The authors are grateful to Philipp Grundtner for his help with the statistical analyses.

protokol Friedrich-Alexander Üniversitesi Erlangen-Nürnberg (FAU) yerel etik komitesi kuralları takip eder. 1. dise-TCI-Bispectral Analizi Prosedürü <ol><li> Damara gerçekleştirin ve sakinleştirici yönetmek için damar yolu elde etmek için arka taraftan veya medyan kübital ven sol hastalarda IV kateter yerleştirin. </li><li> Oda sıcaklığında (22 ° C) soruşturma yürütmek. </li><li> Ameliyathane içine uyanık hastayı getirin. ameliyat masasına yatar pozisyonda hasta yerleştirin. </li><li> Bunu takiben, anestezist vital bulguların izleme sistemi bağlamak var. 3 dakikalık aralıklarla periferik pulse oksimetre, 3 kanallı EKG ve non-invazif kan basıncı ölçümü ile tüm prosedürü sırasında hastayı izleyin. </li><li> Anestezist ve anestezik ekipman hem de hastanın sol tarafında olduğundan emin olun. </li><li> t Anestezist yeri var ve düzeltmekbispektral analizi için o tek kullanımlık sensör. <ol><li> Bunu yapmak için, dezenfektan ile cilt silin ve kurumaya bırakın. </li><li> çapraz hastanın alnına konum sensörü (4 birbirine bağlı ve yapışkanlı elektrot): alnın ortasında bir elektrot (sayı 1), elektrotlar 2 ve doğrudan göz ve saç çizgisi köşesinde arasındaki tapınak üzerine kaş ve elektrodun 4 üzerinde 3. </li><li> bispektral analizi-monitöre arabirim kablosu vasıtasıyla sensörünü bağlayın. Basın elektrotlar sıkıca ve otomatik sensör testi geçti olduğundan emin olun. </li></ol></li><li> Anestezist Marsh 17 önceden programlanmış farmakokinetik modeli ile veri yöneticisi propofol hastaların bireysel cinsiyet, yaş, boy, kilo ve plazma hedef konsantrasyonu girmek zorunda. NOT: Bu modele göre, TCI-veri yöneticisi propofol infüzyon oranlarını hesaplar ve ayarlanan hedef plazma konsantrasyonunu kurmak ve otomatik korumak için bağlı TCI-infüzyon pompası çalışır.</li><li> Ameliyathanede ışık loş. </li><li> 2.0 ug / ml&#39;lik bir başlangıç ​​hedef plazma seviyesi TCI-infüzyon pompası ile propofol intravenöz infüzyon ile, yalnızca uyku neden. </li><li> sedasyon istenen derinliğe ulaşılana kadar hastanın solunum, bilinç ve bispektral analizi değerinin devletin sürekli gözetim altında, / ml / 2 dk 0.2 ug adımlarla hedef plazma propofol düzeyini yükseltmek. NOT: sedasyon hedef derinliği muhafaza spontan solunum ve / veya horlamaya başlayan ve / veya endoskop veya anestezist ile araştırmacı tarafından gözlemlenen obstrüktif apne bir uyku hasta (gözleri kapalı) &#39;dir. </li><li> sedasyon hedef derinlikte bispektral analiz rekor elle ortalama değeri. </li><li> endoskop ile muayene yanında hastaya sağ tarafında baş seviyesinde durmak zorunda. </li><li> sedasyon hedef derinliğinde inf yoluyla transnazal bir esnek fiber endoskop eklemekerior burun meatus. </li><li> Endoskopik muayene filme ve dijital olarak saklayın. üreticinin talimatlarına uygun olarak görüntü elde etme sistemini kullanarak. NOT: septal deviasyon veya alt konka hipertrofisi halinde, daha büyük çaplı alt meatus seçilmelidir. </li><li> nazofarenks kadar hipofaringeal girişinde distal yönde bir proksimal endoskopi ile üst solunum yolları inceleyin. </li><li> tıkanıklık site (ler) (perdesini, orofarinks, dil kökü, epiglot) ve yapılandırma / tıkanıklık desen (lateral, konsantrik posterior anterior-) ve derece / şiddeti sınıflandırmak (tıkanma / hayır titreşim, kısmi tıkanma / titreşim, tam tıkanması sedasyon 15 hedef derinliğinde OY sistemine göre / çöküşü). </li><li> İzole uyku endoskopi durumunda, endoskopik muayene tamamladıktan sonra propofol infüzyon durdurarak hastanın sedasyon sonlandırabilir. </li><li> to planlı bir cerrahi işlemin bir parçası olarak uyku endoskopi durumda, anestezist opioid infüzyon başlayarak total intravenöz anestezi uygulamasında izin (örneğin, MKE modunda remifentanil kullanarak) ve propofol (örn., set MKE düzeyi infüzyon artan 4 ug / ml) bilinç kaybı kadar. Kas gevşetici (örneğin, roküronyum) enjekte edilir ve hasta entübe. </li></ol>

