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Weiss RA, Bernardy J, Tichy F. Simultaneous Application of High-Intensity Focused Electromagnetic and Synchronized Radiofrequency for Fat Disruption: Histological and Electron Microscopy Porcine Model Study. Dermatol Surg 2021; 47:1059-1064. [PMID: 34115683 DOI: 10.1097/dss.0000000000003091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Radiofrequency (RF) and high-intensity focused electromagnetic (HIFEM) technologies are used for noninvasive body shaping as standalone modalities. OBJECTIVE To examine the effects of novel synchronized RF and HIFEM on subcutaneous adipose tissue in a porcine animal model. MATERIALS AND METHODS Seven large white pigs aged 6 months received 3 abdominal treatments of simultaneous application of synchronized RF and HIFEM (30 minutes, once per week). Punch biopsies of treated and control subcutaneous tissue were collected at the baseline, 4 days, 2 weeks, 1 month, and 2 months. Specimens were examined by light and scanning electron microscopy. Adipocyte volume was analyzed. Fat tissue temperature was measured in situ (fiber optic probes) and superficially (thermal imager). RESULTS Fat layer was heated to temperatures of 42 to 45°C. Signs of fat apoptosis (shape alternations and pyknotic nuclei) appeared at day 4 and peaked between 2 weeks and 1 month. Adipocyte volume decreased significantly (p < .001) by 31.1% at 2 weeks, 1 month (-23.6%), and 2 months (-22.0%). Control samples showed healthy adipocytes. Scanning electron microscopy micrographs corroborated histology findings, showing flattened, volume-depleted and disrupted adipocytes. CONCLUSION Synchronized RF with HIFEM procedure resulted in a significant and sustained fat reduction with no adverse events.
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Affiliation(s)
- Robert A Weiss
- Maryland Laser Skin, & Vein Institute, Hunt Valley, Maryland
| | | | - Frantisek Tichy
- Department of Anatomy and Histology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, CZ
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Hoss E, Kollipara R, Alhaddad M, Boen M, Goldman MP. Red Deer Umbilical Cord-Derived Stem Cell Conditioned Media Combined With Ablative Resurfacing of the Face. J Drugs Dermatol 2021; 19:1044-1048. [PMID: 33196737 DOI: 10.36849/jdd.2020.5246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Laser resurfacing is the gold standard procedure for photodamage, but is not without downtime and risk. Use of periprocedural products containing stem cell conditioned media may improve results and optimize healing. STUDY DESIGN This was a prospective, randomized controlled, double-blind study, evaluating the efficacy and tolerability of red deer umbilical cord-derived stem cell conditioned media (USCCM) cream and serum pre- and post- ablative facial resurfacing. METHODS AND MATERIALS Twenty patients with moderate to severe photodamage were randomized to receive vehicle or USCCM cream and serum pre- and post- ablative resurfacing of the face. Blinded investigators rated healing, tolerability, and efficacy, while subjects rated post-procedure symptoms, tolerability, and satisfaction. RESULTS Both the active and vehicle pre-procedure cream were soothing, calming and easy to use by all patients. There was a trend towards decreased facial erythema and crusting in the active versus vehicle group. A greater improvement in wrinkling occurred in the active group. The majority of subjects were very satisfied with the active products. There were no serious adverse events. CONCLUSION Red deer umbilical cord-derived stem cell conditioned media (USCCM) is well tolerated, safe and efficacious for use pre- and post- facial laser resurfacing.J Drugs Dermatol. 2020;19(11): 1044-1048 doi:10.36849/JDD.2020.5246.
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Brugger MS, Baumgartner K, Mauritz SCF, Gerlach SC, Röder F, Schlosser C, Fluhrer R, Wixforth A, Westerhausen C. Vibration enhanced cell growth induced by surface acoustic waves as in vitro wound-healing model. Proc Natl Acad Sci U S A 2020; 117:31603-31613. [PMID: 33257581 PMCID: PMC7749343 DOI: 10.1073/pnas.2005203117] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We report on in vitro wound-healing and cell-growth studies under the influence of radio-frequency (rf) cell stimuli. These stimuli are supplied either by piezoactive surface acoustic waves (SAWs) or by microelectrode-generated electric fields, both at frequencies around 100 MHz. Employing live-cell imaging, we studied the time- and power-dependent healing of artificial wounds on a piezoelectric chip for different cell lines. If the cell stimulation is mediated by piezomechanical SAWs, we observe a pronounced, significant maximum of the cell-growth rate at a specific SAW amplitude, resulting in an increase of the wound-healing speed of up to 135 ± 85% as compared to an internal reference. In contrast, cells being stimulated only by electrical fields of the same magnitude as the ones exposed to SAWs exhibit no significant effect. In this study, we investigate this effect for different wavelengths, amplitude modulation of the applied electrical rf signal, and different wave modes. Furthermore, to obtain insight into the biological response to the stimulus, we also determined both the cell-proliferation rate and the cellular stress levels. While the proliferation rate is significantly increased for a wide power range, cell stress remains low and within the normal range. Our findings demonstrate that SAW-based vibrational cell stimulation bears the potential for an alternative method to conventional ultrasound treatment, overcoming some of its limitations.
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Affiliation(s)
- Manuel S Brugger
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany
- Stiftung der Deutschen Wirtschaft gGmbH, 10178 Berlin, Germany
| | - Kathrin Baumgartner
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany
- Studienstiftung des deutschen Volkes e.V., 53175 Bonn, Germany
| | - Sophie C F Mauritz
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany
| | - Stefan C Gerlach
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany
- Hans-Seidel-Stiftung e.V., 80636 Munich, Germany
| | - Florian Röder
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany
| | - Christine Schlosser
- Biochemistry and Molecular Biology, Institute of Theoretical Medicine, University of Augsburg, 86159 Augsburg, Germany
| | - Regina Fluhrer
- Biochemistry and Molecular Biology, Institute of Theoretical Medicine, University of Augsburg, 86159 Augsburg, Germany
- German Center for Neurodegenerative Diseases (DZNE) e.V., 81377 Munich, Germany
| | - Achim Wixforth
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany
- Center for NanoScience, 80799 Munich, Germany
| | - Christoph Westerhausen
- Experimental Physics I, Institute of Physics, University of Augsburg, 86159 Augsburg, Germany;
- Center for NanoScience, 80799 Munich, Germany
- Physiology, Institute of Theoretical Medicine, University of Augsburg, 86159 Augsburg, Germany
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Alexiades M. At-Home Transvaginal Device Following Fractional Carbon Dioxide Laser Treatment for Genitourinary Syndrome of Menopause. J Drugs Dermatol 2020; 19:1076-1079. [PMID: 33196757 DOI: 10.36849/jdd.2020.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Device-based therapeutic approaches have been developed to treat women’s genitourinary post-menopausal symptoms. Fractional carbon dioxide laser resurfacing (FxCO2) has been demonstrated to be safe and effective in the treatment of GSM symptoms, however the results begin to wane by 12-months post-treatment. OBJECTIVE This study aims at assessing the application of an at-home transvaginal red and infrared light device as a maintenance treatment commencing 12 months following FxCO2 laser treatment for genitourinary syndrome of menopause (GSM). STUDY DESIGN Subjects completing 12-month follow-up after three fractional CO2 laser vulvovaginal treatments received an at-home device and monitored for GSM symptoms with long-term follow-up to 12 months (2 years post-laser). METHODS 10 post-menopausal subjects completing 12-months follow-up after three FxCO2 vulvovaginal treatments for GSM were treated with an at-home red and infrared LED device. Treatment consisted of intravaginal application three times per week, and subjects were followed to 1, 3, 6, and 12 months. Subjects completed the vaginal assessment scale subject satisfaction, and QUID to assess for vulvovaginal and stress urinary incontinence (SUI) symptoms. RESULTS Vulvovaginal symptoms measured by VAS were mean 89% improved at 12-month follow-up after FxCO2 and maintained at 73% improved over baseline (2 years post-laser) following an additional 12 months of at-home transvaginal light therapy (P<0.05). VAS symptoms gradually increased over the 12 months maintenance period by a mean of 17% (P<0.05). Mean subject satisfaction was 0 at baseline, 1.86 at 1 year following FxCO2, and 1.00 after an additional 1 year of at-home light therapy. SUI symptoms as measured by QUID were mean 81% improved at 12-month follow-up after FxCO2and maintained at 38% improved over baseline (2 years post-laser) following an additional 12-months of at-home light therapy (P<0.05). SUI symptoms gradually increased by a mean of 43% over the 12-month maintenance period (P<0.05). CONCLUSIONS At-home transvaginal red and near infrared light therapy commencing at 12 months post-FxCO2 vulvovaginal treatment in a post-menopausal population maintained statistically significant improvements in vulvovaginal and SUI symptoms over the additional12-month period (2 years post-laser); however, a gradual return of symptoms suggests that laser re-treatment or combination withhormone therapy may be necessary to maintain optimal outcomes.J Drugs Dermatol. 2020;19(11):1076-1079. doi:10.36849/JDD.2020.1012.
