Mahalo no kou kipa ʻana iā Nature.com.Ke hoʻohana nei ʻoe i kahi polokalamu kele pūnaewele me ke kākoʻo CSS palena ʻole.No ka ʻike maikaʻi loa, manaʻo mākou e hoʻohana i kahi polokalamu kele pūnaewele hou (a i ʻole e hoʻopau i ke ʻano Compatibility Mode ma Internet Explorer).Eia kekahi, e hōʻoia i ke kākoʻo mau, hōʻike mākou i ka pūnaewele me ka ʻole o nā styles a me JavaScript.
ʻO nā slider e hōʻike ana i ʻekolu ʻatikala ma kēlā me kēia paheʻe.E hoʻohana i nā pihi hope a i hope no ka neʻe ʻana i nā paheʻe, a i ʻole nā ​​pihi hoʻokele paheʻe ma ka hopena e neʻe i kēlā me kēia paheʻe.
Ua koi mua ka centrifugation lapaʻau hilinaʻi i ka hoʻohana ʻana i nā lako kalepa pipiʻi, nui, a hilinaʻi i ka uila, ʻaʻole i loaʻa pinepine ʻia i nā hoʻonohonoho palena waiwai.ʻOiai ua wehewehe ʻia kekahi mau centrifuges lawe lima, maʻalahi, ʻaʻole kaʻa, ua manaʻo nui ʻia kēia mau hopena no nā noi diagnostic e koi ana i ka liʻiliʻi o ka sedimentation.Eia kekahi, koi pinepine ka hoʻolālā ʻana o kēia mau mea hana i ka hoʻohana ʻana i nā mea kūikawā a me nā mea hana i loaʻa ʻole i nā wahi maʻamau.Ma ʻaneʻi, wehewehe mākou i ka hoʻolālā, hui, a me ka hōʻoia hoʻokolohua o ka CentREUSE, kahi kumu kūʻai haʻahaʻa haʻahaʻa loa, hana ʻia e ke kanaka, hoʻohana ʻia i ka ʻōpala no nā noi lapaʻau.Hōʻike ʻo CentREUSE i ka ikaika centrifugal awelika o 10.5 ikaika centrifugal pili (RCF) ± 1.3.ʻO ka hoʻonohonoho ʻana o 1.0 ml vitreous suspension o triamcinolone ma hope o 3 mau minuke o ka centrifugation ma CentREUSE ua hoʻohālikelike ʻia me kēlā ma hope o nā hola 12 o ka sedimentation gravity-mediated (0.41 ml ± 0.04 vs 0.38 ml ± 0.03, p = 0.14).ʻO ka mānoanoa sediment ma hope o CentREUSE centrifugation no 5 a me 10 mau minuke i hoʻohālikelike ʻia me ka mea i ʻike ʻia ma hope o ka centrifugation ma 10 RCF (0.31 ml ± 0.02 vs. 0.32 ml ± 0.03, p = 0.20) a me 50 RCF (0.20 ml) no 5 mau minuke me ka hoʻohana ʻana i nā lako kalepa Similar. 0.02 vs. 0.19 ml ± 0.01, p = 0.15).Hoʻokomo ʻia nā ʻōkuhi a me nā kuhikuhi kūkulu hale no CentREUSE i kēia pou open source.
He hana koʻikoʻi ka Centrifugation i nā hoʻokolohua diagnostic a me nā interventions therapeutic1,2,3,4.Eia nō naʻe, ʻo ka loaʻa ʻana o ka centrifugation kūpono i ka mōʻaukala ua koi ʻia ka hoʻohana ʻana i nā lako kalepa pipiʻi, nui, a hilinaʻi i ka uila, ʻaʻole i loaʻa pinepine i nā hoʻonohonoho palena waiwai2,4.Ma 2017, ua hoʻokomo ka hui o Prakash i kahi centrifuge manual liʻiliʻi ma ka pepa (i kapa ʻia ʻo "pepa puffer") i hana ʻia mai nā mea hana i hana mua ʻia ma ke kumukūʻai o $0.20 ($)2.Mai ia manawa mai, ua kau ʻia ka fugue pepa i loko o nā hoʻonohonoho palena waiwai no nā noi diagnostic haʻahaʻa (e laʻa me ka hoʻokaʻawale ʻana o nā ʻāpana koko i loko o nā paipu capillary no ka ʻike ʻana i nā maʻi malaria), no laila e hōʻike ana i kahi mea hoʻohana i ke kanaka.centrifuge 2 .Mai ia manawa mai, ua wehewehe ʻia kekahi mau mea hana centrifugation paʻa, maʻalahi, ʻaʻole i hoʻohana ʻia 4,5,6,7,8,9,10.Eia nō naʻe, ʻo ka hapa nui o kēia mau haʻina, e like me ka uahi pepa, ua manaʻo ʻia no nā kumu diagnostic e koi ana i nā leo sedimentation liʻiliʻi a no laila ʻaʻole hiki ke hoʻohana ʻia e centrifuge i nā laʻana nui.Eia kekahi, ʻo ka hui ʻana o kēia mau hoʻonā e koi pinepine i ka hoʻohana ʻana i nā mea kūikawā a me nā mea hana i loaʻa pinepine ʻole i nā wahi underserved4,5,6,7,8,9,10.
