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Single Treatment (single + treatment)
Selected AbstractsOcular haemodynamic changes after single treatment with photodynamic therapy assessed with non-invasive techniquesACTA OPHTHALMOLOGICA, Issue 6 2009Noemi Maar Abstract. Purpose:, To investigate in patients with neovascular age-related macular degeneration (ARMD) the changes in ocular perfusion caused by single treatment with photodynamic therapy (PDT) by different non-invasive methods; to evaluate correlations between relative changes of ocular haemodynamic parameters after PDT among each other and compared to morphological parameters; and to assess this in relation to early changes of visual acuity. Methods:, Study population: 17 consecutive patients with subfoveal choroidal neovascularization (CNV) caused by ARMD scheduled for PDT without previous PDT treatment (four patients with predominantly classic CNV and 13 patients with occult CNV). Observation procedures: best-corrected visual acuity (before PDT, 6 and 8 weeks after PDT), fundus photography, fluorescein angiography, haemodynamic measurements with laser Doppler flowmetry (LDF), laser interferometry and ocular blood flow (OBF) tonometry (baseline and 1, 2, 6 and 8 weeks after treatment). Main outcome measures: choroidal blood flow (CHBF), fundus pulsation amplitude (FPA), pulsatile ocular blood flow (POBF), visual acuity. Changes smaller than 20% were considered clinically irrelevant. Results:, Ocular haemodynamic parameters did not change significantly in the follow-up period. Changes of haemodynamic parameters showed no correlation to treatment spot, morphological changes or visual acuity. Changes of visual acuity were comparable to results of earlier studies. Conclusion:, Single treatment with PDT did not modify ocular blood flow parameters above 20% as assessed with different non-invasive methods. [source] Endothelin-1-mediated coronary vasoconstriction deteriorates myocardial depression in hearts isolated from lipopolysaccharide,treated rats: Interaction with nitric oxideCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2004Jie Tu Summary 1.,The aim of the present study was to evaluate the contribution of disturbance of coronary perfusion to myocardial depression in hearts isolated from lipopolysaccharide (LPS)-treated rats and to investigate the involvement of endothelin (ET)-1 and nitric oxide (NO). 2.,Rats were treated with LPS (10 mg/kg, i.p.) and, 4 h later, plasma ET-1 concentrations were measured by radioimmunoassay and hearts were excised for perfusion at a constant perfusion flow. The selective ETA receptor antagonist BQ-123, in the absence or presence of aminoguanidine, a specific inhibitor of inducible NO synthase, was given 15 min before LPS challenge. Coronary perfusion pressure (CPP) and measures of myocardial contractile function were recorded. 3.,In hearts isolated from LPS-treated rats, there was a marked increase in CPP that was abolished by pretreatment with BQ-123. In parallel, an increase in plasma ET-1 concentrations was seen in these rats. Lipopolysaccharide also induced decreases in left ventricular developed pressure (LVDP), the product of LVDP and heart rate and maximal rate of rise/fall of left ventricular pressure (+/, dP/dtmax). Single treatment with BQ-123 or aminoguanidine attenuated LPS-induced myocardial depression. However, when these two drugs were given simultaneously, myocardial depression elicited by LPS was blocked significantly. 4.,Endothelin-1-mediated coronary vasoconstriction, together with NO, contributes to myocardial depression in hearts isolated from LPS-treated rats. [source] Double-Blind, Randomized, Placebo-Controlled, Dose-Response Study of the Safety and Efficacy of Botulinum Toxin Type A in Subjects with Crow's FeetDERMATOLOGIC SURGERY, Issue 3 2005Nicholas J. Lowe MD Background Published evidence suggests that botulinum toxin type A (BTX-A) is an effective treatment for crow's feet. However, few dose-ranging studies have been performed. Objectives To assess the safety and efficacy of a single treatment with one of four doses of BTX-A (Botox/Vistabel, Allergan Inc) compared with placebo for the improvement of crow's feet. Methods Subjects received a single bilateral treatment of 18, 12, 6, or 3 U of BTX-A or placebo injected into the lateral aspect of the orbicularis oculi muscle (parallel-group, double,blind design). Investigators and subjects rated crow's feet severity at maximum smile on day 7 and at 30-day intervals from days 30 to 180. Results As observed by both investigators and subjects, all doses of BTX-A resulted in improvements in crow's feet severity when compared with placebo. A dose-dependent treatment effect for efficacy was observed, with higher doses having an increased magnitude and duration of effect. However, a clear differentiation between the 18 U and 12 U doses was not apparent. Few adverse events were reported, with no statistically significant differences between BTX-A and placebo in the incidence of subjects experiencing adverse events. Conclusion BTX-A is safe and effective in decreasing the severity of crow's feet, with 12 U per side suggested as the most appropriate dose. THIS STUDY WAS FUNDED BY ALLERGAN, WHICH WAS ALSO INVOLVED IN THE DESIGN AND CONDUCT OF THE STUDY; COLLECTION, MANAGEMENT, ANALYSIS, AND INTERPRETATION OF THE DATA; AND PREPARATION, REVIEW, AND APPROVAL OF THE MANUSCRIPT. DRS. LOWE AND FRACZEK ARE PAID CONSULTANTS FOR ALLERGAN, DRS. KUMAR AND EADIE ARE EMPLOYEES OF ALLERGAN, AND DRS. LOWE AND KUMAR HOLD STOCK OPTIONS. [source] Multicenter Study of the Safety and Efficacy of a 585 nm Pulsed-Dye Laser for the Nonablative Treatment of Facial RhytidesDERMATOLOGIC SURGERY, Issue 1 2005T. S. Jeffrey Hsu MD Objective The objective of this study was to assess the safety and efficacy of a 585 nm flashlamp pulsed-dye laser for the nonablative treatment of facial rhytides. Methods A multicenter prospective randomized controlled study on 58 volunteers was performed. A split-face approach was adopted, with one periorbital region acting as a control and the other receiving either one or two treatments. Patients were photographed and imaged three-dimensionally before and after treatment. Histologic sections were analyzed. Results Three-dimensional topographic evaluation showed improvements of 9.8% (p= .0022) and 15% (p= .0029) in surface roughness for single and double treatments, respectively. Histology revealed an increase in type I collagen messenger ribonucleic acid expression, type III procollagen, chondroitin sulfate, and grenz zone thickness. Two