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Abstract
BACKGROUND Electromechanical- and robot-assisted gait-training devices are used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane Review first published in 2007 and previously updated in 2017. OBJECTIVES Primary • To determine whether electromechanical- and robot-assisted gait training versus normal care improves walking after stroke Secondary • To determine whether electromechanical- and robot-assisted gait training versus normal care after stroke improves walking velocity, walking capacity, acceptability, and death from all causes until the end of the intervention phase SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched 6 January 2020); the Cochrane Central Register of Controlled Trials (CENTRAL; 2020 Issue 1), in the Cochrane Library; MEDLINE in Ovid (1950 to 6 January 2020); Embase (1980 to 6 January 2020); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 20 November 2019); the Allied and Complementary Medicine Database (AMED; 1985 to 6 January 2020); Web of Science (1899 to 7 January 2020); SPORTDiscus (1949 to 6 January 2020); the Physiotherapy Evidence Database (PEDro; searched 7 January 2020); and the engineering databases COMPENDEX (1972 to 16 January 2020) and Inspec (1969 to 6 January 2020). We handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trial authors in an effort to identify further published, unpublished, and ongoing trials. SELECTION CRITERIA We included all randomised controlled trials and randomised controlled cross-over trials in people over the age of 18 years diagnosed with stroke of any severity, at any stage, in any setting, evaluating electromechanical- and robot-assisted gait training versus normal care. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, assessed methodological quality and risk of bias, and extracted data. We assessed the quality of evidence using the GRADE approach. The primary outcome was the proportion of participants walking independently at follow-up. MAIN RESULTS We included in this review update 62 trials involving 2440 participants. Electromechanical-assisted gait training in combination with physiotherapy increased the odds of participants becoming independent in walking (odds ratio (random effects) 2.01, 95% confidence interval (CI) 1.51 to 2.69; 38 studies, 1567 participants; P < 0.00001; I² = 0%; high-quality evidence) and increased mean walking velocity (mean difference (MD) 0.06 m/s, 95% CI 0.02 to 0.10; 42 studies, 1600 participants; P = 0.004; I² = 60%; low-quality evidence) but did not improve mean walking capacity (MD 10.9 metres walked in 6 minutes, 95% CI -5.7 to 27.4; 24 studies, 983 participants; P = 0.2; I² = 42%; moderate-quality evidence). Electromechanical-assisted gait training did not increase the risk of loss to the study during intervention nor the risk of death from all causes. Results must be interpreted with caution because (1) some trials investigated people who were independent in walking at the start of the study, (2) we found variation between trials with respect to devices used and duration and frequency of treatment, and (3) some trials included devices with functional electrical stimulation. Post hoc analysis showed that people who are non-ambulatory at the start of the intervention may benefit but ambulatory people may not benefit from this type of training. Post hoc analysis showed no differences between the types of devices used in studies regarding ability to walk but revealed differences between devices in terms of walking velocity and capacity. AUTHORS' CONCLUSIONS People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that eight patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase 3 trials undertaken to address specific questions about the most effective frequency and duration of electromechanical-assisted gait training, as well as how long any benefit may last. Future trials should consider time post stroke in their trial design.
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Affiliation(s)
- Jan Mehrholz
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
| | - Simone Thomas
- Wissenschaftliches Institut, Klinik Bavaria Kreischa, Kreischa, Germany
| | - Joachim Kugler
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
| | - Marcus Pohl
- Neurological Rehabilitation, Helios Klinik Schloss Pulsnitz, Pulsnitz, Germany
| | - Bernhard Elsner
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
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Dong Y, Yang Q, Guo B, Zhu J, Sun X. The effects of tacrolimus plus phototherapy in the treatment of vitiligo: a meta-analysis. Arch Dermatol Res 2020; 313:461-471. [PMID: 32785837 DOI: 10.1007/s00403-020-02121-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/31/2020] [Indexed: 10/23/2022]
Abstract
The objective of this meta-analysis was performed to compare the effects of tacrolimus plus phototherapy in the treatment of patients with vitiligo. Relevant studies were identified by searching PubMed, Embase, and Web of Science databases. The main outcomes of interest included excellent response (≥ 75% repigmentation), good response (50-75% repigmentation), moderate response (25%-50% repigmentation), and poor response (< 25% repigmentation). Risk ratio (RR) with 95% confidence intervals (95% CIs) was used to calculate the data. Eleven studies were included in this study. Compared with phototherapy alone, combination treatment of tacrolimus and phototherapy significantly improved excellent response rate (RR = 1.40, 95% CI 1.16, 1.69; P < 0.001) and reduced the poor response rate (RR = 0.37, 95% CI 0.22, 0.61; P = 0.001). However, the good response rate (RR = 1.00, 95% CI 0.59, 1.69, P = 1.000) and moderate response rate (RR = 0.91, 95% CI 0.60, 1.38; P = 0.653) were not significantly different between the two treatments. Subgroup analysis suggested that combination treatment had a higher excellent response rate than phototherapy alone for lesions located in the face and proximal limbs. Both NB-UVB and EL, when added to tacrolimus, resulted in a significantly higher excellent response rate than they were used alone. Meta-regression analysis showed that age was a predictive factor that influenced the effect of combination treatment on an excellent response, in which children had a high excellent response to the treatment. Other demographic and clinical variables, including gender, disease duration, family history, and type of vitiligo, did not have any impact on the treatment effect. Combination treatment with tacrolimus and phototherapy was more effective than phototherapy monotherapy for patients with vitiligo, especially in the lesions located in the face and proximal limbs. More large-scale, well-performed trials are needed to verify our findings.
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Affiliation(s)
- Yujie Dong
- Department of Emergency, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Qi Yang
- Department of Obstetrics and Gynecology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Baofeng Guo
- Department of Plastic and Reconstruction Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Jiajing Zhu
- Radiology Department, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Xiaojie Sun
- Department of Plastic and Reconstruction Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, 130033, China.
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Weinreich UM. Domiciliary high-flow treatment in patients with COPD and chronic hypoxic failure: In whom can we reduce exacerbations and hospitalizations? PLoS One 2019; 14:e0227221. [PMID: 31887206 PMCID: PMC6937157 DOI: 10.1371/journal.pone.0227221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/13/2019] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Domiciliary High-flow, humidified, nasal cannula (HFNC) is a possible add-on in patients with chronic respiratory diseases. This post-hoc study investigates benefit of HFNC in subgroups of advanced COPD patients with chronic hypoxic failure on reduction of exacerbations and hospitalizations. METHODS One hundred patients were randomized to HFNC in a previous trial. Subgroups with 0-1 (N = 32) respectively two or more (2+) (N = 68) exacerbations 12 months pre-study were investigated. Changes in number of exacerbations and hospitalizations pre- and in study were analyzed, corrected for HFNC days with HFNC. RESULTS Patients were comparable at baseline. Exacerbations increased in subgroup 0-1 (p = 0.01) and decreased in subgroup 2+ (p = 0.03). Correcting for HFNC days no correlation was seen in subgroup 0-1 (p = 0.08), but in subgroup 2+ (p<0.001). Number of hospitalizations increased in subgroup 0-1 (p = 0.01) with no change in days of hospitalization (p = 0.08). Number and days of hospitalization decreased in subgroup 2+ (p = 0.002 resp. 0.025). Correcting for HFNC days no correlation was found in number or days of hospitalization in subgroup 0-1 (p = 0.48 and p = 0.65). Positive correlation was found in subgroup 2+ (both p<0.001). CONCLUSION In patients with advanced COPD, chronic hypoxic failure and two or more exacerbations per year, HFNC significantly reduced exacerbations and hospitalizations.
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Affiliation(s)
- Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, and The Clinical Institute, Aalborg University, Aalborg, Denmark
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Pathania V, Oberoi B, Shankar P, Bhatt S. Single-handed vampire facial: Combining microneedling with platelet-rich plasma for single-hand use. J Am Acad Dermatol 2019; 84:e77-e78. [PMID: 31408682 DOI: 10.1016/j.jaad.2019.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 08/05/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Vikas Pathania
- Armed Forces Medical College and Command Hospital, Pune, India.
| | - Bhavni Oberoi
- Armed Forces Medical College and Command Hospital, Pune, India
| | - Prerna Shankar
- Armed Forces Medical College and Command Hospital, Pune, India
| | - Siddharth Bhatt
- Armed Forces Medical College and Command Hospital, Pune, India
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Boldrini P, Bonaiuti D, Mazzoleni S, Posteraro F. Rehabilitation assisted by robotic and electromechanical devices for persons with neurological disabilities: an Italian consensus conference. Funct Neurol 2019; 34:123-124. [PMID: 31556393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Sweeney DL, Wang EB, Austin E, Jagdeo J. Combined Hyperthermic 1060nm Diode Laser Lipolysis With Topical Skin Tightening Treatment: Case Series. J Drugs Dermatol 2018; 17:780-785. [PMID: 30005101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND As body contouring procedures have become more popular, post-procedural skin laxity is a concern. Non-invasive body contouring technologies may effectively reduce body fat, but modestly affect skin tightening. OBJECTIVE To assess the efficacy and safety of a topical skin tightening agent in combination with hyperthermic diode laser lipolysis. METHODS Herein, we describe five patients in which a skin tightening concentrate of 5% yeast extract, 2% hydrolyzed rice protein content, and 2.5% tripeptide was used after 1500-2100 J/cm2 of hyperthermic 1060 nm diode laser. RESULTS Overall, all patients had a subjective positive response and high satisfaction with the combined treatment results of improvement in skin laxity and fat reduction. In all five cases, patients demonstrated visible fat reduction and skin improvement on photographs taken between weeks 6-18 compared to baseline. Blinded investigators correctly predicted the order of the photographs based on treatment results. No adverse events were reported. CONCLUSION This case series demonstrated that a combined topical skin tightening concentrate with a hyperthermic laser lipolysis device may achieve improved aesthetic outcomes without adverse events. J Drugs Dermatol. 2018;17(7):780-785.
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Abstract
Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions. The retrospective examination of the results concerning by now more than 100 patients provided with an endo-exo femoral prosthesis (EEFP) showed a very satisfying outcome concerning objective as well as subjective values, such as duration of daily use and wearing comfort of the exoprosthesis. Regaining the ability of osseoperception due to the intraosseous fixation is described by the patients as a great advantage. The step from a socket prosthesis to an EEP is felt to be a big increase in quality of life by nearly all patients included into the follow-up. Nearly all of the patients questioned would choose an endo-exo prosthesis again. Meanwhile, the success of the EEP resulted in the broadening of indications from above-knee amputations to transtibial as well as transhumeral amputations. The results are likewise encouraging. The use of EEP for the upper limbs leads to substantial improvement in the range of motion of the shoulder joint with the intramedullary anchored percutaneous implant. Furthermore, new pathbreaking possibilities in the fixation of myoelectrically controlled arm prostheses may arise from the EEP technique.
