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density and blood flow in these lesions could be useful in evaluating the effectiveness of both standard and experimental treatments for this disease. Patients 18 years of age or older with Kaposi s sarcoma involving the skin may be eligible for this study. Participants will have photographs taken of their lesions and will undergo three imaging procedures (described below) at the beginning of the study (baseline) and then about once every 3 months or so while on the study (up to 2 years) to compare (...) the test results over time. (Imaging may be done at more or less frequent intervals depending on the findings.) A small amount of blood (less than a tablespoon) will be drawn the day of each imaging procedure. Laser Doppler imaging This technique measures the amount of blood flow in KS lesions by scanning the lesions with a low-power laser beam. Each lesion takes about 3 minutes to scan. The imaging may be done before and after a blood pressure cuff around the arm is inflated for a short time (usually
in a particular area of skin that did not sweat enough. A small amount of a medicine called acetylcholine is put on the skin and made to enter the skin using a very small electric current. Doppler skin blood flow: This test measures blood flow to the blood vessels of the skin. A machine takes pictures of blood flow in the skin of the forearm using a laser beam. Pictures are taken before and during application of medicines that cause blood vessels to dilate. Acetylcholine is used on one forearm (...) and nitroprusside is used on the other. The medication is made to enter the skin using a small el... Condition or disease Intervention/treatment Phase Fabry Disease Drug: Replagal Phase 2 Detailed Description: Objectives: The goal of this study is to determine whether higher frequency of dosing of enzyme replacement therapy (ERT) can either significantly slow the decline of renal function or continuously sustain the normalization of other objective functions in patients with Fabry disease who have been
session, and blood flows and skin electrical conduction are measured intermittently. Blood flow is measured using sensors applied to the skin and a blood pressure cuff around the limb. For skin blood flow measurements, a laser beam scans the skin surface. The skin electrical conduction test measures how well the skin conducts electricity. This is measured through sensors placed on the fingers or other sites. The effects of the test drug are allowed to wear off for 1 week, after which the entire tilt (...) test procedure is repeated. Patients who were given propranolol for the first test session take placebo for the repeat session, and those who were given placebo take propranolol. Condition or disease Intervention/treatment Phase Neurocardiogenic Syncope Drug: Propranolol Phase 4 Detailed Description: This protocol is to evaluate treatment with oral propranolol for a particular form of neurocardiogenic syncope (NCS), characterized by a neuroendocrine pattern called, sympathoadrenal imbalance, (SAI
therapy Exposure to any investigational drug or procedure within 1 month prior to study entry The use or expected use of antineoplastic drugs or history of cancer within 5 years, except for basal cell carcinoma of the skin Skeletal muscle disease, either primary (i.e., myopathy) or secondary (i.e., ischemic) or any underlying myopathy such as myasthenia gravis, muscular dystrophy, etc. as determined by a board certified pathologist examining sample of patients muscle biopsy Serum creatinine > 2.5 mg (...) walk test Exclusion Criteria: Myocardial infarction within 12 weeks (84 days) prior to investigational procedure New York Heart Association Symptom Class I or IV Coronary Artery Bypass Grafting (CABG) within 3 months (90 days) prior to scheduled MyoCell™ implantation Percutaneous Coronary Intervention (PCI) within 6 months (180 days) prior to MyoCell™ implantation Canadian Heart Classification of angina > Class II or unstable angina Any cardiac valve replacement Heart failure secondary to valvular
Procedure: Prevention of Pressure Ulcers Phase 2 Detailed Description: Many spinal cord injury (SCI) and otherwise debilitated patients develop pressure ulcers over the course of their injury or disease. Despite enhanced wound care management, many pressure ulcers do not heal completely and require surgical myocutaneous rotational flap coverage. Even then they often recur. HYPOTHESIS: Subatmospheric pressure dressing (SPD) treatment applied to pressure ulcers will either completely close them, or heal (...) to a point allowing for skin graft coverage, more often than 0.9% normal saline wet-to-moist dressing (WTMD) treatment. OBJECTIVES: The objectives of this study are: (1) to conduct a controlled comparative study of the effectiveness of subatmospheric pressure dressing (SPD) in healing pressure ulcers versus conventional saline wet-to-moist dressing techniques; (2) to establish indications and contra-indications for use of SPD In treating pressure ulcers; and (3) to develop a noninvasive, clinically
