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Ubuvuzi bwizewe bwa centrifugation bwasabye kuva kera gukoresha ibikoresho byubucuruzi bihenze, binini, kandi bishingiye kumashanyarazi, akenshi ntibishoboka mubushobozi buke.Nubwo ibyasobanuwe byinshi, bidahenze, bidafite moteri ya centrifuges byasobanuwe, ibi bisubizo bigenewe cyane cyane kubisuzuma byo kwisuzumisha bisaba umubyimba muto ugereranije.Mubyongeyeho, igishushanyo cyibikoresho akenshi bisaba gukoresha ibikoresho byihariye nibikoresho bidasanzwe biboneka ahantu hatabigenewe.Hano turasobanura igishushanyo, guteranya, no kwemeza igeragezwa rya CentREUSE, igiciro cyinshi cyane, gikoreshwa n'abantu, kigendanwa imyanda ishingiye kuri centrifuge yo kuvura.CentREUSE yerekana impuzandengo ya centrifugal yingufu za 10.5 ugereranije na centrifugal imbaraga (RCF) ± 1.3.Gukemura miriyoni 1.0 ya vitreous ihagarikwa rya triamcinolone nyuma yiminota 3 ya centrifugation muri CentREUSE yagereranijwe nkiyo nyuma yamasaha 12 yumubyigano wa mediya (0.41 ml ± 0.04 vs 0.38 ml ± 0.03, p = 0.14).Kwiyongera kwimyanda nyuma ya CentREUSE centrifugation muminota 5 na 10 ugereranije niyagaragaye nyuma ya centrifugation kuri 10 RCF (0.31 ml ± 0.02 na 0.32 ml ± 0.03, p = 0.20) na 50 RCF (0,20 ml) muminota 5 ukoresheje ibikoresho byubucuruzi Bisa ± 0.02 na 0.19 ml ± 0.01, p = 0.15).Inyandikorugero n'amabwiriza yo kubaka CentREUSE yashyizwe muriyi nyandiko ifunguye.
Centrifugation nintambwe yingenzi mubizamini byinshi byo gusuzuma no kuvura 1.1,3,4.Ariko, kugera kuri centrifugation ihagije byasabye kuva kera gukoresha ibikoresho byubucuruzi bihenze, binini, kandi biterwa n’amashanyarazi, akenshi ntibishoboka mubushobozi buke2,4.Muri 2017, itsinda rya Prakash ryashyizeho intoki ntoya ishingiye ku mpapuro (bita “impapuro puffer”) ikozwe mu bikoresho byateguwe ku giciro cya $ 0.20 ($) 2.Kuva icyo gihe, impapuro fugue zashyizwe mumikoreshereze yubushobozi buke bwo gupima indwara (urugero nko gutandukanya ibice bigize amaraso mu miyoboro ya capillary kugirango tumenye malariya), bityo bikerekana ibikoresho bihendutse cyane byifashishwa n'abantu.centrifuge 2.Kuva icyo gihe, ibindi bikoresho byinshi byoroheje, bidahenze, bidafite moteri ya centrifugation byasobanuwe 4,5,6,7,8,9,10.Nyamara, ibyinshi muribi bisubizo, nkumwotsi wimpapuro, bigenewe intego yo kwisuzumisha bisaba ubunini buke bwimitsi bityo ntibishobora gukoreshwa muri centrifuge ingero nini.Byongeye kandi, guteranya ibi bisubizo akenshi bisaba gukoresha ibikoresho nibikoresho bidasanzwe bitaboneka ahantu hatabigenewe4,5,6,7,8,9,10.
Hano turasobanura igishushanyo, guteranya, no kwemeza igeragezwa rya centrifuge (bita CentREUSE) yubatswe mumyanda isanzwe ya fugue yimyanda ikoreshwa mubuvuzi busanzwe busaba ubwinshi bwimitsi.Urubanza 1, 3 Nkikimenyetso cyigitekerezo, twagerageje igikoresho hifashishijwe ubuvuzi bwamaso: imvura yo guhagarika triamcinolone muri acetone (TA) kugirango yinjizwemo imiti ya bolus mumubiri wijisho ryijisho.Nubwo centrifugation yibanda kuri TA nigikorwa cyemewe cyo kwifashisha mugihe gito cyo kuvura indwara zamaso zitandukanye, gukenera centrifuges ziboneka mubucuruzi mugihe cyo gufata ibiyobyabwenge nimbogamizi ikomeye yo gukoresha ubu buvuzi mumikoreshereze idafite amikoro1,2, 3.ugereranije nibisubizo byabonetse hamwe na centrifuges isanzwe yubucuruzi.Inyandikorugero n'amabwiriza yo kubaka CentREUSE yashyizwe muriyi soko ifunguye yohereza mu gice "Ibisobanuro byinshi".
