Laser treatment of cutaneous vascular lesions

Methods for treating maladies such as cutaneous vascular lesions. A patient in need of vascular lesion treatment is identified. A hyperosmotic agent is administered to a region adjacent the lesion. Blood flow velocity is slowed within the region using the hyperosmotic agent, and the lesion is exposed to laser radiation.Board of Regents, University of Texas Syste

Rapid aqueous photo-polymerization route to polymer and polymer-composite hydrogel 3D inverted colloidal crystal scaffolds

Successful regeneration of biological tissues in vitro requires the utilization of three-dimensional (3D) scaffolds that provide a near natural microenvironment for progenitor cells to grow, interact, replicate, and differentiate to form target tissues. In this work, a rapid aqueous photo-polymerization route was developed toward the fabrication of a variety of polymer hydrogel 3D inverted colloidal crystal (ICC) scaffolds having different physical and chemical properties. To demonstrate the versatility of this technique, a variety of polymer hydrogel ICC scaffolds were prepared, including (1) polyacrylamide (pAAM) scaffolds, (2) poly(2-hydroxyethyl methacrylate) (pHEMA) scaffolds, (3) poly(2-hydroxyethyl acrylate) (pHEA) scaffolds, and composite scaffolds including (4) pAAM-pHEMA scaffolds, (5) pHEMA-pMAETAC [poly(2-methacryloyloxy) trimethyl ammonium] scaffolds, and (6) pHEA-pMEATAC scaffolds. Templates for scaffolds incorporated both uniform sized (104 Μm diameter) and nonuniform sized (100 ± 20 Μm diameter) closely packed noncrosslinked poly(methyl methacrylate) beads. Human bone marrow stromal HS-5 cells were cultured on the six different types of scaffolds to demonstrate biocompatibility. Experimental results show that cells can remain viable in these scaffolds for at least 5 weeks. Of the six scaffolds, maximal cell adhesion and proliferation are obtained on the positively charged composite hydrogel pHEMA-pMEATAC and pHEA-pMAETAC scaffolds. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res, 2007Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56168/1/31199_ftp.pd

Quantitative assessment of microbicide-induced injury in the ovine vaginal epithelium using confocal microendoscopy

<p>Abstract</p> <p>Background</p> <p>The development of safe topical microbicides that can preserve the integrity of cervicovaginal tract epithelial barrier is of great interest as this may minimize the potential for increased susceptibility to STI infections. High resolution imaging to assess epithelial integrity in a noninvasive manner could be a valuable tool for preclinical testing of candidate topical agents.</p> <p>Methods</p> <p>A quantitative approach using confocal fluorescence microendoscopy (CFM) for assessment of microbicide-induced injury to the vaginal epithelium was developed. Sheep were treated intravaginally with one of five agents in solution (PBS; 0.02% benzalkonium chloride (BZK); 0.2% BZK) or gel formulation (hydroxyethyl cellulose (HEC); Gynol II nonoxynol-9 gel (N-9)). After 24 hours the vaginal tract was removed, labeled with propidium iodide (PI), imaged, then fixed for histology. An automated image scoring algorithm was developed for quantitative assessment of injury and applied to the data set. Image-based findings were validated with histological visual gradings that describe degree of injury and measurement of epithelial thickness.</p> <p>Results</p> <p>Distinct differences in PI staining were detected following BZK and N-9 treatment. Images from controls had uniformly distributed nuclei with defined borders, while those after BZK or N-9 showed heavily stained and disrupted nuclei, which increased in proportion to injury detected on histology. The confocal scoring system revealed statistically significant scores for each agent versus PBS controls with the exception of HEC and were consistent with histology scores of injury.</p> <p>Conclusions</p> <p>Confocal microendoscopy provides a sensitive, objective, and quantitative approach for non-invasive assessment of vaginal epithelial integrity and could serve as a tool for real-time safety evaluation of emerging intravaginal topical agents.</p

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Reduction of light scattering in biological tissue : implications for optical diagnostics and therapeutics

textBiomedical Engineerin

Coherent thermal wave imaging of subsurface chromophores in biological materials.

Thermal wave imaging of discrete subsurface chromophores in biological materials is reported using a phase sensitive coherent detection technique applied to recorded infrared (IR) images. We demonstrate that utilization of a periodically modulated laser source for thermal wave excitation and coherent detection applied to each pixel may be used to compute images of thermal wave amplitude and phase at the laser modulation frequency. In comparison to recorded IR images, the narrow-band detection technique significantly improves the quality of thermal wave amplitude images of subsurface chromophores in biological materials. Additionally, the technique provides phase information, which may be used to estimate chromophore depth in tissue. Application of the technique is demonstrated using tissue phantoms and in vivo biological models. We present a theoretical analysis and computer simulations that demonstrate the effect of tissue optical and thermal properties on thermal wave amplitude and phase. In comparison to the pulsed photothermal technique, coherent thermal wave imaging of subsurface chromophores in tissue for diagnostic applications allows reduction of peak incident laser fluence by as much as four orders of magnitude and is safer and more amenable to in vivo imaging

Coherent thermal wave imaging of subsurface chromophores in biological materials.

Thermal wave imaging of discrete subsurface chromophores in biological materials is reported using a phase sensitive coherent detection technique applied to recorded infrared (IR) images. We demonstrate that utilization of a periodically modulated laser source for thermal wave excitation and coherent detection applied to each pixel may be used to compute images of thermal wave amplitude and phase at the laser modulation frequency. In comparison to recorded IR images, the narrow-band detection technique significantly improves the quality of thermal wave amplitude images of subsurface chromophores in biological materials. Additionally, the technique provides phase information, which may be used to estimate chromophore depth in tissue. Application of the technique is demonstrated using tissue phantoms and in vivo biological models. We present a theoretical analysis and computer simulations that demonstrate the effect of tissue optical and thermal properties on thermal wave amplitude and phase. In comparison to the pulsed photothermal technique, coherent thermal wave imaging of subsurface chromophores in tissue for diagnostic applications allows reduction of peak incident laser fluence by as much as four orders of magnitude and is safer and more amenable to in vivo imaging

Dynamic measurements of laser light attenuation by cryogen film and frost formation

The purpose of this study was to investigate the dynamics of laser light attenuation during cryogen spray cooling (CSC). Two detection schemes were used to approximate collimated and diffuse light transmittance measurements of continuous-wave (λ = 594 nm) and pulsed (λ = 585 nm) laser light during application of short (20-100 ms duration) cryogen spurts on a glass substrate. High-speed video images were also obtained during CSC. Collimated light transmittance varied considerably during CSC. Comparison of collimated and total transmitted light detection indicated that the diffuse component was substantial. Light attenuation occurred despite transparency of the liquid cryogen layer. Light scattering by cryogen results in a diverging laser beam incident on the skin surface. Since specular reflectance at the cryogen-skin interface may differ for diffuse light, further study of light scattering during CSC is warranted. Due to the differences in optical properties of glass and skin, experiments on skin need to be performed to extrapolate our results to the clinical scenario. For dermatologic procedures such as laser port wine stain and vascular lesion removal, hair removal, and nonablative skin rejuvenation, recommended τd are 10-80 ms. This range of τd appears to be appropriate, although more studies are required to arrive at a definite conclusion. © 2002 SPIE