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Medicine

Transcriptomic Analysis of Human Retinal Surgical Specimens Using jouRNAl

Published: August 14, 2013 doi: 10.3791/50375

Summary

We used retinal samples from retinectomy for a transcriptomic analysis of retinal detachment. We developed a procedure that allows RNA conservation between the surgical blocks and the laboratory. We standardized a protocol to purify RNA by cesium chloride ultracentrifugation to assure that the purified RNAs are suitable for microarray analysis.

Abstract

Retinal detachment (RD) describes a separation of the neurosensory retina from the retinal pigmented epithelium (RPE). The RPE is essential for normal function of the light sensitive neurons, the photoreceptors. Detachment of the retina from the RPE creates a physical gap that is filled with extracellular fluid. RD initiates cellular and molecular adverse events that affect both the neurosensory retina and the RPE since the physiological exchange of ions and metabolites is severely perturbed. The consequence for vision is related to the duration of the detachment since a rapid reapposition of the two tissues results in the restoration of vision 1. The treatment of RD is exclusively surgical. Removal of vitreous gel (vitrectomy) is followed by the removal non essential part of the retina around the detached area to favor retinal detachment. The removed retinal specimens are res nullius (nothing) and consequently normally discarded. To recover RNA from these surgical specimens, we developed the procedure jouRNAl that allows RNA conservation during the transfer from the surgical block to the laboratory. We also standardized a protocol to purify RNA by cesium chloride ultracentrifugation to assure that the purified RNAs are suitable for global gene expression analysis. The quality of the RNA was validated both by RT-PCR and microarray analysis. Analysis of the data shows a simultaneous involvement of inflammation and photoreceptor degeneration during RD.

Introduction

The main therapeutic objective in retinal detachment (RD) is to find a way to limit photoreceptor cell damage and retinal inflammation resulting from the separation of the photoreceptors from the retinal pigmented epithelial cells. During RD, RPE cells are activated, migrate, dedifferentiate, and proliferate at the surface of the detached retina, exerting contractile forces leading to complications. Transcriptomics analysis of RD is a way to identify target genes with modified expression following RD and hence future therapeutic molecules that could improve final visual outcome in combination with surgery. It is well known ribonucleic acid (RNA) is not stable as is deoxyribonucleic acid (DNA), the latter being used extensively for genetic studies, its stability had permitted the sequencing of the Neanderthal genome from paleontological samples of more than 30,000 years old 2. Transcription of DNA of the genes from the genome into messenger RNA is the major process in gene expression, and the mRNA is labile in order to constitute a signal. RNAs are very rapidly degraded by RNAse enzymes which terminate the signal. When tissues are isolated from an organism, the RNAs are very often degraded before the expression is studied in a research laboratory. Degraded RNA is not suited for analysis gene expression. Because the laboratory staff cannot participate in surgery, we developed a procedure that is easy and only requires that the surgeon to recover the tissues into an appropriate RNAse-free solution. The RNA of the tissues is stable and can be analyzed without any sign of degradation after 72 hr at room temperature in this solution. The RNAs from specimens are purified by a standardized method involving an ultracentrifugation on a cesium chloride gradient after having been transferred to the laboratory 3. Then, quality of the RNAs are assessed by agarose gel electrophoresis and by RT-PCR. The RNA purification protocol has the advantage of separating the molecules according to their density that is different for DNA and RNA and assures that the RNA is not contaminated by a DNA molecules that will generate artifactual signals in gene expression studies. In addition, the transfer RNAs (tRNAs), which are quantitatively the most abundant RNA within a cell, are separated according to the same physical property from the ribosomal RNA (rRNAs) and the messenger RNAs (mRNAs), those two last one being the end product of the purification process. The removal of tRNA from the preparation is useful since most of the microarray analytical protocols involved the use of reverse transcriptases and RNA polymerases which are inhibited by tRNA 4-6. The purified RNA from surgical specimens are labeled using standard protocol and hybridized to a microarray chip and the results are analyzed using two complementary methods, the false discovery rate method, and using a novel method based on mutual information and visualized on the web-based server Retinobase 7,8.