treatments resulted in greater improvement than one treatment. Conclusion Clinical improvement was achieved following a single treatment. Further improvement was observed following a second treatment. The subjective evaluation of clinical improvement was consistent with both histologic and topographic quantitative measurements. SUZANNE KILMER, MD, AND JAY BURNS, MD, RECEIVED THE USE OF THE LASER FOR RESEARCH AND A DISCOUNTED PURCHASE AGREEMENT. THEY BOTH ACKNOWLEDGE RECEIVING HONORARIA FOR LECTURING FROM THE MANUFACTURER. BRIAN ZELICKSON, MD, RECEIVED RESEARCH GRANTS FROM ICN. [source] Collagen Remodeling After 585-nm Pulsed Dye Laser Irradiation: An Ultrasonographic AnalysisDERMATOLOGIC SURGERY, Issue 10 2003Brent R. Moody MD Background and Objectives. Nonablative dermal remodeling is an evolving technology that has generated great interest among both laser surgeons and patients. Evidence indicates that dermal collagen formation is the key mechanism of action for the nonablative techniques. We studied, with ultrasound, new collagen formation after nonablative laser irradiation. Methods. Ten patients with facial rhytids underwent a single treatment with a 585-nm pulsed dye laser. The patients were all female, ranging in age from 47 to 67, and were Fitzpatrick skin types I,III. Laser parameters were as follows: an energy fluence of 2.4 to 3.0 J/cm2, a pulse duration of 350 ,sec, and a spot size of 5 mm with no overlap. Ultrasonographic assessments of dermal collagen were taken at baseline and at 30 and 90 days after treatment. Results. Ultrasonography demonstrated an increase in dermal collagen after a single treatment with the 585-nm pulsed dye laser. The greatest degree of neocollagenesis occurred periocularly. Conclusion. A single treatment with a 585-nm pulsed dye laser appears to increase dermal collagen. This increase in dermal collagen can be assessed with noninvasive cutaneous ultrasound. [source] Botulinum toxin injection therapy in the management of lower urinary tract dysfunctionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2006A. K. PATEL Summary We have great pleasure in introducing this supplement containing a collection of articles reviewing the contemporary clinical management of functional disorders of the lower urinary tract (LUT) with particular emphasis on the potential role of botulinum toxin injection therapy. Detrusor sphincter dyssynergia (DSD), detrusor overactivity (DO), painful bladder syndrome (PBS) and LUT symptoms consequent on bladder outflow obstruction (LUTS/BPH) have all been treated by the injection of botulinum toxin. This treatment can be administered as a minimally invasive, outpatient procedure which on the initial trials for DO (particularly of neurogenic aetiology) shows a remarkable efficacy with effects lasting up to a year after a single treatment with few significant side effects. Success has been reported with the management of detrusor sphincter dyssynergia and preliminary series report positive outcomes in the management of PBS and LUTS/BPH. However, most of the studies to date include small numbers and have a recruitment bias with few randomised controlled trials having been reported. The answers to some of the key questions are addressed with reference to our contemporary knowledge. It is clear that considerable work both clinical and basic science still needs to be performed to answer the many remaining questions with regard to this treatment modality but undoubtedly it will be a major future treatment option in those with intractable symptoms or those unable to tolerate medications. Currently, all botulinum toxin use for urological conditions is off-label and unlicensed, therefore caution should be exercised until future large randomised studies are reported. [source] Diabetic foot ulcer burden may be modified by high-dose atorvastatin: A 6-month randomized controlled pilot trialJOURNAL OF DIABETES, Issue 3 2009Odd Erik JOHANSEN Abstract Background:, Diabetic foot ulcers (DFUs) are common complications of diabetes mellitus (DM), with a complex pathogenesis. Treatment is difficult and no single treatment with measurable clinical impact is available. In the present clinical pilot trial, we investigated whether statins could be of use against some of the pathogenic factors in DFUs. Methods:, Thirteen diabetic patients (10 men; 11 with Type 2 DM; mean age 64 years; mean duration of DM 18 years) with neuropathic DFUs <4 months were randomized to treatment with either 10 mg (six patients; six ulcers) or 80 mg (seven patients; nine ulcers) atorvastatin for 6 months in addition to conventional DFU care (i.e. prompt debridement, DFU pressure relief, and management of any underlying infection). Results:, There were no significant differences in background factors (i.e. HbA1c 8.9%, micro- and macrovascular complications, concomitant medications) or DFU characteristics (duration, surface area, grading) between the two groups. All ulcers in the group receiving 10 mg atorvastatin healed, compared with six of nine ulcers in the group receiving 80 mg atorvastatin (NS). However, two previously healed DFUs recurred and six new DFUs developed in the low-dose group compared with none and one, respectively, in the high-dose group (P = 0.048). There was a significant decrease in C-reactive protein (,1.5 mg/L; P = 0.044) and a non-significant trend towards beneficial effects on lipids and the ankle,arm blood pressure index in the high-dose compared with the low-dose group. Conclusions:, We observed a possible beneficial effect of 6-months high-dose atorvastatin on DFUs, which should be tested in appropriately sized prospective studies. [source] Advances in mechanisms of postsurgical gastroparesis syndrome and its diagnosis and treatmentJOURNAL OF DIGESTIVE DISEASES, Issue 2 2006Ke DONG Postsurgical gastroparesis syndrome (PGS) is a complex disorder characterized by post-prandial nausea and vomiting, and gastric atony in the absence of mechanical gastric outlet obstruction, and is often caused by operation at the upper abdomen, especially by gastric or pancreatic resection, and sometimes also by operation at the lower abdomen, such as gynecological or obstetrical procedures. PGS occurs easily with oral intake of food or change in the form of food after operation. These symptoms can be disabling and often fail to be alleviated by drug therapy, and gastric reoperations usually prove unsuccessful. The cause of PGS has not been identified, nor has its mechanism quite been clarified. PGS after gastrectomy has been reported in many previous studies, with an incidence of approximately 