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Biomedical subjects

E Glassberg

Publications and source records attributed to E Glassberg.

15 recordsLinked to original sources

[Non-freezing cold injury in soldiers].

Non-freezing cold injury (NFCI) is an injury of the hands or feet resulting from exposure to wet conditions and temperatures just above freezing, typically found in soldiers. NFCI is due to microvascular endothelial damage, stasis and vascular occlusion. At first, the tissue is cold and anesthetic, progressing to hyperemia in 24-48 hours. Hyperemia is accompanied by an intense painful burning sensation as well as blisters, redness, and possibly, ulcerations. NFCI management raises frustration in both medical officers and commanders. Most authorities are not aware of or remain unimpressed with the severity of NFCI, nor do they realize that it produces lifelong symptomatology. The following review of the available literature attempts to clear up some issues regarding the definition, pathogenesis, symptoms and preventative measures available in NFCI, including our own experience.

Cold Temperature↗

Current trends in laser blepharoplasty. Results of a survey.

BACKGROUND: The use of lasers in cosmetic surgery has been expanded fairly recently to include blepharoplasties. Controversy exists as to the efficacy of this procedure. This survey is designed to gain an understanding of the efficacy of blepharoplasty performed by laser versus conventional scalpel techniques. METHODS: A group of surgeons who perform the procedure were questioned. Over 4,000 cases of upper and lower lid laser blepharoplasty were reported by the responding physicians. RESULTS: The results of this survey indicate that carbon dioxide is by far the most common laser used in laser blepharoplasty (96%). A laser is used as a sole cutting tool by 70% of the responders and as a sole hemostasis tool by 88% of surgeons. Overall, both the intraoperative time and postoperative recovery period were reported as significantly reduced when blepharoplasty is performed by laser as compared with scalpel. In general, the incidences of edema, ecchymosis, and postoperative pain were reported as less severe with laser. No serious complications related to the laser were documented by the survey responders. CONCLUSIONS: This study confirms that laser blepharoplasty techniques can be safe and effective in skilled hands and may even have some potential advantages over conventional blepharoplasty.

Eyelids↗

Photodynamic therapy for the treatment of squamous cell carcinoma using benzoporphyrin derivative.

BACKGROUND: Photodynamic therapy (PDT) involves laser light excitation of a tumor-localizing photosensitizer to destroy neoplasms. Benzoporphyrin derivative (BPD) is a new photosensitizer with several favorable characteristics. OBJECTIVE: Studies were designed to: 1) assess the efficacy of BPD-mediated PDT in treating in vivo squamous cell carcinomas (SCC); 2) obtain dosimetry data for BPD and laser parameters; and 3) establish clinical and histologic correlates of BPD-induced tumor regression. METHODS: Human SCC was implanted into nude mice. One group received BPD followed by laser light of 150 J/cm2 from an argon-pumped dye laser at 690 nm. Three control groups included laser energy alone, BPD alone, and no treatment. RESULTS: At day 21 posttreatment only PDT-treated tumors showed a statistically significant decrease in tumor volume and complete cure rate. Clinical resolution (scar) correlated perfectly with histologic resolution (scar). CONCLUSION: Human SCC in a nude mouse model responds to BPD-mediated PDT.

Anaplasia↗

Hyperthermia potentiates the effects of aluminum phthalocyanine tetrasulfonate-mediated photodynamic toxicity in human malignant and normal cell lines.

The purpose of this study was to examine the effects of photodynamic therapy utilizing aluminum phthalocyanine tetrasulfonate in vitro on several human malignant and normal cell types, with or without hyperthermia. Cells examined included normal skin fibroblasts, HT-1080 fibrosarcoma cells, SCC-25 (squamous cell carcinoma) and malignant melanoma cells. An argon-pumped continuous wave tunable dye laser at 675 nm was used as the light source, hyperthermia groups were heated to 42.5 degrees C, and radioisotope incorporation was used to measure DNA and protein synthesis as toxicity assays. Results showed an energy-dose, and A1PcS-concentration dependent toxicity in all cell lines examined, with moderate selectivity toward malignant cells. Hyperthermia alone was slightly toxic in melanomas and HT-1080 cell lines but had no effect in normal fibroblasts or SCC-25 cells. Hyperthermia synergistically potentiated the effects of PDT in all cell lines, and the combined modality was significantly more toxic in all malignant cell lines compared with normal cells. Thus, addition of hyperthermia to PDT protocols may enhance the efficacy of this treatment modality in vitro.