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Protocol

1. jouRNAl: Procedure to Recover the Specimens from the Surgical Block

In the lab

  1. Get an importation contract from express shipping company.
  2. Fill 10 (or 25) shipping forms with the postal address of the laboratory indicating the contact person in the laboratory (Phone number and Email address).
  3. Prepare 10 (or 25) samples forms numbered 1 to 10 (or 25). These forms include dedicated spaces to inform on a) anonymous identification of the patient, b) the date of the surgery and c) any additional remarks the surgeon would like to add. Prepare 10 (or 25) padded envelopes (150 x 210 mm).
  4. Prepared using RNAse-free reagents 25 (or 65) ml of 6 M guanidine chloride in diethylpyrocarbonate (DEPC)-treated H2O (GHCl).
  5. Fill 10 or 25 numbered 5 ml sterile polyethylene round bottom tubes with 2.4 ml of GHCl solution.
  6. Used argon gas to fill the top part of these tubes, than press tightly on the cap to prevent the oxidation of the GHCl solution over several years of storage in the surgical cabinet.
  7. Introduce every 5 ml tubes in a 50 ml sterile polypropylene conical bottom tube with screw cap. Use a piece of clean paper tissue to hold the 5 ml tube into the 50 ml tube, close the tube.
  8. Place the 50 ml tubes on a polystyrene rack and the rack into a cardboard box with the padded envelopes, the shipping forms, the samples forms.
  9. Paste the instructions (see : 1.12-1.19) inside of the cover of the cardboard box to facilitate their reading.
  10. Send the cardboard box by mail to the contact person in the hospital.

In the hospital

  1. Bring the cardboard box from the surgical cabinet to the surgical room. Caution note: if the procedure involves an immune compromised patient, the cardboard should not be brought to the surgical room.
  2. During the surgery, place the retinal specimen into numbered 5 ml sterile polypropylene filled with GHCl solution. Close tightly the tube.
  3. Return the tube briefly.
  4. Place the tube on the blood tube rocker for 10 min.
  5. Fill in the accompanying sample numbered form.
  6. Report the identification number onto the corresponding numbered 50 ml tube.
  7. Introduce the 5 ml tube with the surgical specimen into the 50 ml tube, replace paper tissue and screw the tube.
  8. Introduce the tube and the filled sample form into it in one of the accompanying padded envelopes. Close it.
  9. Call the express shipping company for pick up.

2. RNA Purification

In the lab

  1. Homogenize the specimen in its 5 ml tube polypropylene with GHCl solution with a homogenizer for 1 min while moving the tube up and down.
  2. Add 270 μl of 2 M potassium acetate pH 5.0. Shake vigorously for 10 min by placing the tube on a shaker in its horizontal position (420 min-1).
  3. Centrifuge 10 min at 5,000 rpm (6,500 x g) at 20 °C.
  4. Aspirate smoothly the soluble fraction without disturbing the pellet.
  5. Transfer into a 14 ml sterile tube.
  6. Add 5.3 ml of 100 mM Tris pH 8.0, N-Lauroylsarcosine 1%.
  7. Add 3.2 g of cesium chloride (CsCl) and mix the tube by vortexing.
  8. Add 1.8 ml of CsCl/ ethylenediaminetetraacetic acid (EDTA) in a sterile 11 ml polyallomer centrifuge tube.
  9. With a 10 ml sterile Pasteur pipette, transfer the RNA solution onto 1.8 ml CsCl/EDTA by sliding slowly on the edge of the tube to avoid disturbing the density cushion.
  10. Place the tubes (a second tube containing the buffers without retina if necessary) into the rotor.
  11. Centrifuge 24 hr at 32,000 rpm (225,000 x g) at 20 °C.
  12. Remove the superior part of the solution with a sterile Pasteur pipette, and discard it.
  13. Remove gradually while checking the moment when the DNA (viscous) is aspirated with a second sterile Pasteur pipette, and discard it.
  14. Remove the remaining solution taking care not to release the RNA pellet with a third sterile Pasteur pipette.
  15. Section the bottom of the tube with a scalpel flame-sterilized, then put the remaining part of the tube it upside down on a sterile gaze.
  16. Reverse the tube and rinse delicately with 160 μl of GHCl.
  17. Let the pellet dry for 10 min.
  18. Resuspend the pellet in 150 μl of (10 mM Tris pH 7.5 - 1 mM EDTA - 0.1% SDS).
  19. Transfer the solution into a 2 ml sterile microcentrifuge tube, then harvest the residual pellet with 30 μl of (10 mM Tris pH 7.5 - 1 mM EDTA - 0.1% SDS).
  20. Add 150 μl of (10 mM Tris pH 7.5 - 1 mM EDTA).
  21. Add 30 μl of 3 M sodium acetate pH 5.0, vortex the tube.
  22. Add 900 μl of ethanol 100% (-20 °C), vortex the tube.
  23. Place the tube 30 min in melting ice.
  24. Centrifuge the tube 30 min at 15,000 rpm at 4 °C.
  25. Aspirate delicately the soluble fraction, and discard it.
  26. Add 500 μl 70% ethanol (RT), vortex the tube.
  27. Centrifuge the tube 20 min at 15,000 rpm (18,000 x g) at 4 °C.
  28. Repeat the rinsing step (70% ethanol).
  29. Centrifuge briefly and eliminate the remaining ethanol with a P200 pipette.
  30. Let the pellet air dry for 10 min.
  31. Resuspend the pellet in 50 μl DEPC-treated H2O.
  32. Mix vigorously by vortexing.
  33. Incubate 15 min at 45 °C in a water bath.