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Affiliation(s)
- T Hoffmeister
- Sana Kliniken Lübeck GmbH, Kronsforder Allee 71/73, 23560, Lübeck, Deutschland
| | - F Schwarze
- Sana Kliniken Lübeck GmbH, Kronsforder Allee 71/73, 23560, Lübeck, Deutschland
| | - H H Aschoff
- Sana Kliniken Lübeck GmbH, Kronsforder Allee 71/73, 23560, Lübeck, Deutschland.
- Sektion Endo-Exo-Prothetik, Unfallchirurgische Klinik der MHH, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
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Cirrone GAP, Manti L, Margarone D, Petringa G, Giuffrida L, Minopoli A, Picciotto A, Russo G, Cammarata F, Pisciotta P, Perozziello FM, Romano F, Marchese V, Milluzzo G, Scuderi V, Cuttone G, Korn G. First experimental proof of Proton Boron Capture Therapy (PBCT) to enhance protontherapy effectiveness. Sci Rep 2018; 8:1141. [PMID: 29348437 PMCID: PMC5773549 DOI: 10.1038/s41598-018-19258-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 12/27/2017] [Indexed: 01/16/2023] Open
Abstract
Protontherapy is hadrontherapy's fastest-growing modality and a pillar in the battle against cancer. Hadrontherapy's superiority lies in its inverted depth-dose profile, hence tumour-confined irradiation. Protons, however, lack distinct radiobiological advantages over photons or electrons. Higher LET (Linear Energy Transfer) 12C-ions can overcome cancer radioresistance: DNA lesion complexity increases with LET, resulting in efficient cell killing, i.e. higher Relative Biological Effectiveness (RBE). However, economic and radiobiological issues hamper 12C-ion clinical amenability. Thus, enhancing proton RBE is desirable. To this end, we exploited the p + 11B → 3α reaction to generate high-LET alpha particles with a clinical proton beam. To maximize the reaction rate, we used sodium borocaptate (BSH) with natural boron content. Boron-Neutron Capture Therapy (BNCT) uses 10B-enriched BSH for neutron irradiation-triggered alpha particles. We recorded significantly increased cellular lethality and chromosome aberration complexity. A strategy combining protontherapy's ballistic precision with the higher RBE promised by BNCT and 12C-ion therapy is thus demonstrated.
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Affiliation(s)
- G A P Cirrone
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy.
| | - L Manti
- Physics Department, University of Naples Federico II, Naples, Italy
- INFN Naples Section, Complesso Universitario di Monte S. Angelo, Via Cintia, Naples, Italy
| | - D Margarone
- Institute of Physics ASCR, v.v.i. (FZU), ELI-Beamlines Project, Na Slovance 2, Prague, 18221, Czech Republic
| | - G Petringa
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- Physics Department, University of Catania, via S. Sofia, 64, Catania, Italy
| | - L Giuffrida
- Institute of Physics ASCR, v.v.i. (FZU), ELI-Beamlines Project, Na Slovance 2, Prague, 18221, Czech Republic
| | - A Minopoli
- Physics Department, University of Naples Federico II, Naples, Italy
| | - A Picciotto
- Fondazione Bruno Kessler, Micro-Nano Facility, Via Sommarive 18, 38123, Povo-Trento, Italy
| | - G Russo
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- Institute of Molecular Bioimaging and Physiology - National Research Council - (IBFM-CNR), Cefalù, (PA), Italy
| | - F Cammarata
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- Institute of Molecular Bioimaging and Physiology - National Research Council - (IBFM-CNR), Cefalù, (PA), Italy
| | - P Pisciotta
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- Physics Department, University of Catania, via S. Sofia, 64, Catania, Italy
| | - F M Perozziello
- Physics Department, University of Naples Federico II, Naples, Italy
- INFN Naples Section, Complesso Universitario di Monte S. Angelo, Via Cintia, Naples, Italy
| | - F Romano
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- National Physical Laboratory, Acoustic and Ionizing Radiation Division, Teddington, TW11 0LW, Middlesex, United Kingdom
| | - V Marchese
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
| | - G Milluzzo
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- Physics Department, University of Catania, via S. Sofia, 64, Catania, Italy
| | - V Scuderi
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
- Institute of Physics ASCR, v.v.i. (FZU), ELI-Beamlines Project, Na Slovance 2, Prague, 18221, Czech Republic
| | - G Cuttone
- Istituto Nazionale di Fisica Nucleare- Laboratori Nazionali dei Sud, via S. Sofia, 62, Catania, Italy
| | - G Korn
- Institute of Physics ASCR, v.v.i. (FZU), ELI-Beamlines Project, Na Slovance 2, Prague, 18221, Czech Republic
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Abstract
BACKGROUND Electromechanical- and robotic-assisted gait-training devices are used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane Review first published in 2007. OBJECTIVES To investigate the effects of automated electromechanical- and robotic-assisted gait-training devices for improving walking after stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (last searched 9 August 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 8), MEDLINE in Ovid (1950 to 15 August 2016), Embase (1980 to 15 August 2016), CINAHL (1982 to 15 August 2016), AMED (1985 to 15 August 2016), Web of Science (1899 to 16 August 2016), SPORTDiscus (1949 to 15 September 2012), the Physiotherapy Evidence Database (PEDro) (searched 16 August 2016), and the engineering databases COMPENDEX (1972 to 16 November 2012) and Inspec (1969 to 26 August 2016). We handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted authors in an effort to identify further published, unpublished, and ongoing trials. SELECTION CRITERIA We included all randomised controlled trials and randomised controlled cross-over trials in people over the age of 18 years diagnosed with stroke of any severity, at any stage, in any setting, evaluating electromechanical- and robotic-assisted gait training versus normal care. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, assessed methodological quality and risk of bias, and extracted the data. The primary outcome was the proportion of participants walking independently at follow-up. MAIN RESULTS We included 36 trials involving 1472 participants in this review update. Electromechanical-assisted gait training in combination with physiotherapy increased the odds of participants becoming independent in walking (odds ratio (random effects) 1.94, 95% confidence interval (CI) 1.39 to 2.71; P < 0.001; I² = 8%; moderate-quality evidence) but did not significantly increase walking velocity (mean difference (MD) 0.04 m/s, 95% CI 0.00 to 0.09; P = 0.08; I² = 65%; low-quality evidence) or walking capacity (MD 5.84 metres walked in 6 minutes, 95% CI -16.73 to 28.40; P = 0.61; I² = 53%; very low-quality evidence). The results must be interpreted with caution because 1) some trials investigated people who were independent in walking at the start of the study, 2) we found variations between the trials with respect to devices used and duration and frequency of treatment, and 3) some trials included devices with functional electrical stimulation. Our planned subgroup analysis suggested that people in the acute phase may benefit, but people in the chronic phase may not benefit from electromechanical-assisted gait training. Post hoc analysis showed that people who are non-ambulatory at intervention onset may benefit, but ambulatory people may not benefit from this type of training. Post hoc analysis showed no differences between the types of devices used in studies regarding ability to walk, but significant differences were found between devices in terms of walking velocity. AUTHORS' CONCLUSIONS People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that seven patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase III trials undertaken to address specific questions about the most effective frequency and duration of electromechanical-assisted gait training as well as how long any benefit may last.
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Affiliation(s)
- Jan Mehrholz
- Technical University DresdenDepartment of Public Health, Dresden Medical SchoolFetscherstr. 74DresdenGermany01307
| | - Simone Thomas
- Klinik Bavaria KreischaWissenschaftliches InstitutKreischaGermany01731
| | - Cordula Werner
- Medicalpark, Schlaganfallzentrum Berlin13507 Berlin ‐ TegelGermany
| | - Joachim Kugler
- Technical University DresdenDepartment of Public Health, Dresden Medical SchoolFetscherstr. 74DresdenGermany01307
| | - Marcus Pohl
- Helios Klinik Schloss PulsnitzNeurological RehabilitationWittgensteiner Str. 1PulsnitzSaxonyGermany01896
| | - Bernhard Elsner
- Dresden Medical School, Technical University DresdenDepartment of Public HealthFetscherstr. 74DresdenSachsenGermany01307
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14
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Suzuki K, Tanaka H, Ebara M, Uto K, Matsuoka H, Nishimoto S, Okada K, Murase T, Yoshikawa H. Electrospun nanofiber sheets incorporating methylcobalamin promote nerve regeneration and functional recovery in a rat sciatic nerve crush injury model. Acta Biomater 2017; 53:250-259. [PMID: 28179161 DOI: 10.1016/j.actbio.2017.02.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/23/2017] [Accepted: 02/02/2017] [Indexed: 12/17/2022]
Abstract
Peripheral nerve injury is one of common traumas. Although injured peripheral nerves have the capacity to regenerate, axon regeneration proceeds slowly and functional outcomes are often poor. Pharmacological enhancement of regeneration can play an important role in increasing functional recovery. In this study, we developed a novel electrospun nanofiber sheet incorporating methylcobalamin (MeCbl), one of the active forms of vitamin B12 homologues, to deliver it enough locally to the peripheral nerve injury site. We evaluated whether local administration of MeCbl at the nerve injury site was effective in promoting nerve regeneration. Electrospun nanofiber sheets gradually released MeCbl for at least 8weeks when tested in vitro. There was no adverse effect of nanofiber sheets on function in vivo of the peripheral nervous system. Local implantation of nanofiber sheets incorporating MeCbl contributed to the recovery of the motor and sensory function, the recovery of nerve conduction velocity, and the promotion of myelination after sciatic nerve injury, without affecting plasma concentration of MeCbl. STATEMENT OF SIGNIFICANCE Methylcobalamin (MeCbl) is a vitamin B12 analog and we previously reported its effectiveness in axonal outgrowth of neurons and differentiation of Schwann cells both in vitro and in vivo. Here we estimated the effect of local administered MeCbl with an electrospun nanofiber sheet on peripheral nerve injury. Local administration of MeCbl promoted functional recovery in a rat sciatic nerve crush injury model. These sheets are useful for nerve injury in continuity differently from artificial nerve conduits, which are useful only for nerve defects. We believe that the findings of this study are relevant to the scope of your journal and will be of interest to its readership.