CentREUSE irashobora kubakwa hafi ya yose.Amakopi yombi yicyitegererezo cyizengurutse (Ishusho yinyongera S1) yacapishijwe kumpapuro zisanzwe za karubone zo muri Amerika (215.9 mm × 279.4 mm).Inyandikorugero ebyiri zometseho zisobanura ibintu bitatu byingenzi byashushanyijemo ibikoresho bya CentREUSE, harimo (1) impande yinyuma ya disiki ya 247mm izunguruka, (2) yagenewe kwakira syringe 1.0ml (hamwe na cap na pomper yaciwe).grooves muri shank) na (3) ibimenyetso bibiri byerekana aho ugomba gukubita umwobo kugirango umugozi ushobora kunyura muri disiki.
Komera (urugero hamwe nintego zose zifatika cyangwa kaseti) inyandikorugero kurubaho (ubunini ntarengwa: 247 mm × 247 mm) (Ishusho yinyongera S2a).Ikibaho gisanzwe “A” gikonjesha (mm 4,8 mm z'ubugari) cyakoreshejwe muri ubu bushakashatsi, ariko ikibaho gikonjesha gifite ubunini busa gishobora gukoreshwa, nk'ikibaho cyometse ku dusanduku twoherejwe.Ukoresheje igikoresho gityaye (nk'icyuma cyangwa imikasi), gabanya ikarito ku nkombe ya disiki yo hanze igaragara ku gishushanyo (Ishusho y'inyongera S2b).Noneho, ukoresheje igikoresho gifunganye, gityaye (nk'isonga ry'ikaramu y'umupira), kora ibice bibiri byuzuye byuzuye hamwe na radiyo ya mm 8.5 ukurikije ibimenyetso bikurikirana ku gishushanyo (Ishusho yinyongera S2c).Ibice bibiri kuri 1.0 ml ya siringes noneho bigabanywa uhereye ku gishushanyo no hejuru yubutaka bwikarito ukoresheje igikoresho cyerekanwe nkicyuma cyogosha;hagomba kwitonderwa kutangiza ibyangiritse cyangwa igice gisigaye (Ishusho yinyongera S2d, e).Noneho, shyira agace k'umugozi (urugero: 3mm yo guteka umugozi w'ipamba cyangwa urudodo urwo arirwo rwose rufite ubunini busa kandi bworoshye) unyuze mu mwobo yombi hanyuma uhambire uruziga ruzengurutse impande zose za disiki ifite uburebure bwa 30cm (Ishusho yinyongera. S2f).
Uzuza inshinge ebyiri 1.0 1.0 hamwe nubunini bungana (urugero 1.0 ml ya TA ihagarikwa) na cap.Inkoni ya singe yaciwe noneho yaciwe kurwego rwa flangeri (Ishusho yinyongera S2g, h).Icyuma cya silinderi noneho gitwikiriwe na kaseti kugirango wirinde gusohora piston yaciwe mugihe cyo gukoresha ibikoresho.Buri shinge ya ml 1.0 noneho yashyizwe muri siringi neza hamwe na capit ireba hagati ya disiki (Ishusho yinyongera S2i).Buri syringe noneho yomekaga byibuze kuri disiki hamwe na kaseti ifata (Ishusho yinyongera S2j).Hanyuma, uzuza inteko ya centrifuge ushyira amakaramu abiri (nk'amakaramu cyangwa ibikoresho bisa nkibikoresho bifatika) kuri buri mpera yumugozi imbere yumuzingi (Ishusho 1).
