단장증후군 환자를 위한 Eclipse XL1 시스템의 안전성과 효과를 살피는 치료 연구입니다.

All subjects will be assigned to the XL1 Coil treatment group.

The surgeon verifies the intestinal diameter and selects the appropriate device diameter size. The device is introduced into the lumen of the intestine and advanced about 5-10cm. The surgeon uses 4-0 chromic sutures placed in the seromuscular layer to secure the XL1 Coil within the intestine. The surgeon places metal clips on proximal and distal sutures and in the mesentery adjacent to the XL1 Coil ends to mark the location for radiologic evaluation. The surgeon releases the XL1 Coil and closes the enterotomy.

Distraction Enterogenesis in Adult Patients with Short Bowel Syndrome

모든 피험자는 XL1 코일 치료 그룹에 배정됩니다.

단장증후군 성인 환자의 장간막 형성술

Shweta Namjoshi, MD

Matthew Lin, MD

Anisha Abreo

Joseph Forrester, MD

Clarivet Torres, MD

Meghan Fitzgerald

Mark Puder, MD

Beth Cobb

Michael Helmrath, MD

Paul Wales, MD

단장증후군을 가진 성인 및 소아 환자에서 장 연장술을 위한 Eclipse XL1 시스템의 안전성 및 예상 효과를 평가하기 위한 타당성 연구

Patients randomized to this arm will undergo radical nephrectomy (which may be performed via open, laparoscopic, or robot-assisted approach based on the surgeon's expertise) combined with a standardized template lymph node dissection.

The template lymph node dissection is defined as follows:

For Left-sided Tumors: Removal of lymphatic tissue anterior and lateral to the abdominal aorta, extending from the diaphragmatic crus superiorly to the aortic bifurcation inferiorly, including the renal hilar lymph tissue.

For Right-sided Tumors: Removal of lymphatic tissue surrounding the inferior vena cava and in the interaortocaval space, extending from the liver edge of the vena cava superiorly to the iliac vein bifurcation inferiorly, including the renal hilar lymph tissue.

A standardized surgical procedure to remove lymph nodes within defined anatomical boundaries during radical nephrectomy for kidney cancer. For left-sided tumors, this includes tissue anterior and lateral to the aorta from the diaphragmatic crus to the aortic bifurcation. For right-sided tumors, it includes tissue around the vena cava and between the vena cava and aorta from the liver edge to the iliac bifurcation. The renal hilar lymph tissue is always included.

Template Lymph Node Dissection

Patients randomized to this arm will undergo radical nephrectomy (which may be performed via open, laparoscopic, or robot-assisted approach). In this arm, only lymph nodes that are identified as \>1 cm in the short axis on preoperative cross-sectional imaging (CT/MRI) OR are grossly enlarged and suspicious during the surgeon's intraoperative assessment will be resected. If no such nodes are identified preoperatively or intraoperatively, no formal lymph node dissection is performed.

A surgical approach during radical nephrectomy for kidney cancer where lymph nodes are removed only if they meet specific criteria: being larger than 1 cm on preoperative CT/MRI scans, or appearing grossly enlarged and suspicious to the surgeon during the operation. If no such nodes are identified, no lymph node dissection is performed.

Selective Lymph Node Resection

Tianjin Medical University Second Hospital

In step 1, persons living with dementia or cognitive impairment (PLWD/CI) will complete the PELI (hereafter, "assessment PELI-CI" for Cognitive Impairment) to articulate their preferences. In step 2, care partners will consider the preferences of PLWD/CI; care partners will complete concurrent but separate proxy PELI assessments from the perspective of the PLWD/CI (i.e., as if acting as surrogate decision-makers; hereafter "assessment PELI-CP" for Care Partner). In the Intervention (step 3), the study clinician will ask the PLWD/CI to identify up to 3 "social engagement" preferences that matter most to them. Second, in discussion with the PLWD/CI and care partner, the study clinician will review areas where there is a difference in ratings between the PELI-CI and PELI-CP. The study clinician will then ask the PLWD/CI to identify up to 3 items of disagreement that are most important for the care partner to know about. A 1-page Preferences Priorities document will then be created.