<ol>
	<li>Punjabi, N. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+epidemiology+of+adult+obstructive+sleep+apnea.">The epidemiology of adult obstructive sleep apnea.</a> Proc Am Thorac Soc. 5 (2), 136-143 (2008).</li><li>Giles, L. T., Lasserson, T. J., Smith, B., White, J., Wright, J. J., Cates, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Continuous+positive+airways+pressure+for+obstructive+sleep+apnoea+in+adults.">Continuous positive airways pressure for obstructive sleep apnoea in adults.</a> Cochrane Database Syst Rev. 19 (3), (2006).</li><li>Mayer, G., 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=Deutsche+Gesellschaft+f&#252;r+Schlafforschung+und+Schlafmedizin+(DGSM),+S3-Leitlinie.+Nicht+erholsamer+Schlaf/Schlafst&#246;rungen.">Deutsche Gesellschaft f&#252;r Schlafforschung und Schlafmedizin (DGSM), S3-Leitlinie. Nicht erholsamer Schlaf/Schlafst&#246;rungen.</a> Somnologie. 13, 1-160 (2009).</li><li>McArdle, N., Devereux, G., Heidarnejad, H., Engleman, H. M., Mackay, T. W., Douglas, N. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+use+of+CPAP+therapy+for+sleep+apnea/hypopnea+syndrome.">Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome.</a> Am J Respir Crit Care Med. 159 (4), 1108-1114 (1999).</li><li>Verse, T., 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=HNO-spezifische+Therapie+der+obstruktiven+Schlafapnoe+bei+Erwachsenen.">HNO-spezifische Therapie der obstruktiven Schlafapnoe bei Erwachsenen.</a> AWMF. , (2015).</li><li>Sher, A. E., Schechtman, K. B., Piccirillo, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+efficacy+of+surgical+modifications+of+the+upper+airway+in+adults+with+obstructive+sleep+apnea+syndrome.">The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome.</a> Sleep. 19 (2), 156-177 (1996).</li><li>Croft, C. B., Pringle, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sleep+nasendoscopy:+a+technique+of+assessment+in+snoring+and+obstructive+sleep+apnoea.">Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea.</a> Clin Otolaryngol Allied Sci. 16 (5), 504-509 (1991).</li><li>De Vito, 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=Drug-induced+sleep+endoscopy:+conventional+versus+target+controlled+infusion+techniques--a+randomized+controlled+study.">Drug-induced sleep endoscopy: conventional versus target controlled infusion techniques--a randomized controlled study.</a> Eur Arch Otorhinolaryngol. 268 (3), 457-462 (2011).</li><li>Kezirian, E. J., 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=Interrater+reliability+of+drug-induced+sleep+endoscopy.">Interrater reliability of drug-induced sleep endoscopy.</a> Arch Otolaryngol Head Neck Surg. 136 (4), 393-397 (2010).</li><li>Rodriguez-Bruno, K., Goldberg, A. N., McCulloch, C. E., Kezirian, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Test-retest+reliability+of+drug-induced+sleep+endoscopy.">Test-retest reliability of drug-induced sleep endoscopy.</a> Otolaryngol Head Neck Surg. 140 (5), 646-651 (2009).</li><li>De Vito, 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=European+position+paper+on+drug-induced+sedation+endoscopy+(DISE).">European position paper on drug-induced sedation endoscopy (DISE).</a> Sleep Breath. 18 (3), 453-465 (2014).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sleep-related+breathing+disorders+in+adults:+recommendations+for+syndrome+definition+and+measurement+techniques+in+clinical+research.+The+Report+of+an+American+Academy+of+Sleep+Medicine+Task+Force.">Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force.</a> Sleep. 22 (5), 667-689 (1999).</li><li>Iber, C., Ancoli-Israel, S., Chesson, A., Quan, S. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. 1st ed. , (2007).</li><li>Berry, R. B., 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=Rules+for+scoring+respiratory+events+in+sleep:+update+of+the+2007+AASM+Manual+for+the+Scoring+of+Sleep+and+Associated+Events.+Deliberations+of+the+Sleep+Apnea+Definitions+Task+Force+of+the+American+Academy+of+Sleep+Medicine.">Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine.</a> J Clin Sleep Med. 8 (5), 597-619 (2012).</li><li>Kezirian, E. J., Hohenhorst, W., de Vries, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Drug-induced+sleep+endoscopy:+the+VOTE+classification.">Drug-induced sleep endoscopy: the VOTE classification.</a> Eur Arch Otorhinolaryngol. 268 (8), 1233-1236 (2011).</li><li>Ihmsen, H., Schraag, S., Kreuer, S., Bruhn, J., Albrecht, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Target-controlled+infusion.+Clinical+relevance+and+special+features+when+using+pharmacokinetic+models.">Target-controlled infusion. Clinical relevance and special features when using pharmacokinetic models.</a> Anaesthesist. 58 (7), 708-715 (2009).</li><li>Marsh, B., White, M., Morton, N., Kenny, G. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pharmacokinetic+model+driven+infusion+of+propofol+in+children.">Pharmacokinetic model driven infusion of propofol in children.</a> Brit J Anaesth. 67 (1), 41-48 (1991).</li><li>Schnider, T. W., 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+influence+of+method+of+administration+and+covariates+on+the+pharmacokinetics+of+propofol+in+adult+volunteers.">The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers.</a> Anesthesiology. 88 (5), 1170-1182 (1998).</li><li>Sigl, J. C., Chamoun, N. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+introduction+to+bispectral+analysis+for+the+electroencephalogram.">An introduction to bispectral analysis for the electroencephalogram.</a> J Clin Monitor. 10 (6), 392-404 (1994).</li><li>Avidan, M. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anesthesia+awareness+and+the+bispectral+index.">Anesthesia awareness and the bispectral index.</a> New Engl J Med. 358 (11), 1097-1108 (2008).</li><li>Kissin, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Depth+of+anesthesia+and+bispectral+index+monitoring.">Depth of anesthesia and bispectral index monitoring.</a> Anesth Analg. 90 (5), 1114-1117 (2000).</li><li>Borowiecki, B., Pollak, C. P., Weitzman, E. D., Rakoff, S., Imperato, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fibro-optic+study+of+pharyngeal+airway+during+sleep+in+patients+with+hypersomnia+obstructive+sleep-apnea+syndrome.">Fibro-optic study of pharyngeal airway during sleep in patients with hypersomnia obstructive sleep-apnea syndrome.</a> Laryngoscope. 88 (8), 1310-1313 (1978).</li><li>Fujita, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+the+effectiveness+of+uvulopalatopharyngoplasty.">Evaluation of the effectiveness of uvulopalatopharyngoplasty.</a> Laryngoscope. 95 (1), 70-74 (1985).</li><li>Zerpa Zerpa, ., Carrasco Llatas, M., Agostini Porras, G., Dalmau Galofre, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Drug-induced+sedation+endoscopy+versus+clinical+exploration+for+the+diagnosis+of+severe+upper+airway+obstruction+in+OSAHS+patients.">Drug-induced sedation endoscopy versus clinical exploration for the diagnosis of severe upper airway obstruction in OSAHS patients.</a> Sleep Breath. 19 (4), 1367-1372 (2015).</li><li>Fernandez-Julian, E., Garcia-Perez, M. A., Garcia-Callejo, J., Ferrer, F., Marti, F., Marco, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+planning+after+sleep+versus+awake+techniques+in+patients+with+obstructive+sleep+apnea.">Surgical planning after sleep versus awake techniques in patients with obstructive sleep apnea.</a> Laryngoscope. 124 (8), 1970-1974 (2014).</li><li>Vroegop, A. 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=Drug-induced+sleep+endoscopy+in+sleep-disordered+breathing:+report+on+1,249+cases.">Drug-induced sleep endoscopy in sleep-disordered breathing: report on 1,249 cases.</a> Laryngoscope. 124 (3), 797-802 (2014).</li></ol>

