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New Modality (new + modality)
Selected Abstracts3335: New modalities for the treatment of corneal dystrophiesACTA OPHTHALMOLOGICA, Issue 2010I CLAERHOUT Purpose To give an overview of current treatment modalities of corneal dystrophies. Results New transplant techniques have changed the way that corneal dystrophies are being treated in the last few years. Phototherapeutic keratectomy is still a very valuable tool for superficial dystrophies. Depending on the layers involved the laser will be set to a depth of 5 to 100µm. DALK is now the preferred method of treatment of most stromal dystrophies, although macular dystrophy is an exception to this rule since there is evidence of endothelial involvement in this dystrophy. Endothelial dystrophies are now almost exclusively being treated by different types of endothelial grafts (DSAEK or DMEK). Conclusion Current treatment of corneal dystrophies has evolved from one size fits all to a more customised treatment schedule, still dependent on the layers involved in the disease. [source] Striae Distensae (Stretch Marks) and Different Modalities of Therapy: An UpdateDERMATOLOGIC SURGERY, Issue 4 2009MOHAMED L. ELSAIE MD BACKGROUND Striae distensea (SD; stretch marks) are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The origins of SD are poorly understood, and a number of treatment modalities are available for their treatment, yet none of them is consistently effective, and no single therapy is considered to be pivotal for this problem. With a high incidence and unsatisfactory treatments, stretch marks remain an important target of research for an optimum consensus of treatment. OBJECTIVE To identify the current treatment modalities and their effectiveness in the treatment of stretch marks. MATERIALS AND METHODS Review of the recent literature regarding clinical treatment of stretch marks with emphasis on the safety and efficacy of the newer optical devices and laser applications. RESULTS No current therapeutic option offers complete treatment, although there are a number of emerging new modalities that are encouraging. CONCLUSION The therapeutic strategies are numerous, and no single modality has been far more consistent than the rest. The long-term future of treatment strategies is encouraging with the advance in laser technologies. [source] Tumor-infiltrating lymphocytes derived from human renal cell carcinoma: Clonal analysis of its characteristicsINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2008Tomoyuki Shimabukuro Aim: To assess the characteristics of activated tumor-infiltrating lymphocytes (TIL), we report the isolation, growth response, and functional analysis of a CD4 - CD8+ TIL-clone derived from human renal cell carcinoma (RCC). Methods: Bulk TILs were expanded from a human RCC and the lymphocytes were separated into a CD8+ enriched population. Subsequently, using the limiting dilution technique, a TIL clone was established and its growth response, phenotype and cytotoxic activity were analyzed. Results: A clone, T16-13, by day 94 numbering 1 × 107 cells, was harvested and characterized as a CD4 - CD8+ clone. On day 144, the cytotoxic activity of this clone against the autologous tumor was relatively high (2.3 ± 0.7 LU30/106 cells). Meanwhile, against allogeneic renal tumors, there was no cytotoxic activity (,0.1 LU30/106 cells). Conclusions: A TIL clone possessing modest autologous tumor-specific cytotoxicity can be isolated from human RCC. The characteristics analysis of various TIL clones may provide a better understanding of an RCC tumor microenvironment and may help to establish new modalities for the treatment of patients with metastatic kidney cancer. [source] Utilizing an Oral Sucrose Solution to Minimize Neonatal PainJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2005Debbie Gearner Thompson issues and purpose.,To present an evidence-based practice protocol for oral sucrose administration to minimize neonatal procedural pain. conclusion.,Examination of published research may provide additional modalities to expand an established pediatric pain-management program. practical implications.,The extensive research evaluating oral sucrose supports its inclusion in a pediatric pain-management program. A thorough implementation plan will allow new modalities to be included to optimize procedural pain relief for hospitalized neonates with minimal staff resistance