Amabwiriza yo gukoresha CentREUSE asa nay'ibikinisho gakondo bizunguruka.Kuzunguruka bitangizwa no gufata ikiganza muri buri kiganza.Buhoro buhoro mumigozi itera disikuru kunyeganyega imbere cyangwa inyuma, bigatuma disikuru izunguruka imbere cyangwa inyuma.Ibi bikorwa inshuro nyinshi muburyo buhoro, bugenzurwa kuburyo imirongo igoramye.Noneho uhagarike urugendo.Mugihe imirya itangiye gukingurwa, ikiganza gikururwa cyane kugeza igihe imirongo ikozwe neza, bigatuma disikuru izunguruka.Mugihe umugozi ukimara gukurwaho rwose hanyuma ugatangira gusubira inyuma, ikiganza kigomba kuruhuka buhoro.Mugihe umugozi utangiye kongera gufungura, koresha urukurikirane rwimikorere kugirango igikoresho kizunguruka (video S1).
Kubisabwa bisaba gutembera guhagarikwa na centrifugation, igikoresho cyahoraga kizunguruka kugeza igihe granulation ishimishije igerwaho (Ishusho yinyongera S3a, b).Ibice bigoye bizakorwa kumpera ya barring ya siringe kandi ndengakamere izibanda kumutwe wa syringe.Supernatant yahise ikurwaho ikuraho kaseti itwikiriye ingunguru ya barrel hanyuma itangiza plunger ya kabiri kugirango isunike buhoro buhoro plunger kavukire yerekeza kumutwe wa syringe, ihagarara iyo igeze mubutaka bwuzuye (Ishusho yinyongera S3c, d).
Kugirango umenye umuvuduko wo kuzunguruka, igikoresho cya CentREUSE, gifite siringi ebyiri za 1.0 zuzuye amazi, cyafashwe na kamera yerekana amashusho yihuta (amakaramu 240 kumasegonda) muminota 1 nyuma yo kugera kumurongo uhamye.Abamamaza hafi yuruhande rwa disiki izunguruka bakurikiranwe nintoki bakoresheje ikadiri-y-isesengura ryamajwi kugirango bamenye umubare wimpinduramatwara kumunota (rpm) (Ishusho 2a-d).Subiramo n = 10 kugerageza.Imbaraga zijyanye na centrifugal (RCF) hagati ya baringa ya syringe noneho ibarwa ukoresheje formula ikurikira:
Kugereranya umuvuduko ukabije hamwe na CentREUSE.(A - D) Amashusho akurikirana yerekana igihe (iminota: amasegonda. Millisekondi) kugirango arangize ibikoresho bizunguruka.Imyambi yerekana ibimenyetso byerekana ibimenyetso.(E) Umubare wa RPM ukoresheje CentREUSE.Imirongo yerekana uburyo (umutuku) iation gutandukana bisanzwe (umukara).Amanota yerekana ibigeragezo kuminota 1 (n = 10).
Siringi ya ml 1.0 irimo guhagarika TA yo gutera inshinge (40 mg / ml, Pharmaceuticals Amneal, Bridgewater, NJ, USA) yashizwemo iminota 3, 5 na 10 ukoresheje CentREUSE.Kwibiza ukoresheje ubu buhanga byagereranijwe nibyagezweho nyuma ya centrifugation kuri 10, 20, na 50 RCF ukoresheje rotor ya A-4-62 muminota 5 kuri Eppendorf 5810R intebe ya centrifuge (Hamburg, Ubudage).Ingano yimvura nayo yagereranijwe nubunini bwimvura yabonetse ukoresheje imvura iterwa nububasha bwibihe bitandukanye kuva muminota 0 kugeza 720.Igiteranyo cya n = 9 cyigenga cyakozwe kuri buri nzira.
Isesengura ry’imibare yose ryakozwe hifashishijwe porogaramu ya Prism 9.0 (GraphPad, San Diego, Amerika).Indangagaciro zitangwa nkibisobanuro iation gutandukana bisanzwe (SD) keretse bivuzwe ukundi.Itsinda risobanura ryagereranijwe ukoresheje t-test ya Welch ikosowe.Alpha isobanurwa nka 0.05.Kuri gravit-iterwa no kugabanuka, icyiciro kimwe cyerekana icyerekezo cyangirika cyashyizweho hifashishijwe byibuze-kwaduka kwisubiraho, bifata y inshuro zisubirwamo kubiciro byatanzwe x agaciro nkingingo imwe.
aho x nigihe cyo muminota.y - ingano yubutaka.y0 nigiciro cya y mugihe x ari zeru.Ikibaya ni y agaciro kuminota itagira iherezo.K ni igipimo gihoraho, kigaragazwa nkibisubizo byiminota.