0.4,5.0%. PGS is also a frequent complication of pylorus-preserving pancreatoduodenectomy (PPPD), and the complication occurs in the early postoperative period in 20,50% of patients. PGS caused by pancreatic cancer cryoablation (PCC) has been reported about in 50,70% of patients. Therefore, PGS has a complex etiology and might be caused by multiple factors and mechanisms. The frequency of this complication varies directly with the type and number of gastric operations performed. The loss of gastric parasympathetic control resulting from vagotomy contributes to PGS via several mechanisms. It has been reported that the interstitial cells of Cajal (ICC) may play a role in the pathogenesis of PGS. Recent studies in animal models of diabetes suggest specific molecular changes in the enteric nervous system may result in delayed gastric emptying. The absence of the duodenum, and hence gastric phase III, may be a cause of gastric stasis. It was thought that PGS after PPPD might be attributable, at least in part, to delayed recovery of gastric phase III, due to lowered concentrations of plasma motilin after resection of the duodenum. The damage to ICC might play a role in the pathogenesis of PGS after PCC, for which multiple factors are possibly responsible, including ischemic and neural injury to the antropyloric muscle and the duodenum after freezing of the pancreatoduodenal regions or reduction of circulating levels of motilin. As the treatment of gastroparesis is far from ideal, non-conventional approaches and non-standard medications might be of use. Multiple treatments are better than single treatment. This article reviews almost all the papers related to PGS from various journals published in English and Chinese in recent years in order to facilitate a better understanding of PGS. [source] Interpreting interactions between treatments that slow agingAGING CELL, Issue 1 2002David Gems Summary A major challenge in current research into aging using model organisms is to establish whether different treatments resulting in slowed aging involve common or distinct mechanisms. Such treatments include gene mutation, dietary restriction (DR), and manipulation of reproduction, gonadal signals and temperature. The principal method used to determine whether these treatments act through common mechanisms is to compare the magnitude of the effect on aging of each treatment separately with that when two are applied simultaneously. In this discussion we identify five types of methodological shortcomings that have marred such studies. These are (1) submaximal lifespan-extension by individual treatments, e.g. as a result of the use of hypomorphic rather than null alleles; (2) effects of a single treatment on survival through more than one mechanism, e.g. pleiotropic effects of lifespan mutants; (3) the difficulty of interpreting the magnitude of increases in lifespan in double treatments, and failure to measure and model age-specific mortality rates; (4) the non-specific effects of life extension suppressors; and (5) the possible occurrence of artefactual mutant interactions. When considered in the light of these problems, the conclusions of a number of recent lifespan interaction studies appear questionable. We suggest six rules for avoiding the pitfalls that can beset interaction studies. [source] Photodynamic therapy with violet light and topical ,-aminolaevulinic acid in the treatment of actinic keratosis, Bowen's disease and basal cell carcinomaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2001AT Dijkstra Abstract Background Most clinical studies using photodynamic therapy (PDT) with topical application of ,-aminolaevulinic acid (,-ALA) use red light because it allows greater depth of penetration. However, given the porphyrin-like spectrum of ,-ALA-induced photosensitivity, violet light provides a maximal overlap with the excitation spectrum of protoporphyrin IX, meaning that PDT with violet light uses less light energy to induce the phototoxic reaction. Aim To study the efficacy of violet light in combination with topical ,-ALA PDT in the treatment of premalignant and malignant skin lesions. Methods Eight hours after 20%,-ALA was applied topically, photoirradiation was performed with an incoherent light source (Philips HPM-10, 400 W) emitting predominantly violet light (400,450 nm). Lesions received 10,20 J/cm2 during an exposure time of 30 min. The 38 subjects treated included three with basal cell naevus syndrome with multiple (> 30) superficial and nodular basal cell carcinomas (BCCs), one subject had multiple lesions of Bowen's disease, involving 50% of the scalp, and the remaining 34 subjects presented a total of 35 superficial BCCs, 10 nodular BCCs, four large solar keratoses and five solitary lesions of Bowen's disease. Results Complete remission both clinically and histologically was seen after a single treatment in 82% of the superficial BCCs (100% after a second treatment), 50% of the nodular BCCs, one of the four solar keratosis lesions (partial remission in the other three) and 90,100% of the solitary lesions of Bowen's disease. Conclusions ,-ALA PDT using violet light appears to be a well tolerated and effective alternative treatment for premalignant and malignant skin lesions, especially when there are multiple lesions or large patches comprising a large area of skin. [source] Recent advances in extending the shelf life of fresh Agaricus mushrooms: a reviewJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 9 2010Preeti Singh Abstract Postharvest browning of Agaricus mushrooms is a severe problem that reduces the shelf life of harvested mushrooms because of their continued respiration and biochemical activity. There are no simple answers and no single treatment is known to limit overall quality deterioration. However, there are several strategies that are being implemented in order to reduce the rate of respiration for mushrooms. Packaging technology is the common denominator that allows us to implement these strategies and thus is key to quality preservation. In this review, first, the major factors involved in postharvest quality deterioration are discussed and then technological advances/methods used to counteract these hurdles are presented. Copyright © 2010 Society of Chemical Industry [source] The Application of Hydrogen Peroxide as a Treatment for the Ectoparasite Amyloodinium ocellatum (Brown 1931) on the Pacific Threadfin Polydactylus sexfilisJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 2 2001Dee Montgomery-Brock Ectoparasite infections can cause death or a decline in the general health