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Open Journal of Anesthesiology 2014年第9期4卷 227-230页

作者： Andrew Ng victor romo Dajie Wang Department of Anesthesiology Thomas Jefferson University Hospital Philadelphia PA USA

Intrathecal drug delivery systems are commonly used in the management of chronic pain, cancer pain and neuromuscular disorders with muscle spasticity. The complications associated with in-trathecal pump placement include persistent cerebrospinal fluid (CSF) leak, hygroma, meningitis, and granuloma formation. A severe persistent CSF leak may cause postdural puncture headache along with acute intracranial subdural hematoma, which can be potentially life threatening. Surgical exploration with dural repair is required to treat this severe complication when conservative treatments fail. We present a case report of severe persistent CSF leak after intrathecal pump revision that resulted in a subdural hematoma and postdural puncture headache. In this case, an epidural blood patch was performed using epidural catheter under fluoroscopic guidance to target the site of CSF leak and to avoid damaging the intrathecal catheter. This patient’s headache was resolved and intrathecal catheter remained intact after this blood patch.

关键词： Postdural Puncture Headache Subdural Hematoma Intrathecal Pump Epidural Blood Patch

Transradial approach for acute stroke intervention: technical procedure and clinical outcomes

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Stroke & Vascular Neurology 2020年第1期5卷 103-106页

作者： Omaditya Khanna Nikolaos Mouchtouris Ahmad Sweid Nohra Chalouhi Ritam Ghosh Fadi Al Saiegh Michael R Gooch Stavropoula Tjoumakaris Robert H Rosenwasser victor romo Pascal Jabbour Neurosurgery Thomas Jefferson University HospitalPhiladelphiaPennsylvaniaUSA Anesthesia Thomas Jefferson University-Center City CampusPhiladelphiaPennsylvaniaUSA

background and purpose Radial artery catheterisation is an alternate route of access that has recently started to gain more widespread use for neuroendovascular procedures,including acute stroke *** this small case series,we present our institution’s outcomes in patients undergoing acute stroke interventions via transradial *** and methods We present a retrospective study of 15 patients who underwent acute stroke intervention via radial artery *** analyse these patients’periprocedural and clinical outcomes after undergoing mechanical *** A total of 15 consecutive patients were included in the study(9 males and 6 females),and all patients were able to successfully undergo mechanical thrombectomy via radial artery *** mean time of arterial puncture to reperfusion was 50±28 min(range:15-104).A TICI 2b/3 revascularisation was achieved in 13/15 patients(87%);a TICI 1 and TICI 2a outcome was achieved on the other two *** patient incurred an iatrogenic vessel dissection during the *** of out 15 patients(53%)had favourable mRS(0-3)at the time of discharge from the *** Radial artery catheterisation is technically feasible for performing acute stroke interventions with favourable time to revascularisation and good overall clinical outcomes.

关键词： acute clinical radial

Acute ischaemic stroke interventions: large vessel occlusion and beyond

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Stroke & Vascular Neurology 2020年第1期5卷 80-85页

作者： Ahmad Sweid Batoul Hammoud Sunidhi Ramesh Daniella Wong Tyler D Alexander Joshua Harrison Weinberg Maureen Deprince Jaime Dougherty Dimitri Jean-Mickael Maamari Stavropoula Tjoumakaris Hekmat Zarzour Michael R Gooch Nabeel Herial victor romo David M Hasan Robert H Rosenwasser Pascal Jabbour Neurosurgery Thomas Jefferson University HospitalPhiladelphiaPennsylvaniaUSA Endocrinology Children’s Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA Sydney Kimmel Medical College Thomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA School of Medicine American University of BeirutBeirutLebanon Anesthesia Thomas Jefferson University-Center City CampusPhiladelphiaPennsylvaniaUSA Neurosurgery University of Iowa Hospitals and ClinicsIowa CityIowaUSA

Care for acute ischaemic stroke is one of the most rapidly evolving fields due to the robust outcomes achieved by mechanical *** vessel occlusion(LVO)accounts for up to 38%of acute ischaemic stroke and comes with devastating outcomes for patients,families and society in the pre-intervention era.A paradigm shift and a breakthrough brought mechanical thrombectomy back into the spotlight for acute ischaemic stroke;this was because five randomised controlled trials from several countries concluded that mechanical thrombectomy for acute stroke offered overwhelming *** review article will present a comprehensive overview of LVO management,techniques and devices used,and the future of stroke *** addition,we review our institution experience of mechanical thrombectomy for posterior and distal circulation occlusion.

关键词： acute occlusion breakthrough

Protein kinase inhibitors affect spermatogenic functions and blood testis barrier remodelling:A scoping review

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Asian pacific Journal of Reproduction 2023年第3期12卷 97-108页

作者： Oyovwi Mega Obukohwo Onome Bright Oghenetega Falajiki Yewande Faith Emojevwe victor Rotu Arientare Rume Joseph Gregory Uchechukwu Oyeleke Abiodun Abioye Department of Physiology Faculty of Basic Medical SciencesAdeleke UniversityEdeOsun StateNigeria Department of Physiology School of Basic Medical ScienceBabcock UniversityIllisan-RomoOgun StateNigeria Department of Physiology University of Medical SciencesOndo StateNigeria Department of Physiology University of IbadanIbadanOyo StateNigeria Department of Medical Laboratory Science Adeleke UniversityEdeOsun StateNigeria Department of Physiology Federal University Oye-EkitiNigeria

Objective:To identify the role of protein kinase in male reproduction in animal models and human spermatogenic ***:This study assessed the protein kinase of male reproduction in animal models and human using different reviewed paper indexed in PubMed,Science Direct,EBSCO,Scopus,Cochrane Library,Sage Journals,and Google *** were charted based on author,year of publication published between 1893 and 2023,country,purpose,data collection,key findings,and research focus/***:The MAPK pathway contributed to the growth,maturation,and functionality of male germ *** also found out that certain influencing factors categorized into hormonal/non hormonal factors and chemotoxicant,as well as heat stress expressed an inhibitory mechanism on protein kinase,thus affecting spermatogenic functions and maintenance/remodeling of the blood testis barrier,as well as the physiology of the Sertoli cells necessary for nutritional support of ***,activating protein kinases pathway like the mTOR pathway as well as increased expression of peroxiredoxin-4 and L-carnitine mediated protein kinases may be useful for treating or managing male reproductive ***:Protein kinase plays an important role in spermatogenic functions and blood testis remodeling in animal and *** assessment provides essential information that can guide treatment strategies aimed at improving male reproductive *** together,these recent advances highlight a future therapeutic intervention in assessing male reproductive *** might also be possible to look at potential targets for male contraceptives in the MAPK pathway.

关键词： Spermatogenesis Protein kinase Inhibitors Sertoli cells Capacitation mTOR