Igikoresho cya CentREUSE cyerekanye ihindagurika ryizewe, rigenzurwa ridafite umurongo ukoresheje siringi ebyiri zisanzwe 1.0 ml zuzuyemo ml 1.0 y'amazi buri (videwo S1).Mu bigeragezo n = 10 (umunota 1 buri umwe), CentREUSE yari ifite umuvuduko wikigereranyo cya 359.4 rpm ± 21.63 (intera = 337-398), bivamo impuzandengo yabazwe ya centrifugal ya 10.5 RCF ± 1, 3 (intera = 9.2–12.8 ).(Ishusho 2a-e).
Uburyo butandukanye bwo guhagarika TA ihagarikwa muri miriyoni 1.0 ya syringes yarasuzumwe kandi ugereranije na CentREUSE centrifugation.Nyuma yamasaha 12 yuburemere bushingiye ku rukuruzi, ubwinshi bwibimera bwageze kuri ml 0.38 ± 0.03 (Ishusho yinyongera. S4a, b).Imirasire ya TA iterwa na TA ihujwe nicyiciro kimwe cyerekana ibyangirika (byakosowe na R2 = 0.8582), bivamo ikigereranyo cya 0.3804 mL (95% intera yicyizere: 0.3578 kugeza 0.4025) (Ishusho yinyongera S4c).CentREUSE yabyaye impuzandengo ya 0.41 ml ± 0,04 mu minota 3, ibyo bikaba byari bisa n’agaciro kagereranijwe ka 0.38 ml ± 0.03 byagaragaye ku butumburuke bushingiye ku rukuruzi mu masaha 12 (p = 0.14) (Ishusho 3a, d, h) .CentREUSE yatanze urugero rwinshi rwa 0.31 ml ± 0,02 muminota 5 ugereranije nuburyo bwa 0.38 ml ± 0.03 byagaragaye kubutaka bushingiye ku rukuruzi rwamasaha 12 (p = 0.0001) (Ishusho 3b, d, h).
Kugereranya ubucucike bwa TA pellet bwagezweho na CentREUSE centrifugation hamwe ningufu zikomeye hamwe na centrifugation yinganda zisanzwe (A - C).Amashusho yerekana ishusho yimvura ya TA muri 1.0 ml ya syringes nyuma yiminota 3 (A), min 5 (B), na 10 min (C) yo gukoresha CentREUSE.(D) Amashusho yerekana TA yabitswe nyuma ya 12 h yingufu zikomeye.(EG) Amashusho yerekana TA yaguye nyuma yubucuruzi busanzwe kuri 10 RCF (E), 20 RCF (F), na 50 RCF (G) kuminota 5..Imirongo yerekana uburyo (umutuku) iation gutandukana bisanzwe (umukara).Utudomo twerekana kwigenga (n = 9 kuri buri kintu).
CentREUSE yatanze urugero rungana na 0.31 ml ± 0.02 nyuma yiminota 5, ibyo bikaba bisa nuburyo bwa 0.32 ml ± 0.03 byagaragaye muri centrifuge isanzwe yubucuruzi kuri 10 RCF muminota 5 (p = 0,20), kandi biri munsi yubunini buke yabonetse hamwe na 20 RCF yagaragaye kuri 0,28 ml ± 0.03 mu minota 5 (p = 0.03) (Ishusho 3b, e, f, h).CentREUSE yatanze urugero rungana na 0,20 ml ± 0,02 mu minota 10, yari yoroheje (p = 0.15) ugereranije n’ubunini bwa 0.19 ml ± 0.01 mu minota 5 yagaragaye hamwe na centrifuge yubucuruzi kuri 50 RCF (Ishusho 3c, g, h)..