3. RNA Analysis by Gel Electrophoresis

  1. Pour an agarose gel inside a chemical hood.
  2. In a sterile 1.5 ml microcentrifuge tube, add 2 μl of RNA to be analyzed and 6.4 μl of sample prep buffer.
  3. In a second 1.5 ml tube, add 3 μl of RNA standards and 9.6 μl of sample prep buffer.
  4. Heat the tubes 15 min at 65 °C, put them on ice.
  5. Add 1 μl ethidium bromide (EB) loading buffer without dye in the RNA sample tube and 1 μl EB loading buffer with dye in the RNA standards tube.
  6. Run the gel under 80 - 100 V Inside a chemical hood in running buffer, until one of the dyes (bromophenol blue) reaches 2/3 of the bottom of the gel.
  7. Rinse the gel twice 15 min with 250 ml de DEPC-treated 2x SSC.
  8. Take a digitalized image under UV illumination.
  9. Calculate the ratio between the upper band (23S rRNA) and the lower band (16S rRNA).

4. Final Purification of the RNA

  1. Adjust the volume of the RNA sample to 100 μl with DEPC-treated H2O (if necessary).
  2. Add 100 μl of Acid phenol (1 ml phenol saturated in DEPC-treated H2O + 130 μl of 50 mM of sodium acetate, pH 5.2), vortex vigorously.
  3. Centrifuge the 10 min at 13,000 rpm (15,000 x g) at room temperature.
  4. Recover carefully and transfer the aqueous phase (upper phase) into a novel a sterile 1.5 ml microcentrifuge tube.
  5. Add 10 μl of 3 M sodium acetate, pH 5.2 and 250 μl of ethanol 100% (-20 °C).
  6. Incubate the tube 30 min into melting ice.
  7. Centrifuge the tube 30 min at 14,000 rpm (18,000 x g) at 4 °C.
  8. Aspirate carefully the soluble fraction, and discard it.
  9. Add 500 μl of 70% ethanol (room temperature), and vortex the tube.
  10. Centrifuge the tube 20 min at 14,000 rpm (18,000 x g) at 4 °C.
  11. Repeat the rinsing step (70% ethanol).
  12. Centrifuge briefly and eliminate the remaining ethanol with a P200 pipette.
  13. Let air dry the pellet for 10 min.
  14. Resuspend the pellet into 50 μl of DEPC-treated H2O.
  15. Incubate then tube 15 min at 45 °C.
  16. Measure the absorbance (Abs) at 260 nm and 280 nm on 2 μl of the RNA sample. Calculated the ratio Abs260/Abs280.
  17. Store the RNA sample at -80 °C (stable for several years).