and improved patient outcomes. [source] Regulation of gene expression in melanoma: New approaches for treatmentJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 1 2005Michael C. Leslie Abstract The molecular changes associated with the transition of melanoma cells from radial growth phase (RGP) to vertical growth phase (VGP, metastatic phenotype) are not yet well defined. We have demonstrated that the progression of human melanoma is associated with loss of expression of the transcription factor AP-2. In metastatic melanoma cells, this loss resulted in overexpression of MCAM/MUC18, MMP-2, the thrombin receptor (PAR-1), and lack of c-KIT expression. The transition from RGP to VGP is also associated with overexpression of the angiogenic factor IL-8. Additionally, the transition of melanoma cells from RGP to VGP is associated with overexpression of the transcription factors CREB and ATF-1, both of which may act as survival factors for human melanoma cells. Inactivation of CREB/ATF-1 activities in metastatic melanoma cells by dominant-negative CREB or by anti-ATF-1 single chain antibody fragment (ScFv), resulted in deregulation of MMP-2 and MCAM/MUC18, increased the sensitivity of melanoma cells to apoptosis, and inhibition of their tumorigenicity and metastatic potential in vivo. In this prospect article, we summarize our data on the role of AP-2 and CREB/ATF-1 in the progression of human melanoma and report on the development of new fully human antibodies anti-MCAM/MUC18 and anti-IL-8 which could serve as new modalities for the treatment of melanoma. © 2004 Wiley-Liss, Inc. [source] Review article: diagnosis and treatment of non-alcoholic fatty liver diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2008M. K. OH Summary Background, Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent condition affecting adults and children, leading to significant morbidity. It is often associated with the metabolic syndrome, although multiple pathogenetic mechanisms have been suggested. In the coming decades, it promises to be the leading cause of liver disease in industrial countries. Aim, To provide a comprehensive, updated review of diagnosis and management of NAFLD and to appraise the evolution of new modalities in these areas. Methods, An Ovid MEDLINE search was performed to identify pertinent original research and review articles. Selected references in these articles were also evaluated. Results, The diagnosis of hepatic steatosis and steatohepatitis or non-alcoholic steatohepatitis (NASH) is not yet possible without liver biopsy. This is impractical given the large numbers affected by the condition. Current therapy has focused on improving insulin resistance and mediators of inflammation, factors probably associated with disease progression. Conclusions, There are no proven non-invasive diagnostic modalities to distinguish NAFLD and NASH, but new biomarker panels are approximating the liver biopsy in accuracy. Therapeutic targets of drug development are in early stages, but a multifaceted approach will probably yield several treatment options in the years to come. [source] Treatment of pigmented lesions of neurofibromatosis 1 with intense pulsed,radio frequency in combination with topical application of vitamin D3 ointmentTHE JOURNAL OF DERMATOLOGY, Issue 4 2007Yuichi YOSHIDA ABSTRACT Cafe-au-lait spots and pigmented freckling are found in most of patients with neurofibromatosis 1 (NF1). Although many modalities have been used for treating the pigmented lesions, the response to treatment has been variable. Therefore, we performed the treatment of pigmented lesions with NF1 by intense pulsed,radio frequency (IPL,RF) in combination with topical application of vitamin D3 ointment. Eight patients were treated in this study and the improvement was moderate to good in six cases (75%) although the response was relatively mild. Thus, results from our study indicate that IPL,RF irradiation in combination with topical application of vitamin D3 ointment would be useful as new modalities, especially for treatment of numerous small pigmented lesions in patients with NF1. Although further studies with large groups of patients should be performed for a better conclusion, it could improve quality of life with NF1 patients who are concerned with serious cosmetic and social problems. [source] Fractionated Laser Skin Resurfacing Treatment Complications: A ReviewDERMATOLOGIC SURGERY, Issue 3 2010ANDREI