Hano turasobanura igishushanyo, guteranya, hamwe no kugenzura igeragezwa rya ultra-igiciro gito, kigendanwa, gikoreshwa n'abantu, impapuro zishingiye kuri centrifuge ikozwe mumyanda isanzwe ivura.Igishushanyo ahanini gishingiye ku mpapuro zishingiye kuri centrifuge (bita "impapuro fugue") zatangijwe nitsinda rya Prakash muri 2017 kugirango zisuzumwe.Urebye ko centrifugation yasabye kuva kera gukoresha ibikoresho byubucuruzi bihenze, binini, kandi biterwa n’amashanyarazi, centrifuge ya Prakash itanga igisubizo cyiza cyikibazo cyo kubona umutekano muke kuri centrifugation mumikoreshereze idafite umutungo2,4.Kuva icyo gihe, paperfuge yerekanye akamaro gakomeye muburyo butandukanye bwo gupima indwara, nko kugabanya amaraso ashingiye ku bucucike bwo kumenya malariya.Nyamara, uko tubizi, ibikoresho bisa na ultra-bihendutse bishingiye kuri centrifuge ibikoresho ntabwo byakoreshejwe muburyo bwo kuvura, ibintu bisanzwe bisaba kugabanuka kwinshi.
Hamwe nibitekerezo, intego ya CentREUSE nukwagura ikoreshwa ryimpapuro centrifugation mubikorwa byo kuvura.Ibi byagezweho muguhindura byinshi mubishushanyo mbonera bya Prakash guhishura.Ikigaragara ni uko kugirango wongere uburebure bwa siringi ebyiri zisanzwe 1.0, CentREUSE irimo disiki nini (radius = 123,5 mm) kuruta impapuro nini nini ya Prakash yapimwe (radius = 85 mm).Mubyongeyeho, kugirango ushyigikire uburemere bwinyongera bwa miriyoni 1.0 ya siringi yuzuyemo amazi, CentREUSE ikoresha ikarito ikarito aho gukoresha ikarito.Hamwe na hamwe, ibyo byahinduwe byemerera centrifugation yubunini bunini kuruta ubwageragejwe mu isuku yimpapuro za Prakash (ni ukuvuga siringi ebyiri za 1.0 ml hamwe na capillaries) mugihe ugikomeza gushingira kubintu bisa: filament nibikoresho bishingiye ku mpapuro.Ikigaragara ni uko izindi centrifuges zihenze zikoreshwa n'abantu zasobanuwe hagamijwe gusuzuma indwara 4,5,6,7,8,9,10.Harimo kuzunguruka, gukubita salade, gukubita amagi, hamwe n'amatara y'intoki kubikoresho bizunguruka5, 6, 7, 8, 9. Nyamara, ibyinshi muribi bikoresho ntabwo bigenewe gukora amajwi agera kuri miriyoni 1.0 kandi bigizwe nibikoresho bikunze kuba bihenze cyane kandi ntibishoboka kuruta ibyakoreshejwe mu mpapuro centrifuges2,4,5,6,7,8,9,10..Mubyukuri, impapuro zajugunywe akenshi ziboneka ahantu hose;kurugero, muri Reta zunzubumwe zamerika, impapuro nimpapuro zibarirwa hejuru ya 20% yimyanda ikomeye ya komine, itanga isoko ryinshi, ihendutse, cyangwa nubuntu bwubaka impapuro centrifuges.urugero CentREUSE11.Na none, ugereranije nibindi bisubizo bidahenze byatangajwe, CentREUSE ntisaba ibyuma byabugenewe (nka 3D icapura ibyuma na software, ibyuma bikata laser na software, nibindi) kugirango bikore, bigatuma ibyuma birushaho gukomera..Aba bantu bari mubidukikije 4, 8, 9, 10.
Nkikimenyetso cyingirakamaro mubikorwa byimpapuro centrifuge mugikorwa cyo kuvura, turerekana gukemura byihuse kandi byizewe bya triamcinolone ihagarikwa muri acetone (TA) kugirango itere vitreous bolus-hashyizweho uburyo buke bwo kuvura igihe kirekire kuvura indwara zinyuranye1 , 3.Gukemura ibisubizo nyuma yiminota 3 hamwe na CentREUSE byagereranijwe nibisubizo nyuma yamasaha 12 ya rukuruzi-yunganirwa.Byongeye kandi, ibisubizo bya CentREUSE nyuma ya centrifugation muminota 5 na 10 byarenze ibisubizo byabonetse kuburemere kandi byari bisa nibyagaragaye nyuma ya centrifugation yinganda kuri 10 na 50 RCF muminota 5.Ikigaragara ni uko, mubyatubayeho, CentREUSE itanga intera ikarishye kandi yoroshye yimitekerereze-ndengakamere kuruta ubundi buryo bwageragejwe;ibi birakenewe kuko bituma hasuzumwa neza igipimo cyimiti yatanzwe, kandi biroroshye kuvanaho ndengakamere hamwe no gutakaza bike kwijwi.