5. Solutions and Cleaning Procedures

  1. Potassium acetate 2 M, pH 5.0: Dissolve 19.6 g Potassium acetate into 70 ml of DEPC-treated H2O. Clean the pH meter probe by soaking it into with 1M NaOH for 15 min, followed by 5 rinses with DEPC-treated H2O. Adjust to pH 5.0 with acetic acid then adjust volume to 100 ml with DEPC-treated H2O.
  2. Tris-HCl 100 mM, pH 8.0, N-Lauroylsarcosine 1%: Dissolve 2 g of N-Lauroylsarcosine (under a hood) in to 40 ml of 0.5 M Tris-base pH 8.0. Adjust volume to 200 ml with DEPC-treated H2O.) CsCl/EDTA: 96 g of CsCl in 50 ml 10 mM EDTA pH 7.5 prepared with DEPC-treated H2O. Autoclave and adjust volume to 100 ml with DEPC-treated H2O. Check for pH<7.5.
  3. Agarose gel 1%: Put 1 g of agarose in 62 ml DEPC-treated H2O. Boil in a microwave oven. Add 18 ml of 12.3 M formaldehyde, 20 ml of 5x MOPS. Pour inside a chemical hood.
  4. Sample prep Buffer: To be prepared extemporary. Mix inside a chemical hood 8 μl of 5x MOPS, 16 μl of 12.3 M formaldehyde and 40 μl of formamide.
  5. EB loading buffer (without dye): To be prepared extemporary. Add 4 μl 10 mg/ml ethidium bromide into 20 μl of 80% glycerol prepared with DEPC-treated H2O.
  6. EB loading buffer (with dye): To be prepared extemporary. Add 2 μl 10 mg/ml ethidium bromide into 10 μl of 80% glycerol containing 0.25% xylen cyanol, 0.25% bromophenol blue with DEPC-treated H2O.
  7. Running buffer: To 60 ml 5x MOPS, add 54 ml of 12.3 M formaldehyde and 186 ml of DEPC-treated H2O.
  8. DEPC-treated H2O: Incubate distilled water with 0.1% v/v diethylpyrocarbonate for 2 hr at 37 °C with stirring. Sterilize by Autoclave.
  9. Cleaning the homogenizer: Add 25 ml of cleaning solution (RBS) to 1 L of DEPC-treated H2O, and immerge the axis 1 min with stirring. Incubate 2 hr at 60 °C. Rinse thoroughly with DEPC-treated H2O Wrap the instrument into aluminum and put into the instrument box. Wrap the box. Sterilize by Autoclave.
  10. Cleaning the electrophoresis device: Wash the apparatus, the tray and the 15-wells comb. Incubate 15 min in 3% hydrogen peroxide. Rinse once with 100% ethanol. Air dry.
  11. Cleaning the glass dishes: Clean the glass dishes RBS 2% all the night, then rinse with distilled water before sterilization at 200 °C.

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Representative Results

The procedure jouRNAl (Figure 1) allows us recover specimens of retina from the surgical block to purified RNA, and to analyze the transcriptome of retinal detachment. Retinal detachment results in the upregulation of the monocyte chemotactic MCP1 gene CCL2, and in the decrease in expression of the rod photoreceptor transducing gene GNAT1, the short wave cone opsin OPN1SW, and the homeogene CRX (Figure 2). The induction of CCL2 is resulting from inflammation 9, while the concomitant reduction of GNAT1, OPN1SW and CRX is the result of photoreceptor degeneration, both rods and cones. The loss of cones may result from the loss of expression of NXNL1, which encodes for a Rod-derived Cone Viability Factor 7,10, or its paralogue RdCVF2, which is encoded by the NXNL2 gene. Surprisingly, the NXNL2 messenger exists in two different versions. Version 1 (NM_001161625.1) is a coding sequence derived from phylogenic analysis but has not been previously reported to be expressed 11, while version 2 (NM_145283.2), for which several ESTs has been identified is an abnormal mRNA that excludes the second exon of the gene and contains a alternative second exon, containing a repetitive Alu sequence, located more than 40 kb in the 3' direction (Figure 3a). Using RNA purified from Human retina, we can now reported that the two versions of the NXNL2 mRNA are expressed (Figure 3b).

Figure 1
Figure 1. Picture of the cardboard box containing the material provided by jouRNAl.

Figure 2
Figure 2. Representation of the expression of a subset of genes using Retinobase. For the genes displayed in these radar graphs, CCL2, GNAT1, OPN1SW, and CRX, the right part of the figure corresponds to RNA from specimens of retinal detachments (RD1-18), while the left part (NR1-18) are RNA from age-matched controls prepared using post-mortem retinas. The radar graph method is described in 8.

Figure 3
Figure 3. Expression of the two version of the NXNL2 gene in the retina. a. Schematic representation of the NXNL2 gene on chromosome 9. NXNL2v1 has two exons that are predicted by multiple alignment and phylogenic analysis. NXNL2v2 is missing that second exon and includes an alternative exon 2', located >40 kb in the 3' direction. The arrows show the position of the primer used. b. RT-PCR showing the expression of both NXNL2v1 and NXNL2v2 in the retina. The right lanes correspond to reaction in the absence of reverse transcriptase. ACTB, cytoplasmic actin. Primers used: NXNL2v1: 5'-GCATGAGCTGAGGAAGAGGT-3', 5'-CTCA AACGGAGAAATTCTGGA-3', NXNLv2: 5'-TCTGCACCCCCACGTTTATT-3', 5'-AGGGCCTCCT TTTCCATCTA-3'.