Maʻaneʻi mākou e wehewehe i ka hoʻolālā, hui, a me ka hōʻoia hoʻokolohua o kahi centrifuge (i kapa ʻia ʻo CentREUSE) i kūkulu ʻia mai ka ʻōpala fugue pepa maʻamau no nā noi lapaʻau e koi maʻamau i nā leo sedimentation kiʻekiʻe.ʻO ka hihia 1, 3 Ma ke ʻano he hōʻoia o ka manaʻo, ua hoʻāʻo mākou i ka hāmeʻa me kahi hana ophthalmic maoli: ka ua o ka hoʻokuʻu ʻana o ka triamcinolone i ka acetone (TA) no ka hoʻokomo ʻana i kahi lāʻau bolus i loko o ke kino vitreous o ka maka.ʻOiai ʻo ka centrifugation no ka manaʻo ʻo TA he hana haʻahaʻa haʻahaʻa i ʻike ʻia no ka mālama lōʻihi ʻana o nā ʻano maka like ʻole, ʻo ka pono o nā centrifuges i loaʻa i ke kālepa i ka wā o ka hoʻokumu ʻana i ka lāʻau lapaʻau he mea pale nui i ka hoʻohana ʻana i kēia lāʻau lapaʻau i nā hoʻonohonoho palena waiwai1,2, 3.hoʻohālikelike ʻia me nā hopena i loaʻa me nā centrifuges kalepa maʻamau.Hoʻokomo ʻia nā ʻōkuhi a me nā ʻōlelo aʻo no ke kūkulu ʻana i CentREUSE i kēia hoʻolaha ʻana i ka open source ma ka ʻāpana "More Information".
Hiki ke kūkulu ʻia ʻo CentREUSE mai ka ʻōpala.Ua paʻi ʻia nā kope ʻelua o ka hoʻohālike semi-circular (Supplementary Figure S1) ma ka pepa kalapona kalapona US maʻamau (215.9 mm × 279.4 mm).ʻO nā hiʻohiʻona semi-circular ʻelua i hoʻopili ʻia e wehewehe i ʻekolu mau hiʻohiʻona hoʻolālā koʻikoʻi o ka mea CentREUSE, me (1) ka ʻaoʻao o waho o ka 247mm spinning disk, (2) i hoʻolālā ʻia e hoʻokomo i kahi syringe 1.0ml (me ka pāpale a me ka plunger amputated).nā mākuʻe i loko o ka shank) a me (3) ʻelua hōʻailona e hōʻike ana i kahi e kuʻi ai i nā lua i hiki i ke kaula ke hele i loko o ka disk.
E hoʻopili (e laʻa me ka mea hoʻopili āpau a i ʻole ka lipine) i ke kumu hoʻohālike i ka papa ʻahuʻula (ka liʻiliʻi liʻiliʻi: 247 mm × 247 mm) (Kiʻi Pākuʻi S2a).Ua hoʻohana ʻia ka papa corrugated "A" maʻamau (4.8 mm mānoanoa) i kēia haʻawina, akā hiki ke hoʻohana ʻia ka papa corrugated o ka mānoanoa like, e like me ka papa corrugated mai nā pahu hoʻouna i hoʻolei ʻia.Ke hoʻohana nei i kahi mea hana ʻoi (e like me ka ʻili a i ʻole ʻokiʻoki), ʻoki i ka pahu pahu ma ka ʻaoʻao o ka disc waho i hōʻike ʻia ma ke kumu hoʻohālike (Kiʻi Pākuʻi S2b).A laila, me ka hoʻohana ʻana i kahi hāmeʻa haiki a ʻoi (e like me ka piko o ka peni pōpō), e hana i ʻelua perforations mānoanoa piha me ka radius o 8.5 mm e like me nā kaha i ʻike ʻia ma ka template (Supplementary Figure S2c).A laila ʻoki ʻia ʻelua mau puka no nā syringes 1.0 ml mai ke kumu hoʻohālike a me ka papa o lalo o ka pahu pahu e hoʻohana ana i kahi mea hana kiko e like me ka pahi pahi;pono e mālama ʻia ʻaʻole e hōʻino i ka papa corrugated lalo a i ʻole ke koena o ka ʻili o ka ʻili (Supplementary Figure S2d, e) .A laila, e hoʻopaʻa i kahi ʻāpana kaula (e laʻa me 3mm ke kaula pulupulu kuke a i ʻole kekahi milo like ka mānoanoa a me ka elasticity) ma nā puka ʻelua a hoʻopaʻa i kahi loop a puni kēlā me kēia ʻaoʻao o kahi diski ma kahi o 30cm ka lōʻihi (Hoʻohui Fig. S2f).
E hoʻopiha i ʻelua 1.0 ml syringe me ka nui like (e laʻa me 1.0 ml o TA hoʻokuʻu) a me ka pāpale.Ua ʻoki ʻia ke koʻokoʻo plunger syringe ma ke kiʻekiʻe o ka flange barela (Hoʻohui Kiʻi S2g, h).A laila uhi ʻia ka flange cylinder me kahi papa lipine e pale ai i ka hoʻokuʻu ʻia ʻana o ka piston i ʻoki ʻia i ka wā e hoʻohana ai i nā mea hana.Hoʻokomo ʻia kēlā me kēia 1.0 ml syringe i loko o ka pūnāwai me ka pāpale e kū pono ana i ke kikowaena o ka disc (Supplementary Figure S2i).Hoʻopili ʻia kēlā me kēia syringe i ka liʻiliʻi o ka disc me ka lipine adhesive (Supplementary Figure S2j).ʻO ka hope, e hoʻopau i ka hui ʻana o ka centrifuge ma ke kau ʻana i ʻelua peni (e like me nā penikala a i ʻole nā ​​​​mea hana koʻikoʻi like ʻole) ma kēlā me kēia kihi o ke kaula i loko o ka loop (Figure 1).
ʻO nā ʻōlelo kuhikuhi no ka hoʻohana ʻana i ka CentREUSE ua like ia me nā mea no nā mea pāʻani wili kuʻuna.Hoʻomaka ka hoʻololi ʻana ma ka paʻa ʻana i kahi lima ma kēlā me kēia lima.ʻO ka lohi iki o nā kaula e haʻalulu ai ka diski i mua a i hope paha, e huli ai ka diski i mua a i hope paha.Hana ʻia kēia i kekahi mau manawa ma ke ʻano mālie a hoʻomalu ʻia i ʻōwili ʻia nā kaula.A laila ho'ōki i ka neʻe.I ka hoʻomaka ʻana o ka wehe ʻana o nā kaula, huki ikaika ʻia ka ʻau a hiki i ka paʻa ʻana o nā kaula, e wili ai ka disc.Ke hemo loa ke kaula a hoʻomaka e hoʻihoʻi, pono e hoʻomaha mālie ka lima.I ka hoʻomaka ʻana o ke kaula e wehe hou, e hoʻopili i nā ʻano hana like e hoʻomau i ka wili ʻana o ka mīkini (wikiō S1).