Guhitamo iyi porogaramu nkigihamya cyibitekerezo byatewe no gukomeza gukenera kunoza uburyo bwo kugera kuri interavitreal steroid ndende-mumikoreshereze yimikoreshereze.Intravitreal steroid ikoreshwa cyane mukuvura indwara zinyuranye zamaso, harimo kurwara diyabete ya macula edema, kwangirika kwimyaka, kugabanuka kwamaraso, uveitis, retinopathie imirasire, hamwe na cystic macular edema3,12.Muri steroid iboneka kubuyobozi bwa intravitreal, TA ikomeza gukoreshwa cyane kwisi12.Nubwo imyiteguro idafite imiti igabanya ubukana bwa TA (PF-TA) irahari (urugero, Triesence [40 mg / mL, Alcon, Fort Worth, USA]), imyiteguro hamwe n’ibiyobyabwenge bya benzyl (urugero, Kenalog-40 [40 mg / mL, Bristol- Myers Squibb, New York, Amerika]) ikomeje kuba icyamamare3,12.Twabibutsa ko itsinda rya nyuma ryibiyobyabwenge ryemejwe n’ikigo cy’Amerika gishinzwe ibiryo n’ibiyobyabwenge (FDA) kugira ngo gikoreshwe mu nda no mu nda gusa, bityo ubuyobozi bw’imitsi bufatwa nk'utiyandikishije 3, 12.Nubwo igipimo cyatewe inshinge za intravitreal TA gitandukana ukurikije ibyerekanwe nubuhanga, ikinini gikunze kuvugwa ni mg 4.0 (ni ukuvuga inshinge zingana na ml 0.1 kuva 40 mg / ml), ubusanzwe itanga igihe cyo kuvura hafi amezi 3 Ingaruka 1 , 12, 13, 14, 15.
Kugirango wongere ibikorwa bya intravitreal steroid mu ndwara zidakira, zikomeye cyangwa zisubiramo, hashyizweho ibikoresho byinshi bimaze igihe kirekire byatewe cyangwa byatewe na steroid, harimo dexamethasone 0,7 mg (Ozurdex, Allergan, Dublin, Irlande), Relax fluoride acetonide 0.59 mg (Retisert , Bausch na Lomb, Laval, Kanada) na fluocinolone acetonide 0,19 mg (Iluvien, Ubumenyi bwa Alimera, Alpharetta, Jeworujiya, Amerika) 3,12.Ariko, ibyo bikoresho bifite ibibi byinshi bishobora kugaruka.Muri Amerika, buri gikoresho cyemewe gusa kubimenyetso bike, bigabanya ubwishingizi.Byongeye kandi, ibikoresho bimwe bisaba guterwa kubagwa kandi birashobora gutera ingorane zidasanzwe nko kwimuka kwibikoresho mucyumba cyimbere3,12.Mubyongeyeho, ibyo bikoresho bikunda kuboneka byoroshye kandi bihenze cyane kuruta TA3,12;ku biciro biriho muri Amerika, Kenalog-40 igura amadorari 20 kuri 1.0 ml yo guhagarikwa, mugihe Ozurdex, Retisert, na Iluvien basobanura.Amafaranga yo kwinjira ni $ 1400., $ 20.000 na $ 9.200.Hamwe na hamwe, ibi bintu bigabanya kugera kuri ibyo bikoresho kubantu muburyo bwimikoreshereze yimikoreshereze.