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Affiliation(s)
- Koji Suzuki
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiroyuki Tanaka
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Mitsuhiro Ebara
- International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki 304-0044, Japan
| | - Koichiro Uto
- International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki 304-0044, Japan
| | - Hozo Matsuoka
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Shunsuke Nishimoto
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kiyoshi Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Medical Center for Translational and Clinical Research, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tsuyoshi Murase
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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15
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Feng Q, Lin S, Zhang K, Dong C, Wu T, Huang H, Yan X, Zhang L, Li G, Bian L. Sulfated hyaluronic acid hydrogels with retarded degradation and enhanced growth factor retention promote hMSC chondrogenesis and articular cartilage integrity with reduced hypertrophy. Acta Biomater 2017; 53:329-342. [PMID: 28193542 DOI: 10.1016/j.actbio.2017.02.015] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/20/2017] [Accepted: 02/08/2017] [Indexed: 12/22/2022]
Abstract
Recently, hyaluronic acid (HA) hydrogels have been extensively researched for delivering cells and drugs to repair damaged tissues, particularly articular cartilage. However, the in vivo degradation of HA is fast, thus limiting the clinical translation of HA hydrogels. Furthermore, HA cannot bind proteins with high affinity because of the lack of negatively charged sulfate groups. In this study, we conjugated tunable amount of sulfate groups to HA. The sulfated HA exhibits significantly slower degradation by hyaluronidase compared to the wild type HA. We hypothesize that the sulfation reduces the available HA octasaccharide substrate needed for the effective catalytic action of hyaluronidase. Moreover, the sulfated HA hydrogels significantly improve the protein sequestration, thereby effectively extending the availability of the proteinaceous drugs in the hydrogels. In the following in vitro study, we demonstrate that the HA hydrogel sulfation exerts no negative effect on the viability of encapsulated human mesenchymal stem cells (hMSCs). Furthermore, the sulfated HA hydrogels promote the chondrogenesis and suppresses the hypertrophy of encapsulated hMSCs both in vitro and in vivo. Moreover, intra-articular injections of the sulfated HA hydrogels avert the cartilage abrasion and hypertrophy in the animal osteoarthritic joints. Collectively, our findings demonstrate that the sulfated HA is a promising biomaterial for the delivery of therapeutic agents to aid the regeneration of injured or diseased tissues and organs. STATEMENT OF SIGNIFICANCE In this paper, we conjugated sulfate groups to hyaluronic acid (HA) and demonstrated the slow degradation and growth factor delivery of sulfated HA. Furthermore, the in vitro and in vivo culture of hMSCs laden HA hydrogels proved that the sulfation of HA hydrogels not only promotes the chondrogenesis of hMSCs but also suppresses hypertrophic differentiation of the chondrogenically induced hMSCs. The animal OA model study showed that the injected sulfated HA hydrogels significantly reduced the cartilage abrasion and hypertrophy in the animal OA joints. We believe that this study will provide important insights into the design and optimization of the HA-based hydrogels as the scaffold materials for cartilage regeneration and OA treatment in clinical setting.
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Affiliation(s)
- Qian Feng
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong
| | - Sien Lin
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Orthopaedic and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, 999077, Hong Kong
| | - Kunyu Zhang
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong
| | - Chaoqun Dong
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong
| | - Tianyi Wu
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Orthopaedic and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, 999077, Hong Kong
| | - Heqin Huang
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong
| | - Xiaohui Yan
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong
| | - Li Zhang
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong
| | - Gang Li
- Department of Orthopaedic and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, 999077, Hong Kong
| | - Liming Bian
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Shun Hing Institute of Advanced Engineering, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong; China Orthopedic Regenerative Medicine Group (CORMed), Hangzhou, PR China; Centre for Novel Biomaterials, The Chinese University of Hong Kong, Shatin, New Territories, 999077, Hong Kong.
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16
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Erath JW, Sirat AS, Vamos M, Hohnloser SH. Epicardial CRT-P- and S-ICD Implantation in a Young Patient with Persistent Left Superior Vena Cava. Herzschrittmacherther Elektrophysiol 2016; 27:396-398. [PMID: 27645220 DOI: 10.1007/s00399-016-0451-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/02/2016] [Indexed: 06/06/2023]
Abstract
Persistent left superior vena cava is known to be a challenging anatomic abnormality for transvenous cardiac device implantation. In the a case of a young man presenting with dilative cardiomyopathy with severely impaired left ventricular ejection fraction (LVEF) and second-degree atrioventricular block (AV block), cardiac resynchronization therapy (CRT) with defibrillator (CRT-D) implantation was indicated. A transvenous approach was attempted, but placement of the right ventricular lead was not successful due to anatomic abnormalities. Therefore, epicardial CRT leads were implanted via a left mini-thoracotomy. For primary prevention of sudden death, the patient was also fitted with an additional subcutaneous implantable cardioverter defibrillator (S-ICD). Any cross-talk between the devices was ruled out both intraoperatively and by ergometry prior to discharge. The combination of epicardial CRT-P with S‑ICD implantation might be a safe and effective alternative in patients with cardiac anatomic abnormalities.
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Affiliation(s)
- Julia W Erath
- Dep. of Cardiology, Div. of Clinical Electrophysiology, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Abdul Sami Sirat
- Dep. of Cardio-Thoracic Surgery, Helios Klinikum Siegburg, Siegburg, Germany
| | - Mate Vamos
- Dep. of Cardiology, Div. of Clinical Electrophysiology, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Stefan H Hohnloser
- Dep. of Cardiology, Div. of Clinical Electrophysiology, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
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17
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Möhlenbruch MA, Pfaff J, Herweh C, Bösel J, Rizos T, Nagel S, Ringleb PA, Bendszus M, Pham M. One-pass endovascular treatment of intracranial atherosclerotic stenosis with a novel PTA balloon and self-expanding microstent. Neuroradiology 2016; 58:893-9. [PMID: 27312474 DOI: 10.1007/s00234-016-1716-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/06/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION We present a novel endovascular technique to treat intracranial atherosclerotic stenosis (ICS) with the specific potential to reduce the procedure-related complications which so far limited safety and efficacy of endovascular ICS intervention. METHODS Six consecutive patients were included in this study with the following criteria of inclusion: (1) failure of dual antiplatelet therapy defined as recurrent TIA or ischemic stroke, (2) presence of ICS of ≥70 %, and (3) endovascular accessibility of the target lesion as judged by CTA or MRA. Technical feasibility, safety, and efficacy were observed for the first-ballon-then-stent (FBTS) technique using the percutaneous transluminal angioplasty (PTA) balloon microcatheter over which a self-expandable microstent can be directly delivered obviating the need to exchange microcatheters. RESULTS FBTS was performed in six patients (four female, median age 69, median stenosis 82.5 %) all refractory to best medical treatment: three V4, two M1, and one supraclinoid ICA stenosis. PTA and stent deployment were technically feasible in all patients and immediately effective with a median postprocedural stenosis grade of 10 %. Angiographic and clinical safety measures were met with no occult or clinically evident hemorrhage or ischemic complications (four patients discharged without alteration in mRS, two patients with significant clinical improvement). No occurrence of TIA, stroke, or death was observed during follow-up. CONCLUSION The FBTS method in this series appeared to be safe and effective for the endovascular treatment of ICS. It bears the specific potential to reduce wire perforations, which so far have been linked to major procedure-related adverse events of endovascular ICS treatment.
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Affiliation(s)
- Markus A Möhlenbruch
- Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany.
| | - Johannes Pfaff
- Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany
| | - Christian Herweh
- Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany
| | - Julian Bösel
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Timolaos Rizos
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Simon Nagel
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter A Ringleb
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany
| | - Mirko Pham
- Department of Neuroradiology, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany
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18
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Leigh S, Idris I, Collins B, Granby P, Noble M, Parker M. Promoting health and reducing costs: a role for reform of self-monitoring of blood glucose provision within the National Health Service. Diabet Med 2016; 33:681-90. [PMID: 26443548 DOI: 10.1111/dme.12977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2015] [Indexed: 12/22/2022]
Abstract
AIM To determine the cost-effectiveness of all options for the self-monitoring of blood glucose funded by the National Health Service, providing guidance for disinvestment and testing the hypothesis that advanced meter features may justify higher prices. METHODS Using data from the Health and Social Care Information Centre concerning all 8 340 700 self-monitoring of blood glucose-related prescriptions during 2013/2014, we conducted a cost-minimization analysis, considering both strip and lancet costs, including all clinically equivalent technologies for self-monitoring of blood glucose, as determined by the ability to meet ISO-15197:2013 guidelines for meter accuracy. RESULTS A total of 56 glucose monitor, test strip and lancet combinations were identified, of which 38 met the required accuracy standards. Of these, the mean (range) net ingredient costs for test strips and lancets were £0.27 (£0.14-£0.32) and £0.04 (£0.02-£0.05), respectively, resulting in a weighted average of £0.28 (£0.18-£0.37) per test. Systems providing four or more advanced features were priced equal to those providing just one feature. A total of £12 m was invested in providing 42 million self-monitoring of blood glucose tests with systems that fail to meet acceptable accuracy standards, and efficiency savings of £23.2 m per annum are achievable if the National Health Service were to disinvest from technologies providing lesser functionality than available alternatives, but at a much higher price. CONCLUSION The study uncovered considerable variation in the price paid by the National Health Service for self-monitoring of blood glucose, which could not be explained by the availability of advanced meter features. A standardized approach to self-monitoring of blood glucose prescribing could achieve significant efficiency savings for the National Health Service, whilst increasing overall utilisation and improving safety for those currently using systems that fail to meet acceptable standards for measurement accuracy.