No nā noi e koi ana i ka sedimentation o kahi hoʻokuʻu ʻia e ka centrifugation, ua hoʻololi mau ʻia ka mea hana a hiki i ka loaʻa ʻana o ka granulation ʻoluʻolu (Supplementary Figure S3a,b).E hoʻokumu ʻia nā ʻāpana paʻakikī ma ka hopena plunger o ka barela syringe a e hoʻopili ka supernatant i ka piko o ka syringe.Ua hoʻokahe ʻia ka supernatant ma ka wehe ʻana i ka lipine e uhi ana i ka flange barela a hoʻokomo i kahi plunger lua e hoʻokuke mālie i ka plunger maoli i ka piko syringe, e kū ana i ka wā i hiki ai i ka sediment hui (Supplementary Figure S3c,d).
No ka hoʻoholo ʻana i ka wikiwiki o ka hoʻololi ʻana, ua hoʻopaʻa ʻia ka mea CentREUSE, i hoʻolako ʻia me ʻelua 1.0 ml syringes i hoʻopiha ʻia me ka wai, me kahi pahu kiʻi wikiō kiʻekiʻe (240 mau kiʻi i kēlā me kēia kekona) no 1 min ma hope o ka hiki ʻana i kahi kūlana paʻa o ka oscillation.Hoʻopaʻa lima ʻia nā māka kokoke i ka lihi o ka diski milo me ka hoʻohana ʻana i ka nānā ʻana i ka frame-by-frame o nā hoʻopaʻa leo e hoʻoholo ai i ka helu o nā kipi i kēlā me kēia minuke (rpm) (Nā Kiʻi 2a-d).E hana hou n = 10 hoao.A laila helu ʻia ka ikaika centrifugal pili (RCF) ma ka waena waena o ka pahu syringe me ka hoʻohana ʻana i kēia ʻano:
Ka helu ʻana i ka wikiwiki o ka rotational me CentREUSE.(A–D) Nā kiʻi ʻelele e hōʻike ana i ka manawa (mau minuke: kekona. milliseconds) no ka hoʻopau ʻana i ka hoʻololi ʻana o ka mea hana.Hōʻike nā pua i nā hōʻailona hōʻailona.(E) ka helu RPM me CentREUSE.Hōʻike nā laina i ka mean (ʻulaʻula) ± hoʻokaʻawale maʻamau (ʻeleʻele).Hōʻike nā helu i nā hoʻokolohua hoʻokahi minuke 1 (n = 10).
ʻO kahi syringe 1.0 ml i loaʻa ka hoʻokuʻu TA no ka injection (40 mg / ml, Amneal Pharmaceuticals, Bridgewater, NJ, USA) i centrifuged no 3, 5 a me 10 mau minuke me ka hoʻohana ʻana iā CentREUSE.Hoʻohālikelike ʻia ka sedimentation me ka hoʻohana ʻana i kēia ʻenehana me ka mea i loaʻa ma hope o ka centrifugation ma 10, 20, a me 50 RCF me ka hoʻohana ʻana i kahi rotor A-4-62 no 5 min ma kahi centrifuge benchtop Eppendorf 5810R (Hamburg, Kelemānia).Ua hoʻohālikelike ʻia ka nui o ka ua me ka nui o ka ua i loaʻa me ka hoʻohana ʻana i ka ua pili i ka gravity ma nā wahi manawa like ʻole mai 0 a 720 mau minuke.ʻO ka nui o n = 9 mau hana hou kūʻokoʻa i hana ʻia no kēlā me kēia kaʻina hana.
Ua hana ʻia nā ʻikepili helu a pau me ka polokalamu Prism 9.0 (GraphPad, San Diego, USA).Hōʻike ʻia nā waiwai ma ke ʻano he mean ± standard deviation (SD) ke ʻole i ʻike ʻia.Ua hoʻohālikelike ʻia nā ʻano hui me ka hoʻohana ʻana i kahi hoʻokolohua Welch-corrected t-huʻu ʻelua.Ua wehewehe ʻia ʻo Alpha he 0.05.No ka hoʻohaʻahaʻa ʻana i ka ʻumekaumaha, ua hoʻokomo ʻia kahi kumu hoʻohālike hoʻoheheʻe exponential hoʻokahi me ka hoʻohana ʻana i ka regression liʻiliʻi loa, e mālama ana i nā koina y hou no kahi waiwai x i hāʻawi ʻia ma ke ʻano hoʻokahi.
kahi o x ka manawa i loko o nā minuke.y – ka nui o ka sediment.ʻO y0 ka waiwai o y inā ʻaʻole ʻo x.ʻO ka pāpū ka waiwai y no nā minuke pau ʻole.ʻO K ka pākēneka mau, i hōʻike ʻia e like me ka pānaʻi o nā minuke.
Ua hōʻike ka mea ʻo CentREUSE i nā oscillations pono ʻole i hoʻopaʻa ʻia me ka hoʻohana ʻana i ʻelua syringes 1.0 ml maʻamau i hoʻopiha ʻia me 1.0 ml wai i kēlā me kēia (wikiō S1).Ma n = 10 ho'āʻo (1 minuke kēlā me kēia), CentREUSE i ka awelika rotational māmā holo o 359.4 rpm ± 21.63 (pae = 337-398), hopena i ka helu awelika centrifugal ikaika o 10.5 RCF ± 1, 3 (pae = 9.2-12.8). ).(Kii 2a-e).