I. METELITSA MD BACKGROUND Fractional photothermolysis represents a new modality of laser skin resurfacing that was developed to provide a successful clinical response while minimizing postoperative recovery and limiting treatment complications. OBJECTIVES To review all of the reported complications that develop as a result of fractional ablative and nonablative laser skin resurfacing. METHODS A literature review was based on a MEDLINE search (1998,2009) for English-language articles related to laser treatment complications and fractional skin resurfacing. Articles presenting the highest level of evidence and the most recent reports were preferentially selected. RESULTS Complications with fractional laser skin resurfacing represent a full spectrum of severity and can be longlasting. In general, a greater likelihood of developing post-treatment complications is seen in sensitive cutaneous areas and in patients with intrinsically darker skin phototypes or predisposing medical risk factors. CONCLUSIONS Although the overall rate of complications associated with fractional laser skin resurfacing is much lower than with traditional ablative techniques, recent reports suggest that serious complications can develop. An appreciation of all of the complications associated with fractional laser skin resurfacing is important, especially given that many of them can be potentially prevented. The authors have indicated no significant interest with commercial supporters. [source] Clinical Improvement of Solar Lentigines and Ephelides with an Intense Pulsed Light SourceDERMATOLOGIC SURGERY, Issue 6 2002Akira Kawada MD background. A noncoherent, broadband, intense pulsed light (IPL) source has been used for the symptoms of photoaging skin as a nonablative method. objective. To investigate the efficacy and tolerability of IPL in solar lentigines and ephelides on the face. methods. An open study was performed in patients with solar lentigines and ephelides who received three to five treatments of IPL. results. Forty-eight percent of patients had more than 50% improvement and 20% had more than 75% improvement. In the group of solar lentigines, 40% of patients showed more than 50% improvement and 16% had more than 75% improvement. Patients with small plaques of solar lentigines responded well, whereas patients with small + large and large plaques showed poor response. Patients with solar lentigines + ephelides and ephelides responded remarkably with 75% and 71% of patients, respectively, having more than 50% improvement. conclusion. IPL was well tolerated and may be a new modality for the therapy of solar lentigines and ephelides. [source] Nocturnal Haemodialysis , A Preliminary Cost Comparison with Conventional Haemodialysis in AustraliaHEMODIALYSIS INTERNATIONAL, Issue 1 2003JWM Agar A 6 night/wk, home-based, government funded nocturnal haemodialysis (NHDx) program, believed to be the first outside North America, commenced in July 2001. Previously published Canadian and US costs suggest NHDx to be more cost-efficient than conventional haemodialysis (CHDx) as, although consumable-expensive, NHDx is home-based and is thus highly infrastructure, wage and hospital inpatient bed-day efficient. Comparable Australian cost evaluation is essential, however, before NHDx is widely encouraged as a new modality here. Cost comparisons for 3 × wk CHDx vs preliminary costs for 9/12 pts on 6 × wk NHDx (3 excluded for inadequate program time) include: consumables/fluids CHDx @$A8781/pt/yr vs NHDx @$A17562/pt/yr; estimated nursing costs CHDx (62.25 nurse hrs/wk with a nurse/pt ratio of 3:9)@$A12666/pt/yr vs NHDx (40 nurse hrs/wk with a nurse/pt ratio of 1:9)@$A8111/pt/yr with projected reduction to A$4866 for nurse/pt ratio of 1:15; pharmaceutical costs (includes all medication & Fleet® for dialysate but excludes EPO/iron polymaltose) CHDx one month prior to NHDx @$A1412/pt/yr vs NHDx costs after one month starting home-based treatment @$A1273/pt/yr. Though the NHDx pts have been carefully selected, only 3 hospitalizations for a total of 4 bed-days have been necessary in 348.5 pt wks of experience to September 2002. Our preliminary cost analyses confirm prior North American data. Cumulative financial modeling shows NHDx is more costly than CHDx at low pt numbers, reaching approximate equivalence @ 12 pts and progressively dropping below CHDx costs thereafter. NHDx appears cost-competitive with CHDx whilst yielding superior