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Affiliation(s)
- S Leigh
- Lifecode® Solutions, Liverpool, UK
- Liverpool Health Economics, University of Liverpool, Liverpool, UK
| | - I Idris
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK
| | - B Collins
- Liverpool Health Economics, University of Liverpool, Liverpool, UK
- Public Health, Wirral Council, Wirral, UK
| | - P Granby
- Lifecode® Solutions, Liverpool, UK
- Liverpool Health Economics, University of Liverpool, Liverpool, UK
| | - M Noble
- Lifecode® Solutions, Liverpool, UK
| | - M Parker
- Lifecode® Solutions, Liverpool, UK
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19
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Dell'Osso G, Bugelli G, Celli F, Petrini M, Trombi L, Guido G, Giannotti S. Grafting of Expanded Mesenchymal Stem Cells without Associated Procedure in a Healed Case of Ulna Pseudarthrosis: A Case Report. Surg Technol Int 2016; 28:289-292. [PMID: 27121410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The surgical management of pseudoarthrosis is often a challenge. The use of mesenchymal multipotent cells expanded and manipulated in the laboratory is an interesting treatment of pseudoarthrosis, because they can lead to differentiation into osteocytes and thus the formation of bone tissue. CASE DESCRIPTION We present a case of a 47-years-old man with isolate ulna fracture, treated with plate and screws and evolved in non-union. The patient underwent an expanded stem cells graft on the site of non-union with a small incision of approximately 3cm, without changing the synthesis system. After one year, the X-ray showed a complete fracture consolidation. DISCUSSION In our opinion, this case is interesting because it highlights the cellular action that is the only healing factor; it is an important demonstration of the biological action of expanded mesenchymal stem cells (MSCs). CONCLUSION To validate the use of MSCs, it is necessary to perform comparative studies for age, sex, general condition, location, and mechanism of injury as a further clinical validation of the efficiency of this cell line.
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Affiliation(s)
- Giacomo Dell'Osso
- Department of Orthopedic and Traumatology, University of Pisa, Pisa, Italy
| | - Giulia Bugelli
- Department of Orthopedic and Traumatology, University of Pisa, Pisa, Italy
| | - Fabio Celli
- Department of Orthopedic and Traumatology, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Hematology Division, Department of Oncology, University of Pisa, Pisa, Italy
| | - Luisa Trombi
- Hematology Division, Department of Oncology, University of Pisa, Pisa, Italy
| | - Giulio Guido
- Department of Orthopedic and Traumatology, University of Pisa, Pisa, Italy
| | - Stefano Giannotti
- Department of Orthopedic and Traumatology, University of Pisa, Pisa, Italy
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20
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Studer D, Hasler CC, Schulze A. [Treatment of early onset scoliosis : How far can we go?]. Orthopade 2015; 44:896-904. [PMID: 26345169 DOI: 10.1007/s00132-015-3163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recently, inconsistent definitions of early onset scoliosis (EOS) and a wide variety of treatment options have been observed. OBJECTIVES To clearly define the term EOS, to depict non-operative and operative treatment options, and to present the limitations of the boundaries of these techniques. METHODS Review of the literature, including conference presentations and expert opinions, in addition to personal experiences. RESULTS Early onset scoliosis (EOS) refers to spine deformity that is present before 10 years of age, regardless of etiology. All existing operative treatment options share a high risk of complications. Therefore, non-operative treatment should act as a time-buying approach to postpone surgery. DISCUSSION Awareness of treatment options and their specific indications, in addition to respecting each patient's individual needs and feasibilities, are crucial for the optimal outcome.
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Affiliation(s)
- D Studer
- Universitätskinderspital beider Basel, Spitalstrasse 33, 4056, Basel, Schweiz.
| | - C C Hasler
- Universitätskinderspital beider Basel, Spitalstrasse 33, 4056, Basel, Schweiz
| | - A Schulze
- Universitätskinderspital beider Basel, Spitalstrasse 33, 4056, Basel, Schweiz
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21
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Song XR, Wang X, Yu SX, Cao J, Li SH, Li J, Liu G, Yang HH, Chen X. Co₉ Se₈ nanoplates as a new theranostic platform for photoacoustic/magnetic resonance dual-modal-imaging-guided chemo-photothermal combination therapy. Adv Mater 2015; 27:3285-91. [PMID: 25885638 PMCID: PMC5242345 DOI: 10.1002/adma.201405634] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/18/2015] [Indexed: 04/14/2023]
Abstract
A new theranostic platform is developed based on biocompatible poly(acrylic acid) (PAA)-Co9 Se8 nanoplates. These PAA-Co9 Se8 nanoplates are successfully utilized for photoacoustic imaging (PAI)/magnetic resonance imaging (MRI) dual-modal imaging. Moreover, the PAA-Co9 Se8 -DOX shows pH-responsive chemotherapy and enables the combination of photothermal therapy and chemotherapy to receive superior antitumor efficacy. This work promises further exploration of 2D nanoplatforms for theranostic applications.
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Affiliation(s)
- Xiao-Rong Song
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOE State Key Laboratory of Photocatalysis on Energy and Environment, College of Chemistry Fuzhou University, Fuzhou, 350108, PR China
| | - Xiaoyong Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine School of Public Health, Xiamen University, Xiamen, 361005, PR China
| | - Shu-Xian Yu
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOE State Key Laboratory of Photocatalysis on Energy and Environment, College of Chemistry Fuzhou University, Fuzhou, 350108, PR China
| | - Jianbo Cao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine School of Public Health, Xiamen University, Xiamen, 361005, PR China
| | - Shi-Hua Li
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOE State Key Laboratory of Photocatalysis on Energy and Environment, College of Chemistry Fuzhou University, Fuzhou, 350108, PR China
| | - Juan Li
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOE State Key Laboratory of Photocatalysis on Energy and Environment, College of Chemistry Fuzhou University, Fuzhou, 350108, PR China
| | - Gang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine School of Public Health, Xiamen University, Xiamen, 361005, PR China
| | - Huang-Hao Yang
- The Key Lab of Analysis and Detection Technology for Food Safety of the MOE State Key Laboratory of Photocatalysis on Energy and Environment, College of Chemistry Fuzhou University, Fuzhou, 350108, PR China
| | - Xiaoyuan Chen
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), MD, 20892, USA
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22
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Pottek TS. [Surgical treatment of erectile dysfunction]. Urologe A 2015; 54:676-83. [PMID: 25987333 DOI: 10.1007/s00120-015-3795-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
During the past decades several efforts had been undertaken to treat erectile dysfunction by vascular surgery. Today one option survived: Implantation of Penile Prostheses. A lot of improvements of the material and the process quality lead to very good long term results. Patients with severe erectile dysfunction can be recommended in good conscience for implant surgery.
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Affiliation(s)
- T S Pottek
- Klinik für Urologie, Asklepios Westklinikum Hamburg, Suurheid 20, 22559, Hamburg, Deutschland,
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Kitrou PM, Spiliopoulos S, Katsanos K, Papachristou E, Siablis D, Karnabatidis D. Paclitaxel-coated versus plain balloon angioplasty for dysfunctional arteriovenous fistulae: one-year results of a prospective randomized controlled trial. J Vasc Interv Radiol 2015; 26:348-54. [PMID: 25542635 DOI: 10.1016/j.jvir.2014.11.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/01/2014] [Accepted: 11/01/2014] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To report 1-year results of a single-center randomized controlled trial comparing paclitaxel-coated balloon (PCB) versus high-pressure plain balloon angioplasty for the treatment of failing arteriovenous fistulae (AVFs). MATERIALS AND METHODS Forty patients (26 men; mean age, 61 y ± 14.63) were randomized at 1:1 to undergo PCB (n = 20) or high-pressure balloon (HPB; n = 20) angioplasty of dysfunctional AVFs. There were no significant differences in baseline demographics between groups. Enrollment required a clinical diagnosis of a dysfunctional AVF attributed to a single stenotic lesion verified with digital subtraction angiography. Primary endpoints included device success, anatomic success, clinical success, and target lesion revascularization (TLR)-free survival. Secondary endpoints included dialysis circuit primary patency and procedure-related complication rates. RESULTS Device success rates were 100% in the HPB group and 35% in the PCB group (P < 0001): further dilation with an HPB was needed to achieve anatomic success in 13 of 20 cases in the PCB group (65%). Anatomic and clinical success rates were 100% in both groups. TLR-free survival (PCB, 308 d; HPB, 161 d; hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.236-0.966; P = .03) and access circuit primary patency (PCB, 270 d; HPB, 161 d; HR, 0.479; 95% CI, 0.237-0.968; P = .04) were significantly in favor of PCB angioplasty. No minor or major procedure-related complications occurred. CONCLUSIONS In this single-center study, the use of PCBs resulted in superior TLR-free survival and dialysis access circuit primary patency of dysfunctional AVFs. However, additional HPB postdilation was required in the majority of cases.
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Affiliation(s)
- Panagiotis M Kitrou
- Interventional Radiology Department, Patras University Hospital, Patras, Achaia 26500, Greece
| | - Stavros Spiliopoulos
- Interventional Radiology Department, Patras University Hospital, Patras, Achaia 26500, Greece..
| | - Konstantinos Katsanos
- Interventional Radiology Department, Guy's and St. Thomas Hospitals National Health Service Foundation Trust, London, United Kingdom
| | | | - Dimitris Siablis
- Interventional Radiology Department, Patras University Hospital, Patras, Achaia 26500, Greece
| | - Dimitris Karnabatidis
- Interventional Radiology Department, Patras University Hospital, Patras, Achaia 26500, Greece
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Li K, Zhu M, Xu P, Xi Y, Cheng Z, Zhu Y, Ye X. Three-dimensionally plotted MBG/PHBHHx composite scaffold for antitubercular drug delivery and tissue regeneration. J Mater Sci Mater Med 2015; 26:102. [PMID: 25655503 DOI: 10.1007/s10856-015-5455-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 12/07/2014] [Indexed: 06/04/2023]
Abstract
A suitable drug-loaded scaffold that can postoperatively release an antituberculosis drug efficiently in a lesion area and help repair a bone defect is very important in the clinical treatment of bone tuberculosis (TB). In this study, a composite drug-loaded cylindrical scaffold was prepared by using three-dimensional printing technology in combination with the mesoporous confinement range, surface chemical groups, and gradual degradation of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate). This achieves the slow release of a drug for as long as possible. We implanted the drug-loaded compound scaffold into New Zealand rabbits' femur defect model to study the in vivo drug release performance and osteogenic ability. The in vivo release of isoniazid and rifampicin from the prepared composites could be effectively sustained for 12 weeks in local tissues, whereas these drugs were sustained for just 2 weeks in a control group. The blood drug concentrations were very low and most concentrations were below 5 μg/ml. Therefore, the systemic toxic adverse effect is very low. In addition, the composite exhibits good osteogenic potential in a rabbit bone defect model. The results of this study indicate that this composite has great potential for treating osteoarticular TB.