of farm-raised finfish. This paper reports the findings from two studies conducted to evaluate the efficacy of hydrogen peroxide as a therapeu-tant for the control of infections of Amyloodinium sp. on cultured Pacific threadfin Polydactylus sexfilis (locally called "moi"). Threadfin with amyloodiniasis collected from a commercial farm were used in both trials. Prior to the trials, and following hydrogen peroxide treatment, the extent of infection was determined by a gill biopsy procedure. An initial trial was conducted in the laboratory to assess the response of juvenile threadfin and Amyloodinium sp. trophonts to hydrogen peroxide exposure at four dosages: 0, 75, 150, or 300 mg/L for 30 min. In a trial on a commercial farm, a hydrogen peroxide treatment at 75 mg/L for 30 min was applied to juvenile threadfin in a grow-out tank. In both trials, hydrogen peroxide was immediately flushed from the culture system with sea-water after the 30 min exposure period. In the laboratory trial, treatment with 300 mg/L hydrogen peroxide resulted in 100% mortality of the exposed group of fish. However, single treatments with hydrogen peroxide at concentrations of 75 or 150 mg/L eliminated Amyloodinium sp. trophonts without causing loss of fish. In the field trial, a single treatment with 75 mg/L hydrogen peroxide greatly reduced levels of Amyloodinium infestation, and a second treatment 6 d later reduced Amyloodinium trophonts to a nondetectable level. These findings suggest that hydrogen peroxide is a suitable chemical for the treatment of amyloodiniasis of cultured, juvenile Pacific threadfin. [source] A Phase II Clinical Trial of Vinorelbine in Dogs with Cutaneous Mast Cell TumorsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 2 2008I.A. Grant Background: Few effective drugs are available to treat dogs with locally aggressive or metastatic mast cell disease. Hypothesis: Vinorelbine, a semisynthetic derivative of vinblastine, is an effective drug for the treatment of canine mast cell tumors (MCT). Animals: Twenty-four dogs with cutaneous MCT. Methods: Dogs with at least 1 measurable, cytologically confirmed, and previously untreated cutaneous MCT received a single treatment with vinorelbine at the previously established dosage of 15 mg/m2 IV. Tumor measurements and CBC were evaluated before and 7 days after treatment. Adverse events were graded according to Veterinary Cooperative Oncology Group (VCOG) guidelines. Statistics: Data were accrued in accordance with a Simon's 2-stage design with a noninteresting response rate of .05, a target response of .25, and , and , values of .10. Results: Three of 24 dogs (13%) had a response to treatment, including 1 measurable complete response and 1 measurable partial response. The 3rd dog had microscopic complete response to treatment with stable measurable disease. Twenty other dogs (83%) had stable disease and 1 dog (4%) had progressive disease. Neutropenia occurred in 13 dogs (54%) (grade 1, n = 4; grade 3, n = 6; grade 4, n = 3). Gastrointestinal toxicity occurred in 11 dogs (46%) (anorexia: grade 1, n = 3; grade 2, n = 1; grade 3, n = 1; diarrhea: grade 1, n = 2; grade 3, n = 1; vomiting: grade 1, n = 5; grade 3, n = 1). Conclusions and Clinical Importance: Vinorelbine was associated with an overall response rate of 13% and a high prevalence of neutropenia. Additional studies are indicated to determine if repeated dosing of vinorelbine or combination of vinorelbine with other drugs increases the observed biologic activity against canine MCT. [source] Pilot study examining the combined use of pulsed dye laser and topical Imiquimod versus laser alone for treatment of port wine stain birthmarksLASERS IN SURGERY AND MEDICINE, Issue 9 2008Cheng-Jen Chang MD Abstract Background and Objective The objective of this study was to improve port wine stain (PWS) therapeutic outcome in response to laser therapy. Our specific aim was to determine whether the combined use of pulsed dye laser (PDL) therapy and topical Imiquimod versus PDL alone can improve PWS therapeutic outcome. Study Design/Materials and Methods This pilot study involved a retrospective review of 20 subjects, all Asian, with PWS. Subject ages ranged between 3 and 56 years. Upon enrollment, three test sites were prospectively identified on each subject for treatment assignments to the following regimens: (A) PDL+Imiquimod; (B) PDL alone; and (C) Imiquimod alone. PDL test sites received a single treatment with a 585 nm wavelength; 1.5 milliseconds pulse duration; spot size 7 mm using a light dosage of 10 J/cm2 with cryogen spray cooling. For the PDL+Imiquimod and Imiquimod alone test sites, subjects were instructed to apply Imiquimod topically to the sites once daily for 1 month after PDL exposure. Subjects were followed-up at 1, 3, 6, and 12 months after PDL exposure to evaluate each of the three test sites. The primary efficacy measurement was the quantitative assessment of blanching responses as measured by a DermoSpectrometer to calculate the hemoglobin-index of each site at 1, 3, 6, and 12 months after PDL exposure. Subjects were also closely monitored for any adverse effects. Results Based on paired sample test analysis, there were clinically, and statistically significant, differences in blanching responses over time favoring PWS receiving PDL+Imiquimod as compared to either PDL or Imiquimod alone (P<0.05). At 12 months, it should be noted that there was some evidence of redarkening of PWS test sites treated by PDL+Imiquimod and PDL alone, presumably due to revascularization of blood vessels. However, based on comparison of the hemoglobin-indices determined at 1 and 12 months after PDL exposure, there was less revascularization of PWS test sites treated with PDL+Imiquimod as compared to PDL alone (P<0.05). Transient hyperpigmentation was noted in 10% (n,=,2) and 40% (n,=,8) of subjects on the PDL+Imiquimod and PDL alone test sites, respectively. On all sites, hyperpigmentation resolved spontaneously without medical intervention within 6 months. Permanent hypopigmentation or scarring was not observed on any test site. Conclusion Based on the results of this pilot study, PDL+Imiquimod resulted in superior blanching responses over time as compared to PDL alone for treatment of test sites on PWS lesions. Although the PDL+Imiquimod approach is intriguing, clinical validation in large PWS patient samples is required. Lesers Surg. Med. 40:605,610, 2008. © 2008 Wiley-Liss, Inc. [source] Single-treatment skin tightening by radiofrequency and long-pulsed, 1064-nm Nd: YAg laser compared,LASERS IN SURGERY AND MEDICINE, Issue 2 