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Discussion

The development of a procedure for tissue recovery from the surgical block has been essential to the transcriptome analysis of retinal detachment. One should notice that this type of surgery is practiced in emergency and that the ophthalmologists operating have little time to participate in a biological research program when they operate. This retinectomy is also performed stochastically in each service, so that the easier way to reach statistical numbers is to work with a network. In such network, the standardization of the tissues collection is essential the success of the biological analysis. By providing a material, very easy to use and precise instructions, that can be stored at room temperature in a surgery cabinet, close to the surgical block, we have encouraged the surgeons to participate in our study.

In addition, the standardization of the purification of the RNA was achieved to get the best of these precious clinical specimens. The collections of pure RNAs can be stored for years at -80 °C and would be used for further studies as novel genomics technologies emerge. The protocol is provided for retinal surgical specimen but can also be used successfully to isolate RNA from rodent retina after dissection. If the RNA are degraded, a) check the pH of the CsCl/EDTA solution. b) make all the solutions from unused chemicals. The main limitation of the technique is the quantity of starting material which should correspond to at least 50,000 cells.

What distinguishes the method used here from most commercial reagents provided to isolate total RNA is the degree of purity. RNA is depleted of any DNA contamination which eliminates the need of using DNAse treatment that can be damaging to any further procedure. In addition, the total RNA preparations are here depleted in tRNA, that are known to be potent inhibitors of RNA polymerases that are commonly used in the amplification step before hybridization to microarray chips. We have observed that the probes synthesized from these RNA preparations have a very high specific activity. The degree of purity of the RNA prepared following the method described here is very well suited for microarray hybridization, but also for constructing cDNA libraries of high quality and for RNA sequencing as we have observed. The laboratory should be RNAse free. The pH of the CsCl/EDTA should be acidic to avoid the degradation of the RNA by alkaline lysis. The density of the CsCl/EDTA should be carefully verified in order not to be too high and to prevent the sedimentation of RNA.

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Disclosures

The authors have nothing to disclose.

Acknowledgments

We thank Sacha Reichman and Dominique Santiard-Baron for their help in editing the RNA purification protocol.

Materials

Name Company Catalog Number Comments
Centrifuge Beckman Coulter Aventi J-E
Rotor Beckman Coulter JS-5.3
Ultracentrifuge Beckman Coulter LE 80K
Rotor Beckman Coulter SW41
Power supply Biorad Pac 3000
PolytronTM Kinematica PT 2100 Supplied with PT-DA 2105:2
Agarose gel electrophoresis device Biorad MiniGel Cell GT
Imaging System Biorad GelDoc-It Imager
5 ml sterile polyethylene tube Greiner 115261
Sterile polyallomer centrifuge tube Beckman Coulter 331372
Chemical reagents Sigma Molecular biology grade (RNase and DNase free products)
Cleaning Solution VWR RBS
Microarray chip Affymetrix Human U133 plus 2 array

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References

  1. Mitry, D., Charteris, D. G., et al. The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. The British Journal of Ophthalmology. 94 (6), 678 (2010).
  2. Green, R. E., Krause, J., et al. A draft sequence of the Neandertal genome. Science. 328 (5979), 710 (2010).
  3. Glisin, V., Crkvenjakov, R., et al. Ribonucleic acid isolated by cesium chloride centrifugation. Biochemistry. 13 (12), 2633 (1974).
  4. Van Gelder, R. N., von Zastrow, M. E., et al. Amplified RNA synthesized from limited quantities of heterogeneous cDNA. Proceedings of the National Academy of Sciences of the United States of America. 87 (5), 1663 (1990).
  5. Cavalieri, L. F., Yamaura, I. E. coli tRNAs as inhibitors of viral reverse transcription in vitro. Nucleic Acids Research. 2 (12), 2315 (1975).
  6. Sawadogo, M. On the inhibition of yeast RNA polymerases A and B by tRNA and alpha-amanitin. Biochemical and biophysical research communications. 98 (1), 261 (1981).
  7. Delyfer, M. N., Raffelsberger, W., et al. Transcriptomic analysis of human retinal detachment reveals both inflammatory response and photoreceptor death. PloS ONE. 6 (12), e28791 (2011).
  8. Kalathur, R. K., Gagniere, N., et al. RETINOBASE: a web database, data mining and analysis platform for gene expression data on retina. BMC Genomics. 9, 208 (2008).
  9. Nakazawa, T., Hisatomi, T., et al. Monocyte chemoattractant protein 1 mediates retinal detachment-induced photoreceptor apoptosis. Proceedings of the National Academy of Sciences of the United States of America. 104 (7), 2425 (2007).
  10. Leveillard, T., Sahel, J. A. Rod-derived cone viability factor for treating blinding diseases: from clinic to redox signaling. Science Translational Medicine. 2 (26), 26ps16 (2010).
  11. Chalmel, F., Leveillard, T., et al. Rod-derived Cone Viability Factor-2 is a novel bifunctional-thioredoxin-like protein with therapeutic potential. BMC Molecular Biology. 8, 74 (2007).