Templated, clinician-facilitated intervention to align everyday living preferences assessment

James Wilkins, MD, DPhil

In patients randomized to standard, only the nodal packet under the external iliac vein and above the obturator nerve will be dissected. For patients randomized to the modified template, the external iliac, hypogastric and obturator fossa nodal groups will be removed.No lymph nodes will be removed in patients randomized to the no PLND arm.

Inclusion of the external iliac, hypogastric and obturator fossa nodal groups in the template undergoing a Radical Prostatectomy. Modifying the template for lymph node dissection may lead to removal of additional affected nodes, reducing the chance of recurrence. .No lymph nodes will be removed in patients randomized to the no PLND arm.

Lymph node template

Transverse versus vertical closure of the port site incision

Transverse versus vertical closure

One vs. three days of antibiotic prophylaxis at catheter removal

antibiotic prophylaxis

For the patients randomized to routine indwelling HA agent use, the operating surgeon may choose to use either Surgicel™, Surgicel SNoW™, Arista™, FloSeal or surgeon's choice HA directed at the prostatic fossa, ligated dorsal vein complex, or neurovascular bundles. Because there is no standard HA or method of application, the surgeon will apply the HA according to the surgeon's experience and document both the HA used, and the location applied in the operative report. For patients randomized to no routine indwelling HA use, surgeons will only apply a HA if they are unable to achieve hemostasis using traditional means or feel it would be unsafe to complete the operation without using a HA for additional hemostasis. Providers in either arm may use HA as needed provided the intention is not to leave the HA indwelling.

Hemostatic Agent

Using each participant's pre-operative imaging, the most ideal aortic arch configuration will be identified. This will be followed by simulation of mechanical effects on the adjacent structures by overlapping the designed aortic arch model on the participant's original images. Computer-aided design of the personalized patch template will then be completed and followed by 3D printing of the sterilizable, personalized patch template.

The personalized, sterilizable patch template will be used as the surgeon's guide in fashioning the precise size and shape of the surgical patch.

Personalized patch template

Cristina Salvo

Rita Nobile

Israel Valverde

David Barron

Shi-Joon Yoo

Osami Honjo

Christopher Macgowan

Christoph Haller

Owais Khan

다운증후군 아동을 대상으로 2개월간 드럼 레슨이 자기 통제력과 타이밍 기술 향상에 미치는 영향을 연구하는 시험입니다.

Experimental group will receive the drumming lesson intervention between baseline and testing approximately 2 to 3 months later, so the effects of the intervention can be assessed in the lab measures.

Drumming lessons consisting of how to use hands to drum on djembe drum, using alternating hands to drum, drumming to a metronome and to music.

2 months of drumming lessons given by a professional drummer with extensive experience working with children with Down syndrome

Children in the Control condition will receive drumming lessons only after they have completed lab baseline and testing measures, about 2 to 3 months later.

Receiving lessons after the two lab visits should still offer any possible positive effects to participants while still allowing us to compare the Control group children's behaviors to those of the Experimental group.

Lessons after measurement

실험군은 기준선과 시험 사이에 약 2~3개월 후에 드럼 연주 레슨 개입을 받게 되므로, 실험실 측정을 통해 개입의 효과를 평가할 수 있습니다.

다운증후군 아동을 대상으로 광범위한 경험을 쌓은 전문 드러머가 제공하는 2개월간의 드럼 레슨

통제 조건에 있는 어린이는 실험실 기준선과 시험 측정을 완료한 후 약 2~3개월 후에만 드럼 레슨을 받게 됩니다.