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Affiliation(s)
- Kun Li
- Department of Orthopedics, Changzheng Hospital of Second Military Medical University, No. 500 Nanjing West Road, Shanghai, 200003, People's Republic of China
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Abstract
Corrective osteotomy is a well established operative option for correction of predominantly congenital skeletal deformities on the growing skeleton. The indications for the use of a suitable corrective instrument result partly from the location, severity of the deformity and the presence of concomitant leg length discrepancies. External fixators are predominantly used for correction of combined deformities. For isolated leg length differences limb lengthening nails can be implanted but only after growth plates have become closed; however, only a few combined deformities can be addressed in this way. Often several surgical steps are necessary. A careful treatment plan can only be created if the analysis of the deformity is carried out with appropriate parameters and a correct prognosis of the further development. The aim of this paper is to describe the indications for the corrective instruments, the planning of corrections and the presentation of typical indications for axis correction and limb lengthening.
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Affiliation(s)
- F Schiedel
- Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland,
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Kim H, Kang J, Chang JH. Thermal therapeutic method for selective treatment of deep-lying tissue by combining laser and high-intensity focused ultrasound energy. Opt Lett 2014; 39:2806-2809. [PMID: 24784108 DOI: 10.1364/ol.39.002806] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Photothermal therapy is performed by delivering laser radiation into the target lesion containing tissue chromophores so as to induce localized heating. For high treatment efficacy, the laser wavelength should be selected to maximize the absorption of incident laser radiation in the tissue chromophores. However, even with the optimal laser wavelength, both the absorption and the scattering of laser energy in tissue openly hamper treatment efficacy in deep-lying lesions. To overcome the limitation, we propose a dual thermal therapeutic method in which both laser and acoustic energies are transmitted to increase therapeutic depth while maintaining high target selectivity of photothermal therapy. Through skin-mimicking phantom experiments, it was verified that the two different energies are complementary in elevation of tissue temperature, and the treatment depth using laser radiation is increased along with acoustic energy.
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Manó S, Pálinkás J, Szabó J, Nagy JT, Bakó K, Csernátony Z. Application of a vibrating device for the prevention of flexion contracture after total knee arthroplasty. Eur J Orthop Surg Traumatol 2014; 25:167-72. [PMID: 24777702 DOI: 10.1007/s00590-014-1466-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/15/2014] [Indexed: 11/26/2022]
Abstract
Our research team developed a new, heel support-based static and vibrating complementary treatment method for the prevention of flexion contractures often arising after total knee arthroplasty. We examined the efficiency of the method performing a randomized clinical trial with 144 patients undergoing total knee replacement. Seventy-nine patients were treated for 1 week with a generally used continuous passive motion (CPM) device complemented with our new method, which was based on the application of a static and an alternating heel support. The 65 patients in the control group were treated with only a CPM device as in usual clinical practice. The femoro-tibial angle was measured immediately following surgery, and after 1 week of treatment. At the end of the 1 week treatment, the target extension angle (0° ± 5°) was achieved by significantly more patients with the new combined method. This way the elevated heel rest and the vibrating device proved to be a good adjunct treatment along with the CPM used in routine clinical practice in the first place for the prevention of flexion contractures.
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Affiliation(s)
- Sándor Manó
- Department of Orthopaedic Surgery, Clinical Center, University of Debrecen, 98 Nagyerdei krt, Debrecen, 4032, Hungary,
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Sekundo W, Bertelmann T, Schulze S. [Combination of different techniques for secondary anchoring of intraocular lenses]. Ophthalmologe 2014; 111:365-8. [PMID: 24671633 DOI: 10.1007/s00347-013-2854-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The four fundamental techniques of secondary intraocular lens (IOL) fixation, namely sulcus placement, scleral or iris suture fixation and scleral haptic fixation can be combined in special situations. AIM When is a combination of different techniques advisable? METHODS This article describes our experiences and gives an example of combined technique use. RESULTS These situations arise in cases when neighboring ocular structures are only partially preserved or show particular distinctive defects that can be repaired at the time of secondary IOL anchoring. This article presents a case of IOL-induced iris chafing and traumatic iridodialysis which was closed by a combined technique of iris suture and scleral suture fixation. CONCLUSION A combination of different anchoring techniques for secondary IOL implantation can achieve a simultaneous repair of perilenticular structures and reduce the amount of suture material used.
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Affiliation(s)
- W Sekundo
- Augenklinik, Philipps-Universität Marburg sowie Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Baldinger Str., 35043, Marburg, Deutschland,
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Andrade G, Ponte De Souza ML, Marques R, Silva JL, Abath C, Azevedo-Filho HRC. Endovascular treatment of traumatic carotid cavernous fistula with balloon-assisted sinus coiling. A technical description and initial results. Interv Neuroradiol 2013; 19:445-54. [PMID: 24355148 PMCID: PMC3902743 DOI: 10.1177/159101991301900407] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 05/12/2013] [Indexed: 11/16/2022] Open
Abstract
This study aimed to propose an alternative treatment for carotid cavernous fistula (CCF) using the balloon-assisted sinus coiling (BASC) technique and to describe this procedure in detail. Under general anesthesia, we performed the BASC procedure to treat five patients with traumatic CCF. Percutaneous access was obtained via the right femoral artery, and a 7F sheath was inserted, or alternatively, a bifemoral 6F approach was accomplished. A microcatheter was inserted into the cavernous sinus over a 0.014-inch microwire through the fistulous point; the microcatheter was placed distal from the fistula point, and a "U-turn" maneuver was performed. Through the same carotid access, a compliant balloon was advanced to cross the point of the fistula and cover the whole carotid tear. Large coils were inserted using the microcatheter in the cavernous sinus. Coils filled the adjacent cavernous sinus, respecting the balloon. Immediate complete angiographic resolution was achieved, and an early angiographic control (mean = 2.6 months) indicated complete stability without recanalization. The clinical follow-up has been uneventful without any recurrence (mean = 15.2 months). An endovascular approach is optimal for direct CCF. Because the detachable balloon has been withdrawn from the market, covered stenting requires antiplatelet therapy and its patency is unconfirmed, but cavernous sinus coiling remains an excellent treatment option. Currently, there is no detailed description of the BASC procedure. We provide detailed angiograms with suitable descriptions of the exact fistula point, and venous drainage pathways. Familiarity with these devices makes this technique effective, easy and safe.
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Affiliation(s)
- Gustavo Andrade
- Interventional Neuroradiology, ANGIORAD-IMIP; Recife PE, Brazil - Department of Neurosurgery, Hospital da Restauração; Recife PE, Brazil -
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Orsama AL, Lähteenmäki J, Harno K, Kulju M, Wintergerst E, Schachner H, Stenger P, Leppänen J, Kaijanranta H, Salaspuro V, Fisher WA. Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: results of a theory-based randomized trial. Diabetes Technol Ther 2013; 15:662-9. [PMID: 23844570 DOI: 10.1089/dia.2013.0056] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes. SUBJECTS AND METHODS This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5-11%) or use of oral diabetes medication, and 30-70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months. RESULTS Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of -0.40% (95% confidence interval [CI] -0.67% to -0.14%) versus 0.036% (95% CI -0.23% to 0.30%) (P<0.03) and significantly greater weight reduction of -2.1 kg (95% CI -3.6 to -0.6 kg) versus 0.4 kg (95% CI -1.1 to 1.9 kg). Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed. CONCLUSIONS Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts.
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Abstract
BACKGROUND Electromechanical and robotic-assisted gait training devices are used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane Review first published in 2007. OBJECTIVES To investigate the effects of automated electromechanical and robotic-assisted gait training devices for improving walking after stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (last searched April 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 2), MEDLINE (1966 to November 2012), EMBASE (1980 to November 2012), CINAHL (1982 to November 2012), AMED (1985 to November 2012), SPORTDiscus (1949 to September 2012), the Physiotherapy Evidence Database (PEDro, searched November 2012) and the engineering databases COMPENDEX (1972 to November 2012) and INSPEC (1969 to November 2012). We handsearched relevant conference proceedings, searched trials and research registers, checked reference lists and contacted authors in an effort to identify further published, unpublished and ongoing trials. SELECTION CRITERIA We included all randomised and randomised cross-over trials consisting of people over 18 years old diagnosed with stroke of any severity, at any stage, or in any setting, evaluating electromechanical and robotic-assisted gait training versus normal care. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, assessed methodological quality and extracted the data. The primary outcome was the proportion of participants walking independently at follow-up. MAIN RESULTS In this update of our review, we included 23 trials involving 999 participants. Electromechanical-assisted gait training in combination with physiotherapy increased the odds of participants becoming independent in walking (odds ratio (OR) (random effects) 2.39, 95% confidence interval (CI) 1.67 to 3.43; P < 0.00001; I² = 0%) but did not significantly increase walking velocity (mean difference (MD) = 0.04 metres/s, 95% CI -0.03 to 0.11; P = 0.26; I² = 73%) or walking capacity (MD = 3 metres walked in six minutes, 95% CI -29 to 35; P = 0.86; I² = 70%). The results must be interpreted with caution because (1) some trials investigated people who were independent in walking at the start of the study, (2) we found variations between the trials with respect to devices used and duration and frequency of treatment, and (3) some trials included devices with functional electrical stimulation. Our planned subgroup analysis suggests that people in the acute phase may benefit but people in the chronic phase may not benefit from electromechanical-assisted gait training. Post hoc analysis showed that people who are non-ambulatory at intervention onset may benefit but ambulatory people may not benefit from this type of training. Post hoc analysis showed no differences between the types of devices used in studies regarding ability to walk, but significant differences were found between devices in terms of walking velocity. AUTHORS' CONCLUSIONS People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of a large definitive, pragmatic, phase III trial undertaken to address specific questions such as the following: What frequency or duration of electromechanical-assisted gait training might be most effective? How long does the benefit last?