The authors have no funding, financial relationships, or conflicts of interest to disclose.

Tıkanıklığın yerini tespit etmek için kendiliğinden uyku sırasında esnek fiber optik rhinopharyngolaryngoscopy kullanarak ilk deneyler 1970&#39;lerde 22 gibi erken olarak nitelendirildi. Ancak, bu soruşturma tekniğin kökleri başlangıçta tamamen açıklayıcı patofizyolojik niteliği vardı. Böyle Fujita Uvulopalatofaringoplasti (UPPP) diye OSA tedavisi için cerrahi tekniklerin, kurulması sırasında, ancak operasyonun başarısı hastanın 23 dikkatli preoperatif seçimine görü...

Obstrüktif uyku apnesi (OSA) tam (apne) veya uyku sırasında üst solunum yollarının kısmi (hipopne) çöküşü tekrarlayan evreleri ile karakterizedir. Bu aşamalar genellikle arteriyel oksijen desatürasyonu ve uyanma neden uyku parçalanması ile ilişkilidir. Erkeklerde% 7 ve 2 - - kadınlarda 1% 5 genel popülasyonda gündüz semptomları eşlik eden OSA bildirilen prevalans 3&#39;tür. % 60 2 - Ciddi OSA orta tedavisinde altın standart uygunluğu uluslararası yaklaşık 40 olarak bildirilmiştir hangi burun sürekli pozitif havayolu basıncı (nCPAP) &#39;dir. En az 4 saat 3 düzenli olarak OUAS&#39;nin hastaların 83% - Bu tedavi 29 tarafından da kullanılır. Hem CPAP kullanımı uzun vadeli uyum konusunda olumlu ve olumsuz belirleyicileri de günümüzde 4 bilinmektedir. Buna ek olarak, duygusal ve klinik yan etkileri genellikle önemli ölçüde uyumu azaltır. Böyle inci üst solunum yolu cerrahisi gibi alternatif tedavi seçeneklerierefore OUA&#39;nın tedavisinde önemli bir rol oynamaktadır. Ancak, cerrahi (yanıtlayıcı oranı) başarı oranı ventilasyon tedavisi ile karşılaştırıldığında nispeten düşük olması 5,6 sorunludur. 1991 yılında Croft ve Pringle tarafından uyku endoskopi tanıtımı OSA patofizyolojisi içine daha fazla anlayış sağlamak kalmayıp, aynı zamanda bireysel cerrahi tedavi 7 ile cevaplayıcı oranını artırmak olabilir umut oldu. Gibi erken 2011 olarak, De Vito ve arkadaşları tarafından çalışmalar. Hedef kontrollü infüzyon (TCI) ve güvenlik, kararlılık ve doğruluğu 8 ile ilgili olarak BİS analize göre araştırmacı teknikler kullanılarak avantajı gösterdi. Bu arada, uyku endoskopi geçerlik ve güvenirlik hiç 2014 Avrupa Pozisyon Belgesi beri, standardizasyon 9-11 yolda, kurulmuş ve oylandı. Bu çalışmanın amacı, uyku endoskop için standart bir protokol kurmakamacıyla bispektral analizi kullanılarak sedasyon derinliğinin gerçek zamanlı izleme ile birlikte sedatif propofol hedef kontrollü infüzyonu ile Y OUA&#39;nın-şiddetine göre tıkanma desen ayırt etmek. Olgu Sunumu: Çalışma tasarımı: retrospektif çalışma, yerel Etik Komitesi tarafından onaylandıktan sonra, Eylül 2012 ve Kasım 2014 arasında Kulak Burun Boğaz, Baş ve Friedrich-Alexander Üniversitesi Erlangen-Nürnberg Boyun Cerrahisi Anabilim Dalında yapılmıştır. 20 73 yaş arası 57 katılımcı hastalar, KBB, Baş ve Boyun Cerrahisi Bölümü tarafından alındı. 52 hasta erkek ve 5 kadın vardı. standart bir görüşme yanı sıra, onlar bir KBB tarafından muayene ve üst solunum yollarını değerlendirmek için bir uyanık endoskopi uygulandı. Kardiyorespiratuvar polisomnografi sonra Bakanlığın içinde gerçekleştirilmiştiruyku laboratuarı onların uyku ile ilişkili solunum bozukluğu tam bir sınıflandırma sağlamaktır. Kuvvet 12 Uyku Tıbbı Görev Amerikan Akademisi kriterlerine göre, (AHİ&gt; 30 / saat), orta (AHİ&gt; 15 &lt;30 / saat) veya şiddetli - OSA şiddeti (15 / saat AHİ 5) hafif olarak sınıflandırıldı . Uyku endoskopi endikasyonu üst solunum yollarında (birincil göstergesi) planlı bir cerrahi müdahale bağlamında veya nCPAP uyumsuzluk (ikincil veya adjuvan göstergesi) durumunda kurulmuştur. polisomnografi ile teşhis, hafif, orta veya şiddetli OSA ile 75 yıl - Bu çalışma için alınma kriterleri 18 yaş arası erkekler ve kadınlar vardı. Dışlama kriterleri Anesthesiologists bir American Society of