Carcinoma, Squamous Cell↗

Extracellular matrix gene expression by human endothelial and smooth muscle cells.

In this study, the expression of extracellular matrix genes by vascular cells from human iliac blood vessels was characterized on the mRNA steady-state level by slot blot and Northern transfer analyses, as well as by in situ hybridization. Endothelial cells were isolated from adult human iliac arteries and veins, as well as from umbilical veins; smooth muscle cells were isolated from adult human iliac arteries and inferior vena cava. The results show that confluent umbilical vein endothelial cells expressed the genes that encode types I, III, IV and VI collagens, as well as fibronectin and laminin. In contrast, the iliac endothelial cells expressed the genes for types IV and V collagens, fibronectin and laminin; mRNA transcripts for types I, III and VI collagens were not detectable. The smooth muscle cells from iliac arteries or inferior vena cava displayed gene expression for types I, III, IV, V and VI collagens, fibronectin and laminin. The results indicate major differences in gene expression for the various types of collagens by human iliac endothelial and smooth muscle cells. Furthermore, the fetal-derived umbilical endothelial cells displayed differential collagen gene expression from that of adult iliac endothelial cells.

Adolescent↗

Laser-induced photodynamic therapy with aluminum phthalocyanine tetrasulfonate as the photosensitizer: differential phototoxicity in normal and malignant human cells in vitro.

Photodynamic therapy (PDT) involves the use of laser or noncoherent light energy with photosensitizing dyes to induce a cytotoxic reaction in the target cells, resulting in cell injury and/or death. In this study, we have examined laser-induced phototoxicity in normal human skin fibroblasts and HT-1080 fibrosarcoma cells incubated with aluminum phthalocyanine tetrasulfonate (AlPcS) in vitro. The culture, laser, and photosensitizer parameters were varied in attempts to establish the conditions for differential cytotoxicity between normal and malignant human fibroblasts. Biochemical assays, as a measure of cytotoxicity, included [3H]thymidine incorporation (an index of DNA replication), [35S]methionine incorporation (a measure of protein synthetic activity), and the MTT assay (an indirect index of mitochondrial activity). In the absence of laser irradiation, AlPcS was non-toxic to both cell lines in concentrations up to 25 micrograms/ml. Laser light alone at 675 nm (the absorption maximum of AlPcS) had no effect on the cells at energy densities up to 16 J/cm2. In the presence of 3 or 10 micrograms/ml of AlPcS, both cell lines demonstrated marked energy-dependent toxicity. If an 8-h or a 24-h "efflux" period in AlPcS-free medium was allowed to take place prior to laser irradiation, normal fibroblasts were much less sensitive to PDT, whereas fibrosarcoma cells still exhibited a marked degree of toxicity. The results indicate that, under appropriate treatment conditions, AlPcS is capable of preferentially sensitizing a malignant mesenchymal cell line, while sparing its non-malignant normal cell counterpart.

Fibroblasts↗

Capillary hemangiomas: case study of a novel laser treatment and a review of therapeutic options.

Capillary (or strawberry) hemangiomas can present a difficult problem in management, and much controversy exists over whether it is better to watch and wait for natural involution, or to be more aggressive and attempt to prevent some of the negative potential sequelae. A case study of a neonate with a large, early macular capillary hemangioma of the head and neck successfully treated with the 585-nm pulsed dye laser is presented. In addition, a review of a number of treatments for more advanced lesions is presented. Modalities discussed include argon, carbon dioxide, and neodymium: YAG lasers; cryotherapy; local and systemic steroids; and surgical excision.

Female↗

Laser abrasion for cosmetic and medical treatment of facial actinic damage.

Previous studies have shown the carbon dioxide (CO2) laser to be effective in the treatment of actinic cheilitis. After CO2 laser abrasion, normal skin and marked cosmetic improvement of the lip were noted. In our study, twenty-three patients were treated with CO2 laser abrasions for cosmetic improvement of facial lines and actinic changes. Pre- and postoperative histopathologic examinations were made on two patients. Preoperative examination of specimens from actinically damaged skin showed atypical keratinocytes in the basal layer of the epidermis, with overlying dense compact orthokeratosis and parakeratosis. Abundant solar elastosis was seen in the papillary dermis. Postoperative histologic specimens showed a normal-appearing epidermis with fibrosis in the papillary dermis and minimal solar elastosis (about four weeks after laser treatment). At present, various modalities are available for the regeneration of the aged skin, including chemical peels and dermabrasion. Significantly fewer complications were noted with CO2 laser abrasion than with these methods. Thus, CO2 laser abrasion can be useful in the cosmetic and medical treatment of the aged skin. Marked clinical and histologic improvement has been demonstrated.