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Affiliation(s)
- Jan Mehrholz
- Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, Kreischa, Germany.
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Cho YD, Kang HS, Lee WJ, Kim KM, Kim JE, Han MH. Stent-assisted coil embolization of wide-necked posterior inferior cerebellar artery aneurysms. Neuroradiology 2013; 55:877-82. [PMID: 23568700 DOI: 10.1007/s00234-013-1178-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 03/20/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Young Dae Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul, Korea 110-744
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Nienkemper M, Wilmes B, Pauls A, Drescher D. Multipurpose use of orthodontic mini-implants to achieve different treatment goals. J Orofac Orthop 2012; 73:467-76. [PMID: 23104396 DOI: 10.1007/s00056-012-0107-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 06/18/2012] [Indexed: 11/25/2022]
Affiliation(s)
- M Nienkemper
- Policlinic of Orthodontics, University Hospital Düsseldorf, Germany.
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Löw S, Herold D. [Palmarly comminuted scaphoid fractures]. Unfallchirurg 2012; 115:1038-40. [PMID: 22706658 DOI: 10.1007/s00113-012-2236-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Two cases of acute scaphoid fractures of the middle third with palmar comminution were treated with cancellous bone transplantation and Herbert screw fixation. Despite 6 weeks of cast immobilization, secondary loss of reduction resulted in primary grade dislocation in one patient. In the other patient scaphoid dislocation led to dorsiflexed intercalated segment instability and the need for screw removal due to secondary joint irritation. As a consequence the authors recommend the use of cortical bone grafting of the iliac crest in cases where palmar defects occur after reduction of the scaphoid.
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Affiliation(s)
- S Löw
- Caritas-Krankenhaus, Uhlandstraße 7, 97980, Bad Mergentheim, Deutschland.
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Spiotta AM, Sivapatham T, Hussain MS, Hui FK, Moskowitz SI, Gupta R. Combined Surgical and Endovascular Approach to a Complex Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus and Torcula. J Stroke Cerebrovasc Dis 2012; 21:283-8. [PMID: 20888786 DOI: 10.1016/j.jstrokecerebrovasdis.2010.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 08/24/2010] [Accepted: 08/15/2010] [Indexed: 11/16/2022] Open
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Inoue H, Ikeda H, Hosoya T, Yoshida A, Onimaru M, Suzuki M, Kudo SE. Endoscopic mucosal resection, endoscopic submucosal dissection, and beyond: full-layer resection for gastric cancer with nonexposure technique (CLEAN-NET). Surg Oncol Clin N Am 2012; 21:129-40. [PMID: 22098836 DOI: 10.1016/j.soc.2011.09.012] [Citation(s) in RCA: 132] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Mucosal cancer in the gastrointestinal tract generally has low risk of lymph node metastasis. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are techniques of local excision of neoplasia confined to the mucosal layer. Specimens from EMR/ESD contribute to several diagnoses, and histologic results affect treatment decisions. A combined laparoscopic and endoscopic approach to neoplasia with a nonexposure technique allows full-thickness resection of the stomach wall without exposing the gastric lumen to the peritoneal cavity, preventing cancer cell dissemination to the peritoneal cavity. This article reviews EMR/ESD and describes a new full-thickness resection method using the nonexposure technique (CLEAN-NET).
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Affiliation(s)
- Haruhiro Inoue
- Showa University International Training Center for Endoscopy, Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
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Bolotova NV, Aver'ianov AP, Dronova EG, Raĭgorodskiĭ IM, Levit SV. [Transcranial physical methods for correction of neuroendocrine and cerebral disorders in adolescent girls with obesity]. TERAPEVT ARKH 2012; 84:33-36. [PMID: 23227497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM To evaluate the efficiency of combined central and local physiotherapeutic procedures in correcting neuroendocrine and menstrual disorders in pubertal girls (PG) with obesity. SUBJECTS AND METHODS Eighty-seven PGs, including 67 with different levels of obesity and 20 healthy non-obese girls, were examined. The hormonal profile, lipidogram, and fasting insulin and glucose levels were studied. Body mass index (BMI) and waist and hip circumferences were estimated. The functional state of the central nervous system was studied by electroencephalography. The parameters of the autonomic nervous system were estimated by cardiointervalography. The PGs with obesity were divided into 2 groups: a study group (SG) (n = 40) and a control group (CG) (n = 27). The healthy PGs (n = 20) formed a comparison group. The SG patients received bitemporal transcranial magnetic therapy in combination with frontomastoid transcranial electrostimulation, as well as myoelectrostimulation of the anterior abdominal wall, by transferring the area of stimulation from right to left hypochondrium. A course consisted of 10-15 daily sessions. CG had placebo physioprocedures (with disconnected electrodes). RESULTS After 6-month treatment, SG and CG showed average reductions in BMI by 5.9 and 2.5 kg/m2, respectively. Lipidograms normalized in 70%; menstrual cycles were restored in 25 of 30 patients with impaired cycles in SG and in 1 of 22 in CG. Hormonal profiles were significantly improved in 62.5% of the patients in SG and unchanged in CG. CONCLUSION The high efficiency of combined (central and local) physiotherapeutic procedures is likely to be dueto the normalization of pituitary-ovarian relationships and enables one to recommend the proposed procedure in a rehabilitation program for PGs with obesity and reproductive system disorders.
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Li H, Gasbarrini A, Cappuccio M, Terzi S, Paderni S, Mirabile L, Boriani S. Outcome of excisional surgeries for the patients with spinal metastases. Eur Spine J 2009; 18:1423-30. [PMID: 19655177 DOI: 10.1007/s00586-009-1111-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Revised: 07/10/2009] [Accepted: 07/19/2009] [Indexed: 01/09/2023]
Abstract
To evaluate the outcome of the excisional surgeries (en bloc/debulking) in spinal metastatic treatment in 10 years. A total of 131 patients (134 lesions) with spinal metastases were studied. The postoperative survival time and the local recurrence rate were calculated statistically. The comparison of the two procedures on the survival time, local recurrence rate, and neurologic change were made. The median survival time of the en bloc surgery and the debulking surgery was 40.93 and 24.73 months, respectively, with no significant difference. The significant difference was shown in the local recurrence rate comparison, but not in neurological change comparison. 19.85% patients combined with surgical complications. The en bloc surgery can achieve a lower local recurrence rate than the debulking surgery, while was similar in survival outcome, neurological salvage, and incidence of complications. The risk of the excisional surgeries is high, however, good outcomes could be expected.
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Affiliation(s)
- Haomiao Li
- Orthopedic Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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Martin D, Cinca S, Margaritescu I, Neagu M, Iacob N, Ighigeanu D, Matei C, Craciun G, Manaila E, Chirita DA, Moisescu M. Combined microwave and electron beam exposure facilities for medical studies and applications. J Microw Power Electromagn Energy 2009; 43:12-20. [PMID: 21384705 DOI: 10.1080/08327823.2008.11688617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The paper presents two radiation exposure facilities (REFs) which permit separate and simultaneous irradiation with microwaves (MW) of 2.45 GHz and electron beams (EB) of 6.23 MeV for malignant melanoma (MM) cell investigations, in vitro (MW+EB-REF-vitro) and in vivo (MW+EB-REF-vivo). The REFs are specifically designed for the following medical studies: 1) The effects of separate and combined (successive and simultaneous) MW and EB irradiation on the B16F10 mouse--MM cell cultures without/with drugs incubation, 2) The effects of separate and combined MW and EB irradiation on human blood components irradiated in samples of integral blood from healthy donors and from donors with MM; 3) The effects of separate and combined MW and EB whole body irradiation on the C57 BL/6 mice bearing MM without/with drugs administration. Several representative results obtained by experiments with REFs in vitro and in vivo are discussed. The most important conclusion of the experimental results is that low dose-total body MW+EB irradiation combined with drugs administration could present a valuable potential for an advanced study in malignant melanoma therapy.
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Affiliation(s)
- Diana Martin
- National Institute for Lasers, Plasma and Radiation Physics, Bucharest, Romania.
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Brindisi N, Stammers A, Trowbridge C, Klayman M, Pezzuto J, Marko M. Use of a multi-modality life support system. J Extra Corpor Technol 2008; 40:268-270. [PMID: 19192756 PMCID: PMC4680716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this study was to describe the design and utilization of a multi-modality life support system (MMLSS), which is used to provide extracorporeal support for cases such as left heart bypass (LHB), extracorporeal life support (ECLS), veno-venous bypass, and hypothermic resuscitation. The design of the MMLSS consisted of a mobile cart outfitted with a centrifugal pump, heater cooler, an in-line blood gas monitor, oxygen blender/flow meter, and assorted safety devices (pressure sensors and level and bubble detectors). A single disposable circuit was used for all procedures and designed to be easily modifiable to support a variety of clinical scenarios, with and without the use of an oxygenator. The system was designed for rapid deployment throughout the hospital. From January 1, 2006 to December 31, 2007, the MMLSS has been used in three LHB procedures (63 +/- 72 minutes), four adult ECLS cases (57.2 +/- 56.9 hours), four veno-venous bypasses (72 +/- 35 minutes), and one hypothermic resuscitation (182 minutes). The MMLSS was designed to be used in patients > 20 kg and could achieve flows in the range of 1-5.5 L. There were no complications associated with the device. The MMLSS is a versatile system that can be used throughout the hospital with a single disposable circuit, accommodating a diverse caseload in a safe and reproducible manner.