Sınıflaması (ASA) IV / V, santral uyku apnesi, sedatifler, alkol veya bağımlılık yapan ilaçlara, propofol alerjisi, hamile kadınların kötüye pozitif öyküsü vardı. Tanı, Değerlendirme ve Plan: arabadiorespiratory polisomnografi (PSG): Polisomnografi 33 kanallı Kardiyorespiratuar teşhis sistemi ile yürütülmüştür. polisomnografik teşhis için teknik prosedür elektroensefalogram kullanarak standart teknikle Amerikan Uyku Tıbbı Akademisi (AASM) önerilerini takip (EEG; F4-M1, C4-M1, O2-M1), sağ ve elektro-oculogram sol mentalis ve tibialis kaslarının, nazal basınç kanül, göğüs ve karın solunum çaba sensörleri (endüktif plethysmographs), vücut pozisyonu sensörleri, pulse oksimetre, horlama mikrofon ve elektromyogram, tek kanallı EKG ve bir kızılötesi bir video 13 kayıt. Değerlendirme AASM Kriterlerine göre gerçekleştirilmiştir (Sürüm 2.0, 2012) ve Alman Uyku Derneği (DGSM) 13, 14 akredite tıbbi uyku uzmanı tarafından gerçekleştirilmiştir. polisomnografi OSA teyit ettikten sonra, her 57 hasta standart propofol tabanlı İlaç Kaynaklı SLE yapıldıMKE ve bispektral analizi (dise-TCI-bispektral analizi) ile ep Endoskopi (dise). Ameliyat öncesi hazırlıklar: Nedeniyle kas gevşetici etkisi, benzodiazepinler hiçbir premedikasyon sadece tanısal amaçlı yapılan uyku endoskopi durumunda verildi. uyku endoskopi planlı bir cerrahi işlem sırasında gerçekleştirildi ise, klonidin dikkate ilgili kontrendikasyonlar alarak, benzodiazepinler için bir alternatif olarak premedikasyon için kullanılmıştır. tıkanma sınıflandırılması: OY sistemi sınıflandırma amaçları 15 kullanılmıştır. tıkanma aşağıdaki siteler kabul edildi: velum, orofarenks (yanal orofaringeal duvarlar, bademcik), dil kökü ve küçük dil. İkaz şiddeti üç derecede (kısmi ve tam tıkanma yok tıkanıklığı) bölündü. tıkanıklığın yapılandırma ön-posta bölündüerior, yanal ve konsantrik. Hedef kontrollü infüzyon (TCI): Hedef Kontrollü İnfüzyon (MKE) kanda hedef konsantrasyonu elde etmek için mikroçip kontrollü infüzyon pompaları kullanılarak ilaçların infüzyon açıklar. Bu yöntemin amacı, hızlı başarı ve belirli bir (tanımlanır) plazma seviyesi veya efekt sitesi MKE durumunda bir etki düzeyine dayalı belirli bir etkisi (örneğin, sedasyon) bakımıdır. Plazma seviyesi veya efekt-site düzeyinde hesaplanması gönüllü nüfusu 16-18 belirlenen farmakolojik yarılanma ömrü değerleri ve dağıtım katsayıları kullanmak (Marsh veya Schnider göre) farmakokinetik 3-kompartman modelleri dayanmaktadır. hızla elde etmek ve plazma içinde propofol belirtilen hedef seviyesini korumak için gerekli olan infüzyon oranları otomatik olarak hesaplanır ve infüzyon pompası tarafından kontrol edilir. Bu çalışma, bir infüzyon pompası içeren bir sistem ve bir veri ma kullanılanBirlikte Marsh önceden programlanmış farmakokinetik modeli ile nager. sedasyon amacı derinliği aynı zamanda BİS analizi ile izlenmiştir. Bispektral analizi: bispektral analizi / index beyindeki elektriksel aktivite ile ilişkilidir. bispektral analiz kayıtlarının monitör çeşitli özel algoritmalar yardımıyla, EEG güç spektrumunun dağılımını analiz, EEG sinyallerini frontal ve. BİS endeksi 0 ile 100 19 ile boyutsuz bir sayıdır. Genel olarak, yaklaşık 90 değeri yüksek frekanslı beta dalgaları bir üstünlüğü yansıtır ve hasta uyanık olduğunu gösterir. 10, aşağıdaki Bispectral analiz değerleri EEG bastırma 20, 21 işaret etmektedir. Bu ölçek, bu nedenle beyin üzerinde sakinleştirici etkisi dolaylı ölçüm sağlar. Bir bisp anestezi yeterli bir derinliğe korumak ve hastanın istenmeyen bir ameliyat uyanıklık önlemek için60 &lt;ait ectral endeksi tavsiye edilir. Diğer taraftan, &lt;40 bispektral indeksi değerleri gereksiz derin anestezi önlenmesi için, kaçınılmalıdır. Tüm uyku endoskopi ek uyku tıbbında niteliklerin (TM 59.6% (34/57), AF% 40.4 (23/57) ile iki deneyimli kulak burun boğaz danışmanları tarafından yapılmıştır.