Tags

Keywords: Retinal Detachment Retinal Pigmented Epithelium Photoreceptor Vitrectomy RNA Extraction Transcriptomics Gene Expression Analysis Inflammation Photoreceptor Degeneration
Transcriptomic Analysis of Human Retinal Surgical Specimens Using jouRNAl
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Cite this Article

Delyfer, M. N., Aït-Ali, N.,More

Delyfer, M. N., Aït-Ali, N., Camara, H., Clérin, E., Korobelnik, J. F., Sahel, J. A., Léveillard, T. Transcriptomic Analysis of Human Retinal Surgical Specimens Using jouRNAl. J. Vis. Exp. (78), e50375, doi:10.3791/50375 (2013).

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    Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
  • Research • Medicine
    Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations
  • Research • Medicine
    Isolation of Primary Human Decidual Cells from the Fetal Membranes of Term Placentae
  • Research • Medicine
    Skeletal Muscle Neurovascular Coupling, Oxidative Capacity, and Microvascular Function with 'One Stop Shop' Near-infrared Spectroscopy
  • Research • Medicine
    Collecting Hair Samples for Hair Cortisol Analysis in African Americans
  • Research • Medicine
    In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears
  • Research • Medicine
    Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
  • Research • Medicine
    Standardized Measurement of Nasal Membrane Transepithelial Potential Difference (NPD)
  • Research • Medicine
    Taste Exam: A Brief and Validated Test
  • Research • Medicine
    Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples
  • Research • Medicine
    Methodology for Sputum Induction and Laboratory Processing
  • Research • Medicine
    Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography
  • Research • Medicine
    A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
  • Research • Medicine
    Oral Biofilm Sampling for Microbiome Analysis in Healthy Children
  • Research • Medicine
    Using Retinal Imaging to Study Dementia
  • Research • Medicine
    Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
  • Research • Medicine
    3D Ultrasound Imaging: Fast and Cost-effective Morphometry of Musculoskeletal Tissue
  • Research • Medicine
    The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
  • Research • Medicine
    A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
  • Research • Medicine
    A Novel Method: Super-selective Adrenal Venous Sampling
  • Research • Medicine
    A Method for Quantifying Upper Limb Performance in Daily Life Using Accelerometers
  • Research • Medicine
    Non-invasive Assessments of Subjective and Objective Recovery Characteristics Following an Exhaustive Jump Protocol
  • Research • Medicine
    Experimental Protocol of a Three-minute, All-out Arm Crank Exercise Test in Spinal-cord Injured and Able-bodied Individuals
  • Research • Medicine
    Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle
  • Research • Medicine
    Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise
  • Research • Medicine
    Assessment of Child Anthropometry in a Large Epidemiologic Study
  • Research • Medicine
    Video Movement Analysis Using Smartphones (ViMAS): A Pilot Study
  • Research • Medicine
    Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients
  • Research • Medicine
    A Model to Simulate Clinically Relevant Hypoxia in Humans
  • Research • Medicine
    Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
  • Research • Medicine
    Induction and Assessment of Exertional Skeletal Muscle Damage in Humans
  • Research • Medicine
    A Detailed Protocol for Perspiration Monitoring Using a Novel, Small, Wireless Device
  • Research • Medicine
    Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
  • Research • Medicine
    Integrated Compensatory Responses in a Human Model of Hemorrhage
  • Research • Medicine
    Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
  • Research • Medicine
    Impression Cytology of the Lid Wiper Area
  • Research • Behavior
    A Protocol of Manual Tests to Measure Sensation and Pain in Humans
  • Research • Medicine
    Unbiased Deep Sequencing of RNA Viruses from Clinical Samples
  • Research • Medicine
    A Choroid Plexus Epithelial Cell-based Model of the Human Blood-Cerebrospinal Fluid Barrier to Study Bacterial Infection from the Basolateral Side
  • Research • Medicine
    Isolation and Profiling of MicroRNA-containing Exosomes from Human Bile
  • Research • Medicine
    Generation of Microtumors Using 3D Human Biogel Culture System and Patient-derived Glioblastoma Cells for Kinomic Profiling and Drug Response Testing
  • Research • Medicine
    Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
  • Research • Medicine
    Using a Laminating Technique to Perform Confocal Microscopy of the Human Sclera
  • Research • Medicine
    Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation
  • Research • Medicine
    Modeling and Simulations of Olfactory Drug Delivery with Passive and Active Controls of Nasally Inhaled Pharmaceutical Aerosols
  • Research • Medicine
