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Radiofrequency (RF) lesions have been used for over 25 years in the treatment of intractable pain of spinal origin. The conventional idea is that the heat generated in the tissue surrounding the electrode tip leads to destruction of nerve fibers. In case of mechanical back pain, an electrode positioned adjacent to the medial branch of the dorsal root may reduce the input of noxious nerve stimuli and alleviate pain. For treatment of patients with severe radicular pain the authors often apply pulsed radiofrequency current. This technique enables the application of a relatively high voltage near the dorsal root ganglion, avoiding the deleterious thermal effect of the current. It was found to exert a beneficial effect in cases of intractable radicular pain. This study reports the result of pulsed RF in 28 patients suffering from severe radicular pain treated by pulsed radiofrequency current with follow-up at periods of 3, 6 and 12 months after treatment. There were 20 cases of low back pain and 8 with neck pain, with an average age of 56.7 years. The first follow-up after 3 months revealed the following results: excellent results in 2 cases (7.1%), good results in 12 cases (42/9%), fair in 9 (32/1%) and 5 (17/9%) reported that their condition have not changed. Results after 6 and 12 months were excellent in 2 (both groups), good in 7 and 6 respectively, 11 fair (both groups) and unresponsiveness to treatment was noticed in 8 patients after 6 and 9 after 12 months. Significant reduction was found in the Visual Analog Scale for pain from an average of 8.8 to 4.2 after 3 months, 4.8 after 6 months and 4.9 after 1 year. ⋯ Pulsed RF treatment is a safe and simple procedure to control radicular pain in the cervical and lumbar regions. Following the current study the authors stress the need for further prospective, double-blind studies for better investigation of this technique.
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Review
Stem cell-derived organoids and their application for medical research and patient treatment.
3D culture has allowed the initiation and expansion of organ-like structures, called organoids, from either tissue-resident adult stem cells or pluripotent stem cells. Today, organoids can be grown to resemble a wide variety of organs, exhibiting remarkable similarity to their in vivo counterparts. ⋯ They have already found their way into the clinic, enabling personalized medicine in small patient trials. In this review, we provide an update on current organoid technology and summarize their application in basic research, disease modelling, drug development, personalized treatment and regenerative medicine.
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Ulus Travma Acil Cer · Jan 2018
Operative and non-operative management of children with abdominal gunshot injuries.
Non-operative management (NOM) is a standard treatment method for solid organ injuries worldwide. There is no consensus on the management of gunshot wounds (GSW) because of the higher frequency of hollow viscus injuries (HVI) and the unpredictable depth of tissue damage produced by kinetic energy transfer during retardation of the bullet. Here we aimed to reevaluate indications for surgery and NOM based on our pediatric patients with abdominal GSW. ⋯ The major drawback of NOM is the difficulty in diagnosing HVI in abdominal GSW, which may delay treatment. We suggest that patients with solid organ damage who are hemodynamically stable and exhibit no signs of peritonitis upon serial abdominal exam may be treated with NOM.
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Sestrin 2 (SESN2) is a stress-inducible protein that protects tissues from oxidative stress and delays the aging process. However, its role in maintaining the functional and structural integrity of the cochlea is largely unknown. Here, we report the expression of SESN2 protein in the sensory epithelium, particularly in hair cells. ⋯ Hair cell death occurred by caspase-8 mediated apoptosis. Compared to C57BL/6J control mice, Sesn2 KO mice displayed enhanced expression of proinflammatory genes and activation of basilar membrane macrophages, suggesting that loss of SESN2 function provokes the immune response. Together, these results suggest that Sesn2 plays an important role in cochlear homeostasis and immune responses to stress.