve Technique in a Mouse Model of Aortic Transplantation - An Instructional Video

Orthotopic aortic transplantation using the sleeve technique reduces injury to the aorta with failure rate of only 10-20%. The time to anastomose the aorta in mice using the sleeve method was short and easy averaging 20 min, permitting studies of iso/allo grafts. The following article describes the aortic transplantation procedure used in our laboratory. The mice were anesthetized with a mixture of 1.5% volume isoflurane and 100% oxygen through a face mask. At this point, the segment of the aorta between the renal arteries and its bifurcation was separated from the vena cava, freely prepared and clampedat the proximal and distal segments with a single silk suture. Prior to the removal of the aorta, a saline solution containing heparin was injected into the inferior vena cava. Then the aorta was cut between the clamps and a saline heparin solution was used to flush the lumen. The sleeve technique with monofilament sutures was used in order to transplant the abdominal aorta in the orthotopic position.

We present an orthotopic aortic transplantation model using the sleeve technique in mice. It is a very rapid anastomosis method, which can be employed in studies of vascular disease.

Kol tekniği aort transplantasyonu - eğitici bir Video bir fare Model kullanma

Orthotopic aortic transplantation using the sleeve technique reduces injury to the aorta with failure rate of only 10-20%. The time to anastomose the ...

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome (TTTS), but is technically challenging and can lead to significant complications. Acquiring and maintaining the necessary surgical skills require consistent practice, a critical caseload, and time. Training on realistic surgical simulators can potentially shorten this steep learning curve and enables several proceduralists to acquire procedure-specific skills simultaneously. Here we describe realistic simulators designed to allow the user familiarity with the equipment and specific steps required in the surgical treatment of TTTS, including fetoscopic handling, approaches to anterior and posterior placenta, recognition of anastomoses, and efficient coagulation of vessels. We describe the skills that are especially important in conducting placental laser coagulation that the surgeon can practice on the model and apply in a clinical case. These models can be adapted easily depending on the availability of materials and require standard fetoscopy equipment. Such training systems are complementary to traditional surgical apprenticeships and can be useful aids for fetal medicine units that provide this clinical service.

Practicing the specific skills required for fetoscopic laser coagulation of monochorionic placental anastomoses on realistic models can aid less experienced surgeons in overcoming the steep learning curve associated with this procedure that is now regarded as the standard of care for twin-twin transfusion syndrome.

Modeli cerrahi eğitim: Fetoscopic Laser Photocoagulation, Monochorionic Diamniotic Tek Kişilik plasenta gerçekçi simülatörleri kullanarak becerileri edinme

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome ...

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Trans-mitral blood flow produces a three-dimensional rotational body of fluid, known as a vortex ring, that enhances the efficiency of left ventricular (LV) filling compared with a continuous linear jet. Vortex ring development is most often quantified with vortex formation time (VFT), a dimensionless parameter based on fluid ejection from a rigid tube. Our group is interested in factors that affect LV filling efficiency during cardiac surgery. In this report, we describe how to use standard two-dimensional (2D) and Doppler transesophageal echocardiography (TEE) to noninvasively derive the variables needed to calculate VFT. We calculate atrial filling fraction (&#946;) from velocity-time integrals of trans-mitral early LV filling and atrial systole blood flow velocity waveforms measured in the mid-esophageal four-chamber TEE view. Stroke volume (SV) is calculated as the product of the diameter of the LV outflow track measured in the mid-esophageal long axis TEE view and the velocity-time integral of blood flow through the outflow track determined in the deep transgastric view using pulse-wave Doppler. Finally, mitral valve diameter (D) is determined as the average of major and minor axis lengths measured in orthogonal mid-esophageal bicommissural and long axis imaging planes, respectively. VFT is then calculated as 4 &#215; (1-&#946;) &#215; SV/(&#960;D3). We have used this technique to analyze VFT in several groups of patients with differing cardiac abnormalities. We discuss our application of this technique and its potential limitations and also review our results to date. Noninvasive measurement of VFT using TEE is straightforward in anesthetized patients undergoing cardiac surgery. The technique may allow cardiac anesthesiologists and surgeons to assess the impact of pathological conditions and surgical interventions on LV filling efficiency in real time.

We describe a protocol to measure vortex formation time, an index of left ventricular filling efficiency, using standard transesophageal echocardiography techniques in patients undergoing cardiac surgery. We apply this technique to analyze vortex formation time in several groups of patients with differing cardiac pathologies.

Transözofajiyal ekokardiyografi kalp cerrahisi sırasında kullanarak girdap oluşumu süre noninvaziv belirlenmesi

Trans-mitral blood flow produces a three-dimensional rotational body of fluid, known as a vortex ring, that enhances the efficiency of left ventricular ...

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Transthoracic (TTE) and transesophageal echocardiography (TEE) is the standard imaging method for atrial septal defect (ASD) and patent foramen ovale (PFO) detection, for patient selection for transcatheter ASD/PFO closure,&#160;for intraoperative guidance and for long-term follow-up. The size, shape, location and the number of the atrial communications schould be determined. The accuracy of PFO detection can be improved by using agitated saline together with maneuvers to transiently increase the right atrial (RA) pressure. The appearance of microbubbles in the left atrium (LA) within 3 cardiac cycles after opacification of the RA is considered positive for the presence of an intracardiac shunt. Three dimensional TEE identifies further septal fenestrations and describes the dynamic morphology of ASD/PFO and atrial septal aneurysm. Follow-up evaluations with TTE is recommended at 1, 6, and 12 months after the procedure, with a subsequent evaluation every year. Previous studies showed an increased incidence of atrial arrhythmias early after device closure. Speckle tracking analysis may help to understand functional left atrial remodeling following percutaneous closure and its impact on atrial arrhythmias.

Transthoracic (TTE) and transesophageal (TEE) echocardiography represent the basic imaging tools for interatrial septum examination. Three dimensional (3D) TEE provides incremental information in the assessment of the interatrial septum. Further advanced echocardiography techniques using speckle tracking echocardiography are applied for sensitive volumetric and functional assessment of the heart chambers.&#160;

Transkreter Kapanması Öncesi Atriyal İletişimin Ekokardiyografik Değerlendirmesi

Transthoracic (TTE) and transesophageal echocardiography (TEE) is the standard imaging method for atrial septal defect (ASD) and patent foramen ovale ...