<table border="0" cellpadding="0" cellspacing="0" width="1421">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="20">
			<td height="20" style="height:20px;width:387px;">Cardiorespiratory polysomnography&#160;</td>
			<td style="width:544px;"></td>
			<td style="width:313px;"></td>
			<td style="width:179px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">SOMNOscreen&#160;</td>
			<td>SOMNOmedics, Randersacker, Germany</td>
			<td>SBT202</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Sedation</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Propofol-Lipuro 20 mg/mL; 2,6-diisopropylphenol</td>
			<td>B. Braun Melsungen AG, Melsungen, Germany</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Target-controlled infusion (TCI)</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Infusion pump Orchestra Module DPS Visio</td>
			<td>Fresenius Kabi, Germany GmbH&#160;</td>
			<td>Z082420</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Data manager Orchestra Base Primea</td>
			<td>Fresenius Kabi Germany GmbH</td>
			<td>Z081320</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Bispectral analysis (BIS)</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">BIS single-use electrode BIS Quatro Sensor</td>
			<td>Covidien, Neustadt/Donau, Germany GmbH</td>
			<td>186-0106</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">BIS monitor BIS VISTA</td>
			<td>Covidien, Neustadt/Donau, Germany GmbH</td>
			<td>186-0210</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Endoscope&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Laryngo fiberscope, length 30 cm, diameter 3.5 mm</td>
			<td>KARL STORZ GmbH &#38; Co. KG, Tuttlingen, Germany</td>
			<td>11101RP</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Picture Archiving&#160; System&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:387px;">AIDA</td>
			<td>Karl STORZ GmbH &#38; Co. KG, Tuttlingen, Germany</td>
			<td>WD 200-XX</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:387px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:387px;">Premedication&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Catapresan; Clonidin-HCl 0.075 mg/0.15 mg/0.3 mg</td>
			<td>Boehringer Ingelheim Pharma, GmbH &#38; Co. KG, Ingelheim am Rhein, Germany</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

drug-induced sleep endoscopy (dise) with target controlled infusion (tci) and bispectral analysis in obstructive sleep apnea

Bu çalışmanın amacı, obstrüktif uyku apnesi (OSA) tıkanıklık desenleri ayırt etmek için ilaca bağlı uyku endoskopi (dise) için standart bir protokol kurmak oldu. sedatif propofol hedef kontrollü infüzyon (TCI) BİS analizi ile sedasyon derinliğinin gerçek zamanlı izleme ile bir araya getirilmiştir. Bir gözlemsel çalışmada 57 hasta (yaş 44.8 yıl, ortalama ± SD 10.5; apne hipopne İndeksi (AHİ) 30.8 / hr, ± SD 21.6, ortalama BMI ortalama / m 2 28.2 kg ± SD 5.3) ile dise ardından Kardiyorespiratuar polisomnografi uygulandı MKE ve bispektral analizi. Uyku 2.0 ug / ml&#39;lik bir başlangıç ​​hedef plazma seviyesi, bir TCI-pompa ile propofol intravenöz infüzyon ile, sadece indüklendi. Hastanın solunum sürekli izleme altında, bilinç ve bispektral analizi değerinin devlet, hedef plazma propofol düzeyi de kadar 0.2 mg / ml / 2 dk adımlarla büyüdüsedasyon sired derinliği ulaşıldı. sedasyon hedef derinlikte bispektral analizin ortalama değeri belirlendi ve dise-TCI-bispektral analizi sırasında tıkanma desenleri daha sonra OY-sistemine göre sınıflandırıldı. Daha sonra sonuçlar polisomnografik ve antropometrik verilere göre analiz edildi. OSA şiddeti tüm dereceleri arasında çok düzeyli tıkanıklığı sitelerinin oluşumu üst solunum yolu cerrahi öncesi uyku endoskopi için gerekliliğini açıklar. Bu tekniğin avantajı da hasta heterojen gruplara protokol tekrar üretilebilir. Buna ek olarak, BİS indeksi gerçek zamanlı kontrol propofol plazma seviyesinin kademeli olarak kontrollü ve standart bir artış sedasyon hassas bir şekilde kontrol edilebilir derinliğine yol açar. standardizasyon yeteneğine - dise-TCI-bispektral analiz prosedürü uyku endoskopi gerekli tekrarlanabilir bir protokol yolunda atılmış bir adımdır. Bununla birlikte henüz W bilinmemektedirhether Gözlenen bu tıkanıklığı desenleri de doğal uyku bulgulara karşılık gelmektedir.