    Exosomal miRNA Analysis in Non-small Cell Lung Cancer (NSCLC) Patients' Plasma Through qPCR: A Feasible Liquid Biopsy Tool
  • Research • Medicine
    A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
  • Research • Medicine
    Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges
  • Research • Medicine
    Using Saccadometry with Deep Brain Stimulation to Study Normal and Pathological Brain Function
  • Research • Medicine
    Quantitative Fundus Autofluorescence for the Evaluation of Retinal Diseases
  • Research • Medicine
    Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination
  • Research • Medicine
    Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
  • Research • Medicine
    Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
  • Research • Medicine
    Transcutaneous Microcirculatory Imaging in Preterm Neonates
  • Research • Medicine
    Using an Ingestible Telemetric Temperature Pill to Assess Gastrointestinal Temperature During Exercise
  • Research • Medicine
    Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)
  • Research • Medicine
    MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
  • Research • Medicine
    Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
  • Research • Medicine
    A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
  • Research • Medicine
    Determining The Electromyographic Fatigue Threshold Following a Single Visit Exercise Test
  • Research • Medicine
    Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules
  • Research • Medicine
    Trabecular Meshwork Response to Pressure Elevation in the Living Human Eye
  • Research • Medicine
    In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
  • Research • Medicine
    Establishment of Human Epithelial Enteroids and Colonoids from Whole Tissue and Biopsy
  • Research • Medicine
    Human Brown Adipose Tissue Depots Automatically Segmented by Positron Emission Tomography/Computed Tomography and Registered Magnetic Resonance Images
  • Research • Medicine
    Preparation and Respirometric Assessment of Mitochondria Isolated from Skeletal Muscle Tissue Obtained by Percutaneous Needle Biopsy
  • Research • Medicine
    A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
  • Research • Medicine
    Isolation and Immortalization of Patient-derived Cell Lines from Muscle Biopsy for Disease Modeling
  • Research • Medicine
    State of the Art Cranial Ultrasound Imaging in Neonates
  • Research • Medicine
    Measurement of Dynamic Scapular Kinematics Using an Acromion Marker Cluster to Minimize Skin Movement Artifact
  • Research • Medicine
    The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
  • Research • Medicine
    Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
  • Research • Medicine
    Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
  • Research • Medicine
    A Neuroscientific Approach to the Examination of Concussions in Student-Athletes
  • Research • Medicine
    DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
  • Research • Medicine
    Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples
  • Research • Medicine
    Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
  • Research • Medicine
    A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
  • Research • Medicine
    Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
  • Research • Medicine
    Multi-electrode Array Recordings of Human Epileptic Postoperative Cortical Tissue
  • Research • Medicine
    Collection and Extraction of Saliva DNA for Next Generation Sequencing
  • Research • Medicine
    Fast and Accurate Exhaled Breath Ammonia Measurement
  • Research • Medicine
    Developing Neuroimaging Phenotypes of the Default Mode Network in PTSD: Integrating the Resting State, Working Memory, and Structural Connectivity
  • Research • Medicine
    Two Methods for Establishing Primary Human Endometrial Stromal Cells from Hysterectomy Specimens
  • Research • Medicine
    Assessment of Vascular Function in Patients With Chronic Kidney Disease
  • Research • Medicine
    Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing
  • Research • Medicine
    Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
  • Research • Medicine
    EEG Mu Rhythm in Typical and Atypical Development
  • Research • Medicine
    The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
  • Research • Medicine
    Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples
  • Research • Medicine
    Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
  • Research • Medicine
    Primary Culture of Human Vestibular Schwannomas
  • Research • Medicine
    Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
  • Research • Medicine
    Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly
  • Research • Medicine
    Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
  • Research • Medicine
    Isolation, Culture, and Imaging of Human Fetal Pancreatic Cell Clusters
  • Research • Medicine
    3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
  • Research • Medicine
    A Novel Application of Musculoskeletal Ultrasound Imaging