Adult↗

Cellular effects of the pulsed tunable dye laser at 577 nanometers on human endothelial cells, fibroblasts, and erythrocytes: an in vitro study.

The 577-nm flashlamp-pumped tunable dye laser pulsed at 450 microseconds is rapidly becoming the treatment of choice for removal of portwine stains and other vascular ectasias. In this study, we examined the mechanisms of vessel destruction by determining the effects of laser irradiation on three types of primary target cells--erythrocytes, endothelial cells, and fibroblasts. Human endothelial cells and fibroblasts in microwell plates were irradiated at various energy densities with the laser, after which several aspects of cellular biology were determined, including 1) viability of cells by trypan blue exclusion test; 2) cell proliferation by [3H]thymidine incorporation; and 3) rate of protein synthesis using [3H]leucine incorporation as a marker. In endothelial cell cultures, both [3H]thymidine and [3H]leucine incorporations were inhibited at energy levels of 5-12 J/cm2 (P less than 0.01). In fibroblast cultures, cell proliferation was similarly inhibited, while supratherapeutic energy density (greater than or equal to 12 J/cm2) was required for inhibition of protein synthesis. The laser energy in the range of 5-8.5 J/cm2 had no effect on cell viability. Erythrocytes as target cells for laser energy demonstrated rapid, dose-dependent lysis, as determined by release of free hemoglobin into culture medium. Addition of erythrocytes into a coculture with endothelial cells abolished the direct inhibitory effect noted in cultures when endothelial cells were present alone. The results of the latter experiment imply that erythrocytes are the primary target cell absorbing the laser energy at 577 nm. However, direct laser effects on endothelial cells may also contribute to the mechanisms of ablation of the vascular ectasias by the tunable dye laser at 577 nm.

Cell Division↗

The flashlamp-pumped 577-nm pulsed tunable dye laser: clinical efficacy and in vitro studies.

The 577-nm flashlamp-pumped tunable dye laser pulsed at 450 microseconds is rapidly becoming the treatment of choice for removal of port-wine stains and other vascular ectasias. In this study, we examined the mechanisms of vessel destruction by determining the effects of laser irradiation on three types of primary target cells in vitro: erythrocytes, endothelial cells, and fibroblasts. Clinical studies were also performed, addressing the efficacy of this laser in the treatment of port-wine stains of the head and neck, trunk, and extremities. In endothelial cell cultures, both [3H]thymidine (measuring cell proliferation) and [3H]leucine (measuring protein synthesis) incorporations were inhibited at energy levels of 5-12 J/cm2 (p less than 0.01). The laser energy in the range of 5-8.5 J/cm2 had no effect on cell viability. Erythrocytes as target cells for laser energy demonstrated rapid, dose-dependent lysis. Addition of erythrocytes into a co-culture with endothelial cells abolished the direct inhibitory effect noted in cultures when endothelial cells alone were present. The results of the latter experiment imply that erythrocytes are the primary target cell absorbing the laser energy at 577 nm. However, direct laser effects on endothelial cells may also contribute to the mechanisms of ablation of the vascular ectasias by the tunable dye laser at 577 nm. Clinical trials on 28 patients with port-wine stains of the face and neck using this laser demonstrated a 75% response rate with greater than 50% lightening of the lesions. Of 9 port-wine stain lesions on the trunk and extremities (on a total of 6 patients), 8 (89%) demonstrated significant (greater than 50%) fading of their lesions. Complications such as scarring or epidermal texture changes were minimal.

Adult↗

Demonstration of elevated type I and type III procollagen mRNA levels in cutaneous wounds treated with helium-neon laser. Proposed mechanism for enhanced wound healing.

To assess laser modulation of wound healing, full-thickness cutaneous wounds were produced in the backs of pigs, and subjected to treatment with helium-neon laser. For comparison, some wounds were treated with non-laser energy source (a tungsten light) or left untreated as controls. Type I and type III procollagen mRNA levels were determined in the wounds by molecular hybridization with cDNA probes. The results indicated that type I and type III mRNA levels were markedly increased at days 17 and 28 of the healing in wounds treated with He-Ne laser, when compared to control or tungsten light-treated wounds. The results suggest that helium-neon laser stimulates wound healing by enhancing procollagen gene expression. These observations may have relevance to previous clinical studies suggesting that helium-neon laser stimulates wound healing.

Animals↗