<html> Hastaların özellikleri Tablo 1 &#39;de gösterilmiştir. sedasyon istenen derinlikte bispektral analizin ortalama değeri 60 (SD 10.4, aralık ± 35 - 80; aralığı 42,0% 95 güven - 47.6) idi. tıkanıklığın Tek veya birden fazla kombine siteler OSA şiddeti tüm seviyelerinde bulundu. tıkanıklık tespit siteleri, sıklık sırasına azalan vardı: velar% 59.6 (34/57), dil kökü% 43,9 (25/57), orofarenks% 42.1 (24/57) ya da epiglot% 29.8 seviyesinde (17/5...

Watch this Scientific Journal Video about Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea at JoVE.com

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Bu çalışmanın amacı, uyku endoskopi obstrüktif uyku apnesi (OSA) tıkanıklık desenleri ayırt etmek için standart bir protokol kurmak oldu. sedatif hedef kontrollü infüzyon (TCI) BİS analizi ile sedasyon derinliğinin gerçek zamanlı izleme ile bir araya getirilmiştir.

İlaç Kaynaklı Obstrüktif Uyku Apnesi Hedef Kontrollü İnfüzyon (MKE) ve Bispectral Analizi ile uyku Endoskopi (dise)

The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in ...

drug-induced-sleep-endoscopy-dise-with-target-controlled-infusion-tci

Research

JoVE Journal

Medicine

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

19.5K Görüntüleme.  Friedrich-Alexander University Erlangen-Nürnberg (FAU).  Bu çalışmanın amacı, uyku endoskopi obstrüktif uyku apnesi (OSA) tıkanıklık desenleri ayırt etmek için standart bir protokol kurmak oldu. sedatif hedef kontrollü infüzyon (TCI) BİS analizi ile sedasyon derinliğinin gerçek zamanlı izleme ile bir araya getirilmiştir. 

Video: Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

A Novel Capsulorhexis Technique Using Shearing Forces with Cystotome

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye.
Method:
Our technique involves creating the initial anterior capsular tear with a cystotome to raise a flap. The flap left unfolded on the lens surface. The cystotome tip is tilted horizontally and is engaged on the flap near the leading edge of the tear. The cystotome is moved in a circular fashion to direct the vector forces. The loose flap is constantly swept towards the centre so that it does not obscure the view on the tearing edge.
Results:
Our technique has the advantage of reducing corneal wound distortion and subsequent anterior chamber collapse. The capsulorhexis flap is moved away from the tear leading edge allowing better visualisation of the direction of tear. This technique offers superior control of the capsulorhexis by allowing the surgeon to change the direction of the tear to achieve the desired capsulorhexis size.
Conclusions:
The EYESI Surgical Simulator is a realistic training platform for surgeons to practice complex capsulorhexis techniques. The shearing forces technique is a suitable alternative and in some cases a far better technique in achieving the desired capsulorhexis.

This video demonstrates a novel capsulorhexis technique in modern cataract surgery. Capsulorhexis is the most difficult and important part of phacoemulsification surgery.

Cystotome ile Makaslama Kuvvetleri kullanma Roman kapsüloreksis Tekniği

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye....

Tıp

A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome

Part 1 : Purpose: To demonstrate a capsulorhexis radial tear out rescue technique using a cystotome on a virtual reality cataract surgery simulator and in a human eye. Part 2 : Method: Steps: When a capsulorhexis begins to veer radially towards the periphery beyond the pupillary margin the following steps should be applied without delay. 2.1) Stop further capsulorhexis manoeuvre and reassess the situation. 2.2) Fill the anterior chamber with ophthalmic viscosurgical device (OVD). We recommend mounting the cystotome to a syringe containing OVD so that the anterior chamber can be reinflated rapidly. 2.3) The capsulorhexis flap is then left unfolded on the lens surface. 2.4) The cystotome tip is tilted horizontally to avoid cutting or puncturing the flap and is engaged on the flap near the leading edge of the tear but not too close to the point of tear. 2.5) Gently push or pull the leading edge of tear opposite to the direction of tear. 2.6) The leading tearing edge will start to do a 'U-Turn'. Maintain the tension on the flap until the tearing edge returns to the desired trajectory. Part 3 : Results: Using our technique, a surgeon can respond instantly to radial tear out without having to change surgical instruments. Changing surgical instruments at this critical stage runs a risk of further radial tear due to sudden shallowing of anterior chamber as a result of forward pressure from the vitreous. Our technique also has the advantage of reducing corneal wound distortion and subsequent anterior chamber collapse. Part 4 : Discussion The EYESI Surgical Simulator is a realistic training platform for surgeons to practice complex capsulorhexis tear-out techniques. Capsulorhexis is the most important and complex part of phacoemulsification and endocapsular intraocular lens implantation procedure. A successful cataract surgery depends on achieving a good capsulorhexis. During capsulorhexis, surgeons may face a challenging situation like a capsulorhexis radial tear-out. A surgeon must learn to tackle the problem promptly without making the situation worse. Some other methods of rescuing the situation have been described using a capsulorhexis forceps. However, we believe our method is quicker, more effective and easier to manipulate as demonstrated on the EYESi surgical simulator and on a human eye. Acknowledgments: List acknowledgements and funding sources. We would like to thank Dr. Wael El Gendy, for video clip. Disclosures: describe potential conflicting interests or state We have nothing to disclose. References: 1. Brian C. Little, Jennifer H. Smith, Mark Packer. J Cataract Refract Surg 2006; 32:1420 1422, Issue-9. 2. Neuhann T. Theorie und Operationstechnik der Kapsulorhexis. Klin Monatsbl Augenheilkd. 1987; 1990: 542-545. 3. Gimbel HV, Neuhann T. Development, advantages and methods of the continuous circular capsulorhexis technique. J Cataract Refract Surg. 1990; 16: 31-37. 4. Gimbel HV, Neuhann T. Continuous curvilinear capsulorhexis. (letter) J Cataract Refract Sur. 1991; 17: 110-111.