Bagerageje kongera ingaruka za intravitreal TA1,3,16,17 kubera igiciro cyayo gito, gusubizwa cyane, no kuboneka kwinshi.Urebye ubushobozi buke bwamazi, TA iguma mumaso nka depot, bigatuma ibiyobyabwenge bigenda bikwirakwizwa buhoro buhoro, bityo rero ingaruka ziteganijwe kumara igihe kinini hamwe na depot nini1,3.Kugira ngo ibyo bishoboke, hashyizweho uburyo bwinshi bwo kwibanda ku guhagarika TA mbere yo guterwa muri vitreous.Nubwo uburyo bushingiye kuri pasiporo (ni ukuvuga imbaraga za rukuruzi) gutuza cyangwa microfiltration byasobanuwe, ubu buryo butwara igihe kandi butanga ibisubizo bihinduka15,16,17.Ibinyuranye na byo, ubushakashatsi bwibanze bwerekanye ko TA ishobora guhita yibanda ku buryo bwihuse kandi bwizewe (bityo ibikorwa birebire) hamwe na centrifugation ifashwa n’imvura1,3.Mu gusoza, ibyoroshye, igiciro gito, igihe bimara, hamwe nubushobozi bwa TA yibanda cyane kuri TA bituma iyi intervention ihitamo neza kubarwayi mumikoro make.Ariko, kutagera kuri centrifugation yizewe birashobora kuba inzitizi ikomeye mugushira mubikorwa iyi intervention;Mugukemura iki kibazo, CentREUSE irashobora gufasha kongera uburyo bwo kuvura igihe kirekire steroid kubarwayi bafite amikoro make.
Hariho imbogamizi mubyigisho byacu, harimo nibijyanye nimikorere kavukire ya CentREUSE.Igikoresho ni umurongo utari umurongo, udaharanira inyungu oscillator yishingikiriza kubitekerezo byabantu bityo ntishobora gutanga igipimo cyukuri kandi gihoraho mugihe cyo gukoresha;umuvuduko wo kuzenguruka biterwa nibihinduka byinshi, nkumukoresha ukoresha kurwego rwa nyirubwite ibikoresho, ibikoresho byihariye bikoreshwa muguteranya ibikoresho, hamwe nubwiza bwibihuza bizunguruka.Ibi bitandukanye nibikoresho byubucuruzi aho umuvuduko wo kuzunguruka ushobora gukoreshwa muburyo bwuzuye kandi neza.Mubyongeyeho, umuvuduko wagezweho na CentREUSE urashobora gufatwa nkuworoheje ugereranije numuvuduko wagezweho nibindi bikoresho bya centrifuge2.Kubwamahirwe, umuvuduko (hamwe nimbaraga zijyanye na centrifugal) zakozwe nigikoresho cyacu zari zihagije kugirango dusuzume igitekerezo kirambuye mubushakashatsi bwacu (ni ukuvuga kubitsa TA).Umuvuduko wo kuzunguruka urashobora kwiyongera mukworohereza misa ya disiki nkuru 2;ibi birashobora kugerwaho ukoresheje ibikoresho byoroheje (nk'ikarito yoroheje) niba ifite imbaraga zihagije zo gufata siringi ebyiri zuzuye amazi.Ku bitureba, icyemezo cyo gukoresha ikarito isanzwe ya “A” yashyizwemo (4,8 mm z'ubugari) yabigambiriye, kubera ko ibi bikoresho bikunze kuboneka mu dusanduku twoherejwe bityo bikaba byoroshye kuboneka nk'ibikoresho bisubirwamo.Umuvuduko wo kuzunguruka urashobora kandi kwiyongera mugabanya radiyo ya disiki nkuru 2.Nyamara, radiyo ya platifomu yakozwe nkana nkana kugirango yakire seringe ya 1.0.Niba umukoresha ashishikajwe na centrifuging yamato magufi, radiyo irashobora kugabanuka-impinduka ziteganijwe kuvamo umuvuduko mwinshi wo kuzunguruka (kandi birashoboka imbaraga za centrifugal).
Mubyongeyeho, ntabwo twasuzumye neza ingaruka zumunaniro wabakoresha kumikorere yibikoresho.Igishimishije, benshi mubagize itsinda ryacu bashoboye gukoresha igikoresho muminota 15 nta munaniro ugaragara.Igisubizo gishobora gukemura umunaniro wabakoresha mugihe kirekire centrifuges isabwa nukuzunguruka abakoresha babiri cyangwa benshi (niba bishoboka).Mubyongeyeho, ntitwasuzumye neza igihe kirekire cyigikoresho, igice kuko ibice bigize igikoresho (nkikarito nu mugozi) byashoboraga gusimburwa byoroshye kuri make cyangwa nta kiguzi mugihe cyo kwambara cyangwa kwangirika.Igishimishije, mugihe cyo kugerageza kwacu, twakoresheje igikoresho kimwe muminota irenga 200.Nyuma yiki gihe, ikimenyetso cyonyine kigaragara ariko gito cyo kwambara ni ugutobora kumutwe.
