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- 저자 : Gooneratne, Ravi (검색결과 3 건)
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Thushan Gooneratne,Mandika Wijeyaratne 대한혈관외과학회 2021 Vascular Specialist International Vol.37 No.3
Contemporary management of iatrogenic pseudoaneurysms is mostly performed using non-surgical techniques. Herein, we present a rare case of deep femoral artery (DFA) pseudoaneurysm with compression neuropathy, which required open repair. A 67-year-old female patient presented with increasing pain in the right groin, sensory neuropathy of the anteromedial thigh and upper leg, and quadriceps paralysis 4 days after coronary angiography via femoral puncture. Computed tomography angiography revealed a pseudoaneurysm of the DFA. The disabling compressive neuropathy warranted urgent open decompression rather than thrombin injection or endovascular therapy. Timely open evacuation of the hematoma, release of compression on the femoral nerve, and postoperative physiotherapy resulted in complete recovery of quadriceps power. The patient was pain free within 12 weeks and able to ambulate independently. This case report highlights the role of prompt open surgery for pseudoaneurysms with compression neuropathy.
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Beneficial Effects of Insulin on Ischemia Reperfusion Injury in Human Skeletal Muscle
Thushan Dhananja Gooneratne,Shervanthi Homer-Vanniasinkam,Serosha Mandika Wijeyaratne 대한혈관외과학회 2022 Vascular Specialist International Vol.38 No.3
Purpose: Exaggerated leucocyte activity is a crucial step in the pathophysiology of skeletal muscle ischemia-reperfusion injury (IRI). We tested the hypothesis that insulin, via its’ anti-leukocyte activity, attenuates skeletal muscle IRI in humans. Materials and Methods: This randomized, blinded, placebo-controlled trial was conducted in patients with skeletal muscle ischemia who required revascularization. Treatment protocols were similar among them except for the insulin group, which received an infusion of insulin at 2.5 U/h. The degree of endothelial adhesiveness; leukocyte activity and pro-inflammatory status via P-selectin, tumor necrosis factor (TNF)-alpha, and myeloperoxidase (MPO) levels in the venous effluent; and clinical outcomes were measured. Results: Twenty-four consenting patients were randomized to the insulin or control group. There were no significant differences between the two groups except for the median serum insulin level, which was higher in the insulin group (P<0.01). No serious intervention-related adverse events were observed. P-selectin (55.04-99.86 pg/mL; P<0.001), MPO (110.8-160.6 pg/mL; P<0.001), and TNF-alpha (12.16-36.01 pg/mL; P<0.001) levels demonstrated a significant increase post-reperfusion in the ‘control’ group, reaching a peak value at 2 hours post-reperfusion. The increase in all three markers from baseline was significantly diminished in the insulin group at the two-hour (P-selectin, P=0.001; MPO, P=0.001; TNF-alpha, P=0.005) and four-hour (P-selectin, P=0.003; MPO, P=0.002; TNF-alpha, P=0.01) intervals. The differences in clinical outcomes between the insulin and control groups were not statistically significant. Conclusion: In clinical practice, insulin has the potential to attenuate the severity of skeletal muscle IRI inhibiting P-selectin, MPO, and TNF-alpha levels.
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Silver nanoparticles enhance wound healing in zebrafish (<i>Danio rerio</i>)
Seo, Seung Beom,Dananjaya, S.H.S.,Nikapitiya, Chamilani,Park, Bae Keun,Gooneratne, Ravi,Kim, Tae-Yoon,Lee, Jehee,Kim, Cheol-Hee,De Zoysa, Mahanama Elsevier 2017 FISH AND SHELLFISH IMMUNOLOGY Vol.68 No.-
<P><B>Abstract</B></P> <P>Silver nanoparticles (AgNPs) were successfully synthesized by a chemical reduction method, physico-chemically characterized and their effect on wound-healing activity in zebrafish was investigated. The prepared AgNPs were circular-shaped, water soluble with average diameter and zeta potential of 72.66 nm and −0.45 mv, respectively. Following the creation of a laser skin wound on zebrafish, the effect of AgNPs on wound-healing activity was tested by two methods, direct skin application (2 μg/wound) and immersion in a solution of AgNPs and water (50 μg/L). The zebrafish were followed for 20 days post-wounding (dpw) by visual observation of wound size, calculating wound healing percentage (WHP), and histological examination. Visually, both direct skin application and immersion AgNPs treatments displayed clear and faster wound closure at 5, 10 and 20 dpw compared to the controls, which was confirmed by 5 dpw histology data. At 5 dpw, WHP was highest in the AgNPs immersion group (36.6%) > AgNPs direct application group (23.7%) > controls (18.2%), showing that WHP was most effective in fish immersed in AgNPs solution. In general, exposure to AgNPs induced gene expression of selected wound-healing-related genes, namely, transforming growth factor (TGF-β), matrix metalloproteinase (MMP) −9 and −13, pro-inflammatory cytokines (IL-1β and TNF-α) and antioxidant enzymes (superoxide dismutase and catalase), which observed differentiation at 12 and 24 h against the control; but the results were not consistently significant, and many either reached basal levels or were down regulated at 5 dpw in the wounded muscle. These results suggest that AgNPs are effective in acceleration of wound healing and altered the expression of some wound-healing-related genes. However, the detailed mechanism of enhanced wound healing remains to be investigated in fish.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Synthesized AgNPs at 50 μg/L were not toxic to zebrafish at 96 h post-immersion. </LI> <LI> AgNPs exhibited clear and faster closure of laser wounds on zebrafish. </LI> <LI> AgNPs immersion was more efficient than direct application for healing the wounds. </LI> <LI> AgNPs altered gene expression of inflammatory phases during wound healing. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
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