PubMed Health⌕ Search

Biomedical subjects

A Orenstein

Publications and source records attributed to A Orenstein.

At least 37 records · Page 2Linked to original sources

The use of porphyrins for eradication of Staphylococcus aureus in burn wound infections.

The assessment of deuteroporphyrin-hemin complex as an agent for the treatment of burn wounds infected with a multiple-drug resistant strain of Staphylococcus aureus was performed. The effect of the porphyrin on the survival of the infectious bacteria was first assayed in culture, and later tested as well in a burned infected animal model. The addition of deuteroporphyrin and hemin, separately or together (as a complex) to a growing culture of S. aureus was monitored during 8 hours. It was found that deuteroporphyrin alone was strongly bactericidal only after photosensitization. On the other hand, hemin alone was moderately bactericidal but light independent. A combination of both deuteroporphyrin and hemin was extremely potent even in the dark and did not require illumination to eradicate the bacteria. The in vivo experiments by application of the above porphyrins in combination to infected burn wounds in guinea pigs was an effective way to reduce dramatically the contaminating S. aureus. Reduction of more than 99% of the viable bacteria was noted after the porphyrin mixture was dropped on the eschar or injected into the eschar, an effect that lasted for up to 24 hours. The deuteroporphyrin-hemin complex may be suggested as a new bactericidal treatment of S. aureus infected burns since it was found to be a potent and promising anti-Staphylococcal agent.

Administration, Topical↗

[Laparoscopic cholecystectomy during pregnancy].

The decision whether to perform cholecystectomy during pregnancy, and in what manner, is complex. A 26-year-old pregnant woman was admitted because of persistent biliary colic, which did not respond to conservative treatment. Laparoscopic cholecystectomy was done, with a normal course and without negative effects on the pregnancy. Contraindications to laparoscopic cholecystectomy are becoming fewer as technique improves and experience accumulates. This case report is added to the other few reported, which reinforce the view that pregnancy should no longer be considered a contraindication to laparoscopic cholecystectomy.

Adult↗

A comparative study of tissue distribution and photodynamic therapy selectivity of chlorin e6, Photofrin II and ALA-induced protoporphyrin IX in a colon carcinoma model.

An in vivo study of tissue distribution kinetics and photodynamic therapy (PDT) using 5-aminolaevulinic acid (ALA), chlorin e6 (Chl) and Photofrin (PII) was performed to evaluate the selectivity of porphyrin accumulation and tissue damage effects in a tumour model compared with normal tissue. C26 colon carcinoma of mice transplanted to the foot was used as a model for selectivity assessment. Fluorescence measurements of porphyrin accumulation in the foot bearing the tumour and in the normal foot were performed by the laser-induced fluorescence (LIF) system. A new high-intensity pulsed light delivery system (HIPLS) was used for simultaneous irradiation of both feet by light in the range of 600-800 nm, with light doses from 120 to 300 J cm-2 (0.6 J cm-2 per pulse, 1 Hz). Photoirradiation was carried out 1 h after injection of ALA, 3 h after injection of Chl and 24 h after injection of PII. A ratio of porphyrin accumulation in tumour vs normal tissue was used as an index of accumulation selectivity for each agent. PDT selectivity was determined from the regression analysis of normal and tumour tissue responses to PDT as a function of the applied light dose. A normal tissue damage index was defined at various values (50, 80 and 100%) of antitumour effect. The results of the LIF measurements revealed different patterns of fluorescence intensity in tumour and normal tissues for ALA-induced protoporphyrin IX (ALA-PpIX), Chl and PII. The results of PDT demonstrated the differences in both anti-tumour efficiency and normal tissue damage for the agents used. The selectivity of porphyrin accumulation in the tumour at the time of photoirradiation, as obtained by the LIF measurements, was in the order ALA-PpIX > Chl > PII. PDT selectivity at an equal value of anti-tumour effect was in the order Chl > ALA-PpIX > PII. Histological examination revealed certain differences in structural changes of normal skin after PDT with the agents tested. The results of PDT selectivity assessment with respect to differences in mechanisms of action for ALA, Chl and PII are discussed.

Aminolevulinic Acid↗

Temperature monitoring during photodynamic therapy of skin tumors with topical 5-aminolevulinic acid application.