Indi mbogamizi yubushakashatsi bwacu nuko tutigeze dupima ubwinshi cyangwa ubwinshi bwa TA yabitswe, bigerwaho hamwe nigikoresho cya CentREUSE nubundi buryo;ahubwo, igeragezwa ryubushakashatsi bwiki gikoresho ryashingiye ku gupima ubwinshi bwimitsi (muri ml).igipimo kiziguye cy'ubucucike.Twongeyeho, ntabwo twagerageje CentreUSE Yibanze kuri TA ku barwayi, ariko, kubera ko igikoresho cyacu cyakoze pellet TA isa niyakozwe hakoreshejwe centrifuge yubucuruzi, twatekereje ko CentREUSE Concentrated TA izagira akamaro kandi ifite umutekano nkuko byakoreshwaga mbere.mu buvanganzo.byatangajwe kubikoresho bisanzwe bya centrifuge1,3.Inyigisho zinyongera zigereranya umubare nyawo wa TA watanzwe nyuma yo gukomera kwa CentREUSE irashobora gufasha kurushaho gusuzuma akamaro nyako k'ibikoresho byacu muriyi porogaramu.
Ku bumenyi bwacu, CentREUSE, igikoresho gishobora kubakwa byoroshye biturutse kumyanda iboneka byoroshye, niyo yambere ikoreshwa n'abantu, igendanwa, impapuro zihenze cyane za centrifuge zikoreshwa muburyo bwo kuvura.Usibye kuba ushobora kuba centrifuge ugereranije nini nini, CentREUSE ntisaba gukoresha ibikoresho kabuhariwe nibikoresho byubwubatsi ugereranije nibindi biciriritse biciriritse byatangajwe.Imikorere yerekanwe ya CentREUSE mugihe cyihuse kandi cyizewe cyimvura ya TA irashobora gufasha kunoza igihe kirekire interavitreal steroid iboneka mubantu mumikoro make, bishobora gufasha kuvura imiterere itandukanye ya ocular.Byongeye kandi, inyungu za centrifuges zikoreshwa n'abantu zishobora guhanurwa zigera ahantu hakize umutungo nkibigo nderabuzima bya kaminuza nini na kane mu bihugu byateye imbere.Muri ibi bihe, kuba ibikoresho bya centrifuging birashobora gukomeza kugarukira muri laboratoire z’ubuvuzi n’ubushakashatsi, hamwe n’ibyago byo kwanduza siringi n’amazi y’umubiri w’umuntu, ibikomoka ku nyamaswa, n’ibindi bintu byangiza.Byongeye kandi, laboratoire ikunze kuba kure y’aho yita ku barwayi.Ibi na byo, birashobora kuba inzitizi y’ibikoresho byita ku buzima bakeneye uburyo bwihuse bwo kubona centrifugation;kohereza CentREUSE birashobora kuba inzira ifatika yo gutegura ingamba zo kuvura mugihe gito bitabujije cyane kuvura abarwayi.
Kubwibyo, kugirango byorohereze buriwese kwitegura kwivuza bisaba centrifugation, inyandikorugero hamwe namabwiriza yo gukora CentREUSE biri muriki gitabo gifungura isoko munsi yinyongera yamakuru.Turashishikariza abasomyi gusubiramo CentREUSE nkuko bikenewe.
Amakuru ashyigikira ibisubizo byubu bushakashatsi araboneka kubanditsi ba SM babisabwe neza.
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SM ishyigikiwe igice nimpano ya Mukai Foundation, Massachusetts Eye and Ear Hospital, Boston, Massachusetts, USA.
Ishami ry'amaso, Ishuri ry'ubuvuzi rya Harvard, Ijisho n'amatwi ya Massachusetts, 243 Charles St, Boston, Massachusetts, 02114, Amerika