Capsulorhexis is an important step in phacoemulsification surgery. A surgeon creates a continous curvilinear tear on the anterior lens capsule by controlling the tearing vector forces. A peripherally extended tear is a serious complication. This video demonstrates a novel technique of rescuing capsular radial tear out using a cystotome.

Bir Cystotome kullanarak Radyal Kurtarma kapsüloreksis Roman Tekniği Gözyaşı-

Part 1 : Purpose:   To demonstrate a capsulorhexis radial tear out rescue technique using a cystotome on a virtual reality cataract surgery simulator and ...

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.

Bronş Thermoplasty: Şiddetli Astım Yeni Bir Tedavi Yaklaşımı

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

Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment (RMCA) in Individuals with Chronic Spinal Cord Injury

During breathing, activation of respiratory muscles is coordinated by integrated input from the brain, brainstem, and spinal cord. When this coordination is disrupted by spinal cord injury (SCI), control of respiratory muscles innervated below the injury level is compromised1,2 leading to respiratory muscle dysfunction and pulmonary complications. These conditions are among the leading causes of death in patients with SCI3. Standard pulmonary function tests that assess respiratory motor function include spirometrical and maximum airway pressure outcomes: Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), Maximal Inspiratory Pressure (PImax) and Maximal Expiratory Pressure (PEmax)4,5. These values provide indirect measurements of respiratory muscle performance6. In clinical practice and research, a surface electromyography (sEMG) recorded from respiratory muscles can be used to assess respiratory motor function and help to diagnose neuromuscular pathology. However, variability in the sEMG amplitude inhibits efforts to develop objective and direct measures of respiratory motor function6. Based on a multi-muscle sEMG approach to characterize motor control of limb muscles7, known as the voluntary response index (VRI)8, we developed an analytical tool to characterize respiratory motor control directly from sEMG data recorded from multiple respiratory muscles during the voluntary respiratory tasks. We have termed this the Respiratory Motor Control Assessment (RMCA)9. This vector analysis method quantifies the amount and distribution of activity across muscles and presents it in the form of an index that relates the degree to which sEMG output within a test-subject resembles that from a group of healthy (non-injured) controls. The resulting index value has been shown to have high face validity, sensitivity and specificity9-11. We showed previously9 that the RMCA outcomes significantly correlate with levels of SCI and pulmonary function measures. We are presenting here the method to quantitatively compare post-spinal cord injury respiratory multi-muscle activation patterns to those of healthy individuals.

Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury

The purpose of this publication is to present our original work on a multi-muscle surface electromyographic approach to quantitatively characterize respiratory muscle activation patterns in individuals with chronic spinal cord injury using vector-based analysis.

Kronik Spinal Kord Yaralanması Bireylerde Solunum Motor Kontrol Değerlendirmesi (RMCA) kullanarak Solunum Kas Aktivasyon Değerlendirilmesi

During breathing, activation of respiratory muscles is coordinated by integrated input from the brain, brainstem, and spinal cord. When this coordination ...

Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies

Biomarkers are directly-measured biological indicators of disease, health, exposures, or other biological information. In population and social sciences, biomarkers need to be easy to obtain, transport, and analyze. Dried Blood Spots meet this need, and can be collected in the field with high response rates. These elements are particularly important in longitudinal study designs including interventions where attrition is critical to avoid, and high response rates improve the interpretation of results. Dried Blood Spot sample collection is simple, quick, relatively painless, less invasive then venipuncture, and requires minimal field storage requirements (i.e.&#160;samples do not need to be immediately frozen and can be stored for a long period of time in a stable freezer environment before assay). The samples can be analyzed for a variety of different analytes, including cholesterol, C-reactive protein, glycosylated hemoglobin, numerous cytokines, and other analytes, as well as provide genetic material. DBS collection is depicted as employed in several recent studies.

Biomarkers are directly-measured biological indicators of disease or health. In population and social sciences, biomarkers need to be easy to obtain, transport, and analyze. Dried Blood Spot (DBS) collection meets this need, can be collected in the field with high response rates&#160;and analyzed for a variety of biomarkers.

Sağlık Biyomarkörler Kan Toplama Noktası Nüfus Etütleri Katılımını özdeyiş Kurutulmuş

Biomarkers are directly-measured biological indicators of disease, health, exposures, or other biological information. In population and social sciences, ...