Temperature monitoring during photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) cream application was performed on 22 patients with solar keratoses (SK) and basal cell carcinoma (BCC). The lesions were located on the forehead, nose, ear and cheek. Temperature measurements during photoirradiation, with a power density of 100 mW/cm2 from an incoherent light source (light delivery system for PDT), were carried out by noncontact (infrared thermal imaging radiometer) and contact (thermocouple) methods. Thermal imaging analysis revealed nonuniform temperature distribution in the irradiated areas. The temperature gradually increased from the peripheral to the central zone of the area. The results showed that photoirradiation induced heating of the skin tumors to 39.5-42.5 degrees C during the PDT procedure. The temperature of normal skin areas disposed symmetrically to the lesions on the contralateral side at the same conditions of irradiation (without prior ALA application) was about 42-43.5 degrees C. The surface temperature differences (delta T) between the normal and tumor tissues after 10 min of irradiation were 3.3 +/- 0.5 degrees C in the forehead areas, 2.5 +/- 0.4 degrees C in the nose areas and 0.8 +/- 0.3 degrees C in the ear areas.

Aminolevulinic Acid↗

Topical application of 5-aminolevulinic acid, DMSO and EDTA: protoporphyrin IX accumulation in skin and tumours of mice.

Topical 5-aminolevulinic acid (ALA) application in three different creams was carried out on mice bearing subcutaneously transplanted C26 colon carcinoma. The creams contained (a) 20% ALA alone, (b) ALA with 2% dimethylsulphoxide (DMSO) and (c) ALA, DMSO and 2% edetic acid disodium salt (EDTA). Protoporphyrin IX (PP) production in the tumour and in the skin overlying the tumour was studied by two methods: laser-induced fluorescence (LIF) and chemical extraction. The kinetics of PP production in the skin and in the tumour, as studied by the LIF method, was similar for all three cream preparations. The PP fluorescence intensity in the tissues reached its maximum 4-6 h after application of the creams. Quantitative analysis showed that the PP concentration after treatment was more pronounced in the skin than in the tumour. The efficiency of porphyrin production in the skin by the creams used was in the following order: ALA-DMSO-EDTA > ALA-DMSO > ALA. In the tumour the enhancing effect of DMSO and EDTA on PP accumulation induced by ALA was observed mainly in the upper 2 mm section. However, the concentration of PP in the tumour was found to be approximately the same for ALA-DMSO and ALA-DMSO-EDTA cream combinations. The possible mechanisms of the effect of DMSO and EDTA are discussed.

Administration, Topical↗

Intervening with high risk youth: a program model.

This paper describes a program model being implemented for older, high-risk adolescents who are beginning to exhibit significant substance use problems. The program provides an initial assessment and refers clients to appropriate services. Only a small percentage are being referred to inpatient treatment; most clients enter outpatient intervention groups, which are conducted by the program. These groups have three purposes: to allow staff to monitor and evaluate clients so that those who are in imminent danger can be placed in protective treatment settings; to help clients see themselves as candidates for recovery and to introduce them to treatment resources by accompanying them to AA and NA meetings; and to change behavior, a goal that seems more immediately achievable for youth with stable community ties who have more to lose if they get into further trouble. Besides describing the program model, this paper examines some of the difficulties of getting referrals from a variety of community agencies.

Adolescent↗

Why some children of alcoholics become alcoholics: emulation of the drinker.

From a review of recent literature, support was found for the hypothesis that the power of an alcoholic parent within a household is related to whether offspring become alcoholic. In considering reasons for this relationship, it is suggested here that children and adolescents are more likely to emulate and identify with a powerful alcoholic parent and, through these processes, learn that alcohol can make them feel powerful.

Adolescent↗

Repair of the severely contracted socket with meshed skin graft and semi-rigid conformer.

Nine severely contracted sockets were reconstructed using a meshed skin graft in conjunction with a semi-rigid conformer-stent. Particularly useful following unsuccessful surgery with mucosal grafting, or in cases where for some reason mucosal grafts cannot be obtained, this technique is superior to current procedures utilizing nonmeshed split-thickness skin grafts.

Adolescent↗

[Sea-urchin injuries].

Sea urchins (Echinoidea) are found along the Mediterranean and especially the Red Sea coasts of Israel. The most important species are Diadema setosum on the Red Sea coast, and Paracentrus lividus on the Mediterranean. When stepped on, the brittle spines penetrate and the venom they carry causes further damage. Thus the injuries are mainly mechanical, but may be complicated by a foreign body reaction to the bits of spine, to small detached segments of their covering epithelium, and damage by the epithelial venom. Severe pain, edema, local sensory loss and sometimes suppuration ensue.

Animals↗

Photochemotherapy of hypervascular dermal lesions: a possible alternative to photothermal therapy?