biochemical, life-style and rehabilitation results (see accompanying clinical data abstract). [source] Selective internal radiation therapy (SIRT): a new modality for treating patients with colorectal liver metastasesHPB, Issue 3 2004RS Stubbs First page of article [source] Surgery for Cardiac Valves and Aortic Root Without Cardioplegic Arrest ("Beating Heart"): Experience with a New Method of Myocardial PerfusionJOURNAL OF CARDIAC SURGERY, Issue 6 2007Tomas A. Salerno M.D. Similarly, beating heart mitral valve surgery via the trans-septal approach with the aorta unclamped, is a novel technique. We, herein, report a series of 346 patients with a variety of cardiac pathologies who were operated upon utilizing a new modality of myocardial perfusion. Among this group of patients, there were 55 patients who were diagnosed with endocarditis of one or more valves. These patients were excluded from this series of patients. Mean age was 59 ± 12, and there were 196 (67.3%) males and 95 (32.7%) females. There were six aortic root procedures, 90 mitral valve replacements (MVR), 46 mitral valve repairs, 20 MVR+ coronary artery bypass grafting (CABG), 28 tricuspid valve repairs, 106 aortic valve replacements (AVR), 17 AVR+CABG, and 8 AVR/MVR. Crude mortality for the group was 20 of 291 (6.8%). Intra-aortic balloon pump utilization at time of weaning from cardiopulmonary bypass was 6/291 (2.06%), and re-operation for bleeding was needed in 12 of 291 (4.1%) patients. Postoperative stroke occurred in 4 of 291 (1.3%) patients. In these patients, the clinical diagnosis of stroke was made prior to surgery. This initial experience with this new method of myocardial perfusion indicates that results are at least comparable, if not superior, to conventional techniques utilizing intermittent cold blood cardioplegia. [source] Complications of fractional CO2 laser resurfacing: Four casesLASERS IN SURGERY AND MEDICINE, Issue 3 2009Douglas J. Fife MD Abstract Background and Objective Fractional ablative laser therapy is a new modality which will likely be widely used due to its efficacy and limited side-effect profile. It is critical to recognize, characterize, and report complications in order to acknowledge the limits of therapeutic efficacy and to improve the safety of these devices. Study Design/Materials and Methods The photographs, treatment parameters, and clinical files of four female patients aged 54,67 who had scarring or ectropion after fractional CO2 laser resurfacing on the face or neck were carefully reviewed to search for any possible linking factors. Results Patient 1 developed erosions and swelling of the right lower eyelid 2 days postoperatively, which developed into scarring and an ectropion. Patient 2 developed linear erosions and beefy red swelling on the right side of the neck which developed into a tender, band-like scar over 1-month. Patient 3 developed stinging and yellow exudate in multiple areas of the neck 3 days postoperatively. Cultures grew methicillin-resistant Staphylococcus aureus. Despite appropriate treatment, she developed multiple areas of irregular texture and linear streaking which developed into scars. Patient 4 developed an asymptomatic patchy, soft eschar with yellowish change on the left side of the neck. Azithromycin was started, however at 2-week follow-up she had fibrotic streaking which developed into horizontal scars and a vertical platysmal band. The treatment and final outcome of each patient are described. Conclusion Scarring after fractional CO2 laser therapy may be due to overly aggressive treatments in sensitive areas (including excessive energy, density, or both), lack of technical finesse, associated infection, or idiopathic. Care should be taken when treating sensitive areas such as the eyelids, upper neck, and especially the lower neck and chest by using lower energy and density. Postoperative infections may lead to scarring and may be prevented by careful taking of history, vigilant postoperative monitoring and/or prophylactic antibiotics. Lasers Surg. Med. 41:179,184, 2009. © 2009 Wiley-Liss, Inc. [source] Reversion and Maintenance of Sinus Rhythm in Patients with Permanent Atrial Fibrillation by Internal Cardioversion Followed by Biatrial PacingPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2002NIKOLAOS FRAGAKIS FRAGAKIS, N., et al.: Reversion and Maintenance of Sinus Rhythm in Patients with Permanent Atrial Fibrillation by Internal Cardioversion