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

One desirable endpoint of general anesthesia is the state of unconsciousness, also known as hypnosis. Defining the hypnotic state in animals is less straightforward than it is in human patients. A widely used behavioral surrogate for hypnosis in rodents is the loss of righting reflex (LORR), or the point at which the animal no longer responds to their innate instinct to avoid the vulnerability of dorsal recumbency. We have developed a system to assess LORR in 24 mice simultaneously while carefully controlling for potential confounds, including temperature fluctuations and varying gas flows. These chambers permit reliable assessment of anesthetic sensitivity as measured by latency to return of the righting reflex (RORR) following a fixed anesthetic exposure. Alternatively, using stepwise increases (or decreases) in anesthetic concentration, the chambers also enable determination of a population's sensitivity to induction (or emergence) as measured by EC50 and Hill slope. Finally, the controlled environmental chambers described here can be adapted for a variety of alternative uses, including inhaled delivery of other drugs, toxicology studies, and simultaneous real-time monitoring of vital signs.

Loss of the righting reflex has long served as a standard behavioral surrogate for unconsciousness, also called hypnosis, in laboratory animals. Alterations in volatile anesthetic sensitivity caused by pharmacological interventions can be detected with a carefully controlled high-throughput assessment system, which may be adapted for delivery of any inhaled therapeutic.

Yerel ya da Sistemik Farmakolojik Müdahale sonrası Farelerin Uçucu Genel Anestezik Hassasiyet Değişiklikleri değerlendirilmesi

One desirable endpoint of general anesthesia is  the state of unconsciousness, also known as hypnosis. Defining the hypnotic state in animals is  less ...

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic pressure through echocardiography, as well as to obtain measurements of the Aorta and PA diameter in mice.
Mice older than 10 d of age can be analyzed using the present technique. The technique is composed of 3 main steps: set-up, image acquisition, and image analysis. The set-up step consists of getting the mouse anesthetized with 1% isoflurane, shaving it, and taping it in a supine position to a heated EKG board where the image acquisition will take place. The image acquisition step consists of learning to identify the cardiac structures and obtaining all the required images with its correspondent probe and axis in order to be able to calculate volumes and diameters. The image analysis step consists of measuring the previously acquired images with the aid of computer software.
Advantages of the proposed technique include a fast (15 min) procedure that would allow the researcher to evaluate interventions in a non-invasive, non-terminal approach and therefore follow the same mouse over time; each mouse can be used as its own control. This fact plus having the same operator perform all the acquisition and analysis for the entire experiment minimizes the limitation of operator-dependency. The present methodology is useful for mouse researchers in cardiovascular and pulmonary medicine.

The following protocol describes the methodology for the acquisition and analysis of echocardiographic images used to obtain the Left Atrial Volume (LAV), Aorta (Ao) diameter, and Pulmonary Artery (PA) diameter in mice. This technique is a non-invasive, non-terminal procedure that allows assessment of the cardiopulmonary function.

Sol Atrium, Aort ve Pulmoner Arter Murin Ekokardiyografi

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic ...

In Vivo Evaluation of the Mechanical and Viscoelastic Properties of the Rat Tongue

The tongue is a highly innervated and vascularized muscle hydrostat on the floor of the mouth of most vertebrates. Its primary functions include supporting mastication and deglutition, as well as taste-sensing and phonetics. Accordingly, the strength and volume of the tongue can impact the ability of vertebrates to accomplish basic activities such as feeding, communicating, and breathing. Human patients with sleep apnea have enlarged tongues, characterized by reduced muscle tone and increased intramuscular fat that can be visualized and quantified by magnetic resonance imaging (MRI). The abilities to measure force generation and viscoelastic properties of the tongue constitute important tools for obtaining functional information to correlate with imaging data. Here, we present techniques for measuring tongue force production in anesthetized Zucker rats via electrical stimulation of the hypoglossal nerves and for determining the viscoelastic properties of the tongue by applying passive Lissajous force/deformation curves.

In Vivo Evaluation of the Mechanical and Viscoelastic Properties of the Rat Tongue

We describe a surgical procedure in an anesthetized rat model for determining the muscle tone and viscoelastic properties of the tongue. The procedure involves specific stimulation of the hypoglossal nerves and application of passive Lissajous force/deformation curves to the muscle.

Sıçan Dilinin Mekanik ve Viskoelastik Özelliklerinin In Vivo Değerlendirilmesi

The tongue is a highly innervated and vascularized muscle hydrostat on the floor of the mouth of most vertebrates. Its primary functions include ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

Büyük erişkinlerde izleme multi-modal ev uyku

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Culture and Imaging of Human Nasal Epithelial Organoids

Individualized therapy for cystic fibrosis (CF) patients can be achieved with an in vitro disease model to understand baseline Cystic Fibrosis Transmembrane conductance Regulator (CFTR) activity and restoration from small molecule compounds. Our group recently focused on establishing a well-differentiated organoid model directly derived from primary human nasal epithelial cells (HNE). Histology of sectioned organoids, whole-mount immunofluorescent staining, and imaging (using confocal microscopy, immunofluorescent microscopy, and bright field) are essential to characterize organoids and confirm epithelial differentiation in preparation for functional assays. Furthermore, HNE organoids produce lumens of varying sizes that correlate with CFTR activity, distinguishing between CF and non-CF organoids. In this manuscript, the methodology for culturing HNE organoids are described in detail, focusing on the assessment of differentiation using the imaging modalities, including the measurement of baseline lumen area (a method of CFTR activity measurement in organoids that any laboratory with a microscope can employ) as well as the developed automated approach to a functional assay (which requires more specialized equipment).

A detailed protocol is presented here to describe an in vitro organoid model from human nasal epithelial cells. The protocol has options for measurements requiring standard laboratory equipment, with additional possibilities for specialized equipment and software.