Ua loiloi ʻia kekahi mau ʻano no ka pelleting TA hoʻokuʻu ʻia i nā syringes 1.0 ml a hoʻohālikelike ʻia me CentREUSE centrifugation.Ma hope o 12 mau hola o ka umekaumaha-kaumaha ka hoʻoholo ʻana, ua hiki ka nui o ka sediment i 0.38 ml ± 0.03 (Hoʻohui Fig. S4a,b).Kūlike ka deposition TA e pili ana i ka gravity me kahi kumu hoʻohālike hoʻoheheʻe exponential hoʻokahi (hoʻoponopono ʻia e R2 = 0.8582), e loaʻa ana i kahi pāpū i manaʻo ʻia o 0.3804 mL (95% manawa hilinaʻi: 0.3578 a i 0.4025) (Supplementary Figure S4c).Ua hoʻopuka ʻo CentREUSE i ka nui o ka sediment awelika o 0.41 ml ± 0.04 i nā minuke 3, ua like ia me ke kumu waiwai o 0.38 ml ± 0.03 i ʻike ʻia no ka sedimentation pili i ka gravity ma nā hola 12 (p = 0.14) (Fig. 3a, d, h) .Ua hāʻawi ʻo CentREUSE i ka leo paʻa loa o 0.31 ml ± 0.02 i nā minuke 5 i hoʻohālikelike ʻia me ka mean o 0.38 ml ± 0.03 i ʻike ʻia no ka hoʻoheheʻe ʻana i ka umekaumaha ma nā hola 12 (p = 0.0001) (Fig. 3b, d, h).
Hoʻohālikelike o TA pellet density i loaʻa e CentREUSE centrifugation me ka gravity settling versus standard industrial centrifugation (A–C).Nā kiʻi hōʻike o ka hoʻokuʻu ʻia ʻana o TA i loko o 1.0 ml syringes ma hope o 3 min (A), 5 min (B), a me 10 min (C) o ka hoʻohana ʻana iā CentREUSE.(D) Nā kiʻi ʻelele o ka TA i waiho ʻia ma hope o 12 mau hola o ka hoʻopaʻa ʻana o ka gravity.(EG) Nā kiʻi makaʻāinana o TA precipitated ma hope o ka centrifugation kalepa maʻamau ma 10 RCF (E), 20 RCF (F), a me 50 RCF (G) no 5 min.(H) Ua helu ʻia ka nui o ka sediment me ka hoʻohana ʻana iā CentREUSE (3, 5, a me 10 min), gravity-mediated sedimentation (12 h), a me ka centrifugation ʻoihana maʻamau ma 5 min (10, 20, a me 50 RCF).Hōʻike nā laina i ka mean (ʻulaʻula) ± hoʻokaʻawale maʻamau (ʻeleʻele).Hōʻike nā kiko i nā hana hou kūʻokoʻa (n = 9 no kēlā me kēia kūlana).
Ua hoʻopuka ʻo CentREUSE i ka nui o 0.31 ml ± 0.02 ma hope o 5 mau minuke, ua like ia me ka mean o 0.32 ml ± 0.03 i ʻike ʻia i loko o kahi centrifuge kalepa maʻamau ma 10 RCF no 5 mau minuke (p = 0.20), a haʻahaʻa iki ma mua o ka mean volume. i loaʻa me 20 RCF uaʻikeʻia ma 0.28 ml ± 0.03 no 5 mau minuke (p = 0.03) (Fig. 3b, e, f, h).Ua hana ʻo CentREUSE i ka nui o ka 0.20 ml ± 0.02 i nā minuke 10, ʻo ia ka mea like me ka paʻa (p = 0.15) i hoʻohālikelike ʻia me ka nui o 0.19 ml ± 0.01 i nā minuke 5 i ʻike ʻia me kahi centrifuge kalepa ma 50 RCF (Fig. 3c, g, h)..
Ma ʻaneʻi, wehewehe mākou i ka hoʻolālā, hui, a me ka hōʻoia hoʻokolohua o kahi centrifuge ultra-haʻahaʻa, lawe lima, hoʻohana ʻia e ke kanaka, pepa i hana ʻia mai ka ʻōpala lapaʻau maʻamau.Hoʻokumu nui ʻia ka hoʻolālā ma luna o ka centrifuge e pili ana i ka pepa (i kapa ʻia ʻo "pepa fugue") i hoʻolauna ʻia e ka hui o Prakash ma 2017 no nā noi diagnostic.Ma muli o kēlā centrifugation i mōʻaukala koi i ka hoʻohana 'ana i ka pipiʻi, bulky, a me electrically hilinaʻi kalepa lako, Prakash's centrifuge hāʻawi i ka nani hoʻonā i ka pilikia o ka insecured komo i centrifugation ma ka waiwai-palena settings2,4.Mai ia manawa mai, ua hōʻike ʻo paperfuge i ka pono kūpono i nā noi diagnostic haʻahaʻa haʻahaʻa, e like me ka haʻihaʻi koko pili koko no ka ʻike ʻana i ka maʻi malaria.Eia naʻe, i ka maikaʻi o ko mākou ʻike, ʻaʻole i hoʻohana ʻia nā mea hana centrifuge e pili ana i ka pepa ultra-cheap no nā kumu lapaʻau, nā kūlana maʻamau e koi ai i ka sedimentation leo nui.