Cervical Cancer Fallopian Tube Cancer Ovarian Cancer Primary Peritoneal Cavity Cancer Drug: gefitinib Other: immunohistochemistry staining method Other: surface-enhanced laser desorption/ionization-time of flight mass spectrometry Procedure: biopsy Procedure: sentinel lymph node biopsy Phase 2 Detailed Description: OBJECTIVES: Determine the reduction in phosphorylation of epidermal growth factor receptor (EGFR), AKT, and ERK by proteomics in tumor and normal skin of patients with ovarian epithelial (...) for cervical cancer patients only as of 4/5/2005) Patients receive oral gefitinib daily. Treatment continues every 28 days in the absence of disease progression or unacceptable toxicity. Biopsies of a sentinel lesion (with CT guidance or laparoscopy) are obtained at baseline and at 4 weeks. Skin biopsies of unaffected areas are also obtained at these time points. Tissue is examined using immunohistochemical methods. Proteomic profiling using surface-enhanced laser desorption/ionization with time-of-flight
angiogenic therapy and/or myocardial laser therapy History of cancer within 5 years, except for basal cell carcinoma of the skin PSA suggestive of carcinoma of the prostate (i.e., > 4) Patient with CEA >2.5 ng/mL or end stage renal disease Patients with active infectious disease and/or who are known to have tested positive for HIV, HTLV, HBV-sAg, HCV, CMV and/or syphilis. If the panel includes antibodies to the HBc and HBV-sAg, then an expert will be consulted. Females who are pregnant or nursing (...) is to assess the safety of MyoCell™(expanded autologous skeletal myoblasts) using a dose escalation methodology following epicardial injection into myocardial scar tissue in patients who have experienced anterior, lateral, posterior or inferior wall myocardial infarction, require coronary artery bypass graft (CABG) surgery and who have an implantable cardioverter defibrillator (ICD) in place (ICD can be implanted during the CABG procedure or 3 to 4 days post CABG procedure). Safety endpoints
radiation in treating patients who have stage II prostate cancer. Condition or disease Intervention/treatment Phase Prostate Cancer Procedure: surgery Radiation: radiation Phase 3 Detailed Description: OBJECTIVES: Compare overall survival in patients with stage II prostate cancer treated with radical prostatectomy vs brachytherapy. Compare metastasis-free survival and probability of survival without symptoms of patients treated with these regimens. Compare the side effects of these treatment regimens (...) : related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: surgery Patients undergo radical prostatectomy. Patients are followed every 6 months for 5 years and then annually thereafter. Procedure: surgery Experimental: radiation Patients undergo brachytherapy with implanted iodine I 125 or palladium Pd 103 seeds. Patients are followed every 6 months for 5 years and then annually thereafter. Radiation: radiation Outcome Measures Go to Primary Outcome Measures : overall
(biphasic pulse, electrodes of identical size, frequency 100 Hz). The method of stimulation was blinded to both the investigator and the subjects investigated. Measurements included cutaneous blood flow of the volar forearm (laser Doppler), skin temperature on two sites of the cheeks (thermistor), pupil diameter and size of the palpebral fissures, sweat production (ninhydrine test) and global sensitivity and pain perception thresholds on both sides (electrical stimulation). Measurements were performed (...) [Stellate ganglion block with transcutaneous electric nerve stimulation (TENS): a double-blind study with healthy probands]. Blockade of the stellate ganglion is an established and highly effective diagnostic and therapeutic procedure for management of certain acute and chronic pain syndromes or other disorders. The paratracheal injection of a local anaesthetic is the simplest and most frequently used approach for blocking the cervicothoracic sympathetic nerves (ganglion stellate). However
Advances in Plastic Surgery Recent progress in plastic surgery has been rapid and many new techniques have been developed. Reconstructive procedures have been advanced by a better understanding of the anatomy of the blood supply to skin and muscle, with the subsequent development of the use of axial flaps, musculocutaneous flaps and neurosensory flaps. Burn treatment has advanced greatly, making it possible to successfully treat larger and more complicated burns. The development of microsurgery (...) deformities resulting from gigantism and acromegaly. Head and neck procedures have advanced, with the emphasis on immediate reconstruction using new flaps. Techniques for treating cleft lip and palate have been refined. Encouraging results have been reported in the treatment of nevus flammeus with argon lasers. In aesthetic surgical procedures, the aim is for safety and consistent long-lasting results. Improved understanding of the physiology and treatment of radionecrosis has evolved.