2007Douglas J. Key MD Abstract Background and Objective To compare single-treatment facial skin tightening achieved with the current radiofrequency (RF) protocol with single-treatment tightening achieved with the long-pulsed, 1064-nm Nd:YAG laser. Study Design/Materials and Methods A total of 12 patients were treated with RF energy on one side of the face and laser energy on the other. Results were evaluated on a numerical scale (0,12 with 12,=,greatest enhancement) from pre- and posttreatment photographs by a blinded panel. Results Upper face improvement (posttreatment score minus pretreatment score) was essentially the same on both sides (30.2 and 31.3% improvement for laser and RF, respectively, P,=,0.89). Lower face improvement was greater in the laser-treated side (35.7 and 23.8% improvement for laser and RF, respectively), but the difference was not significant (P,=,0.074). Overall face improvement was significantly greater on the laser-treated side (47.5 and 29.8% improvement for laser and RF, respectively, P,=,0.028). Conclusion A single high-fluence treatment with the long-pulse 1064-nm Nd:YAG laser may improve skin laxity more than a single treatment with the RF device. Further controlled split-face or very large non-self controlled studies are needed to conclusively determine the relative efficacies of the two technologies. Lasers Surg. Med. 39:169,175, 2007. © 2007 Wiley-Liss, Inc. [source] Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infectionLASERS IN SURGERY AND MEDICINE, Issue 1 2007Aguinaldo S. Garcez DDS Abstract Background and Objective To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Study Design/Materials and Methods Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-µ fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Results Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment. Conclusions Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. Lasers Surg. Med. © 2006 Wiley-Liss, Inc. [source] Cerebral blood flow velocity increases during a single treatment with the molecular adsorbents recirculating system in patients with acute on chronic liver failureLIVER TRANSPLANTATION, Issue 8 2001Lars E. Schmidt The aim of this uncontrolled pilot study is to determine the effect of treatment with the molecular adsorbents recirculating system (MARS) on cerebral perfusion in patients with acute on chronic liver failure (AOCLF). In 8 patients (median age, 44 years; range, 35 to 52 years) admitted with AOCLF, a single 10-hour MARS treatment was performed. Hepatic encephalopathy (HE) was graded according to the Fogarty criteria. Changes in cerebral perfusion were determined by transcranial Doppler as mean flow velocity (Vmean) in the middle cerebral artery. Arterial ammonia and bilirubin levels were monitored as a measure of the capability of the MARS to remove water-soluble and protein-bound toxins. During MARS treatment, HE grade improved in 3 patients and remained unchanged in 5 patients (P = .11). Vmean increased from 42 cm/sec (range, 26 to 59 cm/sec) to 72 cm/sec (range, 52 to 106 cm/sec; P < .05), whereas arterial ammonia level decreased from 88 ,mol/L (range, 45 to 117 ,mol/L) to 71 ,mol/L (range, 26 to 98 ,mol/L; P < .05) and bilirubin level from 537 ,mol/L (range, 324 to 877 ,mol/L) to 351 ,mol/L (range, 228 to 512 ,mol/L; P < .05). In conclusion, cerebral perfusion is increased and levels of ammonia and bilirubin are reduced during MARS treatment in patients with AOCLF. [source] Incidence of side-effects associated with high-dose ferric gluconate in patients with severe chronic renal failureNEPHROLOGY, Issue 1 2003BAHAR BASTANI SUMMARY: Ferric gluconate complex in sucrose (FerrlecitÔ) has been associated with less side-effects than iron dextran; however, the recommended dose of 62.5,125 mg per treatment is only suitable for haemodialysis (HD) patients. We retrospectively analysed the incidence of the side-effects associated with a high dose of FerrlecitÔ infusion (20 treatments in 13 patients; 10 treatments of 250 mg/3,4 h, and 10 treatments of 500 mg/5 h infusion). The patients were in the age range of 32,75 years old, seven with chronic renal failure (CRF), and six on dialysis treatment. One (10%) of the 10 treatments using a 250 mg dose was complicated with severe nausea/vomiting, diarrhoea and a burning sensation in the feet. Three (30%) of the 10 treatments using a 500 mg dose were complicated with: chills, severe nausea/vomiting, hypotension and syncope in one; severe nausea/vomiting, diarrhoea and hypotension in one; and an episode of vomiting in one patient. A single treatment with a 250 mg dose resulted in no significant change in haematological parameters. A single treatment with a 500 mg dose resulted in a significant increase in haemoglobin (Hgb) and haematocrit (Hct), but only a rising trend in serum iron,% transferrin saturation and ferritin pre versus 1,2 months postinfusion. In conclusion, FerrlecitÔ doses of 250 or 500 mg are complicated with significant untoward reactions in 10,30% of patients, in a dose-dependent fashion. [source] Photodynamic Therapy Treatment of Early Oral and Laryngeal Cancers,PHOTOCHEMISTRY & PHOTOBIOLOGY, Issue 5 2007Merrill A. Biel Photodynamic therapy (PDT) is a nonsurgical, minimally invasive treatment that uses a light source to activate light-sensitive drugs or photosensitizers in the treatment of cancer and other diseases. PDT has been successfully employed to treat early carcinomas of the oral cavity and larynx preserving normal tissue and vital functions of speech and swallowing. Two hundred seventy-six patients with early carcinomas of the oral cavity and larynx were treated from 1990 to 2006. Cure rates with a single treatment for early laryngeal and oral cancers were 91% and 94%, respectively. PDT is an effective primary and alternative treatment modality for early oral cavity and laryngeal cancers. [source] Effect of Suppression of FSH with a GnRH Antagonist (Acyline) Before and During Follicle Deviation in the MareREPRODUCTION IN DOMESTIC ANIMALS, Issue 3 2009CM Checura Contents A GnRH antagonist (Acyline) was used to study the role of FSH in early development of a follicular wave in 61 mares. In Experiment 1, a single dose of 3 mg per mare, compared with 0 and 1 mg, suppressed both the FSH and follicle responses to exogenous GnRH. In Experiment 2, high concentrations of FSH were induced by two successive ablations of all follicles , 6 mm on days 10 and 13 (day 0 = ovulation). A single treatment with Acyline resulted in significantly greater suppression of plasma concentrations of FSH than a single treatment with