Me kēia i ka noʻonoʻo, ʻo ka pahuhopu o CentREUSE e hoʻonui i ka hoʻohana ʻana i ka centrifugation pepa i nā hana therapeutic.Ua hoʻokō ʻia kēia ma ka hana ʻana i kekahi mau hoʻololi i ka hoʻolālā o ka hōʻike Prakash.No ka mea, no ka hoʻonui ʻana i ka lōʻihi o nā syringes 1.0 ml maʻamau, loaʻa i ka CentREUSE kahi disk ʻoi aku ka nui (radius = 123.5 mm) ma mua o ka nui o ka pepa ʻo Prakash wringer i hoʻāʻo ʻia (radius = 85 mm).Eia kekahi, no ke kākoʻo ʻana i ke kaumaha hou o kahi syringe 1.0 ml i hoʻopiha ʻia me ka wai, hoʻohana ʻo CentREUSE i ka pahu corrugated ma kahi o ka pahu pahu.ʻO kēia mau hoʻololi e ʻae i ka centrifugation o nā puke ʻoi aku ka nui ma mua o nā mea i hoʻāʻo ʻia i ka mea holoi pepa Prakash (ʻo ia hoʻi ʻelua 1.0 ml syringes me nā capillaries) ʻoiai e hilinaʻi mau ana i nā mea like: filament a me nā mea pepa.ʻO ka mea nui, ua wehewehe ʻia kekahi mau centrifuges ikaika ʻē aʻe no ka diagnostics4,5,6,7,8,9,10.ʻO kēia mau mea nā mea wili, nā mea kuʻi salakeke, nā hua manu, a me nā lama lima no nā mea wili 5, 6, 7, 8, 9. Akā naʻe, ʻaʻole i hoʻolālā ʻia ka hapa nui o kēia mau mea hana no ka mālama ʻana i nā leo a hiki i ka 1.0 ml a loaʻa nā mea i ʻoi aku ke kumukūʻai. a hiki ʻole ke loaʻa ma mua o nā mea i hoʻohana ʻia i nā centrifuges pepa2,4,5,6,7,8,9,10..ʻO kaʻoiaʻiʻo, loaʻa pinepine nā mea pepa i hoʻolei ʻia ma nā wahi āpau;no ka laʻana, ma ʻAmelika Hui Pū ʻIa, helu ʻia ka pepa a me ka pepa pepa no ka ʻoi aku o 20% o nā ʻōpala paʻa o ke kūlanakauhale, e hāʻawi ana i kahi kumu waiwai nui, ʻemi ʻole, a i ʻole manuahi no ke kūkulu ʻana i nā centrifuges pepa.e laʻa, CentREUSE11.Eia kekahi, ke hoʻohālikelike ʻia me kekahi mau haʻina haʻahaʻa haʻahaʻa ʻē aʻe i paʻi ʻia, ʻaʻole koi ʻo CentREUSE i nā lako lako kūikawā (e like me ka lako paʻi 3D a me ka lako polokalamu, ka ʻoki ʻoki laser a me nā lako polokalamu, a me nā mea ʻē aʻe) e hana ai, e hoʻonui ai i ka waiwai..Aia kēia poʻe i ke kaiapuni 4, 8, 9, 10.
Ma ke ʻano he hōʻoia o ka pono pono o kā mākou centrifuge pepa no nā kumu therapeutic, hōʻike mākou i ka hoʻoponopono wikiwiki a hilinaʻi o ka hoʻokuʻu ʻana o ka triamcinolone i ka acetone (TA) no ka vitreous bolus injection - kahi hana haʻahaʻa haʻahaʻa i hoʻopaʻa ʻia no ka mālama lōʻihi o nā maʻi ocular1 ,3.Hoʻohālikelike ʻia nā hopena ma hope o 3 mau minuke me CentREUSE me nā hopena ma hope o 12 mau hola o ka hoʻoponopono ʻana i ka umekaumaha.Eia kekahi, ʻoi aku ka hopena o CentREUSE ma hope o ka centrifugation no 5 a me 10 mau minuke ma mua o nā hopena i loaʻa i ka umekaumaha a ua like me nā mea i ʻike ʻia ma hope o ka centrifugation ʻoihana ma 10 a me 50 RCF no 5 mau minuke.ʻOiaʻiʻo, i kā mākou ʻike, hoʻopuka ʻo CentREUSE i kahi interface sediment-supernatant ʻoi aku ka ʻoi aʻe ma mua o nā ʻano hana ʻē aʻe i hoʻāʻo ʻia;makemake ʻia kēia no ka mea e hiki ai i ka loiloi pololei ʻana i ka nui o ka lāʻau lapaʻau i lawelawe ʻia, a ʻoi aku ka maʻalahi o ka wehe ʻana i ka supernatant me ka liʻiliʻi o ka pohō o ka nui.
ʻO ke koho ʻana o kēia noi ma ke ʻano he hōʻoia o ka manaʻo i alakaʻi ʻia e ka pono mau e hoʻomaikaʻi i ke komo ʻana i nā steroids intravitreal lōʻihi i ka hoʻonohonoho ʻana i nā kumuwaiwai.Hoʻohana nui ʻia nā steroid Intravitreal e mālama i nā ʻano maka like ʻole, e like me ka maʻi macular edema, ka degeneration macular e pili ana i ka makahiki, retinal vascular occlusion, uveitis, radiation retinopathy, a me cystic macular edema3,12.ʻO nā steroid i loaʻa no ka hoʻokele intravitreal, ʻo TA ka mea i hoʻohana pinepine ʻia ma ka honua12.ʻOiai e loaʻa ana nā hoʻomākaukau me ka mālama ʻole ʻana i ka TA (PF-TA) (e laʻa, Triesence [40 mg/mL, Alcon, Fort Worth, USA]), nā hoʻomākaukau me nā mea mālama mālama benzyl alcohol (eg, Kenalog-40 [40 mg/mL, Bristol- ʻO Myers Squibb, New York, USA]) ka mea kaulana loa3,12.Pono e hoʻomaopopo ʻia ua ʻae ʻia ka hui hope o nā lāʻau lapaʻau e ka US Food and Drug Administration (FDA) no ka hoʻohana intramuscular a me intraarticular wale nō, no laila ua manaʻo ʻia ka hoʻokele intraocular ʻaʻole i kākau inoa ʻia 3, 12.ʻOiai ʻokoʻa ka nui o ka injectable o intravitreal TA e like me ka hōʻike a me ka ʻenehana, ʻo ka nui o ka hōʻike maʻamau ʻo 4.0 mg (ʻo ia hoʻi ka nui o ka injection o 0.1 ml mai kahi 40 mg/ml solution), ka mea maʻamau e hāʻawi i ka lōʻihi o ka mālama ʻana ma kahi o 3 mau mahina. , 12, 13, 14, 15.