using intraoperative navigation. For intraoperative referencing a cortical fixed-reference system and a skin scanning laser device were used. Postoperatively, the diplopia was reduced, but the patient asked for further treatment and the procedure was repeated 6 months later. Intraoperatively, the previously implanted titanium mesh was deformed and most of the transplanted bone was resorbed, probably because of pressure. A more extended mesh was implanted and iliac spongiosa was placed on both sides (...) . Intraoperative navigation was used during both procedures. The adverse effects of diplopia were minimized and follow-up computed tomography after seven months confirmed that the bone graft was in place.
a pre-screening procedure with a standard diagnostic patch test with nickel sulfate in 54 healthy human volunteers. 5% nickel sulfate in petrolatum in a Finn Chamber was applied on forearm skin for 48 h to create a standardized dermatitis. Thereafter, the dermatitis was treated with a model topical agent and a placebo control while recording endpoint parameters daily for 10 days. Resolution was quantified with 4 parameters: visual scoring (VS), transepidermal water loss (TEWL) (Tewameter), skin (...) blood flow volume (BFV) (laser Doppler flowmeter), and skin color (a* value) (Colorimeter). The model agent reduced cutaneous allergic reactions, especially on day 8 to 10, in comparison with the placebo control. A highly significant linear relationship exists among all parameters, except between a* and BFV. This model may provide robust biometrics for determining the efficacy of topical therapeutics on experimentally induced ACD.
The influence of Emla cream on cutaneous microcirculation. Emla cream is frequently used in surgical dermatology and in anesthesiology, for instance, during vascular surgery procedures. Because local anesthetics can have a vasoactive effect in addition to producing analgesia, we decided to document the effect of 5% Emla cream on cutaneous circulation in a prospective, placebo-controlled study. Skin circulation was monitored continuously under standardized conditions using video capillaroscopy (...) , laser Doppler flowmetry and skin temperature. Recordings were made at the nailfold of the fourth finger (DIV) of the left hand of 12 volunteers with healthy veins over an observation period of 60 minutes under either Emla occlusive dressing or an occlusive dressing with placebo. Mean capillary red blood cell velocity changed only minimally under the Emla occlusive dressing, while placebo occlusive dressing led to a reduction of mean capillary red blood cell velocity from 0.21 mm/s to 0.12 mm/s (p
Laser and photoepilation for unwanted hair growth. Unwanted hair growth is a therapeutic challenge and considerable resources are spent to achieve a hair-free appearance. Epilation with laser devices (alexandrite, diode, neodymium:YAG, and ruby lasers) and intense pulsed light are commonly used although the long-term effect is uncertain.To assess the effects of epilation with lasers and light sources.We searched the Cochrane Skin Group's Specialised Register in February 2004; MEDLINE (from 1966 (...) to be a short-term effect of approximately 50% hair reduction with alexandrite and diode lasers up to six months after treatment, whereas little evidence was obtained for an effect of intense pulsed light, neodymium:YAG or ruby lasers. Long-term hair removal was not documented with any treatment. Pain, skin redness, swelling, burned hairs and pigmentary changes were infrequently reported adverse effects.Some treatments lead to temporary short-term hair removal. High quality research is needed on the effect
, EpiDex, OASIS Wound Matrix and Promogran against standard treatment in the efficacy measures of wound healing time, wound closure and decreased ulcer area and for pain, recurrence and wound infection. Diabetic foot ulcers (eight RCTs, n=1,173) : Apligraf, Dermagraft, GraftJacket, Hyalograft, LaserSkin, OrCel and Promogran were associated with improved wound healing time and improved wound closure was associated with Apligraf, GraftJacket and OrCel compared against standard care. Bioengineered skin (...) Procedures, Surgical. Bibliographic details Barber C, Watt A, Pham C, Maddern G, Penington A, Mutimer K, Edwards M. Bioengineered skin substitutes for the management of wounds: a systematic review. Stepney, S. Australia, Australia: Royal Australasian College of Surgeons, Australian Safety and Efficacy Register of New Interventional Procedures (ASERNIP) - Surgical. ASERNIP-S Report; 52. 2006 Original Paper URL emplate=/TaggedPage/TaggedPageDisplay.cfm&TPLID=17&ContentID=3297 Indexing Status Subject