Followed by Biatrial Pacing. Patients in atrial fibrillation (AF) who fail external cardioversion are usually regarded as in permanent AF. Internal cardioversion may revert many such patients into sinus rhythm (SR) but the majority relapse rapidly into AF. We investigated whether internal cardioversion followed by biatrial pacing is an effective to restore and subsequently maintain SR in patients with permanent AF. Patients in permanent AF underwent internal cardioversion that was followed by biatrial temporary pacing for 48 hours. Those who remained in SR received a permanent biatrial pacemaker programmed to a rate responsive mode with a lower rate 90 beats/min. Primary end point of the study included maintenance in SR 3 months after internal cardioversion. Sixteen patients (14 men, 57 ± 11 years) were cardioverted. The median duration of AF was 24 months (quartiles, Q1= 8.5 and Q3= 102) and mean left atrium diameter was 48 ± 04 mm. A permanent biatrial pacemaker was implanted in 11 patients. At a mean follow-up of 15 months (range 4 to 24), 8 patients remained in SR for more than 3 months. AF was eliminated in 5 patients, while in two a second internal cardioversion on amiodarone was required. Antiarrhythmic therapy was used in half of our population and did not predict the long-term maintenance of SR. Following internal cardioversion with continuous biatrial pacing, 50% of patients with permanent AF were maintained for prolonged periods in SR. This is a new modality of treatment of permanent AF directed to the maintenance of SR that provides a further therapeutic option in end-stage AF. [source] Use of Botulinum Toxin Type A Injection for Neuropathic Pain after Trigeminal Nerve InjuryPAIN MEDICINE, Issue 4 2010Seung Hyun Yoon DDS Abstract Objective., To present a case that neuropathic pain following traumatic injury of the inferior alveolar nerve, which was relieved by the injection of BTX-A. Design., Case report. Setting., Tertiary care University hospital. Subject., A 62-year-old female was referred by her general dentist to our clinic due to numbness and pain over the left side of her lower lip and chin region. Intervention., Botulinum toxin type A injected into the middle of chin area subcutaneously. Results., At 1 month after BTX-A injection, the affected area had decreased in size. And at 2 months, the patient reported a slight decreased in pain, and CPT differences being sustained at a reduced level. Conclusions., This case report suggests an effective new modality for treating neuropathic pain after trigeminal nerve injury. A further randomized controlled study involving a large number of patients is needed. [source] Cyclic pamidronate treatment in Bruck syndrome: Proposal of a new modality of treatmentPEDIATRICS INTERNATIONAL, Issue 6 2008Nesibe Andiran No abstract is available for this article. [source] Topical photodynamic therapy with 5-aminolaevulinic acid does not induce hair regrowth in patients with extensive alopecia areataBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2000R. Bissonnette Background,Photodynamic therapy (PDT) is a new modality involving the administration of a photosensitizer, or photosensitizer precursor, followed by its activation with light to generate a therapeutic effect. 5-Aminolaevulinic acid (ALA) is a photosensitizer precursor that is transformed by cells into protoporphyrin IX (PpIX), which can in turn be activated by red light. Objectives,To investigate the effect of PDT in alopecia areata (AA). Methods,In six patients with extensive AA, topical ALA lotion at 5%, 10% and 20% as well as the vehicle lotion alone were applied separately to different scalp areas, followed 3 h later by exposure to red light at each treatment session. Results,No significant hair growth was observed after 20 twice-weekly treatment sessions. A significant increase in erythema and pigmentation was observed for the three concentrations of ALA lotion vs. the vehicle, implying that a phototoxic PDT effect was achieved in the skin. In vivo fluorescence spectroscopy in one patient showed an increase in red PpIX fluorescence 3 h after ALA application followed by a decrease after light exposure. On fluorescence microscopy, bright red fluorescence was present in the epidermis and sebaceous glands, but not in the inflammatory infiltrate surrounding the hair follicle following ALA application. Conclusions,PDT was ineffective in the treatment of AA. [source] | ||||||||||