  • Research • Medicine
    Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
  • Research • Medicine
    Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers
  • Research • Medicine
    Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
  • Research • Medicine
    Transcriptomic Analysis of Human Retinal Surgical Specimens Using jouRNAl
  • Research • Medicine
    Improved Protocol For Laser Microdissection Of Human Pancreatic Islets From Surgical Specimens
  • Research • Medicine
    Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment (RMCA) in Individuals with Chronic Spinal Cord Injury
  • Research • Medicine
    Minimal Erythema Dose (MED) Testing
  • Research • Medicine
    Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children
  • Research • Medicine
    Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds
  • Research • Medicine
    A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
  • Research • Medicine
    Using a Chemical Biopsy for Graft Quality Assessment
  • Research • Medicine
    Characterizing Exon Skipping Efficiency in DMD Patient Samples in Clinical Trials of Antisense Oligonucleotides
  • Research • Medicine
    In Vitro Assessment of Cardiac Function Using Skinned Cardiomyocytes
  • Research • Medicine
    Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism
  • Research • Medicine
    Evaluation of Vascular Control Mechanisms Utilizing Video Microscopy of Isolated Resistance Arteries of Rats
  • Research • Medicine
    Bronchoalveolar Lavage (BAL) for Research; Obtaining Adequate Sample Yield
  • Research • Medicine
    Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
  • Research • Medicine
    Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
  • Research • Medicine
    Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
  • Research • Medicine
    Isolation, Characterization and Comparative Differentiation of Human Dental Pulp Stem Cells Derived from Permanent Teeth by Using Two Different Methods
  • Research • Medicine
    Portable Intermodal Preferential Looking (IPL): Investigating Language Comprehension in Typically Developing Toddlers and Young Children with Autism
  • Research • Medicine
    Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
  • Research • Medicine
    The Use of Primary Human Fibroblasts for Monitoring Mitochondrial Phenotypes in the Field of Parkinson's Disease
  • Research • Medicine
    Collection Protocol for Human Pancreas
  • Research • Medicine
    The α-test: Rapid Cell-free CD4 Enumeration Using Whole Saliva
  • Research • Medicine
    The Measurement and Treatment of Suppression in Amblyopia
  • Research • Medicine
    Corneal Donor Tissue Preparation for Endothelial Keratoplasty
  • Research • Medicine
    Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT)
  • Research • Medicine
    Eye Tracking Young Children with Autism
  • Research • Medicine
    Doppler Optical Coherence Tomography of Retinal Circulation
  • Research • Medicine
    Utilizing Transcranial Magnetic Stimulation to Study the Human Neuromuscular System
  • Research • Medicine
    Detection and Genogrouping of Noroviruses from Children's Stools By Taqman One-step RT-PCR
  • Research • Medicine
    Method to Measure Tone of Axial and Proximal Muscle
  • Research • Medicine
    The Trier Social Stress Test Protocol for Inducing Psychological Stress
  • Research • Medicine
    Probing the Brain in Autism Using fMRI and Diffusion Tensor Imaging
  • Research • Medicine
    Multifocal Electroretinograms
  • Research • Medicine
    Isolation of Human Islets from Partially Pancreatectomized Patients
  • Research • Medicine
    Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer's Disease
  • Research • Medicine
    Magnetic Resonance Imaging Quantification of Pulmonary Perfusion using Calibrated Arterial Spin Labeling
  • Research • Medicine
    Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
  • Research • Medicine
    Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
  • Research • Medicine
    A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)
  • Research • Medicine
    An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
  • Research • Medicine
    Corneal Confocal Microscopy: A Novel Non-invasive Technique to Quantify Small Fibre Pathology in Peripheral Neuropathies
  • Research • Medicine
    Methods to Quantify Pharmacologically Induced Alterations in Motor Function in Human Incomplete SCI
  • Research • Medicine
    Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
  • Research • Medicine
    Technique to Collect Fungiform (Taste) Papillae from Human Tongue
  • Research • Medicine
    Assessing Endothelial Vasodilator Function with the Endo-PAT 2000
  • Research • Medicine
    Making Sense of Listening: The IMAP Test Battery
  • Research • Medicine
    An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
  • Research • Biology
    Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees
  • Research • Biology
    Demonstration of Cutaneous Allodynia in Association with Chronic Pelvic Pain
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