Magnetic resonance (MR) image-guided percutaneous laser ablation of uterine fibroids (IPG30) Overview | Magnetic resonance (MR) image-guided percutaneous laser ablation of uterine fibroids | Guidance | NICE Magnetic resonance (MR) image-guided percutaneous laser ablation of uterine fibroids Interventional procedures guidance [IPG30] Published date: December 2003 Share Save Guidance The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England (...) , Wales, Scotland and Northern Ireland on magnetic resonance (MR) image-guided percutaneous laser ablation of uterine fibroids. As part of NICE's work programme, the current guidance was considered for review in May 2009 but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current. Description This procedure is used to treat uterine fibroids (also known as uterine leiomyomas or uterine myomas). Symptoms caused by fibroids include abnormal
from 1 to 16 years. The procedures they underwent were venous cannulation, venipuncture Port-a-Cath puncture and laser treatment. Outcomes assessed in the review The included studies used measures of pain. The measures used were the poker chip tool, visual analogue scale, observer distress rating and faces scale. Three studies used patient assessment of pain only, 3 studies used health professional assessment of pain only, and 2 used patient, professional and parent assessment of pain. How were (...) , clinical outcomes and adverse effects. Methods of synthesis How were the studies combined? A narrative synthesis was undertaken. How were differences between studies investigated? The studies were not pooled in a meta-analysis due to differences in indication for use and outcome measures. The studies were grouped in the narrative synthesis according to the type of procedure the participants underwent: intravenous cannulation, venipuncture, Port-a-Cath puncture, and laser treatment of port-wine stains
Low level laser therapy for tendinopathy: evidence of a dose-response pattern Low level laser therapy for tendinopathy: evidence of a dose-response pattern Low level laser therapy for tendinopathy: evidence of a dose-response pattern Bjordal J M, Couppe C, Ljunggren A E CRD summary This review assessed the effects of low-level laser therapy (LLLT) on pain from tendinopathy. The authors concluded that LLLT can reduce pain in subacute and chronic tendinopathy if a valid treatment procedure (...) laser therapy with the following characteristics: the exposed area was the skin overlying the site of inflammation or post-inflammatory process in the tendon; the intensity and dose were as indicated in the paper; and treatment had to be given at least twice weekly and no less than six times in total. The paper listed the type, power density and dose of laser treatment given in each included study. Participants included in the review Studies of patients with tendinopathy, including studies
for practice. Research: The authors state 'Clearly, much more work is needed in this area' and '...carefully designed clinical as well as basic research appears warranted'. Bibliographic details Marks R, de Palma F. Clinical efficacy of low power laser therapy in osteoarthritis. Physiotherapy Research International 1999; 4(2): 141-157 PubMedID Other publications of related interest 1. Beckerman H, de Bie RA, Bouter LM, De Cuyper HJ, Oostendorp RAB. The efficacy of laser therapy for musculoskeletal and skin (...) Clinical efficacy of low power laser therapy in osteoarthritis Clinical efficacy of low power laser therapy in osteoarthritis Clinical efficacy of low power laser therapy in osteoarthritis Marks R, de Palma F Authors' objectives To conduct a systematic and critical analysis of studies of patient outcomes following either continuous or pulsed low level laser treatment of an osteoarthritic joint. Searching MEDLINE (1966 to 1998), CINAHL (1982 to 1998) were searched using the following terms