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Ciancio S. Wound healing of periodontal pockets using the diode laser: an interview. Pract Proced Aesthet Dent 2006; 18:suppl 14-7. [PMID: 17139949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Laser technology appears to have a promising future in dentistry While these devices are still in their infancy it is important to understand the interaction of laser energy on the intraoral structures of the patient, and to evaluate its effect on bacteria responsible for periodontal disease. The following is an interview that relates the details of one important investigation into tissue response as conducted by the Department of Periodontics and Endodontics, SUNY at Buffalo School of Dental Medicine.
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Valle RF, Valdez J, Wright TC, Kenney M. Concomitant Essure®⁎ ⁎Essure® Permanent Birth Control System, Conceptus Inc., San Carlos, California. tubal sterilization and Thermachoice®† †Balloon Uterine Therapy System IIIC, Gynecare Thermachoice®, Ethicon, Inc., Somerville, New Jersey. endometrial ablation: feasibility and safety. Fertil Steril 2006; 86:152-8. [PMID: 16762347 DOI: 10.1016/j.fertnstert.2005.12.050] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Revised: 12/08/2005] [Accepted: 12/08/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the feasibility and safety of combining endometrial ablation (EA) with a thermal balloon endometrial ablation system (Gynecare Thermachoice IIIC Uterine Balloon Therapy System; Ethicon Inc., Somerville, NJ) and transcervical sterilization by intratubal insert (Essure Permanent Birth Control System; Conceptus, San Carlos, CA). DESIGN Feasibility and safety studies. SETTING University hospital in Chihuahua, Mexico. PATIENT(S) There were 40 volunteers in the feasibility study and 9 in the safety study, all requiring hysterectomies for benign uterine bleeding. INTERVENTION(S) In the feasibility study, both procedures were performed just before hysterectomy; in the safety study, thermocouples were inserted under the tubal serosa to assess heat transmission from the intratubal insert devices to the tubes and surrounding organs during EA. MAIN OUTCOME MEASURE(S) Completeness of EA and possible device dislodgement in the feasibility study; temperature readings in the safety study. RESULT(S) No disturbance of the intratubal insert devices was noted, and EA by the thermal balloon endometrial ablation system was complete visually and histologically, although small areas near the tubal ostia exhibited less endometrial destruction. Mean tubal temperatures ranged from 37.1 degrees C to 37.5 degrees C and did not reach the critical temperature of 45 degrees C. No damage to the tubes was noted. CONCLUSION(S) Performance of EA and sterilization with these two systems in a one-step approach is safe for women who require EA and permanent contraception.
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Affiliation(s)
- Rafael F Valle
- Northwestern University Medical School, Chicago, Illinois 60611, USA.
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Sani S, Lopes DK. Treatment of a middle cerebral artery bifurcation aneurysm using a double neuroform stent "Y" configuration and coil embolization: technical case report. Neurosurgery 2006; 57:E209; discussion E209. [PMID: 15987593 DOI: 10.1227/01.neu.0000163684.75204.cd] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2004] [Accepted: 01/20/2005] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE Wide-necked cerebral aneurysms have been particularly difficult to treat using coil embolization. The introduction of the first intracranial flexible stent (Neuroform stent; Boston Scientific/Target, Fremont, CA) has provided a great advantage to this dilemma by forming a bridge across the aneurysm neck and allowing the packing of coils. Despite this advancement, some parent vessel bifurcation aneurysms can still remain elusive to single stent and coiling technique. CLINICAL PRESENTATION A 55-year-old woman presented for a routine follow-up angiogram. Her past history was significant for a subarachnoid hemorrhage and clipping of an anterior communicating aneurysm with full recovery. An incidental new right middle cerebral artery aneurysm was found on the angiogram. We report here a case of an unruptured asymptomatic wide-neck middle cerebral artery bifurcation aneurysm that was treated with a novel endovascular repair. INTERVENTION The aneurysm was successfully treated using a double stent "Y" configuration and coil embolization technique using the Neuroform stent. Technical aspects are discussed. Perioperative management issues and potential pitfalls are also considered. CONCLUSION Double stenting in "Y" configuration and coiling is feasible. This technique should increase the ability to endovascularly treat wide-necked aneurysms.
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Affiliation(s)
- Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
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LaRocca GM, Shimbo D, Rodriguez CJ, Stewart A, Naka Y, Weinberger J, Homma S, Pizzarello R. The Impella Recover LP 5.0 Left Ventricular Assist Device: A Bridge to Coronary Artery Bypass Grafting and Cardiac Transplantation. J Am Soc Echocardiogr 2006; 19:468.e5-7. [PMID: 16581490 DOI: 10.1016/j.echo.2005.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Indexed: 10/24/2022]
Affiliation(s)
- Gina M LaRocca
- Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, New York 10032, USA.
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Atsumi K, Kamohara S. Bridging conventional medicine and complementary and alternative medicine. BME's pivotal role in the growth of alternative and integrative medicine. IEEE Eng Med Biol Mag 2005; 24:30-4. [PMID: 15825842 DOI: 10.1109/memb.2005.1411345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Kern SE, Jaron D. Complementary and alternative medicine in the technology age. Applying bioengineering to understand and evaluate the efficacy of age-old remedies. IEEE Eng Med Biol Mag 2005; 24:28-9. [PMID: 15825841 DOI: 10.1109/memb.2005.1411344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Steven E Kern
- Department of Pharmaceutics and Anesthesiology, University of Utah, Salt Lake City 84108, USA.
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Ekstrand KE, Hinson WH, Bourland JD, deGuzman AF, Stieber VW, Tatter SB, Ellis TL. The use of a Leksell-BRW adapter for linac radiosurgery as an adjunct to Gamma Knife treatment. Phys Med Biol 2004; 48:4105-10. [PMID: 14727754 DOI: 10.1088/0031-9155/48/24/008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We have investigated the use of an adapter that permits the use of a Leksell coordinate frame with a linear accelerator stereotactic radiosurgery system based on the Brown-Robert-Wells (BRW) design. This device is useful when lesions that are planned for treatment on a Leksell Gamma Knife system are found to be inaccessible to the Gamma Knife. We have found that with this device objects within a head phantom can be targeted by the linear accelerator within an accuracy of approximately 1 mm.
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Affiliation(s)
- Kenneth E Ekstrand
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Affiliation(s)
- A Mueller
- Augenklinik, Ludwig-Maximilians-Universität, München.
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Castelnuovo G, Gaggioli A, Mantovani F, Riva G. From psychotherapy to e-therapy: the integration of traditional techniques and new communication tools in clinical settings. ACTA ACUST UNITED AC 2004; 6:375-82. [PMID: 14511449 DOI: 10.1089/109493103322278754] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Technology is starting to influence psychological fields. In particular, computer-mediated communication (CMC) is providing new tools that can be fruitfully applied in psychotherapy. These new technologies do not substitute for traditional techniques and approaches but they could be used as integration in the clinical process, enhancing or making easier particular steps of it. This paper focuses on the concept of e-therapy as a new modality of helping people resolve life and relationship issues. It utilizes the power and convenience of the Internet to allow synchronous and asynchronous communication between patient and therapist. It is important to underline that e-therapy is not an alternative treatment, but a resource that can be added to traditional psychotherapy. The paper also discusses how different forms of CMC can be fruitfully applied in psychology and psychotherapy, by evaluating the effectiveness of them in the clinical practice. To enhance the diffusion of e-therapy, further research is needed to evaluate all the pros and cons.
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Affiliation(s)
- Gianluca Castelnuovo
- Applied Technology for Neuro-Psychology Laboratory, VEPSY UPDATED Project, Istituto Auxologico Italiano, Via Spagnoletto 3, 20149 Milan, Italy.
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DeLaney TF, Chen GT, Mauceri TC, Munro JJ, Hornicek FJ, Pedlow FX, Suit HD. Intraoperative dural irradiation by customized 192iridium and 90yttrium brachytherapy plaques. Int J Radiat Oncol Biol Phys 2003; 57:239-45. [PMID: 12909239 DOI: 10.1016/s0360-3016(03)00505-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE After vertebral or paravertebral tumor resection, tumor cells may remain on the dura. Because a tumoricidal dose is difficult to achieve using external beam radiotherapy without exceeding the spinal cord tolerance, we developed intraoperative applicators to deliver additional dose to the dura. METHODS AND MATERIALS Eight patients with vertebral or paravertebral tumor underwent conformal external beam radiotherapy, tumor resection, and intraoperative radiotherapy to the dura involved by tumor. At surgery, vertebra, soft tissue, and epidural tumor were resected. A radioactive applicator plaque was placed on the dura to deliver 7.5-15 Gy, and then removed. Vertebral reconstruction and stabilization was completed. Chemotherapy was administered for large, high-grade sarcomas. RESULTS We progressed through three plaque designs, initially (192)Ir, subsequently liquid (90)Y, and finally (90)Y foil in a semicylindrical polycarbonate plaque, in the treatment of 8 patients. The low-energy (90)Y beta-emissions provided a more attractive depth dose profile than that achievable with iridium and gave negligible staff radiation exposure. The (90)Y depth dose measured 29% at 2 mm and 9% at 4 mm from the surface of the foil plaque, with acceptable surface dose homogeneity. The average surface dose rate ranged from 18.7 to 47.6 cGy/min for the iridium plaques and 45.2 to 187.5 cGy/min for the (90)Y plaques. The treatments have been without acute or late neurologic complications. The disease of 6 of 8 patients was locally controlled at median potential follow-up of 24 months. CONCLUSIONS The (90)Y foil applicator is technically elegant, easy to use, and superior to the earlier models. It has been incorporated into a protocol for spinal tumor treatment.
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Affiliation(s)
- Thomas F DeLaney
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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