charcoal-extracted follicular fluid (source of inhibin) or oestradiol. Suppression of FSH was not significantly different between the group treated with Acyline alone and a group treated with a combination of Acyline, inhibin and oestradiol. In Experiment 3, all follicles were ablated on day 10 to induce an FSH surge and a new follicular wave. Acyline treatment on day 10 resulted in an immediate decrease in FSH, without a significant effect on day of emergence of a new wave or growth of follicles from 7 to 11 mm on days 11,13. Treatment on day 15, a day before expected follicle deviation and after the peak of the wave-stimulating FSH surge, resulted in an immediate decrease in FSH and cessation of follicle growth. Results indicated that growth of follicles for about 2 days after wave emergence was independent of FSH. In contrast, during the decline in the wave-stimulating FSH surge and before follicle deviation, growth of follicles was dependent on FSH. [source] Effect of Nasal Surgery on Sleep-Related Breathing DisordersTHE LARYNGOSCOPE, Issue 1 2002Thomas Verse MD Abstract Objective/Hypothesis Single cases of patients who have experienced obstructive sleep apnea (OSA) and who recovered completely after nasal surgery have been described in various studies. The purpose of this study was to evaluate the efficacy of only nasal surgery 1) in a group of patients with obstructive sleep apnea and 2) in simple snorers. Study Design A prospective, controlled study with 26 adult patients who underwent nasal surgery as single treatment of their sleep-related breathing disorders. The cases were evaluated based on the severity level of their preoperative Apnea Hypopnea Index (AHI). Material and Methods Between August 1996 and July 2000, 26 patients who snored and had impaired nasal breathing underwent attended polysomnography in the sleep laboratory as single treatment nasal surgery was performed. Postoperative polysomnographic findings and complications were reviewed. Results Nineteen of 26 patients (73.1%) were diagnosed as having OSA. Seven patients were simple snorers with an AHI below 10. The surgical response rates, defined as greater than or equal to 50% reduction in the postoperative AHI and a postoperative AHI of less than 20, was 15.8% in the apneics. For the whole group, the AHI decreased postoperatively from 31.6 to 28.9. However, daytime sleepiness improved significantly and arousals decreased significantly in both apneics and simple snorers after nasal surgery. Conclusions We conclude that nasal surgery has a limited efficacy in the treatment of adult patients with sleep apnea. Nevertheless, nasal surgery significantly improves sleep quality and daytime sleepiness independent of the severity of obstructive sleep-related breathing disorders. [source] Pulsed-Dye Laser and Retinoic Acid Delay Progression of Oral Squamous Cell Carcinoma: A Murine Model,THE LARYNGOSCOPE, Issue 7 2001Rahul K. Shah MD Abstract Objectives/Hypothesis This study examined the role of the pulsed-dye laser (PDL) at 585 nm coupled with retinoic acid at therapeutic (5.0 mg/kg) and nontherapeutic (0.5 mg/kg) doses to delay the progression of cancer with a two-hit approach. The existing vasculature is selectively targeted by the laser, whereas retinoic acid inhibits future angiogenesis. Study Design Randomized, prospective study in a murine model. Methods Twenty-five athymic nude mice were inoculated with oral squamous cell cancers on six flank sites and randomly divided into five groups: 1) control subjects, 2) treatment with 0.5 mg/kg retinoic acid (RA 0.5), 3) treatment with 5.0 mg/kg retinoic acid (RA 5.0), 4) treatment with RA 0.5 + PDL, and 5) treatment with RA 5.0 + PDL. The PDL groups received irradiation after inoculation. The retinoic acid was administered daily. The tumors were counted and measured for 14 days. Results The control group developed visible tumors in 50% of the inoculation sites at 3 days compared with 3 days (RA 0.5) and 4 days (RA 5.0) for the retinoic acid groups and 9 days (RA 0.5 + PDL) and 10 days (RA 5.0 + PDL) for the laser treatment groups. There was no tumor growth until day 7 in the RA 5.0 + PDL group. The tumor volume was statistically different between the treatment groups. Conclusion This study demonstrated the superiority of a single treatment with the PDL coupled with retinoic acid to delay the progression of cancer when compared with treatment with retinoic acid alone, thus introducing a novel strategy in cancer control. [source] Topical application of acidified nitrite to the nail renders it antifungal and causes nitrosation of cysteine groups in the nail plateBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2007M.J. Finnen Summary Background, Topical treatment of nail diseases is hampered by the nail plate barrier, consisting of dense cross-linked keratin fibres held together by cysteine-rich proteins and disulphide bonds, which prevents penetration of antifungal agents to the focus of fungal infection. Acidified nitrite is an effective treatment for tinea pedis. It releases nitric oxide (NO) and other NO-related species. NO can react with thiol (-SH) groups to form nitrosothiols (-SNO). Objectives, To determine whether acidified nitrite can penetrate the nail barrier and cure onychomycosis, and to determine whether nitrosospecies can bind to the nail plate. Methods, Nails were treated with a mixture of citric acid and sodium nitrite in a molar ratio of 0·54 at either low dose (0·75%/0·5%) or high dose (13·5%/9%). Immunohistochemistry, ultraviolet-visible absorbance spectroscopy and serial chemical reduction of nitrosospecies followed by chemiluminescent detection of NO were used to measure nitrosospecies. Acidified nitrite-treated nails and the nitrosothiols S-nitrosopenicillamine (SNAP) and S-nitrosoglutathione (GSNO) were added to Trichophyton rubrum and T. mentagrophytes cultures in liquid Sabouraud medium and growth measured 3 days later. Thirteen patients with positive mycological cultures for Trichophyton or Fusarium species were treated with topical acidified nitrite for 16 weeks. Repeat mycological examination was performed during this treatment time. Results, S-nitrothiols were formed in the nail following a single treatment of low- or high-dose sodium nitrite and citric acid. Repeated exposure to high-dose acidified nitrite led to additional formation of N-nitrosated species. S-nitrosothiol formation caused the nail to become antifungal to T. rubrum and T. mentagrophytes. Antifungal activity was Cu2+ sensitive. The nitrosothiols SNAP and GSNO were also found to be antifungal. Topical