No ka hoʻolōʻihi i ka hana o nā steroid intravitreal i nā maʻi maʻi maʻi, koʻikoʻi a i ʻole nā ​​​​maʻi maka hou, ua hoʻolauna ʻia kekahi mau mea hana steroid lōʻihi implantable a injectable paha, me ka dexamethasone 0.7 mg (Ozurdex, Allergan, Dublin, Ireland), Relax fluoride acetonide 0.59 mg (Retisert). , Bausch a me Lomb, Laval, Kanada) a me ka fluocinolone acetonide 0.19 mg (Iluvien, Alimera Sciences, Alpharetta, Georgia, USA)3,12.Eia nō naʻe, loaʻa i kēia mau mea pono kekahi mau drawbacks.Ma ʻAmelika Hui Pū ʻIa, ua ʻae wale ʻia kēlā me kēia hāmeʻa no kekahi mau hōʻailona, ​​e kaupalena ana i ka uhi ʻinikua.Eia kekahi, pono kekahi mau mea hana i ka hoʻokomo ʻana i ka ʻokiʻoki a hiki ke hoʻoulu i nā pilikia kūʻokoʻa e like me ka neʻe ʻana o ka mīkini i loko o ke keʻena mua3,12.Eia kekahi, ʻoi aku ka liʻiliʻi o kēia mau mea hana a ʻoi aku ka nui o ke kumukūʻai ma mua o TA3,12;ma nā kumukūʻai US o kēia manawa, ʻo Kenalog-40 ke kumukūʻai ma kahi o $20 no ka 1.0 ml o ka hoʻokuʻu ʻana, ʻoiai ʻo Ozurdex, Retisert, a me Iluvien explants.ʻO ka uku komo ma kahi o $1400., $20,000 a me $9,200 pakahi.Hoʻohui pū ʻia kēia mau mea e kaupalena i ke komo ʻana i kēia mau hāmeʻa no nā poʻe i ka hoʻonohonoho i kaohi ʻia.
Ua hoʻāʻo ʻia e hoʻolōʻihi i ka hopena o intravitreal TA1,3,16,17 ma muli o kona kumu kūʻai haʻahaʻa, ʻoi aku ka maikaʻi o ka hoʻihoʻi hou ʻana, a me ka nui o ka loaʻa.Hāʻawi ʻia i kona haʻahaʻa haʻahaʻa wai, noho ʻo TA i ka maka ma ke ʻano he depot, e ʻae ana i ka hoʻopuehu ʻana o ka lāʻau lapaʻau lohi a ʻano mau, no laila ke manaʻo ʻia nei ka hopena e lōʻihi me nā depots1,3 nui.No kēia hopena, ua hoʻomohala ʻia kekahi mau ala e hoʻopaʻa i ka hoʻokuʻu ʻana o TA ma mua o ka hoʻokomo ʻana i loko o ka vitreous.ʻOiai ua wehewehe ʻia nā ʻano hana e pili ana i ka passive (ʻo ia hoʻi ka gravity dependent) settling a i ʻole microfiltration, ʻoi aku ka lōʻihi o kēia mau ʻano i ka manawa a hāʻawi i nā hopena loli15,16,17.ʻO ka mea ʻē aʻe, ua hōʻike ʻia nā haʻawina mua e hiki ke wikiwiki a hilinaʻi ʻo TA (a pēlā e hoʻolōʻihi ʻia ai ka hana) ma ka centrifugation-assisted precipitation1,3.I ka hopena, ʻo ka maʻalahi, ke kumu kūʻai haʻahaʻa, ka lōʻihi, a me ka maikaʻi o ka centrifugally concentrated TA e hoʻolilo i kēia hana i kahi koho hoihoi no nā poʻe maʻi i nā hoʻonohonoho palena waiwai.Eia naʻe, ʻo ka nele o ka loaʻa ʻana o ka centrifugation hilinaʻi hiki ke lilo i mea pale nui i ka hoʻokō ʻana i kēia hana;Ma ka hoʻoponoponoʻana i kēia pilikia, hiki i ka CentREUSE ke kōkua i ka hoʻonuiʻana i ka loaʻaʻana o ka lāʻau steroid lōʻihi no nā maʻi i nā hoʻonohonoho palena waiwai.
Aia kekahi mau palena i kā mākou noiʻi ʻana, me nā mea e pili ana i ka hana maoli i ka mea hana CentREUSE.ʻO ka mea hana he oscillator non-linear, non-conservative e hilinaʻi nei i ka hoʻokomo kanaka a no laila ʻaʻole hiki ke hāʻawi i ka wikiwiki o ka hoʻololi mau ʻana i ka wā e hoʻohana ai;ʻO ka wikiwiki o ka hoʻololi ʻana e pili ana i nā ʻano like ʻole, e like me ka mana o ka mea hoʻohana i ke kiʻekiʻe o ka mea nona ka lako, nā mea kikoʻī i hoʻohana ʻia i ka hui ʻana o nā mea hana, a me ka maikaʻi o nā pilina e wili ʻia.He ʻokoʻa kēia mai nā lako kalepa kahi e hiki ai ke hoʻohana mau ʻia ka wikiwiki o ka rotational.Eia kekahi, ʻo ka wikiwiki i loaʻa e CentREUSE hiki ke noʻonoʻo ʻia he ʻano haʻahaʻa ke hoʻohālikelike ʻia me ka wikiwiki i loaʻa e nā mea centrifuge ʻē aʻe2.ʻO ka mea pōmaikaʻi, ua lawa ka wikiwiki (a me ka ikaika centrifugal pili) i hana ʻia e kā mākou hāmeʻa e hoʻāʻo ai i ka manaʻo kikoʻī i kā mākou haʻawina (ʻo ia hoʻi, TA deposition).Hiki ke hoʻonui ʻia ka wikiwiki o ka hoʻololi ʻana ma ka hoʻomālamalama ʻana i ka nui o ka diski waena 2;Hiki ke hoʻokō ʻia kēia ma ka hoʻohana ʻana i kahi mea māmā (e like me ka pepa ʻoi aku ka lahilahi) inā ikaika ia e paʻa i ʻelua syringes i piha i ka wai.I kā mākou hihia, ua noʻonoʻo ʻia ka hoʻoholo e hoʻohana i ka pahu pahu pahu "A" maʻamau (4.8 mm mānoanoa), no ka mea, ʻike pinepine ʻia kēia mea i loko o nā pahu hoʻouna a no laila ua maʻalahi ka loaʻa ʻana ma ke ʻano he mea hiki ke hana hou.Hiki ke hoʻonui ʻia ka wikiwiki o ka hoʻololi ʻana ma ka hoʻemi ʻana i ka radius o ka disk kikowaena 2.Eia nō naʻe, ua hana nui ʻia ka radius o kā mākou paepae e hoʻokomo i kahi syringe 1.0 ml.Inā makemake ka mea hoʻohana i ka centrifuging i nā moku pōkole, hiki ke hoʻemi ʻia ka radius-he hoʻololi i hiki ke loaʻa i ka wikiwiki o ka rotational kiʻekiʻe (a me nā ikaika centrifugal kiʻekiʻe paha).