측정 후의 교훈

Caroline Danforth, MS

Alison Rubin, BA

Amy Needham, PhD

Miriam Lense, PhD

드럼 레슨이 다운증후군 아동에게 미치는 영향

Pelvic PSMA PET ± transperineal targeted prostate biopsy

PSMA PET/CT

If the PSMA PET/CT is normal, transperineal prostate biopsy would be omitted If the PSMA PET/CT is abnormal, transperineal prostate biopsies would be performed targeting the MRI (done prior to study) and PSMA PET/CT images

Transperineal targeted prostate biopsy

No pelvic PSMA PET + transperineal template prostate biopsy

Transperineal template prostate biopsies will be performed as per treating urologist's usual practice. No specific template for biopsy is prescribed for the purposes of the study. However, template sampling of the prostate is required, with a minimum of 12 cores, dependent on prostate volume. MRI will be available for any additional targeted biopsies required. Transperineal template biopsies must be labelled appropriately and sent for histopathological analysis.

Transperineal template prostate biopsy

Males aged ≥ 18 years at the time of consent

뇌경색과 당뇨를 가진 환자에게 전통 중의학 치료의 장기 효과를 관찰하는 연구로, 환자의 신경 손상과 생활능력 개선을 평가합니다.

On the basis of standard treatment, a combined treatment plan of TCM universal treatment and syndrome-specific treatment was given.

TCM universal treatment plan:

(Intensive treatment) Chuanzhi Tongluo Capsules (Lunan Pharmaceutical), 4 capsules each time, orally, 3 times a day; administration from day 1 to day 14 of the disease.

(Sequential treatment) Chuanzhi Tongluo Capsules (Lunan Pharmaceutical), 2 capsules each time, orally, 3 times a day; administration from day 15 to day 365.

TCM decoction: Individualized herbal decoction based on TCM diagnosis (four diagnostic methods), administered for 14 days during intensive phase.

4 capsules each time, orally, 3 times a day; administration from day 1 to day 14 of the disease.

(Intensive treatment) Chuanzhi Tongluo Capsules

2 capsules each time, orally, 3 times a day; administration from day 15 to day 365.

(Sequential treatment) Chuanzhi Tongluo Capsules

Individualized herbal decoction based on TCM diagnosis (four diagnostic methods), administered for 14 days during intensive phase.

TCM Syndrome Differentiation Decoction

Guideline-based treatment for cerebral infarction with diabetes: aspirin (100 mg/day) + clopidogrel (75 mg/day) + atorvastatin (20 mg/day) + metformin (500 mg bid). Other antiplatelet/antidiabetic drugs may be added per clinician discretion.

Combination therapy including: 1. Antiplatelet: aspirin 100 mg/day + clopidogrel 75 mg/day. 2. Lipid-lowering: atorvastatin 20 mg/day. 3. Antidiabetic: metformin 500 mg bid (max 2000 mg/day). \*Doses may be adjusted per local guidelines or patient tolerance.

Standard Treatment (Guideline-Based)

Guangzhou University of Traditional Chinese Medicine

Participants will be asked to attend 35 minute, remotely delivered, group exercise classes using choreographed exercise twice a week for 12 weeks.

Adults with Down syndrome will be asked to attend 35 minute, remotely delivered (Zoom®) group dance sessions twice weekly across 12 weeks. All sessions will be directed by an instructor experienced in leading 35 minute, group remote exercise sessions for individuals with intellectual disability as part of the ongoing exercise program for individuals with intellectual disability offered by the Division for Physical Activity and Weight Management.

단장증후군을 가진 성인 및 소아 환자에서 장 연장술을 위한 Eclipse XL1 시스템의 안전성 및 예상 효과를 평가하기 위한 타당성 연구

템플릿 림프절 절제술, 선택적 림프절 절제술

일상 생활 선호도 평가를 조정하기 위한 템플릿화된 임상의 주도 개입

림프절 템플릿, 횡적 폐쇄 대 수직 폐쇄, 항생제 예방, 지혈제

개인화된 패치 템플릿

드럼 레슨이 다운증후군 아동에게 미치는 영향

PSMA PET/CT, 경회음부 템플릿 전립선 생검, 경회음부 표적 전립선 생검

(집중치료) 천지동락캡슐, 표준치료(지침기반), (순차치료) 천지동락캡슐, 중의학 증후군 감별탕

온라인 안무 운동을 통해 알츠하이머병 위험을 줄이는 방법 - 다운증후군 프로그램