acidified nitrite treatment of patients with onychomycosis resulted in > 90% becoming culture negative for T. rubrum. Conclusions, Acidified nitrite cream results in the formation of S-nitrosocysteine throughout the treated nail. Acidified nitrite treatment makes a nail antifungal. S-nitrosothiols, formed by nitrosation of nail sulphur residues, are the active component. Acidified nitrite exploits the nature of the nail barrier and utilizes it as a means of delivery of NO/nitrosothiol-mediated antifungal activity. Thus the principal obstacle to therapy in the nail becomes an effective delivery mechanism. [source] Temozolomide in advanced malignant melanoma with small brain metastasesCANCER, Issue 2 2007Can we Withhold Cranial Irradiation? Abstract BACKGROUND. The efficacy of radiotherapy (RT) in patients who have brain metastases from melanoma is limited. In this study, the authors evaluated the efficacy of treatment with temozolomide in patients with metastatic melanoma, including small brain metastases, who did not require immediate RT and investigated the feasibility of deferring RT. METHODS. Patients with brain metastasis were identified from 3 prospective studies of temozolomide (with or without immunotherapy) for metastatic melanoma. Patients with brain metastasis that measured >2 cm, extensive edema, and localization in the brain stem were excluded from the study. For the current analysis, patients with leptomeningeal metastasis and patients who received previous stereotactic RT were excluded. In patients who achieved a systemic response or stabilization to temozolomide, the response of brain metastasis and the necessity for palliative cranial RT were evaluated. RESULTS. Among 179 patients who received temozolomide for advanced melanoma, 52 patients with brain metastasis were evaluable. Stabilization of systemic metastasis was noted in 7 of 52 patients (13%), and there were 6 responses (5 partial responses and 1 complete response; 11%); thus, in those 13 patients, 6 had stabilization of brain metastasis (11%) and 5 had a response (2 partial responses and 3 complete responses; 9%). Immunotherapy did not influence the neurologic response. The median time to neurologic progression was 7 months (range 2,15, months). RT for cerebral recurrence was required in 2 patients. The median survival of patients with brain metastases was 5.6 months (95% confidence interval, 4.4,6.8 months). Intracranial hemorrhagic complications were not observed. CONCLUSIONS. The current results indicated that it is feasible to treat patients who have advanced melanoma and small brain metastasis with temozolomide as the single treatment. The small subset of patients with systemic response usually showed durable stabilization or a response of brain metastasis. With this approach, neurologic disease can be controlled, and cranial irradiation may be deferred and even withheld in most of patients. Cancer 2007. © 2006 American Cancer Society. [source] DE-310, a novel macromolecular carrier system for the camptothecin analog DX-8951f: Potent antitumor activities in various murine tumor modelsCANCER SCIENCE, Issue 2 2004Eiji Kumazawa DE-310 is a novel macromolecular conjugate composed of DX-8951f, a camptothecin analog, and a carboxymethyldextran polyalcohol carrier, which are covalently linked via a peptidyl spacer. In a murine Meth A (fibrosarcoma) solid tumor model, once daily×5 treatments (qd×5) with DX-8951f at the maximum tolerated dose (MTD) were required to shrink the tumor, and DX-8951f (qd×5) at 1/4 MTD was required to inhibit tumor growth. A single treatment (qd×1) with DE-310 at the MTD or 1/4 MTD shrank the tumor, with no body weight loss occurring at 1/4 MTD. Even at 1/16 MTD, DE-310 inhibited tumor growth. In a long-term assay, Meth A solid tumors disappeared in mice treated with DE-310 (qd×1) at the MTD and 1/2 MTD, and all 6 mice remained tumor-free on the 60th day after administration. Repeated injection (4 times) on schedules of every 3 days, 7 days or 14 days demonstrated that multiple treatment with DE-310 produced greater tumor growth delay than a single treatment with DE-310. Against 5 human tumor (colon and lung cancer) xenografts in mice, DE-310 (qd×1) was as effective as DX-8951f administered once every 4 days, 4 times. The life-prolonging activity of DE-310 was assessed in lung (3LL, Lewis lung carcinoma) and liver (M5076, histiocytoma) metastasis models. Against 3LL, DE-310 (qdx1) at the MTD to 1/3 MTD significantly prolonged survival, with an increase in life span (ILS) of 4.8- to 1.6-fold, respectively, over that in untreated control mice. Also, DE-310 (qd×1) significantly prolonged survival in the liver metastasis model of M5076. These results demonstrate that DE-310 is a promising agent for the treatment of cancer. [source] Prolonged effect of a single serotonin treatment in adult age on the serotonin and histamine content of white blood cells and mast cells of ratsCELL BIOCHEMISTRY AND FUNCTION, Issue 2 2003G. Csaba Abstract Hormonal imprinting was provoked by serotonin treatment in adult age. Three weeks after treatment with 100,,g serotonin, the serotonin and histamine content of peritoneal cells (mast cells, lymphocytes and the monocyte,macrophage,granulocyte group), white blood cells (lymphocytes, granulocytes and monocytes) and thymic lymphocytes was studied by flow cytometry. The content of both amines was significantly higher in the mast cells of males and lower in females. Blood lymphocytes contained a higher serotonin and histamine level in males, and a lower serotonin level in females. The peritoneal monocyte,macrophage,granulocyte group contained less serotonin in both males and females. Thymocytes contained higher levels of both amines in females and higher histamine level in males. The experiments demonstrate that a single treatment at adult age can provoke imprinting, which alters,in the present case,the serotonin and histamine content of immune cells durably. Copyright © 2003 John Wiley & Sons, Ltd. [source] 4366: Treatment of choroidal neovascularization associated with choroidal nevusACTA OPHTHALMOLOGICA, Issue 2010E PILOTTO Purpose Purpose:To evaluate safety and efficacy of different treatments of choroidal neovascularization (CNV) associated with choroidal nevus at the posterior pole. Methods Methods: Six patients affected by choriodal nevus complicated by CNV were treated with photodynamic therapy with verteporfin (PDT; 50 J/cm2, 83 seconds) (five cases), or intravitreal anti-VEGF (bevacizumab, 1.25 mg) (one case). All patients underwent an ophthalmologic evaluation, including fluorescein and