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- 저자 : Walker Melanie (검색결과 4 건)
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Hybrid microcatheter angioplasty for refractory cerebral vasospasm
Walker Melanie,Erdoes Morgan P.,Stricker Chloe G.,Bothell Julie,Kelly Cory M.,Levitt Michael R. 대한뇌혈관외과학회 2021 Journal of Cerebrovascular and Endovascular Neuros Vol.23 No.2
Cerebral vasospasm is a significant cause of morbidity and mortality associated with aneurysmal subarachnoid hemorrhage (aSAH). Intra-arterial chemical and mechanical angioplasty, performed alone or in combination, have been shown to ameliorate cerebral vasospasm and improve patient outcomes. Few options exist for patients who fail these traditional endovascular tactics. We propose a hybrid microcatheter technique that combines the mechanical benefit of transient high pressure induced by microcatheter fluid bolus with a low-dose vasodilator infusion. Five patients with moderate to severe symptomatic vasospasm who failed medical and traditional endovascular management were treated using a hybrid microcatheter technique. All angioplasty procedures were technically successful, and the degree of vasospasm improved following angioplasty. There were no complications related to the cerebral angioplasty procedures. None of the patients required repeat endovascular intervention. Hybrid microcatheter angioplasty may be a useful complement to mechanical or pharmacological techniques in the endovascular management of intractable cerebral vasospasm after aSAH.
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Spasm, stenosis and shelves: balloon-assisted tracking techniques in endovascular interventions
Melanie Walker,Louis J Kim,Michael R Levitt,Basavaraj Ghodke 대한뇌혈관외과학회 2020 Journal of Cerebrovascular and Endovascular Neuros Vol.22 No.1
The technique of balloon-assisted tracking (BAT) has been demonstrated in transradial cardio-angiographic procedures. Using three commonly encountered clinical scenarios, we outline the technical details of BAT for managing peripheral and cerebral interventions with challenging vascular access. We describe methods used to overcome vasospasm, stenosis and vascular shelves during interventions for acute ischemic stroke, but these issues are not unique to neuroendovascular cases and the techniques can be applied across all endovascular interventions. We present three acute stroke interventions where anatomic challenges were overcome with the use of endovascular BAT. This article describes a novel application for BAT techniques in endovascular interventions to assist with access in peripheral, cervical and intracranial vessels. These methods can also be used to improve access during diagnostic cerebral angiography. BAT is a useful adjunct when navigating catheters through vasospasm, tortuous anatomy, vascular step-offs or intraluminal plaques.
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Why epistemic justice matters in and for education
Melanie Walker 서울대학교 교육연구소 2019 Asia Pacific Education Review Vol.20 No.2
The paper considers the importance of epistemic justice in democratic life, and the signifcance of education as a key space to foster the relevant epistemic capabilities. Epistemic in/justice ofers resources to think about conditions of possibility (what Amartya Sen calls ‘conversion factors’), given that societies train our sensibilities in ways which are fawed and prejudiced. It is proposed further that Amartya Sen’s emphasis on public reasoning is central to epistemic justice. Using the space of education to make the argument, core ideas in the capability approach are frst outlined. Epistemic justice is described, and the claim is then advanced that Miranda Fricker’s ‘epistemic contribution capability’ is generative in education settings for developing democratic and public reasoning capabilities. To be fully involved in learning and development and fair-achieved outcomes in formal education, students would need opportunities to develop their epistemic capability of being able both to receive information and to make interpretive contributions to the common pool of knowledge, understanding, and practical deliberation. Conditions of respect, recognition and equal moral worth would be required so that all students should have access to the capability and to have their contributions taken up as integral to their fourishing. Thus, in universities and schools, epistemic virtues should be educated, trained, developed and scafolded pedagogically, including cultivating emotions. The paper then considers the challenge of free speech and what this may demand of us educationally
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Alyna Turner,John J. McGrath,Olivia M. Dean,Seetal Dodd,Andrea Baker,Susan M. Cotton,James G. Scott,Bianca E. Kavanagh,Melanie M. Ashton,Adam J. Walker,Ellie Brown,MIchael Berk 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2
Objective: Garcinia mangostana Linn., commonly known as mangosteen, is a tropical fruit with a thick pericarp rind containing bioactive compounds that may be beneficial as an adjunctive treatment for schizophrenia. The biological underpinnings of schizophrenia are believed to involve altered neurotransmission, inflammation, redox systems, mitochondrial dysfunction, and neurogenesis. Mangosteen pericarp contains xanthones which may target these biological pathways and improve symptoms; this is supported by preclinical evidence. Here we outline the protocol for a double- blind randomized placebo-controlled trial evaluating the efficacy of adjunctive mangosteen pericarp (1,000 mg/day), compared to placebo, in the treatment of schizophrenia. Methods: We aim to recruit 150 participants across two sites (Geelong and Brisbane). Participants diagnosed with schizophrenia or schizoaffective disorder will be randomized to receive 24 weeks of either adjunctive 1,000 mg/day of mangosteen pericarp or matched placebo, in addition to their usual treatment. The primary outcome measure is mean change in the Positive and Negative Symptom Scale (total score) over the 24 weeks. Secondary outcomes include positive and negative symptoms, general psychopathology, clinical global severity and improvement, depressive symptoms, life satisfaction, functioning, participants reported overall improvement, substance use, cognition, safety and biological data. A 4-week post treatment interview at week 28 will explore post-discontinuations effects. Results: Ethical and governance approvals were gained and the trial commenced. Conclusion: A positive finding in this study has the potential to provide a new adjunctive treatment option for people with schizophrenia and schizoaffective disorder. It may also lead to a greater understanding of the pathophysiology of the disorder.
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