Continued improvement in the results of laser treatment of port wine stain, with reduction in scarring, will depend on the ability to use lasers to induce selective injury of only the abnormal blood vessels in the dermis while sparing the normal overlying epidermis. Photodynamic therapy, using an exogenous photosensitizing drug specifically activated by certain wavelengths of light, may be used to destroy selectively certain targets in biological systems. The current study demonstrates, in the chicken comb model, that photochemotherapy can be used to treat hypervascular dermal lesions while leaving the normal overlying epidermis completely intact.

Animals↗

In vivo tumor oxygen tension measurements for the evaluation of the efficiency of photodynamic therapy.

Among the sequence of events which occur during photodynamic therapy (PDT) are depletion of oxygen and disruption of tumor blood flow. In order to more clearly understand these phenomena we have utilized transcutaneous oxygen electrodes to monitor tissue oxygen disappearance. These results provide, for the first time, non-invasive real-time information regarding the influence of light dose on tissue oxygenation during irradiation. Measurements were conducted on transplanted VX-2 skin carcinomas grown in the ears of New Zealand white rabbits. Rabbits were treated with Photofrin II and tumors were irradiated with up to 200 kJ/m2 (500 W/m2) of 630-nm light. Substantial reductions in tumor oxygen tension were observed upon administration of as little as 20 kJ/m2. For a series of brief irradiations, oxygen tension was modulated by the appearance of laser light. Tissue oxygen reversibility appeared to be dependent upon PDT dose. Long-term, irreversible tissue hypoxia was recorded in tumors for large (200 kJ/m2) fluences. These results suggest that transcutaneous oxygen tension may be useful as a general indicator of the effectiveness of PDT and as an in situ predictor of the energy required to elicit tumor damage.

Animals↗

[Resection of invasive orbital tumors and reconstruction with temporalis muscle flap].

3 patients with invasive basal cell carcinoma of the skin which necessitated orbital exenteration are reported. In all 3 treatment was delayed, primary therapy was inadequate and the tumor had reached massive size. Excision of the orbital contents is a radical, mutilating procedure, but in advanced cases of malignant orbital tumors it offers the only chance for survival. The temporalis muscle flap is adaptable, well supplied with blood, and contains a large mass of tissue. Its utilization provides a simple, uncomplicated and effective technique for orbital reconstruction following massive resection. It gives a relatively effective result which is usually acceptable to the patient.

Aged↗

Mid-infrared erbium:YAG laser ablation of bone: the effect of laser osteotomy on bone healing.

A comparative study was undertaken in rabbit tibiae to assess the healing of bone in response to osteotomies by a mid-infrared erbium: YAG (2.94 microns) laser or a mechanical saw. Laser parameters necessary for osteotomy were shown to produce deep cuts with sharp edges and no gross charring or burning of adjacent bone. However, it was noted histologically that there was a delay in healing of the laser osteotomies as compared to saw osteotomies. This delay was caused by a microscopic zone of damage to bone adjacent to the laser cuts. It is concluded that, although the erbium: YAG laser may be a useful tool in orthopaedic surgery to ablate bone, under the conditions used in this study, there will be a delay in the healing process after laser osteotomy.

Animals↗

Neck contracture as a rare complication of cervical soft tissue expansion.

An unusual complication using an inflatable silicon implant for removing postburn scarred tissue of the neck and face is described. The appearance of a fibrotic band along the inflating tube caused neck contracture. The purpose of this article is to present this uncommon complication and to emphasize the technical error when using the tissue expander in the neck region.

Adult↗

Treatment of facial vascular lesions with a 100-mu spot 577-nm pulsed continuous wave dye laser.

The present study documents the treatment and follow-up of 25 patients treated for four different types of superficial facial vascular lesions with the continuous wave, mechanically pulsed, yellow (577-nm wavelength) tunable dye laser using a 100-mu spot diameter handpiece and pulse durations of 0.05 to 0.10 s. When absorbed, this wavelength generates heat specifically within superficial blood vessels and, if delivered in a brief, intense pulse to a small, focused spot, can cause selective damage without destruction of the adjacent epidermis or surrounding dermis. The results indicate that the physician can attain an excellent clinical outcome while significantly reducing potential adverse side effects seen in treating these lesions with more conventional laser systems.

Adolescent↗

Pseudolymphoma of the earlobes due to ear piercing.

Keloids are commonly seen as a complication of earlobe piercing. As biopsies are usually not performed routinely in many instances, some of the lesions might, in fact, represent other entities, such as cutaneous pseudolymphoma. Contrary to keloids, for which surgery alone is not recommended, a simple excision or superficial x-ray is sufficient in such cases.

Adult↗