indocyanine green angiography, A-and B scan ultrasonography and OCT at presentation and at each follow-up examination. CNV was extrafoveal in all PDT treated cases, and a foveal serous detachment was detectable. CNV was subfoveal in the eye treated with anti-VEGF. Results Results: Mean follow-up was 15.5 months (range: 6 , 24). Visual acuity improved in four of the PDT treated cases and in the anti-VEGF treated eye, while it remained unchanged in the remaining PDT treated lesion. In all eyes resolution of the foveal serous detachment was detectable. In all PDT treated eyes a single treatment was performed with no recurrence during follow-up. Meanwhile anti-VEGF was repeated after three months for CNV recurrence. Conclusion Conclusions: PDT and anti-VEGF seem both effective in the treatment of CNV secondary to choroidal nevus but a larger study is required to evaluate long-term efficacy and safety expecially of anti-VEGF therapy. [source] Ocular haemodynamic changes after single treatment with photodynamic therapy assessed with non-invasive techniquesACTA OPHTHALMOLOGICA, Issue 6 2009Noemi Maar Abstract. Purpose:, To investigate in patients with neovascular age-related macular degeneration (ARMD) the changes in ocular perfusion caused by single treatment with photodynamic therapy (PDT) by different non-invasive methods; to evaluate correlations between relative changes of ocular haemodynamic parameters after PDT among each other and compared to morphological parameters; and to assess this in relation to early changes of visual acuity. Methods:, Study population: 17 consecutive patients with subfoveal choroidal neovascularization (CNV) caused by ARMD scheduled for PDT without previous PDT treatment (four patients with predominantly classic CNV and 13 patients with occult CNV). Observation procedures: best-corrected visual acuity (before PDT, 6 and 8 weeks after PDT), fundus photography, fluorescein angiography, haemodynamic measurements with laser Doppler flowmetry (LDF), laser interferometry and ocular blood flow (OBF) tonometry (baseline and 1, 2, 6 and 8 weeks after treatment). Main outcome measures: choroidal blood flow (CHBF), fundus pulsation amplitude (FPA), pulsatile ocular blood flow (POBF), visual acuity. Changes smaller than 20% were considered clinically irrelevant. Results:, Ocular haemodynamic parameters did not change significantly in the follow-up period. Changes of haemodynamic parameters showed no correlation to treatment spot, morphological changes or visual acuity. Changes of visual acuity were comparable to results of earlier studies. Conclusion:, Single treatment with PDT did not modify ocular blood flow parameters above 20% as assessed with different non-invasive methods. [source] Non-viral strategies of intra-ocular gene deliveryACTA OPHTHALMOLOGICA, Issue 2009F BEHAR-COHEN Purpose Systemic anti TNF strategies are efficient to treat intraocular inflammation but require repeated injections and are associated to severe systemic side effects. Our aim was to develop a non viral gene transfer method to produce locally anti-inflammatory proteins in a sustained and minimally invasive manner in the ocular media. For this purpose, we have transformed the ciliary muscle into a bioreactor, using an electrically assisted gene transfer technique. Methods Electrotransfer (ET) of plasmids, encoding for different variants of TNF alpha soluble receptors, was performed in the ciliary muscle cells. Using toptimized conditions, soluble receptors were dosed in the ocular media up to 8 months after a single treatment. The technique has been applied in two models of intraocular inflammation: Endotoxin-Induced Uveitis (EIU) and auto immune experimental uveitis (EAU) in rats. Results When performed 8 days or 3 months before the LPS challenge, ET significantly reduced both clinical and histological signs of EIU. Particularly, iNOS, IL6 and TNF were down regulated while IL10 was upregulated. Importantly, systemic TNF alpha was not decreased demonstrating a local effect of the treatment. In EAU, ET significantly delayed the onset of EAU and deceased its severity. Similarly, a switch towards a Th2 cytokines profile was observed in the ocular media without any effect on systemic TNF alpha. Conclusion - ET is a safe and efficient non viral method to produce locally TNF alpha soluble receptors. - Local anti TNF allows for a local intraocular immunomodulation, without affecting systemic TNF. ET could therefore be used to reduce systemic side effects of anti TNF and prevent repeated injections. [source] Tapetoretinal degenerations: Experiences, experiments and expectationsACTA OPHTHALMOLOGICA, Issue 3 2000Berndt Ehinger ABSTRACT. Tapetoretinal degenerations are a common cause for vision problems, but have until recently not been amenable to rational treatment. With rapidly increasing insights into basic neurobiology and pathobiology this has now begun to change. From having been a relatively small group of largely unknown yet fairly prevalent disorders, they are rapidly forming a large set of well defined diseases, and it is easy to predict that our knowledge about them will continue to increase for many years to come. Vitamin A (15 ,000 IU daily) is currently the only rational treatment available. However, in experimental animals, therapy strategies are now actively being developed along several different lines. Apoptotic photoreceptor cell death can be delayed with different drugs, and at least one of them, diltiazem, is approved for human use in cardiovascular diseases. It remains to be seen if it has any clinically significant effect in human tapetoretinal degenerations. Other strategies aim at counteracting the production of harmful protein variants, acting either on DNA or mRNA levels. Transgenes can also be used to induce the production of important but missing metabolic components. Finally, cells or retina sheets can be transplanted, either to replace failing cells or as a source for missing trophic factors. Neither of these strategies has yet been transferred to humans, but trials are under way. With the high increase in the flow of new information on tapetoretinal disorders, much more precise diagnoses and much improved treatments are soon to be expected, augmenting considerably the possibilities for ophthalmologists to help patients with such diseases. It is not likely that there will be a single treatment for all the many varieties. Instead, we are most likely going to see pharmacological treatments for some of them, DNA transfers for some, and transplantations for others. [source] | ||||||||||||||||||||||||||||