Eia kekahi, ʻaʻole mākou i loiloi pono i ka hopena o ka luhi o ka mea hoʻohana i ka hana pono.ʻO ka mea mahalo, ua hiki i kekahi mau lālā o kā mākou hui ke hoʻohana i ka hāmeʻa no 15 mau minuke me ka ʻole o ka luhi.ʻO kahi hopena kūpono i ka luhi o ka mea hana ke koi ʻia nā centrifuges lōʻihi e hoʻololi i ʻelua a ʻoi aku paha nā mea hoʻohana (inā hiki).Eia hou, ʻaʻole mākou i loiloi koʻikoʻi i ka lōʻihi o ka mea hana, ma kahi ʻāpana no ka mea hiki ke hoʻololi maʻalahi nā ʻāpana o ka hāmeʻa (e like me ka pahu pahu a me ke kaula) me ka liʻiliʻi a i ʻole ke kumu kūʻai inā ʻaʻahu a pōʻino paha.ʻO ka mea hoihoi, i ka wā o kā mākou hoʻokolohua hoʻokele, ua hoʻohana mākou i hoʻokahi mea hana no ka huina o 200 mau minuke.Ma hope o kēia manawa, ʻo ka hōʻailona liʻiliʻi wale nō o ka ʻaʻahu ʻo ia ka perforation ma nā kaula.
ʻO kekahi palena ʻē aʻe o kā mākou noiʻi ʻana ʻaʻole mākou i ana kikoʻī i ka nui a i ʻole ka nui o ka TA i waiho ʻia, hiki ke loaʻa me ka mea CentREUSE a me nā ʻano hana ʻē aʻe;akā, ua hoʻokumu ʻia kā mākou hōʻoia hoʻokolohua o kēia hāmeʻa ma ke ana ʻana o ka sediment density (i ka ml).ana kūʻokoʻa o ka mānoanoa.Eia hou,ʻaʻole mākou i ho'āʻo i ka CentREUSE Concentrated TA i nā maʻi, akā naʻe, no ka mea, ua hana kā mākou mea hana i nā pellets TA e like me nā mea i hanaʻia me ka centrifuge pāʻoihana, ua manaʻo mākou he maikaʻi a palekana ka CentREUSE Concentrated TA e like me ka mea i hoʻohana muaʻia.ma ka palapala.hōʻike ʻia no nā mea centrifuge maʻamau1,3.ʻO nā haʻawina hou e helu ana i ka nui maoli o TA i lawelawe ʻia ma hope o ka hoʻopaʻa ʻana o CentREUSE hiki ke kōkua i ka loiloi hou ʻana i ka pono maoli o kā mākou hāmeʻa i kēia noi.
I ko mākou ʻike, ʻo CentREUSE, kahi mea hiki ke hana maʻalahi ʻia mai nā ʻōpala i loaʻa maʻalahi, ʻo ia ka centrifuge pepa i hoʻohana ʻia i ke kanaka, lawe lima, ultra-haʻahaʻa e hoʻohana ʻia i kahi hoʻonohonoho lapaʻau.Ma waho aʻe o ka hiki ke centrifuge i nā puke nui, ʻaʻole koi ʻo CentREUSE i ka hoʻohana ʻana i nā mea hana kūikawā a me nā mea hana hana i hoʻohālikelike ʻia me nā centrifuges haʻahaʻa haʻahaʻa i paʻi ʻia.Hiki ke kōkua i ka hoʻomaikaʻi ʻana i ka loaʻa ʻana o ka steroid intravitreal i ka wā lōʻihi i ka poʻe ma nā wahi i kaupalena ʻia nā kumuwaiwai, hiki ke kōkua i ka mālama ʻana i nā ʻano ocular.Eia kekahi, ʻo nā pōmaikaʻi o kā mākou mau centrifuges hiki ke hoʻohana ʻia i ke kanaka hiki ke hoʻonui i nā wahi waiwai waiwai e like me nā keʻena olakino tertiary a me quaternary ma nā ʻāina kūkulu.Ma lalo o kēia mau kūlana, hiki ke hoʻomau ʻia ka loaʻa ʻana o nā mea centrifuging i nā keʻena lapaʻau a me ka noiʻi ʻana, me ka pilikia o ka hoʻohaumia ʻana i nā syringes me nā wai kino kanaka, nā huahana holoholona, ​​​​a me nā mea pōʻino ʻē aʻe.Eia kekahi, aia kēia mau laboratories i kahi mamao loa mai kahi o ka mālama ʻana i nā maʻi.ʻO kēia, ma ka huli ʻana, hiki ke lilo i mea hoʻokele logistic no nā mea mālama olakino e pono ai ke komo wikiwiki i ka centrifugation;hiki ke hoʻohana i ka CentREUSE ma ke ʻano he ala kūpono e hoʻomākaukau ai i nā hana lapaʻau i ka wā pōkole me ka ʻole e hoʻopilikia nui i ka mālama maʻi.
No laila, i mea e maʻalahi ai ka hoʻomākaukau ʻana o nā mea a pau no nā hana lapaʻau e pono ai ka centrifugation, ua hoʻokomo ʻia kahi mamana a me nā ʻōlelo aʻoaʻo no ka hana ʻana i ka CentREUSE i loko o kēia hoʻolaha puka wehe ma lalo o ka ʻāpana ʻIke Hou.Paipai mākou i ka poʻe heluhelu e hoʻolālā hou i ka CentREUSE inā pono.
Loaʻa nā ʻikepili e kākoʻo ana i nā hopena o kēia noiʻi mai ka mea kākau SM ma muli o ke noi kūpono.
Ober, MD a me Valizhan, S. Ka lōʻihi o ka hana o ka triamcinolone acetone i loko o ka vitreous ma ka centrifugation.Retina 33, 867–872 (2013).
Bhamla, MS a me nā mea ʻē aʻe.Centrifuge ultra-cheap manual no ka pepa.ʻEpekema Biomedical Lahui.papahana.1, 0009. https://doi.org/10.1038/s41551-016-0009 (2017).
Malinovsky SM a me Wasserman JA ʻO ka manaʻo Centrifugal o kahi hoʻokuʻu intravitreal o ka triamcinolone acetonide: kahi koho maʻalahi, maʻalahi a hiki ke hiki i ka hoʻokele steroid lōʻihi.J. Vitrain.diss.5. 15–31 (2021).
Huck, e kali au.ʻO ke kumu kūʻai kikowaena centrifuge adapter no ka hoʻokaʻawale ʻana i nā laʻana koko nui.PLOS ʻEkahi.17.e0266769.https://doi.org/10.1371/journal.pone.0266769 (2022).
Wong AP, Gupta M., Shevkoplyas SS a me Whitesides GM Ua like ka whisk me ka centrifuge: ka hoʻokaʻawale ʻana i ka plasma kanaka mai ke koko holoʻokoʻa i nā hoʻonohonoho palena waiwai.hale hoʻokolohua.puʻupuʻu.8, 2032–2037 (2008).
Brown, J. et al.Manual, lawe lima, haʻahaʻa kumu kūʻai centrifuge no ka maʻi anemia i loko o nā kumu i kaupalena ʻia.ʻAe.J. Trope.lāʻau lapaʻau.mākū.85, 327–332 (2011).
Liu, K.-H.kali.Ua hoʻokaʻawale ʻia ʻo Plasma me ka wili.anus.Kemika.91, 1247–1253 (2019).
Michael, I. et al.Spinner no ka ʻike koke ʻana i nā maʻi ʻeha.ʻEpekema Biomedical Lahui.papahana.4, 591–600 (2020).
Lee, E., Larson, A., Kotari, A., a me Prakash, M. Handyfuge-LAMP: Inexpensive electrolyte-free centrifugation no ka isothermal detection of SARS-CoV-2 i loko o ke kohu.https://doi.org/10.1101/2020.06.30.20143255 (2020).
Lee, S., Jeong, M., Lee, S., Lee, SH, a me Choi, J. Mag-spinner: ʻO ka hanauna e hiki mai ana o nā ʻōnaehana hoʻokaʻawale magnetic maʻalahi, hiki ke maʻalahi, maʻalahi a lawe ʻia (FAST).Nā Holomua Nano 4, 792–800 (2022).
ʻOihana Hoʻomalu Kaiapuni ʻAmelika.Ke holomua nei i ka hoʻokele waiwai hoʻomau: He pepa ʻoiaʻiʻo 2018 e loiloi ana i nā ʻano o ka hana ʻana a me ka hoʻokele waiwai ma ʻAmelika Hui Pū ʻIa.(2020).https://www.epa.gov/sites/default/files/2021-01/documents/2018_ff_fact_sheet_dec_2020_fnl_508.pdf.
Sarao, V., Veritti, D., Boschia, F. a me Lanzetta, P. Steroids no ka mālama intravitreal o nā maʻi retinal.ka ʻepekema.Nūpepa Mir 2014, 1–14 (2014).
Beer, ahiahi kī, etc. Intraocular concentrations and pharmacokinetics of triamcinolone acetonide after a intravitreal injection.Ophthalmology 110, 681–686 (2003).
Audren, F. et al.Pharmacokinetic-pharmacodynamic model o ka hopena o ka triamcinolone acetonide ma waena o ka mānoanoa macular i nā maʻi me ka maʻi macular edema.hoʻokomo kālā.ophthalmology.ʻike ʻia.ka ʻepekema.45, 3435–3441 (2004).
Ober, MD et al.ʻO ka nui maoli o ka triamcinolone acetone i ana ʻia e ke ʻano maʻamau o ka injection intravitreal.ʻAe.J. Ophthalmol.142, 597–600 (2006).
Chin, HS, Kim, TH, Moon, YS and Oh, JH Concentrated triamcinolone acetonide method for intravitreal injection.Retina 25, 1107–1108 (2005).
Tsong, JW, Persaud, TO & Mansour, SE Ka helu helu ʻana o ka triamcinolone i waiho ʻia no ka injection.Retina 27, 1255–1259 (2007).
Kākoʻo ʻia ʻo SM ma kahi ʻāpana e kahi makana i ka Mukai Foundation, Massachusetts Eye and Ear Hospital, Boston, Massachusetts, USA.
Keʻena o Ophthalmology, Ke Kula Lapaʻau ʻo Harvard, Massachusetts Maka a me Pepeiao, 243 Charles St, Boston, Massachusetts, 02114, USA